A Funny Look At Anxiety
AN APPOINTMENT WITH DREAD
By Alissa Nutting
Across the waiting room in the doctor’s office, a woman is generously showering each page of last month’s Newsweek with wet coughs. Her expression is a dutiful one, like that of a priest sprinkling holy water upon his congregation; occasionally she flips back to bestow a second layer where the first might have been too thin.
The man sitting next to me is browsing a copy of Men’s Health. When the nurse calls his name he smiles and offers me the magazine. I recoil. Touching its communal pages would be the equivalent of having unprotected sex with multiple strangers in a Port-a-John. I manage a terse, “No thank you,” then immediately begin to worry he thinks I refused it because I’m illiterate. Perhaps he thinks I’m not simply illiterate but also stupid, that I thought illiteracy was actually a medical condition and that instead of going to an adult education center I came to the doctor’s office. Next time someone offers me a magazine in a doctor’s office, I decide, I’ll decline by saying, “I’ve already read that one.”
When the man is gone I stare at the magazine there on the chair, thinking about how some poor soul who wants to sit down is going to have to pick it up and irrevocably compromise his immune system. At any moment, I expect its pages to erupt with scarab beetles and fly around the room.
A few minutes later, my name is called. I give a small jump and follow the nurse back toward the examination room, trying to avoid eye contact with the other patients and staff. It’s hard not to be aware of how vulnerable I am now — following a strange woman down an unfamiliar hallway and consensually stepping into a room I have never seen, where anyone or thing could be lying in wait. Although this feels like an emergency, when we pass a fire extinguisher I do not break the glass. I would like to, though. I would like to activate an alarm and run.
“You can have a seat on the table,” the nurse says. Really? I want to ask. Then can I stick my arms inside an aquarium of scorpions? The thin paper sheet drawn across its vinyl is a laughable barrier against germs. They are sending me into a pathogenic hurricane with only a cocktail umbrella for protection. Because it’s socially unacceptable to say so aloud, I telepathically send her a request for an aluminum-shell hazmat suit to wear, but she does not seem to receive it. She leaves me alone in the room. I want to get up and try the doorknob, just to be sure that it isn’t locked from without. But I really don’t want to touch it.
When the doctor enters, I sit up with a jolt.
“Whoa, there,” he says. “We’ve got a live one!”
I pick a corner of the ceiling to stare at so I don’t have to see his fingers. He has a habit of walking them across the page as he reads my chart. They move far too quickly, at a speed I associate with undesirable insects. I finally summon the courage to look directly at him and notice his eyes staring at my foot, which I’m bouncing up and down. I stop. Soon his eyes move to my hands, which I’m wringing.
“Still feeling pretty nervous, huh?”
He looks down at my chart, then looks back at my hands and whistles. “You are tolerating a whopping amount of benzos.” He says this with an air of respect and self-pride, like this is a great accomplishment we are both responsible for. “Incredible,” he adds. I feel like an exhibit at a fair, an overgrown gourd with two warty protuberances atop its crown that just happen to make a shadow resembling Mickey Mouse’s head.
But like the image of Virgin Mary appearing on a piece of burnt toast, this miracle isn’t quite what it seems. There’s a simple reason the pills aren’t working, no matter how high he ratchets the dose: I’m not taking them.
~~~
I initially visited the doctor ― let’s call him Dr. Blank ― in order to get some sedatives for an airplane flight.
“Why does flying make you nervous?” he’d asked.
I’d tried to explain that if he didn’t give me drugs, I would likely spend the first 20 minutes of the flight focused on how at any moment the plane could crack apart like a metal egg in the sky and drizzle a long yolk of passengers out into the ocean, and how I would then urinate in my pants at 30,000 feet before spontaneously passing out, vomiting, then choking on my vomit.
It was then that Dr. Blank went on to ask me all sorts of questions that had nothing to do with flying and everything to do with anxiety.
“What’s one of the ways this worrying impacts your life?” he asked.
I shrugged. “I guess with driving.”
His eyebrows power-lifted a thick row of forehead skin up to his scalp. “What happens when you try to drive?”
That feeling was hard to explain, too. I might compare it to being trapped inside a metal laundry chute while several hundred people bang on its outside with baseball bats. “I feel a little panicked,” I told him. “I have to pull over a lot when it seems like I’m having a heart attack.”
Then we talked drugs.
