GAD

The most common questions I get when people find out that I have this are basically trying to validate that I have it in a disordered manner due to the fact that most people experience some type of anxiety in their life. I'm sure some of you have suffered from test anxiety or had trouble clearing your mind to sleep at night at some point in your life.

In your own way, you can probably understand how obnoxious it is to feel on edge or anxious. Well, the disorder is like having that final exam anxiety every day, and it doesn't stop after the exam or results. Beyond the "normal" anxieties, there is a world you may not be too aware of, although you feel like you might have had your foot in the door.

Background: I went into the doctor saying that I was not sleeping well, that I was really stressed out all of the time and I was starting to dislike basically everything and everyone. At first, I was diagnosed with depression and was prescribed something for that, and eventually stopped. A couple of years later, the symptoms returned, so I went to a psychiatrist who told me that I was dealing with anxiety foremost. Turns out I have GAD and associated depression and OCD. It's not uncommon to suffer from more than one disorder to some degree as they, in their own weird little way, can cause others to occur. I have gone through weekly counseling services that were offered at my university and I feel self-assured to speak about my own experiences.

Due to my success at counseling, I feel I have a good head on my shoulders when it comes to my issues. I went through one-on-one sessions with a lovely female counselor. She is the first person I fully opened up to, besides the psychiatrist who saw me beforehand. She had me not only point out to her what I thought my own issues were, but she made me tell her what it what I thought was making me feel one way or another. She was the person to truly encourage me instead of making me judge myself bluntly. Through her, I saw my errors in ways that didn't allow me to regret them as much. I am only human. I found that this method of breaking down my own issues myself was very successful and she agreed. She beamed the day she shook my hand for the last time telling me that she thought I was doing well enough on my own and had very well understanding of my inner workings and she felt I didn't need her anymore, but encouraged me to come back if I were ever troubled. Due to all of this, I'll always recommend having a good counselor or psychologist around if you need someone to talk to or keep tabs on you. I'll actually advocate this before going to medications as a first step, because sometimes having someone to talk to may be enough to help you through. It's really important to have someone unbiased, with a head full of accurate medical information, in your journey. Feel completely free to switch doctors as you feel the need to or to ask about switching medications or psychiatrists. Every method or personality does not work well for everyone else and that's important to keep in mind if you feel discouraged. I've switched doctors and medications multiple times.

I thought I would lay out the general symptoms with explanations for those interested, or too scared to ask. I won't totally go completely into the DSM-IV-TR criteria or ICD-10 criteria because that is exhausting and a little TMI, but I'll gladly answer any specific questions. I've found a general layout to go by.


What are the signs and symptoms of GAD?
(taken from http://www.nimh.nih.gov)

 
A person with GAD may:

•     Worry very much about everyday things 

I will avoid left turns at all costs unless no one is on the road with me or unless I have a stoplight. I will not parallel park, I'd rather walk half a mile. Those might be common anxieties to those who are uncomfortable driving. I have never driven in a city. I have never pumped my own gas. I'll avoid going through drive-thrus even if it is raining. I have never called to set up any appointment for myself, haircut or medical, because I'd blank out once the phone started ringing.

Should I expand a bit more?: I will never go somewhere for the first time without being totally and seemingly ridiculously prepared. I used to stay inside all of the time, and I still do a lot, because going out was a struggle -- what was going to happen? Would I embarrass myself? What if I say something completely stupid or accidentally offensive? Will I have everything I need? Who will be there? What if I see someone I wish not to see? What if someone thinks I am not interested in making friends because I am too worried about my body language and facial expression? 

Some things are just terrifying to me, mostly one that deal with having other people around. I have had panic attacks before. I try to push myself out of my debilitating habits slowly, but there's a limit because sometimes I will have a panic attack or feel one coming on and it never progresses.

•     Have trouble controlling their constant worries 

This was my first indication that I needed to figure out what was going on. My mind did not have an off switch, not even in my sleep. I would linger on the smallest things that happened months, years ago. I would linger for weeks about small, embarrassing situations, small details, my own errors, conversations that turned awkward, someone saying something terrible to me, etc. I would worry what would happen in the day before it began, I would worry about my mother until it drove me mad.

I would worry about what could happen and over-think what was currently happening. Forget test taking and most debates, I could never make up my mind. I'd think of why something obviously incorrect could actually be correct after thinking about it so long. Why? Probably because I fed off of those ideas but would go way overboard.

