But I don’t have the drugs to sort
I don’t have the drugs to sort it out
Sort it out

“Afraid of Everyone,” The National

For as long as I can remember, I have been at war with my own body. There have been dramatic battles—being diagnosed with scoliosis the summer before I started ninth grade in 1976, my collapse into debilitating panic attacks in October of 1999—but mostly that tension is pervasive, continuous—an anxiety cocktail of somewhat manageable OCD, ADHD, hypochondria, and depression.

The manageable has been orchestrated behind a dedicated stoic front that hides the main feature of anxiety, the relentless mind manufacturing and obsessing on an infinite list of what-ifs.

These self-imposed terrors are fruitless except for the drain and wear on my mind and body. Like the what-ifs on loop in my thoughts, the war with my body seems to insure that my body is always finding ways to let me down, especially a rotating list of chronic pain.

In South Carolina, where I live, we are shifting quicker than many states back toward some sort of normal after a couple of months of sheltering at home because of the Covid-19 pandemic.

The pandemic has been a paradox for me and my anxiety. Anxiety is mostly wrestling with unfounded threats, being afraid of everything for no rational reason.

Fearing a very real pandemic is rational, but in SC, I have been positioned as irrational for taking Covid-19 seriously since many in the state are following a partisan political playbook filled with YouTube videos and outlandish conspiracy theories.

My social media are filled with fellow South Carolinians, many of whom are conservative (which dominates the state), but the pandemic has made that norm of my relationship with my home town and community nearly impossible to manage.

I have moved from my normal of living an anxious (but masked by stoicism) life to struggling with the rational anxiety caused by the pandemic and now to a new sort of anxiety about efforts to return to some sort of normal existence.

During the shut down, I have greatly missed group cycling and visiting my favorite restaurants, breweries, and tap houses. Losing that normal has been exhausting to my mind and, of course, my body.

As SC has relaxed restrictions, however, watching my downtown begin to re-emerge has led to a new set of fears. First, the town closed off Main Street to allow outdoor seating for local restaurants.

Other than once-a-week trips to the grocery store, I haven’t been in any sort of crowds. People swarmed downtown once outdoor dining was allowed, and these crowds are deeply nerve wracking for me.

A normal rendered abnormal in a matter of a couple of months.

Many people are speculating about a new normal once we all return to daily life with Covid-19. No one really knows what this new normal will be.

But some believe we all will change, that life will inevitably be different.

When I look around while people return to visiting restaurants and stores, I see something different than things being different; most people have slipped right back into the normal they were missing.

As if there is no Covid-19, as if we haven’t sheltered for two months, as if we aren’t reigniting a bigger fire that could possibly rage out of control.

It is spring in the South, beautiful sunshine and warm-to-hot days. We are racing mindlessly into that hope we feel each spring, determined to ignore that this is not like any spring before for any of us.

I am afraid, the same as always, and a new afraid.

I also recognize something unexpected. My conservative home has something in common with me; these recalcitrant South Carolinians are afraid of the unknown, clamoring to regain normal just because it is known, not because it is better or even good.

The paradox of the South is a people willing to risk everything because they are risk-averse, afraid of the unknown.

Anxiety is a sort of paralysis. My current Scylla and Charybdis is either continuing to shelter, resist the reopening, or to slowly wade back into the seemingly comfortable and certainly familiar pool of the life I have desperately missed, even as I frantically treaded those waters simply trying to keep my head above water.

Either way, I will be afraid, the same as always and a new afraid I never imagined in all my fruitless pondering of what-ifs.

A few days ago, I noticed the back-up stack of toilet paper was low. I paused, thinking about the urgency to go buy more toilet paper. I have never been one to let anything run out, and I tend to buy double of things I use often anyway.

But these are not ordinary times, and in one of the oddest twists of irrational panicking, many people across the U.S. have begun hoarding toilet paper in response to the possible COVID-19 pandemic.

A toilet paper panic seems to have happened first in Japan, also fearing COVID-19, but in that case, the toilet paper mania was spurred by fake news that Japan depended on toilet paper from China.

