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.

No longer a salad person

Tonight, we had dinner at a local pub. We sat tables across from my son’s classmate (their family is not very friendly, so this seating was unfortunate). The mom, who is quite slim, ordered a salad and picked at it. For a second, I looked down at my forkfuls of mac n’ cheese (swiped from my kids), veggie burger (I have been vegetarian for 2 decades), and french fries, and felt a bit ashamed. But then I remembered the days of being a salad person, and was overwhelmed with happiness that I am no longer a salad person.

Disclaimer: people who eat salads are good people. And salads are good for you. My concern is with being the type of person who would only order “salad, no bread, and dressing on the side, please” and then lose her shit if the dressing was accidentally mixed into the salad or someone dared throw a bread crumb in there. Or someone who spent 2 hours on the elliptical in college because she had “eaten too much” the day before and then headed to the cafeteria mid-day to eat her one meal of the day – salad.

In college, there was a painfully thin blonde freshman with wavy hair and glasses. All she ate was salad. We (including everyone with an eating disorder who didn’t actually think they had an eating disorder) called her Salad Girl. She would buy two trays full of just greens with nothing on them. Then she would work out next to me on the elliptical for 2 hours. There was a 30 minute limit for the elliptical (a popular machine if you have an eating disorder because you can “work out” while still exerting minimal effort since you’re always running on empty) so we would all sign up with different names. This was in the pre-everything-online days so we had to sign in by hand or call the night before. So if you were signing up twice you had to call twice and make sure you waited a while (sometimes hours) so the front desk wouldn’t catch on. But of course other people would see you on the elliptical for that long and realize you were not both Bridget and Amy.

I am so happy to no longer be a salad girl. Sometimes, I think the pendulum swung the other way – my diet is not the best at the moment. But I try to have a few healthy things sprinkled here and there, and mostly I do my best. And I count my blessings that I am no longer counting every calorie, obsessing over every bite, and mapping out the details of every workout – that shit was exhausting.

If you are struggling with food restriction, I don’t have any great advice for you, but I do want you to feel hopeful that your life will not always be this way. I never imagined I could live the way I do now – but here I am! One day the switch just flipped. The main reason I had an eating disorder was because I thought I needed it to succeed. I thought being thin was the ticket to career advancement, finding a man, getting married, having a family, and owning a white picket fence. I held on to that fantasy for dear life. And then when I was told I had to gain weight if I wanted to get pregnant, I panicked. But what about the rest of my life!? The amazing thing was this: when I gained weight, my life did change – it improved. My career went on, I stayed married, I had children, I bought that white picket fence, and, most importantly, I freed myself from the intense anxiety of choosing french fries over salad.

For the record, I now choose french fries 95% of the time, and despite owning an elliptical, I rarely use it.