More than their diagnosis

Misty Ronau said she didn’t use the word anxious, but instead defined herself as high functioning and productive.

SOUTHERN INDIANA — For most Americans, stress is a manageable inconvenience. When agitation confronts them, the body and mind respond accordingly and then return back to their restful state.

Not for Brie Lancaster. Like many living with generalized anxiety disorder, or GAD, the Providence graduate stays constantly alert. If a situation provokes a stress response, her body, already primed for action, reacts as if it’s a life-or-death situation.

“I’ve used that kind of illustration when I’m trying to explain to somebody without anxiety. Here’s where you live all the time, on the bottom line. And then when you get stressed out, you move up to like this middle line,” Brie said. “I live on that middle line. If something stressful happens to me, I shoot up and my brain thinks my life is in danger. I live where you are when you feel like you’re completely stressed out.”

According to the National Institute of Mental Health, an estimated 5.7 percent of Americans experience GAD at some point in their lives. While others exist, a main symptom of the disorder involves difficulty in controlling excessive worrying for more than six months.

“Anxiety is worry and dread and fear that is constant, persistent and pervasive,” said Karen Bassett, a LCSW and mental health therapist for a local private practice group. “And you may find that it’s hard to get the things you need done at work or in school because you’ve got these worries persistently, constantly on your mind. You may not sleep well or you may wake a lot or you may notice that you’re really tense all the time.”

Concentration, emotional regulation and focus may also be affected.

“It’s not just, oh gosh, I’m worried because this specific thing might happen. With generalized anxiety disorder, you can be worried about all kinds of things,” Karen said. “It may be 15 different things that you’re worried about.”

The breakthroughs of Brie

Before attending her daughter’s high school graduation, Brie needed a plan. Freedom Hall, the venue that hosted the ceremony, would be packed.

That made Brie nervous.

GAD doesn’t just affect your mental state but your physical wellbeing as well. When panic begins, Brie’s body responds. She may become nauseous, so much so that she throws up. Dizziness, tunnel vision, heart palpitations and hyperventilation also may occur. At times, she has passed out.

“It’s kind of a Catch-22. When I know I’m going to panic, I’m more likely to panic,” the 46-year-old said. “The more I start feeling nauseous, then I will completely focus on that because obviously I don’t want to throw up. But then that’s all I can think about. And then the panic cycle starts, and it just gets worse and worse and worse until eventually I’ll have to get myself out of that situation. But at the same time, knowing that I have an out, sometimes will prevent me from panicking.”

Brie made it through her daughter’s ceremony by studying the schematics of Freedom Hall, picking a place to sit in advance and identifying exits in case her anxiety began to swell. Preparation goes a long way.

While Brie knew in childhood something was different about her reactions, doctors could never give her or her parents a diagnosis. Only when her mother-in-law, a psychologist, noticed her responses in her early 20s did Brie understand what had been happening.

“I had no idea there was even a name for it,” she said. “It was a relief because I’m like okay I’m not crazy, and I’m not having a stroke. And I’m not having a heart attack. It was a long road of seeing doctors before I figured out what was really wrong.”

And while talking with a therapist helped ease her symptoms, a therapy called Eye Movement Desensitization and Reprocessing (EMDR) brought her the biggest relief. After completing six sessions more than a decade ago, she still feels its power.

“I’m always going to have the anxiety. It’s always going to be there, and I’ve accepted that,” Brie said. “But I was able to go do things again. I could go out to eat. I could go on vacation. You know, normal things.”

Not everyone comprehends the difficulties of living with GAD. When anxiety flares, dates with loved ones or planned appointments might need to be cancelled until a sense of wellbeing can be regained. Friendships may vanish. Brie has experienced all of this.

But she said talking to folks who also experience extreme anxiety, as well as consulting your doctor, provide support.

“There is help out there,” Brie said. “After I started talking about my anxiety, I lost friends. But I also found out some of my friends had really bad anxiety, too. I had no idea before, and it was like okay, I’m not alone. I’m not a freak. Other people have this. And there’s a way to deal with it.”

Mike’s new mellow

Mike Mudd, Sr. used to get mad.

Alongside worry and social isolation, anxiety also manifests this way. Irritations can turn to anger that can be difficult to control.