As a life-long resident of the Upstate of South Carolina, I am well-versed in irrational grocery store panicking; if the weather forecast even hints at cold rain, much less snow, ice, and sleet, the bread and milk shelves are almost instantly barren. I am still not certain why the Southern brain is wired to hoard bread and milk in case we have frozen precipitation (which almost never disrupts travel for more than a day or two any way).

No one seems to understand the toilet paper panic over COVID-19 in the U.S. either, but this is quite a real thing.

So I have been more than once lately temporarily paralyzed over taking normal and even rational measures that balance my normal life with preparing for self- or imposed quarantine—or even, dare I say it?, the zombie apocalypse.

There is a motif running through the film Zombieland in which a main character, Columbus (Jesse Eisenberg), meticulously explains to the audience that people who are anxious were those most well equipped for the zombie apocalypse. In an odd and ugly twist of fate, life-long practice with expecting impending doom prepares one well to survive that doom once impended.

Anxiety is mostly irrational hyper-focusing on the what ifs that virtually never happen. Like hypochondria.

However, tediously working through every worst-case scenario and being hyper-aware of everything (I mean every thing) can be extremely helpful when the worst-case comes to pass.

So I noticed a few more rolls of toilet paper in the bathroom cabinet, deciding not to further stress the system by going to the store. I have more recently bought just a few frozen dinners on the off-chance of quarantine, or COVID-19 mutating into a zombie superbug.

But the larger issue for me has been watching as my anxiety world has expanded into virtually everyone’s life. COVID-19 is something new, unknown, and unlike flu (itself very dangerous but something expected and thus known), it puts us all in an uncomfortable position between over-reacting and under-reacting.

Anxiety, the pervasive and mostly irrational kind, is about not knowing and having little or no power.

For women, there is the pervasive anxiety over physical vulnerability when walking through a dark and secluded parking lot. Being assaulted may be incredibly rare, but the possibility is there.

But clinical anxiety is far less rational or reasonable. I became sick several days ago just as my spring break began. I loathe being sick, but I also immediately thought “What if I have COVID-19?”

That was my clinical anxiety since there are almost no rational reasons for that question except some sort of proximity: I exist in a time when COVID-19 is spreading.

We anxious function in worst-case thinking. That is exhausting, mostly unproductive, and nearly always futile.

COVID-19 has thrust almost everyone into that world where not knowing and a lack of control overshadow functioning in rational and reasonable ways.

This is made even more complicated by the paradox of empirical evidence. If everyone is proactive and the COVID-19 pandemic is averted, then some will see the lack of a pandemic as evidence the proactive measures weren’t needed.

That is the perpetual life of the anxious; dozens of worst-case scenarios fretted over daily until the horrible thing hasn’t happened, or is replaced by a newer worst-case scenario.

Or some simply recycle—every minor illness or pain becomes the worst possible disease, until it isn’t.

I am also constantly policing myself to be reasonable, to give myself a break. The COVID-19 panicking makes me another level of anxious, about wanting to help and soothe those hoarding toilet paper as well as hand sanitizer and soap.

But just as it is very Southern (and ridiculous) to hoard bread and milk in winter weather, it is self-defeating to hoard those things that everyone needs to stem the possibility of COVID-19 becoming an unmanageable pandemic.

Everyone needs soap and cleaning items. Health care providers need the masks and rubber gloves.

Hoarding by a few puts all of us at greater risk.

Just as I think I am my worst self when I am in the throes of anxiety, I am watching COVID-19 spur the very worst of being an American—the got-mine urge of too many of us.

I also am seeing beyond me the very real and negative consequences of being irrational even as I understand the powerful tug of those irrational responses.

There are many of us in the clutches of anxiety and OCD who look at the alarm clock or stove with the nearly irresistible urge to turn them off perpetually. We lock the car door with the remote 19 times, and then once more, and then fret about walking back to the car to check again 15 minutes later.

The possibilities, not knowing, and not having control. These are real monsters and they aren’t lurking under the bed.

I am not certain of the claims made by Columbus, that we anxious are somehow better equipped for apocalypse.

But I am well aware of how the COVID-19 question has sparked a large-scale reaction that I recognize, have a great deal of empathy for.

