snep

(cw: brief, non-graphic mentions of self-harm and suicidal thoughts.)

I have been back in therapy lately trying to get a handle on my anxiety. The official diagnosis is “generalized anxiety disorder”, although there's definitely some depression going on too. I used to be under the mistaken impression that GAD is sort of an “anxiety not otherwise specified” diagnosis, but the way my therapist explained it to me, it actually has a specific meaning. People with GAD have intense and persistent anxiety most of the time over everyday things. It's not specifically performance anxiety, a phobia, or trauma-related anxiety—it's more like anxiety is my go-to response to most situations, whether that's grocery shopping, making a dentist appointment, giving a presentation at work...

I had severe anxiety and depression in high school and was hospitalized twice for it. But I spent a lot of my college career brushing off my mental health issues and claiming that I was totally recovered and no longer was depressed, and that my anxiety was completely under control. My environment and my social support network were so drastically improved from college that I didn't want to admit that I was still struggling, and my parents also asserted confidently that I wasn't depressed anymore—I didn't want to tell them otherwise. Meanwhile I went through periodic bouts of anxiety, panic attacks, autistic shutdowns, self-harm, and intense dysphoria. I eventually got myself treated for the latter. The rest I persistently tried to ignore. If I had a panic attack, that was just because I had let something slip off my schedule, and I'd pay better attention next time so it wouldn't be an issue. When I self-harmed I lied about it to acquaintances and told friends it was a one-time slip-up even when it was happening multiple times a semester.

I thought of myself as basically healthy, but these unusual circumstances just kept cropping up that pushed me into crises! As soon as this one difficult course ended, or as soon as I was back from studying abroad, I was sure the mental issues would cease. I pushed through all the stress and depression, not enjoying myself, but sure that after this next crisis, I'd finally catch a break and be happy. My mantra my senior year of college was “As soon as ____ is over, then I'll be able to relax.” I filled in the blank with public speaking assignments, then important math projects, then different parts of my undergraduate thesis...

I pretty much kept that up for all four years of college. Then I graduated and wrapped up the parts of my transition that were important to me by getting top surgery. A few months later, I was living back at home and getting along well with my parents, had a good full-time job where I was mostly-stealth, and knew I would be able to move out soon. I had access to all my favorite hobbies, was working on a novel, practicing violin and piano, and exercising regularly. And I went through one of the most concerning bouts of suicidality I've had in years.

That was a bit of a wake-up call for me. One of the reasons I was so intent on pushing away my emotional problems during college was that in high school, my mental health was very bad all the time, so the marker for “okay, now it's really serious” with my family and doctors was suicidality. It was easy for me to say “I may be anxious and depressed, but at least I'm not spiraling like I did in high school” right up until the suicidal feelings returned. When that happened I was like “Okay, maybe this isn't normal. Maybe this isn't just one little crisis in a mostly-happy timeline.”

Looking back on it, I lied to myself a lot about my level of stability in college with the “one little crisis” line. Every time I was going through something that terrified and upset me, I'd tell myself “After this, it'll all be smooth sailing”, but in reality I spent a lot of my time bouncing from crisis to crisis, with just hours or days of rest in between obsessive anxiety and the kind of depression that just makes you feel numb. I had lots of friends and distractions around, and I expressed my anxiety as perfectionism and never let my schoolwork slip, so it was easy to ignore until I didn't have grades and a very strong safety net to hang onto after I graduated and I had to admit to myself that the “one little crisis” line wasn't going to cut it anymore.

Realizing—and acknowledging—that this state of bouncing from crisis to crisis is the status quo for me, and not an exception, has been difficult. These last two weeks I've been struggling with getting a piano to practice on and arranging to have it moved to my new apartment and tuned. I have spent whole days in a daze, tearing my hair out over how anxious I am about getting the movers to come at the right time, or calling the tuner back. Even though I've been back in therapy for several months now and my therapist each week points out how I spend most of our sessions obsessing about things I'm anxious about, I'm still tempted to say “Yeah, but as soon as the piano thing is wrapped up, then I'll be settled into my new apartment and everything will be fixed”... forgetting that I have performance evaluations coming up at work, I'm planning to buy a car soon, I told a relative I'd come get some furniture from her and then never emailed her back, etc., etc... all things that I will still worry about when I have a working piano.

I find myself returning to a blog post I read years ago about the mentality. The author described the average person's implicit belief that they deserve to relax—the idea that soon, work and chores will be “over” and one will be able to rest. In reality, work and chores are part of the continuous stream of activity, of waxing and waning tension, that is life.

I also think of my therapist's saying: “Before enlightenment, make tea and wash dishes. After enlightenment, make tea and wash dishes.” I have worked hard to make myself an environment where I can tolerate the necessities of life that I find unpleasant and reduce their impact on my life, and sure, I'd probably be happier if my workplace had four-hour workdays and I had a personal secretary to make phone calls for me. But ultimately, life is these anxiety crises just as much as it is the hours or days (or, very occasionally, even weeks!) of calm between the crises. If I am going to have a fulfilling life I need to acknowledge that anxious days are a part of that and find a way to cope with them other than pretending they aren't happening and waiting for them to stop, because whether I like it or not, these situations aren't going to stop happening entirely, ever.

I find it disheartening to see myself as a person with anxiety and depression problems that seem to be innate, now that I can no longer blame them on family, school, or dysphoria (although those things certainly exacerbated the issue). It's difficult to make sense of pain that seems to be happening for “no reason”. But at the same time, seeing these issues clearly, now that I have ruled out and eliminated some possible causes for them, gives me a strong foundation from which I can start coping with them. Denial worked to get me through college, but I don't want to live in denial of my problems for the rest of my life. I hope that now that I'm back in treatment I can start to look directly at these crises for the first time in a while and come to a better understanding of what they are and how I can enjoy my life during them, not just in the rare moments in between.