I have Generalized Anxiety Disorder, or GAD as it's often known. I can learn to cope better with it. I can take medication to help with the symptoms. It's part of who I am. I'm no different now that I've written this, than I was before. Though now I'm able to put a label on it. Being able to label myself in that manner, is both a relief, and itself a source of anxiety.
A few weeks ago, I took a day to work from home, as I often do. At some point in the afternoon I found myself staring vacantly at a shell prompt, knowing what I needed to do, but utterly unable to do so. I couldn't. I was too preoccupied with myriad other concerns. So preoccupied that I felt crippled; incapable of doing anything. I spoke to my wife, Jo, about it. She said it sounded a lot like anxiety. On her advice, I made an appointment with the doctor. After a good chat about this recent event, and how I felt more generally, and historically, the doctor was fairly confident in diagnosing me as having GAD. She prescribed me an SSRI, Paroxetine (sometimes Paxil, or Seroxat) on a low dosage, with a follow up review of its effects and the dosage, in a month. Thanks Jo, and the NHS.
Feeling a little shy, nervous or anxious from time to time is perfectly normal, and healthy. Anxiety is key to our primitive fight-or-flight response. Having these feelings of anxiety almost all of the time, to the extent that they interfere with every day life is, broadly speaking, Generalized Anxiety Disorder.
Anxiety is a common symptom in a number of mental illnesses, such as Obsessive Compulsive Disorder; Social Anxiety, Depression, Post Traumatic Stress Disorder, various phobias etc. GAD often involves a mix of other symptoms too, for example sometimes some sort of obsessive, or compulsive behaviour; but perhaps not to the extent where a separate diagnosis of OCD would be appropriate.
For those with GAD, it's often the case that the constant worrying and anxiety is over seemingly mundane things; a fact only too well understood by the sufferer. Nevertheless, we can't help but worry. Try as we might, we can't relax, we can't switch off. We know it's irrational, despite being rational beings.
Everybody who suffers from GAD is different, we have a different recipe, a different way it affects us. For me, it's always been there, lurking below the surface, but now I have a name for it. A low humming of background noise, constantly distracting and stealing focus.
Here's an idea about my particular recipe.
I over-think and over-analyse everything, and I mean everything. I'm constantly 'checking in' with Jo to make sure she's okay. Often to her frustration; it's like my brain isn't convinced everything is okay, and I'll keep asking. I can't help it. While I'm going about everyday life, my mind will jump from worry-topic to worry-topic, seemingly at random. I might be thinking about a task at work, but then I lose focus because I have to think about a different task at work. Then all the other tasks. None of which have any real urgency, but their very existence means they warrant my attention. Part way through that, I'll get concerned about what might happen if any one of those things don't get completed. All the while making sure that I don't miss anything else that I have to be aware of, and concerned about. While this is happening, I might start to worry about the state of the garden, or whether the hall carpet needs vacuuming. It probably does need vacuuming. In fact it definitely does need vacuuming. I should do that as soon as I get home. Really, I should do it now. But I can't. I need to though. Now imagine this flow, about any and every arbitrary, mundane, pointless concern that might pop into your mind. Oddly, for me, it's often the trivial things that get my anxiety flaring up. A lot of people get terribly nervous about flying. It doesn't bother me, go figure!
However, airports, that's a different story. Airports, and generally large concentrations of people. Busy streets, like Edinburgh during the Festival Fringe; busy, noisy pubs; music gigs, all get my heart pounding, and my internal body temperature feeling like it's about to burst the mercury. Similarly, in social situations, large groups of people I don't really know that well. I'll want an escape, or a way to quickly excuse myself if it all gets a bit much.
Discussions or interactions at work can often be challenging. I can be very self-conscious. Others' opinions matter a great deal to me. The idea of offending someone, or someone having a negative opinion of me, really worries me. A lot.
If I'm having a discussion about a code change, I'll often over think my response. Did I offend one of my colleagues, do they think I'm a dick? Are they judging me for getting it wrong? Did I get it right? Would they have done it better. What if I'd waited and written the code differently, would they have had a different response? Should I put my neck out and say what I think? If I do, will I be wrong. Will they think I'm a lesser engineer, or a moron, for having a different, or contradictory opinion? What ifs… so many what ifs.
I don't have too many obsessive or compulsive behaviours. I don't check things to certain counts, as the media would typically demonstrate as being how-this-OCD-thing-works. I'll pick the skin on my lips, often until they bleed. Towels need to be folded and put away a particular way. The volume on the TV or the car radio needs to be set on an even number. None of these things have any basis in rational thought. I don't do them because I'm worried something terrible will happen. But I need to do them nevertheless.
I like routine and order. If I'm going somewhere, I need to know all the steps of how I'll get there. If I don't, I get incredibly worried about what might go wrong. Perhaps my need for routine and order is a coping mechanism, that I've come to need to keep ideas clear in my head. I use David Allen's "Getting Things Done" methodology to try to keep my brain empty as much as possible. I dump anything and everything I think of that may need some action. I review these various lists for things that I'd like to do, or that have a deadline, looking for the next action. This helps a lot, but it's a double edge sword. Counter intuitively to the way the methodology should work, I'll find myself worrying whether I have in fact added something to a list. The lists are all massive, necessarily, as intended. This itself makes me get anxious, worrying about all the things I have to do. I don't have to do them, but convincing myself otherwise is an uphill battle!
I know this is all very irrational. Try telling me not to worry though! It's like me telling you not to get hungry! There's a common theme of what-ifs and uncontrollable worry over the trivial. Fortunately, I've never had any full blown panic attacks. Sure, I can get a bit breathy, heart pounding, sweaty - but never uncontrollably shaking, or vomiting. I count my blessings.
My friend and colleague, Jim, has often said to me (quoting 'The Bunk' in 'The Wire'), "…There you go. Givin' a fuck when it ain't your turn to give a fuck…". He's right. Can't help myself. But whenever I hear that, I do have a little chuckle to myself.
Why am I sharing this? Why not? I'm normal. This is normal. I look and act mostly the same as anybody else you might come across. You can't see GAD: things might look calm-ish on the surface, but there's a lot going on under the hood.
There's a lot less stigma around mental illness these days, and I'd like that to continue. For those who know me well, this is just another facet of who I am. It doesn't define me. A number of others in the tech industry have made great strides in raising awareness of mental illness, and helping to educate others. Notably, Ed Finkler(@funkatron) though his Open Sourcing Mental Illness campaign. I'd like to do my bit to further that agenda of awareness, education, and inclusion. I'd like to help others understand that normal is relative.
Thank you for reading. Now, I'll go and think about all the different, terrible ways that posting this might play out.
Here are some links that I've found quite useful, that might give you some more ideas about GAD, what it's like, what we sufferers would like you to know about it.
This book has been a wonderful eye-opener to what it means to suffer from Generalized Anxiety Disorder. Eleanor takes us on an insightful, witty, funny and often poignant journey through her personal experiences.
- What It's Really Like To Live With Generalized Anxiety Disorder by Candace Ganger
A frank and honest article about the particular ways GAD has effected the author
How GAD affects sufferers, and what they'd like you to understand about those effects
A list of quotes that help to explain what it feels like to have GAD