You’ll still need spectacles even if it turns out to be cancer
Survival strategies for living at the edge of madness
(This touches on suicidal ideation and extensively discusses hypochondria, death, dying, and related anxiety. I know how that shit reads just by seeing it all laid out like that, so even though my point is always ultimately disarmingly optimistic with everything I write for the online, there is that to go through to get there, so yeah, if that’s sensitive territory you don’t wish to venture in at this time, you do what you need to do.)
It’s no secret that I live with severe generalised anxiety. What has not been discussed online (until now) is my favourite behavioural poison of choice: hypochondria. There are others, but this one is my special fucking favourite.
Dr. Henry Jekyll
The irony is, I’m never afraid of death, the permanent state. Maybe it’s because of my side dish of depression, maybe it’s because of my personal beliefs (which involve regarding death as a sort of before-birth state, a benign, certain nothing). Maybe it’s both. Case in point being, I’ve always found death itself to be sort of meh. As in, at my best not exactly looking forward to being dead, but meh, has to happen to everyone and everything eventually.
Personally, I believe that once one gets there (dead, the permanent state) one is not actually there to care about being dead. Or about anything else, really, just like I didn’t give a fuck about anything before I was born. Before I was born is not scary, it doesn’t hurt, it isn’t anxious or sad or in any other way really, it just is outside of me. So yeah, sure, the whole will never cuddle cats ever again, will never laugh with my mother over a glass of prosecco, or will never play Sid Meyer’s Civilization: Beyond Earth with my life partner, ever again, is sad, obviously. But once I’m past the edge, actually dead, I won’t per say be there to find that sad. It’s what that is.
However, by contrast, actually getting there, to the being dead part? Damn, that’s scary. It’s not death I fear, as a permanent state, it’s dying I fear, the action verb, the getting to the death part. Now dying, the action verb, is something I’m actually here for, first row seats. The slow diminishing of strength, the inescapable gradual loss of dignity, the suffering it causes to one’s loved ones. Dying, the watch me slowly turn into a carcass until this heart ceases to beat action verb — vs. death, a permanent, emotionless, natural state the universe itself will one day too come to know.
(too graphic? is anyone still here? bear with me for just a tiny bit longer this gets practical soon, pinkie promise.)
This side quest into my personal belief system is to say: my hypochondria is not rooted in my fear of dying; it is rooted in my fear of taking too painstakingly long to do so.
With this said, I am one annoyingly difficult patient to have in your psychiatry practice, since most of my fears are rooted in immutable truths of the human condition (you can’t control how you die unless you kill yourself which is stupid don’t do that because kittens and your mother’s laugh and outdated strategy games or whatever it is you love in life).
Since my anxiety-fuel is rooted so deeply into the immutable truths of life, it’s not as obviously debatable into a healthier life view. I’m sure a lot of people living with anxiety have run into some variation of this problem: over-fretting about shit you can’t change or control, like how long it takes you to die, the action verb, and how decrepit you become on your way there.
Anxiety or depression over immutable truths of life is, in shamelessly borrowing from the words of Andrew Solomon, the maybe instead of that we should focus on what we want to have for breakfast type of mental anguish. As in yeah, sure, true, but fam what in the name of reason, could we like focus on something else, like anything really? (Unless fretting over breakfast is your anxiety thing, in which case, you know, do remember it’s a metaphor, take it as such, you get me.)
This entire immutable-truths-make-me-anxious thing above enables me to be the bearer of some interesting coping strategies.
I’m who you come to for survival strategies when all the traditional arguments fail.
And that’s because, I will debate you to tears of desperation; I’m a cognitive behavioural therapist’s worst nightmare: I’m a fucking philosopher.
That shit is impossibly frustrating to deal with as a therapist, I would imagine. I feel for those who’ve had the pleasure of working with us. I mean me. The both of me.
When I’m on anxiety medication, however, I am fucking invincible.