I have absolutely no idea how dangerous this health event is. I do know I worry about my safety and the safety of loved ones and friends—although those worries are pervasive with or without COVID-19.

As I watch the range from over-reacting to under-reacting, I do know that I do not wish my internal world on anyone.

If you are exhausted by this new COVID-19 anxiety, by not knowing, by not really having any control, you now know my world, one I have yet to find any vacation from.

Sorry.

The last time I acquiesced to boarding a plane to travel was 2007, a series of flying adventures all compressed into November of that year. I had only flown once before, and have avoided flying since 2007, resulting in quite a few long-distance drives as well as passing on several opportunities I genuinely should have taken.

At the core of all this, better framed as at the marrow, is my anxiety, which is best served by retreat, avoidance, and clinging frantically to the stasis of the known. I find new experiences nearly unbearable.

As friends have come to know, even when I do travel somewhere new, my greatest pleasure is to return over and over to the same bar or restaurant while I am away, creating a temporary stasis for my anxious self.

But there is another anxiety, another newness that is inevitable until it isn’t—aging. Each moment as a human is new; we can never know what it is like to be the next moment older, and then the next year or decade older.

Simply living, the anxious know, is a terror train (or plane) adventure.

As ridiculous as number anxiety is, I am terrified by the approaching reality of 60, just a bit over a year away. Some of that anxiety is driving me to re-evaluate my urge toward stasis so I accepted recently an offer to travel to Vermont. To a ski resort town.

Since others have asked when talking to me about the trip, I do not ski, and as noted above, tend not to fly.

I can only do so much new; therefore, I accepted the flight, but did not ski. While the rest of the group did ski a couple days, I created for myself a writing retreat instead.

Dealing with anxiety in a public way, among friends and acquaintances, is its own kind of particular hell. So making my trip somewhat public on social media stirred up the usual exhausting discussions about flying.

I am not “afraid” of flying (I know it is far safer than driving), and I cannot take meds, drink a lot, or somehow sedate myself for the flight to ease the anxiety. The anxiety around flying is about the entire experience from start to finish.

As I have tried to explain, my anxiety starts the moment I know about the entire trip and doesn’t end until the trip does. There is no making it better, there is no reprieve during the trip.

Yet, I must field the same questions over and over from people I like and even love.

It is none the less exhausting itself and part of the formula that drives me wanting simply not to do new things or the things, like flying, that I know make me miserable.

But I discovered an interesting irony to this new, this trying something unenjoyable again. My anxiety around flying is a very specific experience within a much larger set of triggers—sound and claustrophobia.

Trying to talk through flying anxiety again, I spontaneously said that I feel the same way flying that I do in department meetings (or any formal setting), the urge to simply run away, to find that stasis of anywhere else as long as there is space and silence.

Dozens of ways in my day-to-day life include feeling trapped, and thus becoming anxious, that are not much different from flying, although planes are incredibly small spaces that force me into compact social spaces with strangers and suffering loud and abrupt noises in ways that are extreme when compared to my normal life.

People focus on the “flying” and have trouble hearing me about the anxiety. (I am not mad about this, but it is exhausting.)

But the trip also included a whole new experience that seems related to my anxiety as well as my being an introvert and my dislike for coercion (me coercing others and others coercing me).

When I posted images of the ski resort on my social media with a snarky “No thank you” an odd thing happened.

I received a number of repeated demands from friends and acquaintances, chastising me for being at a ski resort and writing instead of skiing.

Of course, I have had this experience before whereby people impose onto others how those others should enjoy the world, but this was another experience with the sorts of stress that come with being anxious. I have no desire for other people to do or enjoy anything because I do, and I take no offense when people do not do or enjoy the things I do.

I truly find it puzzling that most people, it seems, are not only certain others will and should enjoy what they do, but that they must, or it is some sort of judgment passed down on who they are.

I despise the cold and snow so I have every reason to trust that I do not want to ski, even though I have never skied. As I walked around the ski resort, I was further assured of that; the inordinate amount of clothing and gear reminded me of the claustrophobia I endured to get to this damned place.

