Sometimes I wake up with a pain in my chest. It isn't always the same pain--sometimes it's a sharp stab, sometimes it's a tight grip around my chest, sometimes it seems to throb with my heartbeat, sometimes it's a vague, dull ache. For long stretches of time it doesn't happen at all; when it does, it's the very first thing I'm consciously aware of as I wake from sleeping. Before I've even opened my eyes, I'm aware of the pain in my chest, followed by a moment of confusion and a little swell of distress. Then I open my eyes, and I take a deep breath and try to "find" the pain, try to figure out exactly where it is and how it hurts. Then I give up. I grab my phone and take a sip of water and try to forget about it.
Has this ever happened to you? Do you know what it feels like to have your first conscious moment be not just the perception of pain, but the immediate feeling that something is wrong? It's a distressing, disorienting way to wake up, let me tell you. And when it happens for multiple days in a row, something sardonically funny happens: you wake up expecting the pain. And because you expect the pain it is less jarring... but it is also distinctly depressing. If you don't feel jarred by the pain anymore, that means it's become familiar; no longer "just passing through", it seems bound to stay. At the same time, it seems kind of impossible, to be expectant while unconscious--it sounds like a contradiction of terms. It is a contradiction of terms.
Expect: regard as likely to happen; anticipate the occurrence or the coming of.
Unconscious: not knowing or perceiving; not aware.
How do you expect when you're unconscious? The only answer I can think up is that unconsciousness... isn't real? It feels ridiculous to even write that. But I can't reconcile the feelings of familiarity and expectation when arising from a state of unconsciousness without supposing that on some level we are conscious of everything. The mind may be unaware of something while the body may be fully aware of it. We like to think that the mind is the epicenter of the body, the dictatorial overlord that calls all the shots, that keeps track of where everything is and what's going on and when to act and just how to act when the time has come to do so. But like many dictatorial overlords, the mind is sometimes subject to the will of the masses, and the body--greater apparently than the sum of its parts--stages a coup. It will go haywire, it will hurt, it will shake, it will vomit, it will faint, it will act despite the protest of the mind, it will heed no warning and submit to no control. The mind, once pompous and self-assured in its tower atop the body, watches helplessly as its kingdom crumbles and its subjects run amok with scorn and disregard.
There are a lot of metaphors for anxiety.
That's what all of this comes down to, including the pain. The pain I've woken up with for the last 5 days, the pain that's familiar and unsurprising and expected, is just another metaphor. It's really happening, don't get me wrong--I really do feel stabbing or tightness or aching--but it's a representation of something else, and that something is anxiety. My body is taking something my mind can't comprehend and attempting to make it comprehensible in the simplest way possible: Pain. And my relationship to that pain changes depending on the frequency, the intensity, the location, the conditions in which it is experienced, and whether it feels new and surprising or familiar and expected.
Here's another metaphor: It's like seeing a cockroach in your house. You wake up one morning and there's a cockroach on the wall. You feel panic and disgust and a reflexive need to act immediately, to get rid of it. Part of your reaction stems simply from the fact that it's so out of the ordinary that it must be dealt with immediately. If you flush it down the toilet or smash it with a boot and then go about the rest of your day, and go to bed and wake up again tomorrow, and there's no cockroach, you hardly even notice that there's no cockroach--why would there be? It was a one-off, an abnormality, an unpleasant but ultimately insignificant experience to be forgotten. Maybe it happens again, five years later, but by that point enough time has passed that it feels like an entirely new experience; you might not even remember that it happened before. But what if you wake up the very next day and there's another cockroach? And what if there's a cockroach, or multiple cockroaches, in your house (maybe even in different rooms, at different times throughout the day) every day for a week. Two weeks. A month. At some point, you don't feel surprised anymore, and even your reaction of disgust has dulled. It's not that you don't care, but rather that you've gotten so used to caring and noticing and being disgusted and feeling panicked that you're just... always kind of in that state. Your body can't sustain the high pitch of panic you felt that fist time, but with the frequency of the recurrence, your body never relaxes like it relaxed before; you never really let your guard down. There is a word for this feeling: Dread. Your body lives in a state of dread.