I’m rational towards being obnoxiously cold, I’m in control of not being in control, I’m in charge of what I can control, and also why is that there that shouldn’t be there please move that to its rightful location no not like that you’re moving it wrong brb I need to repaint the walls in the living-room yes I do know this isn’t even my living-room.
If that sounded like mania to you, that’s precisely what that shit is. It’s what you get when you give medication to an anxiety-crippled egomaniac. Or, at least what I got out of my attempts at medication so far.
I love that person to be perfectly honest. She makes me feel safe. That person is efficient, merciless with herself, a true Klingon warrior.
I hate that clingy, doubt-ridden puddle of requests for validation that I am when under the unbearable weight of my anxiety. I hate her because I know that’s not me. That’s me carrying a blazing trail of heavy mental illness. That’s what’s left of me after anxiety’s had its way with my brain.
It drives me to self-hatred to think that those closest to me, who get to witness most of my breakdowns, probably have me mistaken for that which I become in the company of my anxiety. That’s because my truest of selves doesn’t speak unnecessary bullshit, and therefore I feel isn’t as heard.
But this chain-smoking, condescending, empathy-lacking, anxiety-free maniac that I inevitably eventually become while on the SSRIs I’ve tried so far for medication (as directed and under medical supervision obviously), isn’t sustainable in the long-term, either. Regardless of how much I love her efficiency, I could do without her self-centeredness and her self-destructive obsessions and her incessant fidgeting, and she should definitely not smoke because actually I don’t smoke unless I’m manic, which means I can go for months without lighting a single cigarette but will promptly compensate for it during a single night of mania.
The real me is of course all and none of that at the same time. The real me cries about abandoned kittens, while also being a ride-or-die rational. The real me is at the intersection of those two altered selves, anxious vs. manic, the anxiety-mess vs. the raging-Klingon. I’m on a quest to bring that self out of the brimstone-soaked depths of anxiety, past the valley of manic narcissistic temptation, and into the light of a semblance of normalcy.
In my quest to achieve this, I’ve had to start clean and let go of the assistance of any form of medication for the first time in three years. It’s been annoying, to say the least. I hate this clingy, anxiety-ridden mess, mostly because I know it’s not who I am-am; I know about most all the strategies and techniques and wish I could get her to care about all that and just stop being such a mess. She doesn’t care. She wants to just sit there and have anxiety and cling to people like a starfish. Frankly, I find her quite disgusting, because she fucking knows better. By now, everything a therapist says to me about all of this is shit I already know and wish I could get Miss Anxiety over here to maybe pay attention to.
The handy surviving alone in the woods of your near-insanity guide
With that being said, I know I must learn to accept both sides of myself if I’m ever to move past anxiety’s grip over my life without falling back into manic-powered slow and steady self-destruction. I know that I am, literally, both of the above people. It’s a metaphor meant to convey the extremes anxiety takes one to. So in other words, it’s intense shit, fam.
A lot of anxious people such as myself wrestle with our need for control vs. the innate uncontrollable nature of life and the world. That’s at the philosophical root of a lot of anxiety disorders, and it’s definitely the leading culprit in its BFF, hypochondria. We equate illness with loss of control. We may equate other stuff with loss of control, like weight gain, or lack of order, or whatever the fuck it is we’re choosing to fixate on at the time. We love us some control, people with an anxiety disorder, so uncertainty is The worst thing you could enforce upon an anxious person. As a result, a lot of people living with anxiety have had at least a little bit of dabbing into the fascinating realm of hypochondria.
Paradoxically, it’s our desperate, anxious obsession with control that leads us outside the realm of any self-control. I mean, at my worst, I literally hallucinate that my extremities are turning purple and I’m rotting alive. Delightful stuff, especially during a client meeting.
This isn’t exactly helping much in the way of control, brain. If it’s control you want, being obsessed about becoming ill and incapacitated isn’t the way into gaining control.