•     Know that they worry much more than they should 

 I was always tired and always thinking. Even thinking about thinking. People told me I would get over things in time, but time did not help in my case. I would keep things inside for so long that they would build up and build up until I would break down and need "mental" days. Those are days I would keep to spend my myself and rebuild my mental state because worrying so much can leave you exhausted and indifferent. My mental days involve staying in bed, or in better days, drawing and reading.

In retrospect, I will say that I felt that keeping things to myself would lessen burdens on those who were wanted to listen. "Why bother?" Sometimes the listener would blow things off because I'd finally admit how much I was worrying (in which most cases they would act they could understand and share similar stories and experiences, like no, just no, stop it) and it didn't seem plausible to them because I could act fine and as if nothing was bothering me.

To them, surely I would be fine because I could still function. That seems like majority opinion. People feel desperate to relate, and that's exhausting. Sorry, but I don't want a fake relation conversation, I just want to rant, and now I'm just embarrassed that I thought I could tell you the truth. It's not offensive to admit you have no idea what it's like to be in someone else's shoes, and just offer support, and try not to dictate what they ought to do, and especially don't go around parading that you know what is best for them and you have the answers.

Just because I've taught myself how to act fine in public doesn't mean I technically am. But for your sake, I am, yes, I'm good, no, I'm excellent. I'll tell you everything is fine if I can predict how you will react. I don't want your sympathy or your 2 cents and the chance that you will act offended if I don't want your input, which is absurd in every way. I don't want to deal with your reaction so I just won't tell you. Sometimes people just want to let things out and want to do it without being criticized or starting chaos. Think about it. Just because I have a disorder doesn't mean I'm unable to make my own decisions or agree to take your orders. Worrying a lot does not make me weak-minded or unable to care for myself. It's a learned skill that often protects both parties, and that's all I can say about it.
 

•     Not be able to relax 

I usually sit and stand "unprofessionally." I am that awkward 23-year old who cannot sit up straight, so I am always sitting/shifting on my legs and moving my chair around. I am usually fidgeting with something to keep calm -- at work it is my nail filer that I go to. I bite my nails, chew around my nails until they bleed. I chew at my lips and I've sucked on the lower side of one lip to the point where I now have a seemingly permanent mucocele (a salivary gland swelling that usually occurs following a lip biting injury). It's a tiny little bump in the same place as it's been since I was about 16 or so. I've removed it and it comes back in the same spot, looking identical. I apparently suck in that one spot so much that my glands in that area of the lip are constantly swollen.

Every now and then, I grind my teeth in my sleep (no, I am not on drugs!) and some of my teeth are constantly chipping away from these things. I chew the inside of my mouth to the point where I have tissue lines on both sides (which my past orthodontist opted for removal when I was like, 14). So as you see, all of this started before I even hit puberty (and when I hit puberty, it got worse). It doesn't happen over night.

I always thought my "oral fixations" as you could call them was just out of learned habit from watching others when I was younger. I have this joke I tell people: when I was a kid, my neighbor bite her nails and I didn't and I made a statement claiming it would be funny if one day she quit biting hers and I started biting mine, and surprise, it happened.

I learned that these things are habits that allow people to remove themselves from anxious situations. Basically, it is doing something else that you can focus on with more confidence. The short-term pain and/or satisfaction gives me something to focus on because it overrides the thoughts. It may sound intolerable and painful to those who have never even bitten their nails before. I assure you, I do it without even realizing I'm doing it half of the time.

•     Have a hard time concentrating 

Finishing a book was the hardest task in the world. I would get side tracked. I shifted around too much to keep focus. My life was in sticky note format. I could be reading the most interesting news ever, and my thoughts will jump to my stressors or other things that are in no way related. From one topic, to the next, then back again, and repeat. I could watch entire movies and not remember watching them because my mind was elsewhere the entire time although my eyes were staring at the screen. I could read entire books and not remember a thing unless I re-read a chapter. I could not remember something I tried to study. I would have study sessions at school, and come up with brilliant ways (if I do say so myself!) to remember information and I would not remember a thing. I had a friend come up to me and thank me for helping her remember a section of dates/names/contributions to an ecology exam, and during that exam, I couldn't remember any of it myself.

When people spoke to me, about anything at all, it was hard for me to take in what they were saying -- I would be focused on the fact that "oh my goodness, someone is talking to me and I must force myself to look into their eyes and be attentive so they are not offended," and completely miss what they were talking about. Then ask them to repeat it, and well...For years I was unable to look people in the eye while talking to them so that I could pay attention.