But there were hundreds of people there, gleefully; and the people I traveled with were also thrilled with the experiences despite the cold and even rain. I seems likely skiing is an enjoyable thing for some people, and I am happy for them.

But not for me.

I do know what I enjoy, and what I do not enjoy. I know myself, in fact, very well, but I do not yet know me of the next moment, the next year, the next decade.

That makes me anxious but I have no urge to flee that reality. I want it quite deeply, and it is there I recognize the seeds of anxiety.

I also care too much. And it is in the caring that we also find our suffering.

Here’s to caring, and to suffering. If that’s not your thing, I am fine with that also.

In retrospect, that I gravitated toward and then chose recreational cycling as one of the primary avocations of my adult life isn’t really that surprising because I have been trafficking in pain my entire life.

To be a cyclist is to manage pain; to be an elite cyclist is to embrace, even scoff at, pain.

Although I did not make the association for the vast majority of my life, I have been navigating chronic pain and anxiety since my earliest memories as a child.

About 20 years ago, I was forced to admit my clinical anxiety, and depression. But the chronic pelvic pain that the anxiety has cultivated for all of my life has never been adequately addressed—mostly because the medical community has failed me.

I am currently rededicating myself to self-care, to addressing my anxiety and chronic pain. Part of that has been in recent years trying to manage on my own what has been identified by Wise and Anderson (and others) as pelvic pain commonly, and in my case, misdiagnosed as prostatitis (singularly as an infection requiring antibiotics).

As part of my journey, I have discovered that the awareness of anxiety and pelvic pain has greatly expanded in recent years, Wise and Anderson publishing a definitive volume of their work as well as many sufferers now sharing their stories and self-care online.

One set of videos (see this one as an entry point), in fact, includes comments from sufferers, mostly men and many in their 20s, that nearly pushed me to tears; their stories are my story repeated over and over, filled with pain, depression, and hopelessness—and embarrassment.

In my 20s, newly married and starting a life that included plans to have a child, I experienced groin pain one day while sitting in the barber shop. The pain was acute and triggered my anxiousness, my tendency toward hypochondria.

This pain led me to my family doctor, and then a urologist.

For several years, after being diagnosed with prostatitis, I regularly visited that urologist and experienced the same pattern of debilitating pain associated with my lower back, groin and pelvis, and all of my bodily functions (including sexual discomfort).

Each visit to the urologist also followed the same pattern: The urologist would acknowledge my pain and symptoms, admit that the repeated screenings revealed no sign of infection in my prostate, explain (again and again) that prostatitis often is hard to diagnose or treat because the infection routinely cannot be identified, and then prescribe (again and again) extended doses of antibiotics, which never impacted the pain or symptoms in any way but had side effects.

Finally, as I approached my late 20s, I discussed this futility with the urologist, and we decided that simply living with the pain posed no real threat to me since he could never find any real sign of infection. So I simply quit going to the urologist and suffered [1].

Silently.

Closeted in pain that was embarrassing because it impacted necessary bodily functions and cloaked my ability to have normal sexual pleasure.

It would be a decade before I realized I had clinical anxiety, panic attacks, and depression, but it was a couple decades before I discovered the work of Dr. David Wise, who had come to treat his own pelvic pain.

The work and book published by Wise and Dr. Rodney Anderson are a damning indictment of the medical profession, seemingly blinded by assumptions about disease (a physical phenomenon) and treatment (bound by pharmaceutical constraints) [2].

Anxiety, in fact, creates a wide range of pelvic pain that has been misdiagnosed and treated incorrectly for decades (see Symptoms & Treatments links, for example).

Since the Wise/Anderson diagnosis and treatments are rare in the field of urology and even within mental health treatment and physical therapy (I have brought the information to a PT, in fact, who had never heard of the condition or the treatments), however, being aware of my conditions and the relationship between anxiety and chronic pain has not really led to any sort of better quality of life.

To my resignation in my late 20s I have simply added some new knowledge.

Wise/Anderson practice on the West coast and require an extended and expensive commitment of time (and probably will not be covered by traditional insurance).

This tiny ray of hope has turned, for me, always into yet more depression and greater fatalism.

A doubling and tripling down on what I know best—leaning into and living with and through chronic pain, and the concurrent embarrassment.