Alas, it is brain’s favourite pastime. A tattoo on my back reads You cannot see the future. It’s a reminder that this is but a waste of time, and you’ll deal with it if and when you get there. Printed where I can’t see it, because you cannot see the future, and also because I’m a nerd and I live for bad puns.
Yet I could ignore that reminder no matter how in my face and permanent I’d make it. Everyone living with anxiety knows how easy it is for us to ignore shit we know.
With this long but, as ever, point-serving intro out of the way, I would like to share my strategies for reminding myself of shit I already know, in the face of all of the above, at those times when I’m most tempted to ignore everything I know. Shit that’s literally saved my life that really bad time 4 years ago when I was in a bathtub contemplating suicide as a shortcut (pro-tip: it’s not.). Shit I hope may help someone else who’s in the grips of the struggle.
So, without any further digression, Moody’s strategies for surviving life on the edge of madness:
1. Focus on something that needs doing today, anyway. Aka, live life one disaster at a time.
My lymph nodes started acting out last week, which is anxiety-talk for deafening alarm bells and blinking lights that read CANCER going off in one’s brain. It’s terribly selfish and stupid to be fussing around what could be when there are people out there actively suffering. It feels moronic to dwell on it. Alas, my brain tries forcing me to dwell on it.
Yes, I am aware of the obvious: regardless of what comes my way, I would want to do one thing and one thing alone anyway, and that is to deal with it with dignity and respect for the plethora of greater suffering that is already out there.
It therefore doesn’t even matter what it is or how serious it is (probably not very, if my previous experience with panic is any indication). I would want to deal with a sinus infection the same way I would anything else more serious:
That being said, I am aware there’s obviously no point in worrying about it or in trying to fatalistically predict the future and subsequently trying to plan for that prediction; it’s just what my brain wants to do, it’s not what makes sense. I have to do my best to distract my brain from this fretting around that it wants to do and just wait for the fucking tests results like a reasonable adult.
But brain really, really wants to do the worrying instead. You’d not believe how badly brain wants to do that, even while brain owner is screaming THIS IS POINTLESS at the top of their internal monologue voice.
I thus had an appointment to get them lymph nodes checked yesterday and, since it was a weekend day and the testing only took out a negligible chunk of my Saturday, I thought I’d go out and buy myself a much-needed new pair of spectacles to replace the ones that had broken a good couple of months ago. Perfectly reasonable, right? Get the test out of the way, head to the mall to buy some new lenses, go home, enjoy some Netflix time with the man: a normal fucking Saturday. The results would come in on Tuesday, whether I worry about them in the meantime or not.
Then a voice in my head proclaims the verdict: this could be cancer AND YOU’RE THINKING ABOUT BUYING FUCKING SPECTACLES?! This is the time to panic and endlessly dwell on that possibility, not go around shopping.
At first, it felt like a compelling argument pro going straight home and worrying about it. That legit felt like a good plan, I was ready to pack it up and give in to the anxious brain and go sit in a corner like a nice hypochondriac and google stuff on WebMD when I know I shouldn’t be.
But then, another voice in my head had something to contribute. She was calm, centred, stoic, she had nothing to prove. I knew that voice. That’s me. That’s my authentic self, choking underneath the anxiety I’m currently feeling but still struggling to be heard.
Even if this does turn out to be cancer, you’ll still need spectacles.
Simple as that. No arguing with the anxiety voice, no indulging it in scenarios, no trying to use the behavioural tricks it was having none of. A simple acknowledgement (yes, it could be cancer), followed by an immutable truth grounded in immediate action (you need spectacles anyway).
This took Miss Anxiety by surprise, because for once I didn’t try to argue with her. I didn’t attempt to undermine her dying, the action verb, scenarios or soother her by telling her that we are, in fact, under control. I allowed myself to surrender to the lack of control, while forcing myself to remain grounded in something that needs to be done today regardless of what may come tomorrow.
