On Getting Help

What I've Done to Manage My Anxiety and Depression

TOKYO, JAPAN - JULY 27: Naomi Osaka of Team Japan reacts after a point during her Women's Singles Third Round match against Marketa Vondrousova of Team Czech Republic on day four of the Tokyo 2020 Olympic Games at Ariake Tennis Park on July 27, 2021 in Tokyo, Japan. (Photo by David Ramos/Getty Images)

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Every day is a battle. I open up a Word document and try to write before the voices flood in telling me I’m not good enough or what I’m writing is dumb and/or not worth more than a sentence let alone a full article or newsletter. Sometimes these voices are hard to detect because they’re not always outwardly negative or mean. Often they belong to the “what’s the point?” family. I tell myself I’ll write tomorrow when I have more to say, but I rarely have more to say. So I push through and force myself to write because if I didn’t then I’d never write anything.

I don’t believe I’m special. I’m telling you this not so that you’ll feel sorry for me or tell me how great I am. I’m writing this because I’m guessing that there’s some part of your life—or maybe many parts of your life—that make you feel the same way. Insecurity masked as procrastination. Fear disguised as “what’s the use?” I don’t know anyone who isn’t being held back in some area of their life by counterproductive or masochistic feelings. I’m writing this post for me, but also for all of you. Naomi Osaka and Simone Biles are the best in the world at what they do. They both recently withdrew from major sporting competitions because they weren’t right mentally. Their courage to be open about what they were dealing with will save lives. I write this post with the hope that it will help someone else, and then the pain I’ve been through in my life will not have been in vain.

I’ve struggled with anxiety and depression since I was 11 or 12 years old when I had my first panic attack. The details aren’t important. If you’ve never had a panic attack imagine being on an airplane cruising at 30,000 feet when suddenly the plane is struck by lightning and goes into a nose dive. Then multiply that experience by 10 or 100 or 1,000—depending on how many panic attacks you endure in a lifetime.

If you’ve never experienced depression, please understand that like anxiety it is a physical illness. When I am severely depressed the first thing I do when I wake up in the morning is vomit. You know those dreams where you’re trying to run but you can’t move? It’s like that. You know that you have to do things like shower and get outside and go to the doctor to get better, but each of these things feels like more activity than you can bear in an entire week.

Depression is like cancer in that there is one name, but that name encompasses infinity different varieties that respond to infinity different treatments. I’ve gotten help over the years. My condition is currently in remission, but I monitor it every day like a diabetic watches her blood sugar. When I’m at my lowest, the thing I do most is google other stories of people who have been through horrible depression and anxiety and how they got better. I hope this post will be a place people can land and come away believing there is help and there is hope. I have also had the good fortune of helping others who climb out of the abyss. I say good fortune because I don’t know if there is a greater honor than helping another person to realize they want to stay here, alive on planet Earth. Treatment is not a one-size-fits-all. But there are some things I wish I knew 20 years ago that I will share with you now:

1. If you are having thoughts of suicide, you are past the point of being able to make decisions on your own. You need to tell a family member, friend, therapist, counselor, priest, nurse, etc. that your brain is not working right and you need someone else to take over the decision making process for you. This might mean being hospitalized for a few days while they sort out your medications. This may feel like an embarrassing situation for you to endure, but you know what? Being dead is worse. If you’ve hit this point, your body is experiencing an emergency and it must be tended to right away. You’d call 911 if someone around you were having a heart attack, right? This is the same thing. Don’t think. Just make the call. Walk into an ER. The goal is to stay alive.

2. A lot of experts say meditation is a key component of dealing with stress and anxiety and bad thoughts. And while I agree this is probably true— I meditate every day— I’ve never been able to meditate my way through a panic attack. It’s not possible. Nope. Sorry. What you can do though, is breathe. I just linked to the only breathing exercise you ever need to learn to manage stress. I successfully breathed my way through a panic attack for the first time using this technique a month ago, and I can’t recommend it enough.

3. You can’t just manage the symptoms. You have to deal with whatever you’re not dealing with. While you can learn how to breathe your way through a panic attack, if you don’t address what’s causing the problem and try to fix it, it’s just going to keep happening. Last year I experienced the most loss I’ve ever experienced in my life. I held a close family member as she died. I held my dog as he died. I did this in a pandemic when gathering with others for support or even funerals was not possible. I thought I handled it as well as anyone could. I cried a little and kept my life moving forward as best as I could. It wasn’t until this spring that my grief exploded into waves of panic and despair and my life became unmanageable. I got back into therapy and my doctor upped my Lexapro. Within a few months things started to feel a little better. Now they feel a whole lot better. I started reading a lot of Brene Brown, because what she writes about vulnerability and perfectionism resonates with me more than anything I’ve ever read in self-help books (and I’ve read them all). If there is something you know you haven’t dealt with, there is no time like the present. It will never feel like the right time to deal with death, or a divorce, or a rejection, or a job loss, or abandonment, or body image issues, etc. but I guarantee that the longer you wait to deal with what ails you, the harder it will be to sort.

4. Anti-depressants work, but they don’t do all the work. I’ve taken Lexapro for the last eight years. Will I be on it for the rest of my life? As long as the benefits continue to outweigh the side effects, absolutely. I feel no stigma whatsoever about popping a happy pill every morning, and neither should you. It took me a while to get here, though. Before finding the right drug and dosage for me, I tried Celexa, Zoloft, Paxil, Trazadone, Ativan, Xanax, Wellbutrin, and Abilify. I’ve also experimented with holistic and alternative approaches like magnesium supplements, St. John’s Wort, CBD, essential oils, acupuncture, psychics, mythic astrologers, etc. If you’ve tried one (or five) of the above and nothing has worked, don’t give up. There is probably some combination of some drug and therapy out there that can help you. But don’t make the mistake I made and think that a pill alone can fix what’s broken. That’s because…

5. ..the right kind of therapy can be life-saving. It took me a long, long time to figure out what kind of therapy works best for me. I used to go to therapists that tried to get me to remember who my friends were when I was three years old and other useless information. I did this because I did not know any better. If the Freudian stuff works for you, great. But my anxiety and depression were happening in the present moment and I needed solutions and tips to help me get through each day. I found a therapist who specializes in cognitive behavior therapy (CBT), and his method was extremely helpful at managing my symptoms. But whenever I mentioned that I might panic about X because of something that happened to me when I was Y age and asked if perhaps we could unpack that, he got a twitch in his eye like whatever happened before I entered his office was irrelevant. That approach did not work for me either. Right now I have a therapist who works with a hybrid CBT/past process model where we can incorporate both a) why I am so upset in the present moment and b) what might have happened to make me that way.

If you are feeling overwhelmed right now, please know that you are not alone. If you are trying to find a therapist, start https://www.psychologytoday.com/us. There is hope and there is help. There is nothing to be ashamed about. We need you here, alive.