Being skeptical by nature, and prone to cynicism, I must admit that discovering the 2018 edition of the Wise/Anderson book and what seems to be a growing online community of sufferers, many who are having success with self-care, has spurred a new sense of hope.

I have modified the stretching routine one PT developed for me by looking at the Wise/Anderson book, added new stretching and trigger point massages based on the online videos by sufferers who also have been inspired by Wise/Anderson’s work, and begun to think more intentionally about how to move beyond the chronic pain instead of simply embracing and suffering with it.

Chronic pelvic pain and anxiety are evil twins because they create and are fed by the fretting and embarrassment that they foster in those of us prone to anxiety.

But having mental and physical conditions recognized and treatable only outside mainstream medicine is a really cruel reality.

I watch and hear, for example, dozens of commercials for anxiety/depression medications, ED medications, and the never-ending promises of herbal solutions to prostate dysfunction.

For me, and many others I have discovered online, these are all tremendous wastes of time and money.

Since anxiety/depression, sexual dysfunction, and prostatitis are big money for the pharmaceutical and medical professions, those of us outside this mainstream approach are left in our closet of pain while grey-haired but smiling men on TV lounge in bath tubs outdoors beside their not-so-subtly younger women partners lounging beside them in their bath tubs, hands joined for the TV audience being promised sexual paradise in a pill.

So I am left here in middle age, a small ray of hope sitting beside some anger, anger I will need to work through as I seek ways to move beyond anxiety and chronic pain instead of resigning myself to this as my life as I did in my 20s.

[1] See this blog post:

Added to an individual’s anxiety is the puzzlement of the doctors. The doctor is often frustrated about his inability to help the problem and is not infrequently worried that perhaps he has missed something. Doctors are problem solvers. As we have discussed in our book and other essays, certain doctors do not respond well to their own helplessness to solve the problem of chronic pelvic pain syndromes. Any anxiety, uncertainty or helplessness felt by the doctor is almost always communicated to the patient – a communication whose impact can be overwhelmingly upsetting to the patient.

[2] See this blog post:

Unfortunately, the historical treatment of pelvic pain has almost entirely been a misdirected physical treatment of the organs of the pelvis such as the prostate or bladder. Indeed, the conventional medical establishment unfortunately continues to place most of the blame for pelvic pain on the pelvic organs, and attempts to throw various pharmaceuticals at the condition, including antibiotics, anti-inflammatories, botox, and other classes of medications, as well as procedures such as nerve blocks and even surgery, all of which have had, at best, mixed results. And, when physical therapy for the pelvic muscles is prescribed, it is almost always prescribed alone, that is, with no accompanying psychological/cognitive support, relaxation training, or self-treatment training.

I’d rather walk all the way home right now than to spend one more second in this place
I’m exactly like you Valentine, just come outside and leave with me

“The Day I Die,” The National

In November 2007, I flew to Iowa from South Carolina for some work I did with ACT and then a couple weeks later to New York City for the annual NCTE convention.

I had flown only once before that, the first time at 42 for the NCTE convention in San Francisco.

My particular fear of flying is a subset of my life-long battle with anxiety—mine a pervasive anxiety that is very difficult to explain to other people, even those also suffering from situational anxiety because anxiety is not a simple or singular monster.

My trip to Iowa in 2007 and San Francisco in 2003 were alone, but the flights to NYC were with my then-colleague and dear friend Nita.

Because our university allows an unrealistically low allowance for housing on trips, Nita and I booked our flight and hotel together to save money, and since Nita knew I was a less-than eager traveller (and flyer), she was convinced she could make the trip better for me.

However, when we returned to SC, Nita admitted she had not fully understood my problems with traveling and flying, that she had a much greater appreciation for the hell that those are for me—even when I have compassionate traveling companions.

Having just returned from a summer trip for cycling to Fayetteville, Arkansas, prompted by two good friends who are professors at the University of Arkansas, I have had once again to confront the burden that my anxiety is for me and others when I travel (even by car on this particular trip).

