Out of the depths

I want to talk about anxiety. 

It’s a common issue, considered the most common mental health disorder in the world, and is thought to affect about 4 percent of the global population. It’s much more widespread in the United States, affecting 40 million — or 18 percent of Americans. Why has anxiety become so prevalent? Lots of theories. Social media addiction, poor lifestyle habits, excess stress, artificial lighting, underreporting in the past, lowered stigma, etc. Uncontrollable risk factors include genetics, brain chemistry, personality, and life events. Nearly every human is exposed to one of these factors, but not everybody considers anxiety to be a negative force in their life. 

Where does this negative force tip the scale from “stressed out” to “generalized anxiety disorder?” I can’t answer this question, because personally, I don’t consider stress and anxiety to be directly related. Stress can exacerbate anxiety, but it doesn’t cause anxiety. So what causes anxiety? This week, more than any other week in my life so far, I feel I am nowhere near to finding an answer. 

Where does it start? Genetics and personality, most likely. I was a mildly anxious child who enjoyed some respite as a self-assured if brooding teenager. In early adulthood, I started pursuing adventure and absorbed a few traumatic experiences that I believe shaped the trajectory of my outdoor life. These experiences include becoming trapped under a raft after it flipped during a whitewater rafting trip, cowering next to boulders near the summit of the highest mountain in Utah as an electrical storm raged overhead, sprinting down an inescapable slot canyon during a heavy rainstorm, and becoming lost for several hours and nearly running out of water during a hike in the desert. 

These were all valuable learning experiences for a 21-year-old who was just starting to explore the scope of her outdoor passion. But in the months that followed that formative period — the spring of 2001 — I noticed that I felt considerably more frightened in situations that hadn’t bothered me in the slightest just months earlier, such as vertical exposure. I started to have “freak-outs” at inopportune times, such as being caught in a July snowstorm on the wrong side of an exposed ridge below Mount Borah (this is a legit scary situation, but the panic was most unhelpful.) 

More generalized anxiety rose out of these depths during what was also a rough patch in my personal life: the summer of 2002. But it didn’t follow my worst fears; it was triggered by what I considered at the time — and still do — some of the dumbest scenarios. I had a panic attack during a thunderstorm even though I was inside my house at the time. I had another panic attack when I awoke one night and realized I’d left my bedroom window open while Elizabeth Smart’s kidnapper was still at large (I lived a few blocks away in Salt Lake City at the time.) I wasn’t actually afraid of a window kidnapper or being struck by lightning on my couch. These were just random triggers, sparking a stress reaction that spiraled out of control. 

These incidents, among a few others in my “poison summer,” convinced me I had a problem. I believed my only two choices where to either be terrified of everything all of the time, or pull myself up by the boot straps and charge toward fear head-on. The summer of 2002 was when I decided to take up cycling and dove headlong into adventure by bike, completing a two-week-long, 600-mile tour by September. I was certain I’d cured myself. I could be fearless as long as I told myself it was so — “be brave, be strong.” 

I’ll have to fast-forward here, but that’s basically how I comported myself until the summer of 2015, when I got sick during the Tour Divide. It’s been a different sort of mindset since, now that I realize I definitely do not have all or even most of the control, and I’m not even solidly in the driver’s seat of my own mind. In the ensuing years, I accumulated two decades of life experience. My amygdala absorbed new traumatic events. I lost relationships and long-held assumptions. I gained security and wisdom. I should be a different person than I was then. I am different. But that same spiraling sea monster (this is how I visualize anxiety, similar to the way depression is a black dog) still lurks in the depths. 

A week ago Thursday, I was in a good place. Like everyone else in the U.S., I struggled with the stressors surrounding the pandemic, racial justice, and politics. But even the pessimist in me believes these issues are (at least for now) following a trend of improvement. I’ve been feeling fit and using hard efforts to stoke all of the positive brain chemicals. So I headed out for a hard 100K bike ride. When it comes to physical effort, “hard” is still relative for me. I engage a higher heart rate but I can still walk normally the following day, so how much did I really bury myself? 

Anyway, a few hours later I came down with a runny nose. It was pretty pronounced — a burn-through-half-a-box-of-Kleenex-in-a-night sort of sinus congestion. The air quality had been poor during my ride, so I blamed allergies. I felt fine otherwise but decided to isolate from Beat just in case I’d caught COVID. 

 The following morning, as quickly as it came on, the sinus congestion cleared and I felt mostly fine. Mostly fine … except for weirdly on edge. Like any little thing could set me off. I thought it was just basic irritability and blamed hormones — “that time of the month” sort of thing, even though it wasn’t that time of the month. 