Sedatives, he explained, were only a small part of the anxiety-relieving buffet — and not a very nutritional one. What I needed was a staple that would help me feel less anxious all the time, and help my panic attacks to decrease in frequency. A panic attack was like a spoiled child at Chuck E. Cheese, he explained: if it really freaked out, sure, just throw cake at it so it doesn’t cause a scene. Let it eat the desserty sedatives until it has its temporary fill. But this doesn’t fix the problem. Soon the kid will be screaming again.
He prescribed me a tampon multipack-style combination therapy. Always I’d wear the protective liner of Lexapro, an antianxiety-antidepressant selective serotonin reuptake inhibitor (SSRI), adding in a small dosage of Xanax for the light days, a stronger dosage for predictably tense situations, and heavy-flow sublingual lozenges for panic attacks. He stressed that Lexapro, the daily component, was the most critical. In tandem with cognitive behavior therapy, my need for the other drugs would gradually lessen, perhaps even someday disappear.
But I don’t want the Lexapro, I wanted to protest. I only want the euphoria-inducing abusable controlled substances. Even those I didn’t want every day. They made me very sleepy, and also made it easy to eat entire pies without noticing. I just needed something to take the edge off when I flew on planes, and other high-adrenaline scenarios. Like waiting in line for a bagel.
I told him I would follow his regimen, but I had a secret plan. I would not take the Lexapro, only the Xanax sporadically, then return to the unbearable appointments again and again for prescriptions until I’d stockpiled enough Xanax that I didn’t have to go back for years. After each appointment, I returned home from the pharmacy cradling the prescription bag, whispering pet names to it like Gollum did his golden ring.
This went on for a few months until a good friend needed a ride home from the airport. I thought I was going to die at least seven hundred times during the half-hour trip. I arrived at baggage claim with soaked hair and a Rorschach-blot of sweat staining the front of my shirt. “Did you run here or drive here?” my friend asked.
That night in bed, I began to wonder what it would be like to drive while feeling relatively normal. My fear in taking an SSRI was that it would transform me into a Disneyfied Alissa, one who could only see sunshine and oddly friendly birds whose facial expressions were anthropomorphized versions of Katie Couric at her morning espresso zenith. I didn’t want to feel lied to. Terrible things happen all the time for no good reason — worrying has always been my way of displacing my rage at this truth. I focus on the possible events themselves instead of the answerless query as to why they must happen. I did this, in fact, the very next morning.
I woke to my dog licking my face. My first thought of the day: I love my dog. My second: His death is inevitable.
Would an SSRI mean that I didn’t have such macabre thoughts upon waking? Maybe blissful ignorance and denial wouldn’t be so bad. Before swallowing my first pill, I decided to try thinking the exact opposite of my fears just to see what a chemical brainwash might be like.
“You are an immortal being who will outlive world apocalypse,” I said to my dog. He leaned back and began licking his bottom.
In the weeks that followed, I was both relieved and disappointed to find that the drugs did not in fact Disneyfy me. But they didn’t cure my anxiety either. What they did do was replace the swords of its hands with sporks, put it in a helmet and kneepads, and reduce its farsighted vision. Combined with behavioral therapy, I can now drive in a normal fashion. Somewhat.
An acquaintance at work recently stopped me in the hallway. “I was behind you in the tunnel the other day,” he said.“You were going like 20 miles under the speed limit and doing Lamaze breathing.”
“I’m sure that wasn’t me,” I said.
He shook his head. “I’m sure it was.”
Reposted from the Opinionator, Exclusive Online Commentary From The Times
Alissa Nutting is author of the short story collection “Unclean Jobs for Women and Girls” and an assistant professor of creative writing at John Carroll University.
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The Journey of Waiting
It all started in 2010 during a Florida football game where I watched them play in all that sunny warmth from my cold little condo in Maryland. It got me thinking about where I wanted to plant my roots. Thus began the journey of waiting.
I have moved twice since then and will move again before it’s all said and done. In that time threats of serious illness have kept my family on the edge of our seat.
My prayer has been “here’s what I want, but more than that I want Your will. Prepare me for what is ahead.”
I hesitate to say God has been gracious to me (He has), but I know people who are in the throws of suffering and sorrow and I cannot believe that He has been any less gracious to them. I guess I’m learning that His grace is not based on the outcome, but in the going through.
I’m re-reading my favorite book “When the Heart Waits” by Sue Monk Kidd. Each time I read it I wonder if it will remain at the top of my list…it does.
Her words have helped me “to not only wait, but to ‘stay’ in my waiting.” To see that waiting is both – passive and active. It requires space and time for the soul “to listen to the disinherited voices within and face the wounded holes in the soul.”
A counselor can be a helpful guide in such places. To find a therapist in your area go to: christiancounselingresource.com or psychologytoday.com.
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