Struggling with Anxiety
one grad student's experience

> Trigger Warning_
If you are currently struggling with mental health, reading these experiences can be triggering. Please be careful <3

The story will be going through my personal experience of severe anxiety, which includes crippling physical and emotional symptoms.
> Purpose_
I think it's important that some experiences of mental health are public to provide validation to those who struggle, and to provide insight to those who don't.

I am being purposefully detailed because I know how demeaning and dehumanising some of the small things can feel. I know how each tiny little indignity can pile up and make you feel further and further away from being a human - less worthy somehow.

I want you to know that you are not less of a person because of your own experiences. The only way I know to make it better is to normalise these experiences, and the only way I know to normalise them is to talk about them. So here we go.

Working on hard problems and struggling with them, as grad students often do, led to me developing a vicious cycle of avoidance patterns causing anxiety, causing avoidance of stressful problems, and so on.

Eventually, I had a few serious crises that landed me in the ER, urgent care, and many, many hospital visits. We suspected I might have had a heart attack, or some other heart condition. It was only after many tests that we finally came to realise it was all caused by anxiety.

During the crises, I couldn't eat, I could barely stay awake, I would have constant palpitations, and eventually anxiety attacks. I barely left the house for months. I wasn't able to function or distract myself. Whenever I tried going back to work, my symptoms got worse again.

The experience was physically, emotionally and psychologically crippling for months. I eventually started taking medication and doing therapy. Things improved, though five months in, I still deal with symptoms every day.

It was a struggle to have access to mental health care. CaPS wasn't helpful, neither was the first psychologist that I saw, and it took forever to finally find a clinic for regular therapy. I wasn't provided with enough information about the medication the doctors wanted to put me on, and no accompaniment to the collapsing sense of self-worth that go along with starting medication and therapy.

But things can get better, and they did. I am now passionate about making sure people get access to the care they need sooner rather than later!
> Story_
I've been working on a hard problem for about 4 years now without any publication to show for it. Every time I seem to be getting close, pulling all-nighters for whatever deadline is coming up, I discover some technical problem with the work, and it's almost back to square one. I've felt out of my depth for a while. I keep thinking that I'm just not prepared because my undergrad was closer to software engineering than CS or anything theoretical. I often have trouble sleeping, with my mind racing for hours on end, cold sweats erupting when I can't see how I'll ever be able to graduate because I feel so unprepared, or, you know, dumb. Out of these conditions, slowly, I developed avoidance patterns, where'd I'd get anxious about a specific task, and go do something else. Then, because I wasn't doing the work I was supposed to be doing, I got anxious. Which made me unable to relax, and because I couldn't relax or rest, relaxed I wanted to avoid work more. And thus the vicious cycle began.

As the last batch of deadlines approached, things got worse. I started shutting down as deadlines came up, whereas before I had been able to use deadlines to be extra productive. I couldn't work, and I couldn't distract myself, or do anything enjoyable.

Then, on January 2nd, I felt really light-headed in the shower. Thinking I just hadn't eaten enough, I got out and tried munching on something. As the first bite went down, my chest suddenly felt empty. A numbness spread slowly through my torso, to my limbs, and I felt incredibly weak and light-headed. I waddled to the couch and lay down. That's when I started noticing my heartbeats were much stronger, louder, than usual, and I got this almost-certainty that I was going to die. I am married, so I called Diana and said something was wrong and that I needed to go to the hospital. It felt like I was about to pass out at any time, and I started worrying I was having a heart attack, so we kept talking until she made it home and got me to the ER. They ran some quick blood tests, put me on an IV, but after a few hours couldn't find anything and told me to go home.

I lost all appetite. I ate maybe a tiny bowl of rice those first three days, living mostly off of sipping gatorade. I was completely lethargic and fatigued, and could barely wake up. I mostly dozed all day, with my waking awareness being restricted to noticing my heart beating really strong and registering the fact that I could barely move, except for my legs, which I couldn't stop moving for some reason.