On Saturday we woke up to my favorite type of weather — new snow and deep cold, 11 below zero. I respect how difficult the Polar Vortex has been for many people, but it was a blessing for me — finally, real moisture to put a dent in the drought, snow to add beauty to the drab sameness of pandemic life, and sharp, cold air to stimulate all of the senses. I eagerly anticipated a morning run with Beat. As we geared up, he questioned me about a hydration pack and it deteriorated into an argument. Amid the anger and perhaps remnants of sinus congestion, my respiratory rate spiked and “breathing difficulty” sparked a panic response. As the sea monster surged from its turbulent depths, my adrenaline skyrocketed and my mind went dark. All I could comprehend was running away from the monster. 

I rushed to a spare bedroom where I could lie in the dark in the fetal position and gasp for air. Beat, thinking I was merely annoyed with him, came downstairs about 20 minutes later and found me in this state. He worked to comfort me as I tried anything I could remember — grounding exercises, reciting a list of favorite songs, counting backward from 100 — to reign in the gasping and sputtering. I was frightened, deeply frightened, not only because I couldn’t breathe, but because I’d finally lost it. I’d gone crazy. I did regain control of my breathing, but by the time it happened, it was as though the monster had already clenched its jaws around me and drained my blood. I felt like I had never been so exhausted — not when I ran 100 miles that one time, or any of the times I ran 100 miles, or anything I ever did to pull my own bootstraps and prove I was brave and strong. 

I laid in the dark for a while longer and then decided I could do my mental health some good if I just got up and went for a walk. I was so exhausted that I would only commit to 15 minutes of walking. It would take me longer to get dressed for the subzero weather. But I got dressed anyway and ended up staying out for two hours. I felt weirdly blank. Not cold, not tired, not angry, not stressed, not relieved, not joyful. Just sort of … nothing. My life force was, in fact, emptied. 

My week since has largely been a lot of this: recognizing my exhaustion, trying to be gentle on all systems to encourage recovery, trying to enjoy the one week of cold weather we were probably going to see this season by getting out for walks, all while feeling baffled by my incapacity for joy. As a calming mechanism, I read a lot of Mary Oliver's poetry and even cried because I felt like I lost that part of myself — the self who never failed to find pure astonishment in the natural world. Meanwhile, as my body rebuilds cortisol and adrenaline, I’ve noticed that I feel “on edge” again. My respiratory rate and heart rate spike when I encounter tiny stressors. I’m terrified the monster will clamp down again, so I avoid anything that might cause unnecessary stress, including hard efforts while exercising. I dutifully keep my heart rate in zone one or two while slogging through shin-deep snow, reminding myself that I love this cold and snowy world. I know I love it on an intellectual level, but feeling this love is another thing altogether. 

It’s been a week since my panic attack and things are improving. I no longer feel deeply upset immediately upon waking up. I’m a little less irritable, a little closer to feeling joy again. I’m a lot less exhausted — my energy levels are almost normal, and I completed a moderately strenuous 90-minute effort on my bike trainer today without fallout. My attention span lengthened enough to read things longer than Mary Oliver poetry and start writing again … although this blog post honestly is the first remote success I’ve had with the effort. It’s difficult to talk about anxiety, but at the same time I feel the need to talk about it. As I repeated to myself multiple times while trying to reign in my panic attack, I rode my bicycle across Alaska alone in the winter once, for crying out loud. But the thing I fear the most is my own mind. 

Searching for answers — a reason not to fear — will be a difficult and possibly never-ending journey. My therapist believes in reconciling past traumas, which is why I’ve been thinking about the spring of 2001, among others. Since my Graves Disease diagnosis, I’ve wondered if there’s an autoimmune component to “flare-ups” of anxiety — that might allow me to pin blame on the short-lived sinus infection for this particularly inexplicable episode — but the autoimmune theory doesn’t have a lot of support outside the functional medicine realm. I plan to get my thyroid levels checked next week, as hyperthyroidism does have a direct link to anxiety. I’ve resolved to “take it easy” for a while, just in case I’ve been inadvertently overtraining and thus overstressing my body. I’ve made an effort to return to the meditation practice that I so dutifully cultivated last spring. 

I just want to feel joy again. To breathe deeply without fear that I’ll lose my breath. I believe I’ll get there, but I have to admit this has been one of my most difficult weeks in a while. The worst part about it is that it’s been difficult for no reason at all. There was no real challenge to overcome. There’s no satisfaction behind me, no reward in the future. It’s all drudgery, although perhaps I’ll emerge on the other end having learned something important, or gained a new appreciation for what I already have. 

 As Mary Oliver wrote, “so long as you don’t mind a little dying, how could there be a day in your whole life that doesn’t have its splash of happiness?”