If there's any question whether anxiety is genetic, my family is a perfect answer. My grandfather had his first panic attack when he was in his forties and spent the next fifty years of his life hunched and terrified. My father's anxiety began in his twenties, and his brother and sister have both struggled with their own anxiety to varying degrees. While my youngest cousin and I are the the most seriously affected by anxiety disorders, the four other grandchildren have struggled with mental health issues as well.

My youngest cousin is ten years younger than I am, and so by the time she was born I had already had my first panic attack. I was in regular therapy by fourteen and by fifteen I was handing out tissues and suggesting therapists and reading materials to friends who seemed to be struggling with similar symptoms. I was a regular anxiety welcome-wagon. But when my cousin started, at age 7 or 8, to talk about the scary thoughts she was having, I was, frankly, at a loss as how to help.

There must be good scholarship out there about kids with anxiety disorders. But by the time I took the initiative to figure out what was going on and get into therapy, I was already a teenager. I'm not sure whether being in therapy sooner would have helped my anxiety -- my anxiety isn't particularly helped by talk-therapy -- but it would have helped me understand that I wasn't going crazy. Understanding anxiety as a disorder was incredibly liberating for me, because suddenly I wasn't insane or oversensitive or hysterical.

For a number of reasons, many of them no fault of their own, my parents didn't pay much attention to my anxiety when I was a kid. I'm not sure how they ignored it, but they more or less did. It's likely that I didn't tell them half of the things that were worrying me, but I do remember calling my mother at work each day after school for reassurance about something or another. "No, getting a little bit of soap in your mouth won't hurt you." "I am sure that you didn't swallow that tiny piece of your braces that fell off." "Your headache is not a brain tumor. Go to sleep."

I work with kids now, and I understand that my parents were probably more annoyed than worried. Parents work hard to make sure that their kids are safe from real live dangers; good parents learn not to sweat the small stuff. From my own experience, a kid who is constantly questioning his or her own safety is frankly kind of annoying. I'm the grown up, I've made sure that the world is more or less safe for you, so why don't you just believe me when I say that it's safe. "Why are you not really going to die? Because I said so!"

But your kid's anxiety is bigger than you. Their anxieties are not about you, they're not about how you react to them, they're not about something you're doing wrong or right as a parent. Even if you can successfully comfort your panicked kid, you will have to keep comforting for the rest of your life. Because if we're talking real, clinical anxiety, then your kid's anxiety is about their brain chemistry.

And so I told my aunt and uncle to find a therapist for my cousin. I told them about all the treatments I'd done, about the changes I made in diet and exercise and the meditation techniques I use and the medication I take.

For you, I will say: most importantly, find a therapist who takes your child's anxieties seriously. A therapist who understands how torturous anxiety can be, who gives your child room to talk about the things they fear and understands that anxiety treatments are as varied as the people who have the disorder.

Good luck.

keeping anxious secrets

I had my first panic attack when I was 10, but I acutely remember being anxious and obsessively fearful for, well, as long as I can remember. I distinctly recall, at 4, being terrified that the "floaters" that appeared in my eyes after looking at a bright light meant that I was going blind. I kept my imminent blindness a secret from my parents because somehow the idea of hearing from them that I was probably going blind was scarier than my own imaginings.

In first grade I discovered a sty on my bottom eyelid and assumed that I would need immediate surgery and would probably go blind. I was too scared to tell my parents about it, and so I walked around for weeks starting at my parents with wide eyes, hoping that they would notice the sty and would save me the trouble of having to tell them.

"Why do you keep looking at me like that?" my mother would ask.

"Oh, nevermind." I would squeeze my eyes shut and wonder why my parents weren't paying closer attention.
* * *

I wonder where this impulse comes from -- this determination that it is better to hide the things that terrify and obsessively preoccupy us. While I learned that talking about the things that made me anxious and seeking reassurance that I am actually ok (which, it turns out, I almost always am) is an incredibly strong antidote to my obsessional fears and health anxieties, I still find myself hiding things from people who could help me. I spent a solid nine months convinced that I was secretly a homicidal maniac before I haltingly admitted my experience to a therapist -- who told me that I had textbook OCD-related obsessional fears of hurting others. And almost immediately afterwards, my fears disappeared.

Next post -- a discussion of how to help kids with anxiety.

panic attack number 000001

The first panic attack I ever had was in a campground in California. It was the summer before sixth grade and my parents buckled my brother and me into the back of our white volvo station wagon for a six week trip across the country.