I let my advisors know what was happening in a super tiny email (mostly that I was incapacitated with I didn't know what), and was lucky that they were supportive. They just told me to get better and keep them up to date. This acceptance and understanding of the situation would be a pattern for them, which I can never be thankful enough for.

Two days into this, I went to urgent care since I was getting weaker from not eating, and couldn't stay awake and active for more than a couple of hours each day. They ran more blood tests and sent me home. That was the first I heard that all this could be anxiety, though it was very unlikely.

Over the next two months, I went from being awake and somewhat active about 2h a day at night, to about 10-14h. I never went to school. I managed to start eating, but my GI tract was not working well at all. I couldn't keep food in for very long, and for months it always came out like vomit, but not from my mouth. I'll leave it at that... I'll only say that I was constantly uncomfortable, and remained at a weight I'd never had for over 15 years, when I was a kid. I just couldn't absorb the food I needed.

I was going to the hospitals and specialists two or three times a week. An incessant battery of blood tests... a stool test (such a dignified name for such an undignified experience)... lugging around a heart monitor for three days... an ultra-sound of my heart...

Nothing. Everything came out negative. Nobody knew what I had. I started obsessing. I wasn't doing well, was weak all the time, didn't know what was happening. After months of this, unable to distract myself, I simply thought my body was giving up. My life was being sick, nothing else. I couldn't think, unless I was thinking about disease and death. Somewhere in there, there was a week when I felt a little and managed to get myself to school and things looked like they were getting better. Then a deadline loomed close, and I had crashed again: I couldn't eat and was stuck at to the couch/bed for another week.

I would have constant palpitations, which is the medical term for noticing every! single! damned! heartbeat!, so that with each one I would be jolted back into the awareness that I was sick, potentially dying. I thought of heart disease or heart attacks. My head felt weird, sometimes I lost my balance, I was constantly light-headed, especially in the shower, so I thought brain tumor. My digestion was definitely still not working, so I thought colon cancer. Asked around, turns out my family has a history for heart and cancer problems - exactly the ones I worried about. That didn't help. Everything mundane little thing became an excuse for my mind to obsess.

I could rarely hang out with friends because it was so exhausting to be up and interacting with anyone or anything for more than 30m. I couldn't dance, because I would feel incredibly dizzy and about to pass out, which had never happened before. I couldn't concentrate enough to play computer or board games. I had nothing that I could do to take my mind off the obsession with disease. It was waking up, then waiting to go to bed, to see if the next day made a difference. The waiting was mostly of sitting there, feeling sick and exhausted and unable to do anything, staring at whatever moving image happened to be on a screen.

Then I started getting anxiety attacks. At first, I was just laying in bed trying to sleep, then suddenly my chest would go empty again, I'd get this feeling I was about to die, break out in cold sweats, my heart would start racing, and I'd be awake for another hour until I could calm down. Then they started waking me up in the middle of the night. Then I got them outside during the day too. I started thinking I'd never get better: I felt myself getting worse, and worse, and worse, and pictured myself stuck forever in a mental hospital. I can't explain how distressing it is to believe you are going to be permanently unable to function, physically or mentally.

Eventually, without any physical medical condition identified, and with the symptoms of anxiety attacks, we had finally homed in on anxiety. It was all I could do to reach out to CaPS. Went in for an appointment, and they said that they couldn't help me; that for work-related anxiety I would need to get cognitive behavioural therapy (CBT), which they didn't offer (really, no support for work-related anxiety at CMU?). They sent me a list of three or four different clinics. I was supposed to call them myself, but I simply didn't have the willpower to do that.

In yet another urgent care visit, the doctor had prescribed Celexa, an SSRI which helps with depression and anxiety, and a limited amount of Klonopin for emergency situations. I was told these could be addictive, so I should be careful. There was barely any talk of side-effects. I got them from the pharmacy, feeling embarrassed and self-conscious as I went to pick them up; feeling like everyone was looking at me like some broken thing, no longer human. Feeling like the pharmacist was judging me for being "broken".