•     Be easily startled 

Short and simple.

•     Have trouble falling asleep or staying asleep 

I used to be self conscious about this. Someone once told me that I looked like I was on cocaine because of my dark eye circles so I splurged on concealer. That thought is sometimes still in the back of my mind when I put on make up and it happened about 8 years ago.

I wake up about half a dozen times throughout the night. At this time, I have refused to look into sleep medication because of the possible outcomes (over-sleeping, sleep walking, seemingly being awake when you're really not, etc.) I usually get 4-5 hours of sleep in a night which makes me feel the most awake, which I get for my working days. I sleep the better on the days I do not work, but I still wake up during the night. I understand that I need more sleep, and that 4-5 hours a night is not enough. I'm still working on it, and am surprised that I actually do really well at my job as my work performance is unaffected. I am 100% focused on my work because I need to be. I'm always sure to put 100% in things I must do that will affect others. I try to go to bed earlier nowadays and limit my caffeine on days I need to get up early. It helps most of the time.

On days that I do not work, every now and then I find that I struggle to get things done efficiently. Sometimes it is because I only got 2 hours of sleep, and sometimes it happens even after 10 hours. It really depends on what level of the spectrum my depression has been. Some days I literally have to lure myself out of bed with a cup of coffee before I can find the energy/mental strength to do anything else. Yeah, that sounds normal though, right?

I would literally allow myself to stay in bed all day, days at a time. I would go days without going outdoors. Why? I would say it is because I didn't have many personal goals like getting up and making up the bed or making myself up to go out. Honestly, on days where my depression is flaring up in a way due to lots of stress, I could care less about getting anything done as it seems of little importance compared to the stress in general. The stress has a way of taking over your life. It seems like a state of malfunction. I'm not lazy, as I've been called before. Realizing that it's just my brain messing with me ("why get out of bed today?") has made me push myself so that I don't get caught up in the cycle.

I don't want lectures from anyone about what I've been doing wrong in this section or the next one. If someone criticizes me for how I handle myself, I'm just going to automatically write it off as them not knowing what depression is truly like. Telling me, "oh just work out a bit, go to sleep earlier, change your diet, etc."is just going to make you look like a fool. I've tried everything, and chances are, so have everyone else because that is all we hear.

•     Feel tired all the time 

I call this the draining stage of it. Sometimes no amount of rest will completely prepare me for the day, as thoughts are very energy consuming and well, that is what I struggle with. I don't have many mornings (even after sleeping in) that I could hop out of the bed and feel productive. I fix that with my go-to. My go-to is a coffee every morning, and that usually lasts me long enough to get everything I need done, done. After a cup, sometimes two, I am up for the day and ready to go! Caffeine is actually very bad for anxiety and other disorders, however it's my own personal choice to keep my coffee and just limit the rest of my caffeine during the rest of the day.

I'd choose being able to function at work with my anxiety and coffee over being unproductive and not being able to work or make money because I'm too tired. I used to take mid-afternoon naps, but that is near impossible when you get older. I work 630am-715pm and there is no time for that. I'll admit that being tired has taken a toll on my friendships as I use a lot of my free time to rest instead of go out. I definitely cannot stay out all night unless I allow my sleeping schedule to go off track. The friends who understand have stayed around and are amazing. I like my work schedule because without it, my body would prefer to sleep from 7am-3pm every day and that's... not good for me.

•     Have headaches, muscle aches, stomach aches, or unexplained pains 

This can happen multiple times a day. When I am at work, my stomach starts to hurt at a certain time during the day (OCD + anxiety here) and does not end until I focus my attention elsewhere. The stomach issue happens no where else except work, and even after snacks. Snacking a few times to make sure that it wasn't a weird hunger pains have lead to vomiting everything back up because of the stomach acid. It's a weird stomach muscle ache which causes me to tense up in the abdomen area, and it is annoying. Abnormal stomach acid levels are increased because anxiety releases epinephrine. It can cause nausea as well sometimes. It's OCD-related as well because it happens around 5pm when I check the time at work (the time my co-workers leave). Tums helps me with it, but sometimes they just come up as well. When I'm not working, it doesn't happen and I'm never constantly checking the time then anyhow. It kinda just becomes background noise as long as I keep myself busy and I've never had any serious threats of illness from it afterward. It's just... one of those things, I guess.

