I’ll start at the beginning: I have a generalized anxiety & panic disorder. I’ve had it since I was a very small child, though it went undiagnosed (and frequently misdiagnosed) until adulthood (which isn’t unusual, especially 20+ years ago). It’s not the result of trauma, poor upbringing, or anything like that — I was born with it, and it’s likely caused by a genetic chemical imbalance outside of anyone’s control.
If you’ve never dealt with mental illness before, you might be thinking that this means that I primarily have psychological symptoms to deal with. In my case, that might mean things like excessive worry, overthinking, irrational fear, high stress levels, lack of concentration, brain fog, fatigue, and so on.
But the reality is that mental illnesses, especially ones like depression and anxiety, can actually be *very* physiological in nature. There’s a lot of stigma surrounding mental illness, with this idea that ‘it’s all in your head’, but in addition to feeling *very real* psychological symptoms, there are also almost always physiological side effects. And sometimes they can be even more debilitating than the psychological symptoms themselves are.
I’ve always had physiological symptoms along with my anxiety, for as long as I can remember. High heart rate, headaches, joint pain, nausea, vomiting, digestion problems, motor ticks, skin rashes, sensitivity to smells and sounds, chest pain, and tension among others. Through the course of my childhood, I was misdiagnosed with everything from environmental allergies, to mild asthma, to chemical insensitivities, all of which I believe to be inaccurate now.
Fast forward to January: I wake up one day and my mouth is so sore that I can barely move it. Chewing sends shooting pain up my teeth and along the sides of my jaw. Drinking cold water hurts so badly that I squeal out involuntarily the first time it hits my gums. I go to the dentist, but there’s no sign of an infection, even though the pain is obviously very, very real. He does x-rays. He pokes around. But there’s nothing to be found. The final verdict is TMJ, with excessive pain from clenching and tension. He sends me home with a muscle relaxer & sedative, followed by a bite-plate later on. It takes weeks, but eventually it gets better.
Fast forward again to mid-June: my mouth pain has been under control for a while by this point, but I start to notice that I’m having more and more problems with indigestion. At first I think that it’s just a bad stomach flare-up that’ll resolve itself in a few days, but days turn into weeks and it doesn’t get better. It gets so out of control that I can barely leave the house. I can’t eat out. I can hardly work. The stomach pain is getting so bad that it wakes me up in the middle of the night. I try all the over-the-counter drugs; gravol, gas-x, pepto, immodium, advil for the pain, but none of it helps much. Every once in a while it seems to get better for a day or two, just long enough to give me hope, but then it always cycles around so I’m right back where I started again.
In mid-August I finally get in to see a doctor. I don’t have a GP at this point, so I find myself trying to explain a buttload of chronic illness issues at a walk-in clinic to someone I’d never met before; an appointment that I almost didn’t even make it to because of a flare-up right before we left the house.
I tell him a bit about my anxiety disorder, and about the digestion problems that had brought me in to see him. And do you know what he says to me? We can try you on an elimination diet to see if you can flesh out any food triggers that you might have, but stress is probably your biggest problem. Most people who end up getting treatment for anxiety or depression don’t actually reach out to their doctor for those things; they reach out to their doctor because of the physical pain caused by those disorders.
Then he started listing off some of the most common things people who have depression or anxiety come to see him about. Headaches. Tension. Chest pain. TMJ. IBS. Insomnia or excessive sleeping. Back pain. Cramps.
This is around the time that the little light bulb finally went off above my head, and he suggested a treatment plan to help with *both* the anxiety and the physiological symptoms that had been causing so much havoc. He also offered to take me on as a patient, and I accepted.
So, now I’m on medication. A lot of it. And it’s helping, but there is no quick fix, and the medications all come with complications of their own. My newest medication has been causing excessive heartburn and dry-heaving every other day since I started in 3 weeks ago. Another one causes excessive sweating and restless leg syndrome, the latter of which can make me twitch uncontrollably for hours. Two out of the four medications I’m on are higher risk compared to others in their perspective categories, with one having a black box warning label. I’m not in the ‘high risk’ category for any of these medications, so the chances of something going wrong for me are pretty low, but I still know it’s there. And if this was *really* all in my head or over-exaggerated, they probably wouldn’t be giving me higher risk medication to treat it.
If you’re struggling, know that you’re not alone. Your problems aren’t ‘all in your head’. It’s never too late to seek out help (whether that be through medication, therapy, or lifestyle coaching), and you deserve to be as happy, functional, and healthy as you can be. If your doctor doesn’t take you seriously because a lot of these symptoms, even the physiological ones, are hard to measure in tangible ways, seek a second opinion.
Just because your illness is less visible than others, doesn’t mean that its impact on you is any less real, and you deserve to be treated with compassion and respect. 💖