Monday, August 10, 2015

Anxiety

On Tuesday, I had an appointment with an oral surgeon. The appointment was kind of a disaster for many reasons, but there was one incident that stood out particularly for me as problematic and anger inducing. When I got to the appointment, I was asked to fill out a basic medical history which asked if I had ever been treated for mental health issues. I checked yes because I have been treated for generalized anxiety disorder. It is mostly under control now, though I still have bad days. However, there was a time where it very much was not. When the oral surgeon asked me why I checked the box, I said "I have an anxiety problem." His response to me was "Oh, just like everyone", with a tone of voice that was offhand and dismissive.


I was taken aback. He wasn't taking me or my anxiety disorder seriously. I felt annoyed and embarrassed. Because I once had a fairly impressive panic attack during a surgery where I was kept awake and couldn't stop thinking about how I could feel the knife cutting into my shoulder, I soldiered on and explained how my anxiety had caused me to obsess about things to the point where I become paralyzed and can't move forward. He went on to ask intelligent questions about medications I had taken, their side effects, and why I was no longer using medication to treat my anxiety. We discussed whether I should be put under or given nitrous or if I could handle being awake.


His initial attitude stuck with me and left me feeling kind of disgruntled. He wasn’t the first person to be dismissive of my anxiety and I'm sure he will not be the last; I just wished he’d been a little more respectful.


On a different day, the story would end here with me just feeling a little bad about the interaction, but trying to mentally move past it. When I returned to work after my appointment, however, my husband told me that a friend from high school had been found dead that morning and that there was a strong possibility it was a suicide. I am sad that this person is no longer a part of the world, and that his pain was so bad that this was his way out. As the week has gone on, and my husband and I have talked about our friend and how saddened we are by his passing, and memorial posts are filtering up on our Facebook pages, I've slowly started to get angrier and angrier at this oral surgeon. There is still a lot of stigma attached to admitting to mental health problems like depression and anxiety that makes it very difficult to get the care and help that someone may desperately need; so how dare this man who is considered a medical professional make me feel like I need to prove that my anxiety is not normal, everyday anxiety before addressing whether it would affect my treatment.  


If one of the most important tenets of being a doctor is “first, do no  harm”, then medical professionals like the surgeon I saw Tuesday need to remember that tone counts. To treat a patient effectively, doctors need the patients to tell them what is wrong. This can include any number of physical symptoms, feelings, and behaviors that are uncomfortable to talk about or have a stigma attached. I am not going to be treated effectively if I’m unable or afraid to talk about my symptoms because I don’t think the doctor is going to believe me or take me seriously, so it’s important to be attentive and empathetic. Don’t make me feel like I can’t tell you what you need to know, otherwise we are going to leave the office still in pain; possibly in even worse shape than the way we came in.


At the height of one of my worst bouts with anxiety I would hide in my bed all day obsessing over minor incidents. I would stay in bed until just before my sister came home from school. Then I would jump in the shower, get dressed, make my bed and eat something so that it wouldn’t look like I had been in bed all day and pretend to be okay.


I was afraid.


I was afraid that my mom and dad would get mad at me for wasting my day; that they wouldn’t believe that I couldn’t make myself stop worrying about these nothing things. I once spent two days agonizing over having to reprint a couple of flyers at work. My boss didn’t care that I needed to reprint a couple flyers and part of me knew this; so why was I still worrying about how I “fucked up” two days later? I had paralyzing anxiety about big things too, graduate school in particular. If I didn’t get out of bed, I didn’t work on assignments. Most of my classmates in library science were English majors for undergrad; I had been a business major and hadn’t read nearly as much literature, so I always worried I was inadequate.


Then there was the really big question; was this the right major/career path for me? I had decided with three classes left in my undergrad that business was not for me; for graduate school I had gone back to an old dream of being a librarian. But what if this wasn’t right either? My parents had instilled me with a very strong work ethic, particularly in regards to school and work. I was afraid that if I told them that my terror over the future was leading me to spend most of my day curled into a ball in bed, they would think I was making excuses to prepare them for poor grades, even though I was maintaining a 4.0 average at the time.


The level of fear and sadness I was carrying around was overwhelming, and I knew that a lot of the anxiety was disproportionate to the cause of said anxieties. I worried that telling someone would make me sound like a crazy person; in my mind crazy people did not get taken seriously. Most of the time, I did a pretty decent job hiding what was going on inside my head because I didn’t want to be belittled for my feelings. I was afraid that people would look down on me and I would lose all credibility; that once someone knew about my constant crippling anxiety whenever I was worried about something, even if it was a legitimate concern, I would be told I was overreacting, just because it was me. I won’t lie, this has happened over the years, but I’ve been lucky. The majority of the people who tell me I’m overreacting are not people whose opinions I really care about.  Having those feelings in the first place, however, made it harder for me to get the help I needed.


I have absolutely no memory of how, but eventually my mom found out how depressed and anxious I was, and sent me to the doctor to seek treatment. I went to a therapist my primary care physician recommended, and was prescribed anti-anxiety medication which I took for many years. Now, in light of our friend’s death, I can’t help but think what if my mom hadn’t sent me to the doctor? What if the first doctor I had gone to had been as dismissive as the oral surgeon was on Tuesday? Where would I be? Had I encountered the attitude of the oral surgeon back then from a doctor it would most certainly have confirmed all of the feelings of inadequacy that my excessive anxiety was giving me. I would not have pushed back and I most certainly would have thought twice before bringing it up to anyone else again.

My friend moved away several years ago and between one thing and another we had drifted apart over the years. Based on when we were kids, I can tell you that he was good at hiding his feelings and that he could be extremely self-destructive, but I also know that he had sought help in the past as well and was able to cope with help. I don’t know if my friend tried to seek help again in his final days, but I am going to wonder.

If you are experiencing depression and suicidal thoughts please try to seek help. The Suicide Prevention Hotline is available 24 hours a day 1 (800) 273-8255.

Also with special thanks to Jonathan A. Desoto for writing advice, editing, proofreading and moral support. 

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