My brother and I slept head to toe in tiny brown tent which leaked at the seams and smelled like it. The night of my first panic attach I crawled into my sleeping bag and pulled out my flashlight and had this thought: if I don't think about my breathing, it will stop. The thought came from nowhere and was suddenly, everything.

I started to cry, gasping and shaking, suddenly terribly sure that I if I fell asleep I would die. My brother tried to comfort me. My parents yelled at us from across the campsite to be quiet and go to sleep. And so I cried myself to sleep, to death.

You already know how this ends. Or rather, what this begins. I woke up the next morning, my brain having miraculously taken over for my labored efforts and steered me safely through the night. If only that one night was enough to help me let go of the obsessional fear (which, now that I think about it, was likely more OCD-related than anxiety/panic). If only I didn't have spend the next four years obsessing about my breathing each night before bed.

* * *

How do we come to terms with brains and bodies and nervous systems that are, at truly significant moments, entirely out of touch with reality? I used to obsess about the possibility that if something really happened -- when that long-obsessed-over heart attack/stroke/asthma attack finally came for me -- that I would have trained myself to well to ignore these feelings of impending doom that I would ignore the real thing.

Of course, the reality is that I haven't yet trained myself to ignore those feelings. Nor has the heart attack come for me. Yet.

a new plan

My hypochondria is so intense sometimes that it clearly crosses the border into the realm of deep, unapologetic narcissism. I'm so tuned in to every ache and pain, twitch and twinge; I am in thrall to my own body, enthralled by my own body.

And so I've resolved to turn a deeply negative, self-involved force in my life into something positive. I spend so much emotional and intellectual energy obsessing about the various different diseases I'm convinced I have -- why not transfer some of that energy into working to eradicate those diseases?

So I'm signing up for a MS bike ride fundraiser next month. I'm not expecting to raise gobs of money -- it's really about stepping up and doing something larger than I am.

And when my MS anxiety fades and some new fear latches itself firmly in my brain, then I'll run or swim or walk or bike for that, too. Because -- let's be honest -- my brain might be wired a little funny, but my body -- it works just fine.

seeking safety

My anxiety is back with a vengeance and I'm engaging in a million "safety-seeking behaviors." I have my phone nestled next to me in case I wake up in the morning paralyzed and need to call my parents two floors below me to tell them that something really has happened this time (I am acutely aware that this only works if I'm paralyzed from the waist down. If my arms don't work then I'll scream, and if my screaming mechanism is broken too then I'll just have to wish as hard as I can that my parents are overcome by the desire to come wake me up). I'm cuddling close to my mangy stuffed polar bear and listening to npr podcasts and doing the crossword puzzle from the washington post and trying to ignore the strange tingling sensation and the heaviness in my leg -- it is the left one this time.

I'm amazed at the way my brain -- in cahoots with my body -- is able to produce such an alarming variety of somaticized symptoms. Once I am certain that this or that symptom isn't a sign of my imminent death but is rather fueled by my decidedly anxious disposition and a healthy dose of adrenaline, another symptom is ready to step up and take its place.

I go back and forth between thinking about my anxiety as if it is some sort of parasitic alien invader bent on sucking intellectual and emotional energy away from my real life -- and as if it is the cowering, abused child of my wrathful subconscious.

If therapy has taught me anything, it is that black-and-white thinking like the dialectic presented above is a surefire way to induce anxiety. So you can understand why I feel so stuck.

I realize that anxiety -- and specifically, health-related anxiety -- is a deeply self-involved (narcissistic, even) mental illness that enables such tragically earnest ventures as a blog. I already have therapy to compliment my frantic internal monologue; to think that anyone (especially a stranger) would willingly subject him/herself to my indulgent ramblings is simply, well, indulgent. Because honestly, if I could not write this, I would. But right now, I think I kind of need to.

ode to google

It's really MS this time, I'm sure of it. Even google corroborates my suspicions, and we all know that if google says it's true, it must be. Google validates my fear when everyone else seems to think that "there's absolutely nothing wrong" with me; google believes in me when I say that I think I might be dying. Google knows nothing of hypochondria -- to google, there is only cancer.

No really, you try it. Type in "blurry vision" and "tingling hands and feet" and "leg weakness" and tell me what you find. Now try to convince me that I'm not really going to die this time.

Seriously, google should offer a special diagnosis service for people with anxiety disorder and hypochondria -- where whenever you type a terrifying string of symptoms into the search bar, a page immediately pops up and flashes the words "IT'S ALL IN YOUR HEAD".