You can’t postpone buying spectacles today because you might get a cancer diagnosis tomorrow — not just because you might never even get the dreaded diagnosis or because this thought is just anxiety and you shouldn’t oblige it, but more importantly because, even if it is cancer, that shouldn’t stop you from buying spectacles, because then if it did you’d both have cancer AND not have spectacles, and that only makes things worse, doesn’t it?
Should my worst fears come to past, bottom line is, I still need new glasses because I’m walking around halfway like a bloody bat; the cats still need feeding, the laundry still needs doing, this article is still due in for work and not focusing on it won’t cure my hypothetical terminal cancer. In my worst nightmares of control loss and illness, I still, nevertheless, need spectacles — seeing as even the active act of dying would not magically cure my myopia. Might as well focus on what needs to be done now instead, and we’ll deal with the hypothetical terminal cancer later, because it’s not like that’s going anywhere should it be there to begin with.
Tomorrow can wait until I do what needs to be done today.
Should that particular tomorrow ever come though,
2. You’ll deal with it better than you assume you would even if it does happen.
This one came from a brilliant therapist, and that’s my mother. Yes, I have seen other paid therapists who are not my mother throughout my life, yet this is the only memorable advice I’ve gotten that has actually helped my reduce-it-to-undeniable-truths-or-go-home brain once all else fails and it decides to sink into its worst; the usual stuff doesn’t nudge me much at my worst, and if you frustratingly find it doesn’t you either, hear me out over here.
This small but heavy bit of wisdom immediately hit home because, and you’ll notice a pattern here, it doesn’t try to argue with Miss Anxiety. It doesn’t try to undermine her whinny shrieking voice and it isn’t any at all condescending towards her fragile ego. It allows for the remote possibility Miss Anxiety is currently keen on, while refuting the related concerns with a simple, reduce to the undeniable truth strategy: previous experience shows that you deal with hindrances better than you had predicted you would.
You’re right, Miss Anxiety. We could have cancer right the fuck now and we could even be dying (the action verb) right now. But previous experience of imagining vs. actually living through hindrances, shows our predictions about how we’ll be dealing with it, whatever those may be, are wrong.
We cope with shit better than we imagine ourselves coping with shit.
Go on, think about it for a second. Think about something you once feared yet have not managed to escape through the obsessive act of worrying about it. Think about how you thought you’d cope (more so towards this is going to be the end of the world) vs. how you actually did end up coping (more so this is not the end of the world quite yet).
Maybe you went through a difficult breakup/divorce and you know now that there is life after the love of your life, despite your predictions at the time being to the contrary. Maybe you went through unexpected job loss and you now have a better job and life as a result, despite your predictions being that you’d never make it out of the imaginary rock bottom. Or maybe you’ve had the difficult experience of being forced to cope with the illness or death of a loved one and have had to learn to honour their life while not feeling guilty about moving on with your own.
Whatever your experience with hardship, I’m sure most any adult who honestly thinks about it can relate to this very simple truth that my mother brilliantly pointed out: the end of the world only comes around once, and you can deal with that when you come to it. So, for the love of all that is logical:
3. The end of the world only happens once, the rest is just time wasted worrying about the end’s unpredictability.
Eventually, the world will end. Both literally and figuratively.
The universe will, literally, experience its inevitable heat-death and become subject to peaceful, uneventful, eternal, ultimate entropy. And, you know, all that stuff.
So who the fuck am I to expect to live forever. Now that, would be submitting to that egomaniac I was talking about earlier on. No, I will die, too, just like the entirety of the fucking universe will, so it’s no use fucking complaining about it.
Figuratively speaking, my world will end one day, as in that world that is my perception and my feelings and my perception of and feelings towards kittens. But the universe is doing a pretty decent job at stoically carrying on and not complaining about its inevitable death, and it’s the bloody universe, fam, who are you to be offended.
