As someone who has struggled with mental health issues, I'm not one to downplay the importance of erasing the stigma attached to them. There are still those lucky people with perfectly healthy brains who tend to label those of us with broken ones as crazy or unstable— stereotypes that make it hard to be taken seriously, or feel accepted. And since Americans being diagnosed with mental illness is a growing phenomenon, it's more important than ever to have an honest discussion about our mental health.
But as much as I encourage people to be as open as they want to be regarding their mental health—after all, the more it's discussed, the more informed people will be and the more we can chip away at this disabling stigma—it is possible to have too much of a good thing. As more and more people come forward to reveal their struggles, it seems others are jumping on the bandwagon, borrowing jargon from the DSM-5 and co-opting the pain. Nothing is more fashionable right now than anxiety disorders.
People have taken to exaggerating their everyday experiences and punctuating sentences with terminology appropriate for a psychiatrist's office. They aren't nervous about an upcoming work presentation; they have "bad anxiety." They aren't uncomfortable to go to a big party where they don't know anyone; they have "social anxiety." And they don't get butterflies in their stomach; they have "panic attacks."
The Real Housewives bases entire storylines around Xanax smoothies, and the Kardashians are hailed as heroes for "opening up about their self-proclaimed anxiety on camera. (Hey, Kim and Kendall: Getting lightheaded on a plane is not the same thing as having a panic attack.) The way people, especially high-profile celebrities, trivialize this often crippling mental disorder leaves the diagnosis void of any credibility.
Anxiety as an illness can come in several forms: Generalized anxiety disorder (GAD), panic disorder, or social anxiety disorder. It's also a common human emotion we all endure. Run-of-the-mill nervousness and severe anxiety, however, are not one and the same.
"Anxiety in itself is just a normal experience," says Shanthi Mogali, director of psychiatry at Mountainside Treatment Center in Connecticut. "What creates abnormal anxiety is when experiences of nervousness and worry start to take over your daily life—people can find [themselves] worrying about mundane things, things that normal people can kind of push out of their mind. [It] starts to consume their life."
Even simple tasks such as picking out an outfit for the day or making plans are enough to send people with anxiety into a downward spiral, consuming them with worry and manifesting itself into physical symptoms such as heart racing, sweating, and heavy breathing.
Whether it's for attention or just the result of a general lack of understanding around how anxiety actually works, the colloquial use of anxiety terminology is a slap in the face to those who are truly suffering, those who wish their feelings were just butterflies—hearing people throw these terms around so casually trivializes the all-encompassing panic they actually feel, making anxiety less likely to be taken seriously by others.
Alyssa Jeffers, 26, has been diagnosed with GAD, panic disorder, social anxiety, and OCD. Although she receives treatment for her disorders, she says they have taken over her life. "It's frustrating when people are like 'I'm so anxious right now' when they're just nervous about something," she says, "because there's a huge difference between being anxious and being nervous and I don't think people understand that."
Although she considers herself an outgoing person, she's uncomfortable in many social situations and is frequently so overwhelmed while getting ready to go out with friends that she cancels plans entirely. Her panic disorder causes to her hyperventilate sometimes to the point of her passing out. On one such occasion, her joints and muscles cramped up and began to shut down due to lack of oxygen; she ended up in the hospital.
Have you ever felt so nervous that your stomach drops, your palms get sweaty, and your mind starts racing? Sorry to break it to you, but you were not having a panic attack. Panic attacks manifest themselves differently in each person, but the consensus of people experiencing them is an overwhelming sense of impending doom—often, they feel like they're going to die. Some people even mistake a panic attack for a heart attack since both can involve chest pain and shortness of breath.
