Nervous Nellie

I’ve had anxiety most (if not all) of my life. Some of my earliest memories are anxiety-laden:

  • sitting in my father’s car while he was outside talking to my uncle, feeling worried about being alone in the car
  • in elementary school, feeling worried about a state project due in May…during the month of December
  • the night before I turned 10, feeling intense worry that I would never be 9 years old again

I could go on and on.

There were times in my life when my worry worsened. A few weeks to months each year during my childhood when I would be exponentially worried – we began to call these episodes “La Etapa” (a stage of my life). I remember the worry intensifying in high school. I moved to a new school district during my freshman year and I would feel intense dread in the morning when people loitered by their lockers since I didn’t (really) know anyone. I remember hiding in the bathroom during this time, as this was preferable to socializing. I experienced intense anxiety during freshman year of college- fear of meeting new people/would I fit in/etc. I drank too much and gained a ton of weight which only made things worse. My anxiety worsened in medical school, especially on rotations where I had less control over my schedule/time. One way of dealing with my anxiety was through food restriction and overexercising – I could have control over one area of my life, even when everything else was in disarray. I started dieting in high school, so that need has been there for a long time.

I did speak to a few people during these years. In college, someone tipped off a counselor that I may have an eating disorder, and so I started seeing her. She would weigh me facing backyards so that I couldn’t see how much I weighed. I lost more weight when I stopped weighing myself because I was afraid of gaining weight, so clearly the anxiety was still there. I then met with a psychiatrist in medical school, during my surgical rotation, because I was incredibly moody and would break down over the smallest things. I remember running to the first appointment so that I wouldn’t miss my workout that day. He started me on Celexa. I took this for a few weeks, maybe 1-3 months max? My husband (boyfriend at the time) thought it helped, but I wasn’t so sure and stopped shortly after starting. The third time I reached out to get help was when I was struggling with infertility due to hypothalamic amenorrhea. I met with a therapist a few times near my residency program, pretty much crying the entire time through those sessions. That also did not last long.

Why did I “quit” so many times? Probably because I have pretty high-functioning anxiety. It never stopped me from accomplishing my goals or having (mostly) healthy relationships. It’s an ever present background hum, but in many ways it has driven me to succeed. I excelled in school, attended an Ivy League college, graduated medical school and matched into a competitive residency. In other words, even though I personally suffered, my goals did not. I was still able to interact normally with others, connect with/take great care of my patients, and perform daily activities with little interference. However, I have recently started wondering whether things could actually be better. For years, I thought being thin had led me to succeed. Part of the fear of gaining weight was that I would lose everything I had worked for. This was obviously a lie I had been telling myself and the world did not end when I gained weight. And so I started thinking: what if life could actually be better with my anxiety under better control? What would it be like to live in the moment, to not have the ever present buzz of worry, to not feel imminent doom over every little thing?

The other tipping point was this: my 4 year old has started to show signs of anxiety and it is heart-breaking. Yes, it could be hereditary. My whole family deals with anxiety, so maybe it would have been passed on anyway. But I also wonder whether an anxious milieu of the womb or anxious parenting (my husband, too, would factor in here; although normally a very calm person, he is quite an anxious parent) had any effect. I feel intense guilt over this. Although I can’t change anything I’ve done, at the very least I can do my very best to control my anxiety as my kids begin to grow and understand more.

Finally, I think it will be good for my marriage. My husband and I love each other dearly, but our differing personalities (mine characterized by anxiety) have definitely led to some repetitive arguments.

And so I scheduled an appointment with a psychiatrist specializing in women’s health, particularly around birth and motherhood. I met with her last week and she agreed I had generalized anxiety disorder and recommended three pillars of treatment:

  1. Medication
  2. Psychotherapy
  3. Self care

She said we could do any combination, so I am started with medication and trying to incorporate self care into my life. I opted for medication because, if I am truly honest with myself, I am dog-tired. I’m tired of always worrying about everything, of making to-do list after to-do list, of constantly playing out scenarios in my head. It is absolutely exhausting. And I want to get better as fast as possible. My father, a psychiatrist, always said that medication could be incredibly helpful to patients, to normalize their brain chemistry while they utilized psychotherapy to change their thought patterns. I picked up Zoloft right after the appointment and felt a huge sense of relief as I swallowed it. Obviously all of my feelings were still there, but I was relieved to finally be doing something about it.

I am holding off on psychotherapy for now because of the time commitment, but I am trying to do some self care. My family is in town this weekend so it’s a wonderful opportunity. I am taking the time to write this, and I also scheduled a couples massage for this evening. In the past week I’ve made time for mom/baby yoga and a stroller workout class.

And so I am trying and hoping for the very best outcome here.

To have and to hold

I love weddings. It is so magical to watch people embark on their “happily ever after”. When I was single, weddings gave me hope that I would find the love of my life. When I was newly married, weddings were a joyous occasion with the knowledge that these newlyweds were as happy as we were. Now, more than half a decade into our marriage and brimming with children, weddings are a reminder of those exciting honeymoon days of a marriage. I love my husband dearly but I have to confess that marriage is very different with children than without children.

As a newlywed, my husband could do no wrong. His quirks were endearing, and I’m sure he felt the same way about mine. Now, after a full day of chasing after my toddlers and feeding/changing/rocking my baby, one of my husband’s quirks can quickly send me over the edge. After a full day with all three boys, my cup is empty, and I often feel like I have nothing to give to my husband. He too seems to need some time to unwind after the kids fall asleep. Don’t get me wrong – we love each other more than we did as newlyweds, but we have found that we need to be more intentional about conveying that love. We also need to take a step back to truly see and acknowledge one another. Most parents find that they have less time for self care once they have children and the same is true of spouse care!

When we argue, one of us may break the ice by bringing up two of the tricks we learned at our Catholic Engaged Encounter weekend, prior to our wedding. Both have always made us laugh. The first is to hold hands while arguing. If you try this, you’ll quickly learn that it is impossible to truly be angry at someone if you are holding their hands. The second is to consider whether your words are “life-giving”. If they are not, consider how they sound to the person hearing them.

We haven’t mastered the art of making time for each other since this last child was born (9 weeks ago). This is partly due to the fact that we live far away from family, but mostly due to the fact that we are exhausted. For now, we are focusing on not being short with one another, spending time together after the kids go to bed, finding joy in the mayhem, and allowing the other parent to rest when one of us feels more energized. This is about as “life-giving” as we can manage to be at the moment.

Adult friendships

This article resonated with me.

It is tough to make adult friendships. I have wonderful friends from childhood, high school, college, medical school, and residency. But as happens with life, I now live far away from most of those people.

In my post-residency life, my friendships have fallen primarily into the following buckets:

  1. Husband’s friends
  2. Mommy friends
  3. Work friends

I have had the opportunity to meet wonderful people in the past 3 years and I feel fortunate to call these people my friends, but the process has been quite different than in the past. In every other situation, my friends and I spent HOURS together. We talked about everything and knew the most intimate details of our lives. We shared in huge successes and massive failures. We participated in the most mundane of activities and also the most exciting. My friendships now are different. We see each other less often. Our knowledge of one another is based off of brief interactions – a few hours here and there spaced weeks (sometimes months!) apart. We are often engaged in other activities when we spend time together – working, chasing after kids, etc.

It is a truth that I recognize but also not sure where to go from here. I miss those deep friendships from my past. It would be so wonderful to have some of those friendships around to complement my new friends!