For fellow atheists or for agnostics, I also recommend soothing the existential anxiety with a good dose of a Carl Sagan audio book. No joke. That man is relentlessly optimistic in an inarguable, no-bullshit, focus-on-what-we-know-for-sure kind of way. At my worst, I will fall asleep listening to The Pale Blue Dot as a child would fall asleep listening to a bedtime story. It makes no difference that I’ve read it already, just like it made no difference that I knew the bedtime story as a child.
The Carl Sagan bedtime ritual actually started as a kind, incredibly touching gesture on my life partner’s part: he brought out his laptop one rough night of anxiety and played that audiobook, in knowing it was a favourite. Simply, without saying a word, as naturally as you would play a bedtime story to a child. And it worked. My brain was sucked into the hypnotic spell of cosmology and related philosophy, and I fell asleep, after hours of exhausting anxiety.
Carl Sagan’s optimistic yet profoundly scientific nature continues to work for me, because it makes me feel reassured of my natural place in the inevitable order of things, and in doing so helps me feel connected to something greater than myself. (Fun fact, atheists do believe in something, sort of, just not a deity, but rather a natural undeniable order of things, aka shit we know about how the universe works is often our equivalent for believing in something greater than ourselves, and believe you me, even in my modest understanding of it, that stuff is vast and greater than we all are indeed.)
If you don’t vibe with that, focus on whatever you do vibe with that reminds you there is an order larger than yourself at play. This is a recurring thing with many belief systems. And that’s the gist of my recommended strategy for accepting death, the permanent state not the action verb: get outside your head and connect to the notion that it’s part of the natural order of things; it’s only your ego that’s trying to lay claim to an immortality not even the universe itself possesses.
It’s also your ego going crazy trying to control how you get there.
I recommend this strategy should a focus on your belief in the afterlife fail to nudge that stubborn existential anxiety, and I say this for a simple non-offensive reason: nobody has come back from being dead, the permanent state, to account for what that’s really specifically like; it’s uncertain by definition, even if your preferred theory about it is a vital part of your definition of self — and non-specific and anxiety, well, they are that co-dependant couple everyone at the party wishes would just end it already. You can feel sure of what happens, but since your brain still doesn’t know the specifics, anxiety still might find it too uncertain for its tastes.
Regardless of how much you believe in something, it might not cut it, in and of itself, when it comes to satisfying your anxiety; your anxiety thrives on uncertainty, but falls quiet in the face of basic, undeniable facts of life. Basic, undeniable facts of life, like everything and everyone ends up dead, it’s okay, it’s fine, we needn’t be egocentric about it.
Whether you believe what comes after this life over here is silence or a chorus of angles, the end of the world that is death still happens to everyone and everything, so might as well be chill about it and try to live our kindest, most fulfilling life possible in the meantime.
Most importantly, that shit only happens once. You only actually become dead that one time. The rest is just pointless fretting around brought on by anxiety.
Yes, it sucks, because you have no idea when that one time is going to be and what that’s going to be like getting there (hence the siren song of a suicide ‘within your control’, which, pro-tip, NO already.). But that end of the world only happens once, and the rest of your time is wasted on worrying about various possible scenarios, none of which will actually come to be your actual journey to inexorable death, and all of which are going to be time spent pointlessly planning a death that will ultimately take you by surprise anyway.
The comparison might feel cynical, but it’s just like trying to plan a breakup or a pregnancy. That shit never works out as planned. You spent the mental equivalent of about 1000 years fretting around about the talk or the birth-plan and the what-not and when it’s going to be and what you’d say and how that’s going to play out like, and then come time to actually be going through it, it’s nothing like that anyway.
Loosely planning for it and then moving on with your life is what I recommend instead, in both life and death. Like sure, have a basic plan for it with the baseline formalities laid out best you can, but then fucking move on and live your life until you get there, and take it all one disaster at a time.
Sleeping in your new-age birthing pool just in case contractions kick overnight isn’t going to save you from giving birth in that Uber assisted by a random doctor who isn’t even an OB-gyn happening by on his way from the baker’s, because life is messy and unpredictable and baby comes when baby comes and not when you’re ready-ready. Which is to say, you can’t plan to the letter for the basics of life because they’re unpredictable and largely outside your need for control. Might as well resign to the impossibility of doing so and live your life as best you can.