As I have written about before, my “I don’t fly” plea is always rebutted with some very brief explanation that I just need some meds or a few drinks on the flight; in other words, the vast majority of people (even those who do not like to fly) just brush aside my very real obstacles with many activities grounded in my pervasive anxiety.

My panic attacks in October of 1999 were the first manifestations of my anxiety that were immediately debilitating. I have lived with anxiety and suffered under the weight of anxiety my entire life, but mostly, I was never really aware that I had a condition since it just seemed normal, what it means to be a human.

Flying, or not flying actually, is a really good example of what virtually everything I do in my life means in terms of navigating anxiety.

To admit I do not fly, or do not want to fly for a trip, is not about the flight itself. If I were just afraid of the flight, then, yes, meds or a few drinks would do the job and I probably would have already flown dozens of places.

My anxiety is about hyperawareness and the inability to manage the burden of the unknown, a series of new experiences.

If I booked a flight today for a trip to France in November, my entire life would then be consumed (off and on) by the uncertainty of that trip. The result is that I could not enjoy my life leading up to the initial flight, I would not enjoy the flight, and then I would not enjoy the trip itself because I would be fretting over the return trip.

That’s why—and friends are well aware of this—my weekly life is one of predictable patterns that include scheduled bicycle rides and nearly an unbroken routine of restaurants each week.

I cringe at “Let’s do this new thing!” in a way that I really am not sure most people can grasp.

Just as another example, when I returned to mountain biking about two years ago, I had a few really bad experiences with group rides that required me to walk across rocks in streams.

These always went badly because the moving water and precariousness of the crossing (carrying a heavy MTB and being a somewhat less stable 50+-year-old), I discovered, triggered my anxiety (I knew the crossings were coming up, so once again, I could never enjoy any of the cycling because of the need to cross the streams, usually twice).

Similar to the lack of understanding about my not flying, many of my friends find this funny, and joke about me being afraid of water—although this has almost nothing to do with water. (A parallel joke surfaced on my Arkansas trip because I balked as canoeing and sat on the bank while friends enjoyed a nearby lake day instead.)

It is about precariousness, a tad bit of vertigo and disorientation, and the overwhelming relationship between the unknown and anxiety.

So on my most recent trip to Arkansas, nearly everything was new—the town itself, the paved cycling trail, the mountain biking trails.

And then on trips, the exhaustion of traveling, the disrupted sleep patterns, and the stress of cycling every day (bad decision) all snowball into a sort of all-consuming exhaustion that renders me incapable of enjoying anything.

Confronted with this reality about midway through the trip, I just confessed in a bit of exasperation that the gauntlet of new experiences had depleted me the same way that being social depletes introverts (which I am).

In other words, the consequence of anxiety for me cast into new experiences is that I am just entirely drained—no psychic or even physical energy available.

None of this, of course, is fair to my friends and companions; none of this is fair to me.

For about 38 years, I lived in silence, actually ignorance, that I suffer from clinical anxiety, something that can be diagnosed and treated in the same way we all experience colds or the flu.

Then I took medication from about 1999 until 2003, eventually gaining some ability to manage the condition but then no longer seeing the side effects as worth the medication itself.

Over about the last 15 years, I have self-medicated (alcohol) and returned to a cycling routine that includes riding about 4-5 times a week. This self-management makes my anxiety nearly invisible to others except those closest to me (the closer, of course, the more severe the consequences for those people), but to be honest, it isn’t really effective for the quality of life I deserve.

As well, the companion to my anxiety is also chronic pelvic pain that also significantly diminished the quality of my life.

Currently, I don’t have a real persuasive way to distinguish for others (or myself) between those things I genuinely do not want to do (canoeing down a river) and those things I simply cannot do because of the weight of my anxiety, the burden of the unknown (flying and traveling).

If left to me, I would simply not do, or in a moment of weakness when I agree to do something new, I would just flee.

Because that is what I almost always want to do—leave the new space if I cannot avoid entering that new space.

I think as a grind toward 60, I am tired of being tired, exhausted by the burden of anxiety, so I am looking into professional help again.

And the paradox of this isn’t lost on me—a new therapist, yet another trip to try to explain to someone else for the umpteenth time my particular journey with a companion I would prefer to be without.