This is what living with chronic anxiety is like.
I used to think that there was something seriously wrong with my heart. I was constantly afraid that going to have a heart attack, or maybe that I had some kind of cancer that was affecting my circulatory system. After numerous trips to the doctor, one emergency room visit, a lot of self-medicating and self-destructive outlets, countless conversations with my partner and my closest friends and family, and a year of therapy, I'm now mostly convinced that it's a physical manifestation of my anxiety. It took years before I would believe that I actually have an anxiety disorder, and longer still before I would accept that anxiety isn't as simple as "feeling stressed or worried", but can in fact make my body go haywire. That might sound like a long time, and maybe it is; why would it take years to believe something that was already happening to me all the time?
It's a pretty common response, as it turns out. It takes a lot of convincing to believe there's nothing physically wrong with you when your body is telling you otherwise on a near-daily basis. Partly because there is just so much that could be physically wrong with a person; the possibilities seem nearly endless! Everything inside you has the potential for failure or defect, and every documented medical ailment known to man has, by virtue of our awareness of it, happened to someone. Which means that anything could happen to you. Also, it's natural to assume that the basis of a physical symptom will be a physical cause--that's usually the case. If you're tired and coughing and have a fever, it usually means you have a cold; If you're stomach hurts and you throw up and feel better, it usually means you have food poisoning. If you're waking up with pain in your chest and a racing heartrate in the middle of the night, or you're having heart palpitations throughout the day, feeling dizzy and short of breath and shaky... It's natural to assume there's something physically wrong with you, probably something wrong with your heart.
And even when an emergency room doctor is looking you in the eye and telling you matter-of-factly that you've had a panic attack, that the EKG has recorded your heartbeat and your sinus rhythm is normal, and that this really does happen to people on a regular basis, you don't believe it. It sounds completely ridiculous. How can you go from being asleep to feeling like you're having a heart attack? If you were asleep, where was the opportunity for panic or anxiety to occur? Panic about what? I was asleep! Nope, no way, absolutely not. The only panic that's happening is the panic that the doctor doesn't believe you and thinks you're crazy. There's got to be something physically wrong.
And then a few years pass, and it keeps happening, and you eventually tire of scouring WebMD, demanding blood tests, taking your pulse every hour, eliminating everything from your diet and reintroducing things one by one to try to find some correlation with what's happening to you... And somewhere along the way, eventually, with a defeated acquiescence that's still tinged with skepticism, you accept that you've got an anxiety disorder. It's hard to let go of the hope that there's something physically wrong--and that might sound backward and fucked up. The hope that there's something physically wrong? Excuse me? But it's true. There's a perverse sort of hope tied to physical illness--if there's a physical cause, it usually means that there's a physical solution, and once treated the whole mess will be resolved for the rest of your life. Not so much with mental illness. Not when it takes years to even accept that a physical symptom can have a non-physical basis. Not when you're on a cross-town bus back home from your therapist's office and you start to have a panic attack for seemingly no reason at all, and no matter how fervently you repeat to yourself, "I'm fine, I'm not dying, I'm going to be okay," you still can't stop it. Not when it's nearly a decade after that trip to the emergency room and you still wake up with a pain in your chest and a feeling of dread, and you know the best you can do is accept that it's happening and believe that it will eventually pass, and attempt to go about your day like normal in spite of the fear.
So I sit down to write about it. Because looking at it from multiple angles, recalling it in the past and comparing it to the present, creating metaphors to describe it, giving up on "solving" it in favor of examining it, is maybe the best I can do to deal with it in the moment when happening. And three hours, two glasses of water and a lot of thinking and writing later, I feel a little better. The pain is gone, for now.
I'm going to go start my day.
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