Do these 3 steps above always work? No. Do I get anxiety anyway? Yes. But I do feel like I’m better prepared if I’ve got my go-to coping strategies. They’re what I fall back on, so I don’t have to think about what I need to be doing when the worst of the anxiety sets in. And that’s a combination of those 3 coping strategies above, plus the following vital bit I wish someone had tried harder to tell me about earlier even if it didn’t fit into their neat bullet plan of magic internet numbers:
4. You have to fake it sometimes. And that’s okay, it doesn’t make you a poser, it’s normal, it’s fine.
You will fall off the wagon and indulge the fretting or the obsessing or the binging in front of the Netflix of the empty calories followed by a subsequent bout of self-punishment, or whatever your behavioural poison of choice.
You will do all the things even though you know exactly why you’re doing them, why you should stop, and what you should be doing to stop. It’s no longer a mystery diagnosis worthy of the psychiatric field equivalent of House Md. It’s quite fucking crystal-clear and you feel the self-hate thing I touched on above for allowing yourself to fall back into it anyway.
The success stories, they all stop just shy of telling you this shit loud enough, so it actually drives home:
Live long enough through mental illness, and you. Will. Relapse. You will relapse in your behaviours and your mental illness, during your journey with healing or finding balance or whatever it is you’re aiming for. It’s just statistics, you most likely will, nearly everyone does, assume you will, too. Because that allows you to proceed from a place of self-benevolence. And you’re going to find self-benevolence extremely fucking useful indeed.
Even though each relapse into your self-destructive behaviours gets easier, it’s still hard. You’ll still need to fake it, some days.
Self-benevolence is useful for when you have to fake it:
You’re having the Bad Day. Usually, you know straight up it’s going to be a bad one.
You wake up and you feel it already creeping on you, the betrayal of the brain at the hands of its own self, as if Mr. Hyde went completely irrational and tried to kill Dr. Jekyll despite knowing that would imply his own suicide and even though it’s technically the Dr. who created him.
That’s when you have to allow yourself to fake it.
Really, it’s fine. Everyone does it sometimes. Wish I knew this 10 years ago, but I tell you, everyone’s faking it all around the room. Don’t feel bad about it. Drag yourself out of bed and pretend. If you can’t, play-pretend in your head until you build up the strength to get out of bed and do so. Stay with it. Don’t give in to the anxiety, especially when you feel like you’re failing at not giving in to the anxiety. You’ve got this. Intent is enough to keep you afloat.
You’re feeling stranded amidst an ocean of anxiety, and doubt is trying to drag you towards the depths of the ocean, but you’ve just got to keep afloat, you don’t always have to be straight-up swimming for the shore.
Sometimes it’s okay to just lie there on your back and float, catch your breath, get back into the game once you’ve regrouped a little.
Because yes, it does feel like that shoreline is moving away from you as you attempt to move towards it and it’s like you’re chasing the horizon, but I assure you, you are indeed moving forward. You can only tell retrospectively, so don’t fuss.
Just pretend, just a little bit. Stay with it, one disaster at a time.
Maybe death and dying and all that can wait, and we don’t have to think about that just right this minute. Maybe we can do the laundry now because it needs doing. Or maybe we can go and buy spectacles, because if you do need them to see where you’re going, you’re going to need them wherever you’re going.
Well my friends, this has been pretty raw. I hope it’s helped someone out there better understand or deal with their own anxiety, or at the very least I hope it’s helped you find a new understanding and compassion towards that anxious person in your life. Even if they’re at their worst, being all clingy like a starfish, or at their manic, ordering you around like a failed movie director. Especially then.
We’re really trying over here, and we will get better.
As ever, whatever your motivation for getting through this tl;dr, thank you for taking the time to debate with me.
Until out next talk, stay safe, nerds.