•     Have a hard time swallowing 

Sometimes it takes me about 15 minutes to eat a small portion of oatmeal. Other days, I have no issues with eating at all. It seems more prevalent when I am out and about or at work, not much when I am at home.
 

•     Tremble or twitch 

These are probably the most embarrassing of all of the symptoms. I will never be able to be a surgeon or tattoo artists because my hands shake, rarely but surely. I have this tick where I hold my breath and cup my hands around my nose/chin and breathe weirdly. From an on-looker it seems very strange, like I am about to sneeze. I used to show symptoms of OCD kinda badly in the past but they've muted a lot since.

I'm actually going to use this section to go off topic and go into depth about the OCD aspects of my life. It was the same routines from towel placement to stepping out the shower on the right foot, until flipping the channel down and back before turning the tv off so I could sleep, checking doors and the refrigerator 15 times. It started about the age of 16, but the thoughts that bad things would happen unless performed perfectly started earlier on. Fought through those tendencies because I knew they were ridiculous. People who suffer from OCD often know it's ridiculous but that doesn't stop it from happening. Telling us it's "in our head" is about as helpful as putting a potted plant who needs a lot of sunshine in a dark corner.

I was in denial a long time, and I generally don't talk about it too much. I will here, because it's been part of the process that just cannot be left out. While my symptoms of anxiety showed sooner than the rest, OCD just kinda hit me out of the blue. A lot of deaths hit my family (father, and both grandparents I ever knew). It was my coping mechanism of having some power in the world, I'd tell myself. It was my own way of ensuring that the day would go well because I thought I was protecting myself as well as my mother. If something was not done a certain way, I was sure that terrible things would happen to me, or possibly her. I had to pay ridiculous attention to small details. If something went wrong, I was sure it was because of me. I was sick of feeling sick.

Why don't I talk about this much? Well, try explaining to someone that you are going to be worried for the rest of the day that you will get into a car crash because you are unsure if you faced your toothbrush a certain way. Try explaining to someone that something bad happened you today because you must've forgotten to check your hair straightener was off at least 5 times and you're thinking about calling your mother to go home and check for you because you're stuck at work. It took self-control to contain it, and actually during the process, my anxiety worsened because I'd still worry in the back of my mind about not performing certain tasks certain ways. It's a lot better now but I went through hell to get it that way. I cannot rid of of my sneezy-looking twitch/tick, but I do it much less. OCD tendencies is how I've coped with GAD. Schedules and times, I am all about that. Specific procedures and re-checking? I am all about that too. Sticky notes so I can trust I will not forget, but I'll still worry that I'll forget anyway. It is important to note here that some disorders are intertwined with other disorders. Due to this, many modern medicines can treat multiple disorders at the same time. I've struggled to find one that works well for what I need.

•     Be irritable, sweat a lot, and feel light-headed or out of breath 

Irritability, I was called arrogant and pretentious because I could not deal with most people and their seemingly self-righteous words. I'd get into a lot of arguments in high school. I felt it was necessary to knock everyone back a peg. When people were wrong, I had to right them, then and there. When they are being idiotic, I called them out. I didn't have much care for what happens after a vocal showdown because my mind was telling me, right then and there, that all that mattered was speaking my mind. In professional settings, I can keep my cool without a doubt because I like my job more than I like arguing with you. Yes, customer, you can be right all you want as long as I'm still getting paid to stand here and take it while representing someone else.

But otherwise, if I'm representing myself or my fellows, and I feel like I need to show my backbone, I'm going to probably tell you how it is because I won't care about the backlash. You're not going to step all over me or someone else. It may seem like putting a lot of effort into something that I might just be wasting my time on, but I don't care. I worry more about not saying anything at all. They've said theirs and I will say mine. I learned it is not uncommon upon the circumstances, it's a weird burning desire to let out my words. The tension just builds and I'll either hold myself back or not.

As far as the rest of my irritability goes, yeah, a lot of it deals with having other human beings around me. I need a significant amount of alone time, or "me" time. If I don't get enough, I'll feel overwhelmed and might snap at you for trying to take away what alone time I do have. Oh no you didn't just interrupt my book reading on my 10 minutes of down time to babble about something that could have waited. I don't mean to, I'm just an introvert to the core and people are sometimes exhausting. Considering most of my work revolves around me being constantly social, I just want to go home and relax and play games or read until I go to sleep.