I couldn't get myself to start taking the meds. The thought of being so "broken" I needed medication (which is such a fundamental misunderstanding of mental health), the feeling of being so... inhuman, was overwhelming. I googled side-effects for hours on end, and read horror stories. It never seemed like people got better on Celexa...

It was sometime in early March that I was reminded that the 10th year anniversary of my wonderful relationship with Diana was only days away. I had completely forgotten it because of all the obsessing I was doing. I broke down into a crying fit. The thought of such an important date, for me and for her, becoming a memory of sickness and brokenness and not, in any way, a celebration of something so beautiful was overwhelming. And so, face covered in tears and snot and unable to stop shaking my head in disbelief at what I had become, I took my first 10mg of Celexa. Days later, I started taking Klonopin, the emergency medication, just so I could fall asleep instead of having anxiety attacks, though I stopped a couple of days later. Both of these really helped early on, part placebo, part being able to sleep properly for a few days. I'm happy to say Diana and I did eventually manage to go out on a tiny date for our anniversary and watch Zootopia, though I had no strength for anything else. At this point, just getting on a bus to go somewhere was a victory.

I was lucky enough to have a PCP (kind of like a family doctor), who sent me to see their psychologist, who in turn offered a repeat of the CaPS visit and gave me a list of clinics to call. My anxiety had calmed down enough by now that I managed to call just one of them. Left a message, and they called me back eventually. I had to describe, yet again, all of my symptoms since January... the ones I'd been repeating to every doctor I'd seen for a while. It took a lot out of me, but for the first time I felt like I was in the hands of people who knew what they were talking about. They were understanding and validating, and, over the phone, they gave me a bunch of instructions that could help me cope until I could get a regular appointment. I felt taken care of in a way I hadn't before. A couple of weeks later, I started seeing a regular therapist.

Each step in the search for a therapist (CaPS, PCP, psychologist, first call to the clinic, first introductory session with therapist, actual first session with therapist) took about two weeks. I am angry and sad and distressed that this is normal. Between urgently needing therapy and starting it, it took me almost two months. I find this completely unacceptable, and lack of institutional support and understanding is a part of that.

Because I was unable to work, I felt I needed to keep my advisors updated on the situation, which I did. It was really stressful having to establish boundaries around what I could or could not do, could or could not discuss - but it was something that was necessary, and easier because of how understanding they both were. They made it clear: getting better came first, and this was a huge part of my being able to recover.

Through therapy, we found ways in which I could start coming back to work. This must've been around late March or early April, so three months after the initial crises. I started slowly at first: a couple hours, only some days. Then a couple hours every day. Eventually more hours, and techniques to deal with avoidance patterns that I had developed. There have been ups and downs - some weeks became overwhelming and I got worse. Some weeks were improvements over the previous ones. And that's how it goes. You learn to cope and you adapt, and hopefully things get better, with the support of those around.

Slowly but surely, I managed to start dancing again; I managed to hang out more and more; I managed to start relaxing. Gradually, obsessive thoughts of sickness decreased in intensity and regularity.

And eventually, I was able to be a bit more open about it, letting friends know what had been happening and putting up a post with some of my experiences on Facebook. That's when I got the validation of hearing that other folks had gone through similar experiences (or sometimes, far worse). I wasn't alone!

That terrible and yet validating knowledge that there are so many others felt like a call to action. I started talking to people at CMU, students, faculty and deans, hoping to shake things up and organise support for what is, undoubtedly, a very common experience here.

So, if you're struggling, you are not alone. I hope you (will soon) have resources you can reach out to, who will help you get the support you need and deserve as quickly as possible.

> Silly things to lighten the mood_
There were a few awesome experiences I got out of this.

First of all, I got a weird asymmetric chest shave so I could have the heart monitor electrodes. That provided quite a few giggles - and also, I couldn't stop scratching my chest for weeks!

Also, I got to see and hear my own heart beating, which was incredibly cool! The room's light was dark and relaxing too. Hmmmm, so nice. I should schedule another one, it's pretty therapeutic! Except for the part where they ram the thing under your rib-cage. That part hurts :/

> Links_
< Main Page