This is how Jeffers describes her experience:
"When I know one's coming on, my hands start getting really jittery and shaky. It feels like I have a cement block on my chest. I get this weird sensation throughout my body that all my senses are heightened, and I start getting a little flushed in my chest area, and then the breathing part is my hardest thing. I have to remind myself to take a breath, and if I can't really wrap my head around that I just start breathing short little breaths, and before I know it I'm in full-blown hysteria. Last time, my fingers and toes started tingling. My muscles get very tense and I can't really move well. It kind of feels like you're paralyzed even though you're not, because you can't, you just can't move yourself and it's just a feeling in your head. You're just thinking a million things and then, oh my god, I'm going to die; this is horrible. Why is this happening to me? What caused this? You just run every bad situation through your head, and it perpetuates all of it."
Unlike anxiety attacks, which have similar physical symptoms but tend to result from a stimulus (your partner just broke up with you, you got fired, someone yelled at you), panic attacks come out of the blue. They're also worsened by the accompanying anticipatory anxiety, or constant fear that another panic attack will happen again without warning.
The solution? Just pop a Xanax, of course. The medication that's a life-saver for some has become a punchline for others. But even when people are trying to be funny, they confuse what Xanax is actually used for. It's not to "relax" or calm down; it's to pull yourself out of a terrifying mental state.
"It's frustrating because people are just like, 'Oh, pop a Xanax, take a Xanax, you're fine,' and 'Oh my god I need a Xanax,' but in reality that is my lifeline when I am feeling the beginning of a panic attack coming on," Jeffers says. "As long as I can catch it and take the medicine before I really get into a panic, then I can sort of pull myself out of it."
A common source of treatment for anxiety disorders—along with cognitive behavioral therapy—is an everyday SSRI medication such as Zoloft or Lexapro and a benzodiazepine (Xanax, Ativan, Klonopin) taken on an as-needed basis, like when you feel an attack coming on.
Between people who pop benzos recreationally and doctors who are loose with their prescription pads, getting your hands on Xanax is pretty easy these days. Add to that a culture that has already watered down the meaning of what it means to be anxious and you've got a generation of people taking Xanax practically like it's a vitamin. This makes it harder for people who actually need Xanax to stay afloat to be taken seriously.
Anxiety serves a biological function: to signal our bodies to oncoming danger. The fight or flight response of extra adrenaline is helpful for when we are, say, being chased by a bear in the woods, but less helpful when we are stressing over work or bills. But some anxiety is still useful to alert your body when there's a stressor or a problem, and shouldn't always be masked.
"A lot of the baseline levels of anxiety that are supposed to be part of our survival are being self-medicated," Mogali says. "I think it's worsening a lot of anxiety disorders because we're not able to tolerate normal levels of anxiety."
If people feel a hint of nerves, they blame their condition on "anxiety," pop a pill, and continue on with their day. In addition to masking an actual human emotion we would normally be experience, it causes people to over-medicate, which can potentially lead to drug resistance and addiction.
"You do form a dependence on these medications—a physical dependence," Mogali explains. "It becomes very unhealthy, and your body can become physically dependent. Your brain can become physically dependent. You end up going through a medically necessary detox in order to get off of these medications."
For every celebrity who comes forward revealing their anxiety issues and inevitable panic attacks (they always have panic attacks) with a splashy magazine story or reality TV storyline, there are millions of others who truly suffer in silence, struggling to get through each day and feeling like a prisoner trapped in their own minds. Sure, I'm not a psychiatrist—maybe anxiety disorders are legitimately taking young Hollywood by storm—but I have struggled with my own anxiety since at least age 12, worrying over the most mundane tasks, waking up in the middle of the night with legitimate panic attacks, thinking I was on my deathbed. I've also simply been nervous for a job interview and had butterflies before a stage performance; there is a difference.
Anxiety isn't cute, or chic, or fashionable. It's not just a word we can overuse to death the way we did "literally" or "amazing." It's a debilitating disorder that 40 million people in the US suffer from. All of us deserve to be taken seriously. Everyone else needs a better word to communicate how they're feeling; sometimes, it's okay to just be nervous.
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