I sweat and get the chills. I've always thought somewhere in the back of my mind that my birth control pill caused my sweats, including night sweats, and it's possible, but the ladder has happened ever since I can remember. I'm usually cold and take sweaters everywhere. Sometimes my toes and fingers will go numb, feel like they are freezing, or go into pins and needles mode. Sometimes get light-headed. I used to pass out at random times: once in the shower, once in a parking lot, and actually the first time I went over to my boyfriend's house. I've had blood tests done on different occasions  (B12, iron, amino acids, etc.) and the results have come back in the clear, so I have to attribute these symptoms to my GAD. In my anxious states, I seem to always go into thoughts about what else could be affecting me instead of anxiety. I may not be a hypochondriac, but I sure can speculate my own diagnoses sometimes. Sometimes I never truly believe them unless a medical assures I am wrong (such as the blood testing). I'm afraid doctors can and will overlook things, and because of that I am very thorough with how I speak of my issues, especially to doctors. Be open with them, they have heard everything before.

•     Have to go to the bathroom a lot.  

This could be linked to many other things, but it is also true in this case. I can also assume I have a small bladder as this has been an issue my entire life. I do run to the rest room a lot. I used to catch myself becoming dehydrated (when I was a waitress) on multiple occasions to avoid constant trips to the bathroom. That's not cool, don't do that.





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I used to be ashamed of what I was struggling with as society sees it as a weakness, and even as a disability. Thanks, media!! In truth, some people do start to treat you differently. Others can disagree with me here, but I don't want to be treated any differently. I don't want to be known as "that girl who has x, y, and z." I want to be seen as an equal who just happens to suffer from something extra if I must be seen as anything at all. I don't want anyone's pity, and honestly, I get frustrated when people show me pity. I am just like you. I am educated, I work, I have friends and a long-term relationship. I have cats I love dearly and hobbies and interests.

I feel it is important I share my experiences with others in hope that they will not feel ashamed about their struggles (what ever they may be). Feeling alone and isolated is awful. You are not alone. I've found that there are people who will still treat you as an equal out there. There are people out there waiting to give you tender loving care through your processes, and you have every right to choose who you keep around in your life for whatever reasons you rightfully choose.

I also wrote this in hopes that maybe it will help others understand what things were/are like for me and others out there. We hide things so well that you may notice something is off at times, but maybe cannot pinpoint what it is. It is not a quirk as portrayed in modern movies, it takes time and attention, and it is real. Please don't pretend as if you have a clue what it is like for others when you have not walked in their shoes before. Others may be looking for validation of that kind, because it does help with feeling not so alone, but there's a certain point where pride needs to be put aside.

These things are constantly swept under the rug, yet millions of people are dealing with similar circumstances. Your brain is just as important as any other organ in your body, so take care of it just the same: with honesty, nutrition, therapy, and medication if necessary. We need to support one another and take care of ourselves if we are to overcome the stigmas. This is all around us, well hidden, and please keep that in mind: that you may never know what someone else is battling behind closed doors. Your best friend could be dying to open up to you but might be too afraid and you wouldn't have a clue. Your rude co-worker could be having home troubles. That office worker could have been a bit cold to you because they spent all night drinking their sadness away. We've all got untold stories.

I will not allow any of this to debilitate my life and will always encourage others to take control. It is never too late to take control. Today, I can say it has made me a stronger, more understanding, and more prepared person. I have so much empathy and respect for humankind. Obviously it has not always been like that, but it is a well-worth-it process.

There are understanding people out there who will care for you in your struggles. There is out there when you are ready to take the first step, or to try again. There are reading materials out there if you want to learn more even if you are looking for understanding. Please try not to get discouraged. Try to keep your head up, and keep trying until you are happy. It will be worth it.


~~~~~~~~~~~~~~



Finishing this up from a relevant perspective from a song that I really take to heart and combine with everything going on, disorder and media and all:

"I was a blindfold, never complained
All the survivors singing in the rain
I was the one with the world at my feet

Got us a battle, leave it up to me
Find us a trap door, find us a plane
Tell the survivors help is on the way

I was a blindfold never complained
All the survivors singing in the rain

I was the one with the world at my feet
Got us a battle, leave it up to me

What it is and where it stops nobody knows
You gave me a life I never chose 

I wanna leave but the world won't let me go"

[Metric -  Blindess]