“My counselor described it as a pot of boiling water with a top on it. When you pulled the top off it would come out all at once,” the 71-year-old said. “I reach the point where it’s going to come out verbally. My problem is that when I get to that point, I don’t care what I say to who it is.”

Growing up in a traditional blue-collar neighborhood in the 1950s, Mike could have been described as having “ants in his pants”. He believes now he may have had Attention-Deficit/Hyperactivity Disorder, but few options were available to those with mental health issues when he was a kid. Mostly, he was told to suck it up.

“I just learned to deal with it because nobody was going to understand anyway,” the Clarksville resident said. “And we had nothing back then, so I took it as far as I could and then I just couldn’t deal with it anymore.”

When his repeated outbursts began to increase in severity, Mike decided to see a therapist. At 66, he began treatment that includes prescribed medication for his diagnosis of GAD. In addition, Mike also experiences depression, which he believes was brought on from his brother’s suicide.

At times, both present together, making life even more challenging.

“Sometimes when you have anxiety and depression together, it can be a real downer. They’re pushing and beating and banging against each other,” Mike said. “I’m happy that I’ve got as far as I have.”

Helping others through tough times helps Mike with his. As a Navy vet, he looks to assist others who have served by creating a local faith-based veteran’s club. He also volunteers through his church with those who are homeless.

And, using his own experiences, Mike recommends that others going through mental health issues find a counselor so they might learn to deal with their issues in a more productive way. For him, that’s journaling and recognizing the triggers that lead to problematic responses.

“I sometimes will let myself put stuff out there on Facebook. Not very often, but sometimes,” he said. “It’s reassuring to hear people talk and people understand it more. They don’t have a choice anymore because it’s gotten so prevalent out there and I think people have to take it up.”

Misty’s mindfulness

Time has allowed Misty Ronau to see the progression of her anxiety disorder.

Now, at 42, she can look back. As a child, she worried deep into the night about how one day her two healthy parents would succumb to death. Then, as a young adult, when folks might consider her high strung instead of truly understanding the reasons behind her apprehensions.

After graduating college and starting a job in social work, her doctor asked if she’d discussed having an anxiety disorder with a medical professional. That was a turning point.

“I would never use the word ‘anxious’. I was always high functioning and productive. And now I know it was probably more of out of urgency or perseverance, but that’s just how I was,” the Floyd County resident said. “It’s been different throughout my life.”

Her anxiety, though, has most always resulted in insomnia. While better now, Misty’s thoughts still can push their way through, preventing her from sleep. It could be overthinking the way she phrased a joke to a friend, or a conversation that might have been interpreted in a way she hadn’t intended. The mind fixates on notions or events and keeps replaying them again and again like a record player needle stuck in a groove.

Maintaining order also remained important in calming Misty. Clutter was a nuisance. A medical emergency brought on by an illness six years ago, though, brought some perspective into her life.

“Let me tell you, there’s nothing like being in a four day medically induced coma to remind you that there is only so much in your day that you can control,” Misty said.

Mindfulness techniques, stepping away from anxiety inducing situations and exercise also help quiet her mind. In fact, anxiety, she said, has benefitted her in numerous ways. For instance, planning for different outcomes to projects makes her a good crisis mitigator. A natural aversion to small talk allows her to have more meaningful conversations.

And, as the development and communications manager for Youth Link Southern Indiana, Misty uses these experiences to help local kids access mental health services.

“Being willing to have these conversations is the single most important way that we can affect those barriers and stigma about mental health,” she said. “And that’s how we increase access to support and treatment, getting people whole and equipped with the tools that they need to live to their potential.”

The therapist’s thoughts

Karen, our mental health therapist, recommends seeing your general practitioner if you experience the symptoms described above. You may also want to phone your insurance company to find a list of mental health providers and see if prior authorization is needed to secure an appointment.

And while cognitive behavioral therapy techniques such as identifying bodily tension and thought patterns can help ease the impact of GAD, Karen doesn’t discount the power of medication for those who require it.

“I’ve had people that came in and did the hard work of therapy and it just wasn’t enough,” the Floyd County resident said. “If your brain is wired in such a way that talk therapy is not enough, and you need medication, there’s no shame in that. Treating your mental health and focusing on what you need to be a healthy person, that’s not a shameful thing and I hope more people can do that.”

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