I’m a hypochondriac, so I know a lot about worrying.
And a good hypochondriac will educate herself so that she has a lot to worry about. I’ve spent years learning the names of disease, the signs and symptoms of disease, the normal course and prognosis of disease. When I go to the doctor and start talking in morbid detail about just where it hurts, I often get the question, “Are you a med student?”
No way. That would send me over the edge.
But in all my personal research on pathology - reading through Merck Manuals, and memorizing medical dictionaries - there is one symptom I’ve just never understood well. Malaise. Malaise is a marker for almost every malady. The flu, a cold, bacterial infection, diseases of internal organs, bodily infestation with parasites - all of these are accompanied by malaise. And although, yes, perhaps I understand the dictionary definition in an intellectual way – and in spite of suffering through my share of sinus infections and miscellaneous heebie-jeebies - I wasn’t quite sure whether I had ever felt this shadowy malaise, whether I could recognize it in myself.
Malaise. A specific kind of melancholy when you’re in too much of a funk to worry about being ill.
My melancholy usually takes the more active form of panic. I’m never too tired to worry. I’m a good hypochondriac.
Along with being a worrier, I have of course sprawled across my share of therapists’ sofas, so I recognize and can intellectualize the inner-workings of my worry. I know why I worry. And why I think I need to worry. And, of course, the logical reasons for why I shouldn’t worry.
The first thing to know about an anxiety attack is that by the time you’ve launched your counter-attack of rational thought in an attempt to stop the obsessive irrational thoughts (or super-rational thoughts, depending on your sense of humor), your body is already in fight-or-flight mode. You’re so keyed-up on an adrenaline and lactate high that your skin literally buzzes for weeks and your bowels are caught in a mad cycle of ridding the body of excess “weight” so you can run faster from hungry tigers. Or terrorists. But here’s where the mentality of anxiety differs from real fear: with anxiety, the tigers are in your own head. They’re imaginary. There is nothing to fight and nowhere to run, and so the anxiety feeds upon itself, regurgitates, then dines some more.
At any rate, we worriers spend a lot of time in the bathroom, losing weight so we can run away faster. It’s an irreconcilable conflict. Anxiety over x, focus your anxiety on your health, worry causes real health problems, health problems causing more anxiety…
I’d been caught off-guard these past few days suffering through a bad bout of some disgusting intestinal illness. I assumed it was a real virus, as opposed to worry-induced irritable bowl syndrome, because I had a fever. A fever is pretty hard to fake even for the best hypochondriac. Also, I figured the frequent bathroom visits weren’t just a symptom of overactive imagination because, frankly, I’d been feeling pretty worry-free these days. But when a week had passed and my skin was still buzzing and my stomach still rumbling, I wondered…am I anxious about something and I just don’t know it? Was I not taking enough time to self-reflect and in my blissful ignorance the anxiety crept up and bit me on the…well…bit me on the butt?
I took a moment to do a quick check under the hood of my mind. My marriage seemed fine - my husband was helping out with the dishes and that’s always a sign that things are going well. I had recently celebrated my thirty-seventh birthday, so I had at least three more years before I needed to worry about being old. My children seemed happy and only occasionally told me that they’d rather live with their grandmothers. So why was my plumbing going haywire? And why was my heart palpitating? And why, underneath all the recognizable symptoms, was I now aware of an uncomfortable new feeling…a sort of apathetic and exhausted lack of energy. There was no oomph to fuel my fight-or-flight. Instead, I felt more like the warrior who hears the enemy approaching and feels the adrenaline rush, yet tosses aside his sword and just sits down in the moss. Was this, finally, the shadowy malaise? Was it a honest -to-goodness symptom of flu-bug invasion? Or was my anxiety reinventing itself, mutating like a virus?
And then tonight, in an instant, I realized what had been eating at me.
After the kids were in bed, I was puttering around in the kitchen with one ear tuned-in to the television. I had made myself a cup of peppermint tea and was nibbling on a rice cake to calm my nerves and my sour stomach, when suddenly my heart skipped and I felt my pulse begin to pound in my neck, in my wrists, in my fingertips. That sound…that whooooooosh coming from the television. That loud rush of engines. The sound of impact. The sound of the explosion. The replay again and again from different angles, different cameras.
I could feel the hair standing on the back of my neck. And then the voices…”we were on the 50th floor and the building rocked”…” the smoke was so thick”…”people were running, screaming, their clothes on fire….”
Damn. I had missed what any two-bit Freud could see coming from a mile away.
It’s September. Again.
It used to be January that I dreaded. Just thinking of January and those winter months after the holidays, I would always imagine January – feel January - as a long, dark stretch of nothingness. Days filled with cold and nothing. The anxiety attack months. Maybe it was genetic programming – a gift from my panicky ancestors and their eons of Januarys spent worrying whether they’d have enough food to last the winter or whether everyone would survive the coughing and sneezing during months of being cooped up together. January traditionally has been my month to go easy on my psyche, drink warm milk and poach eggs, renew my subscription to Prevention magazine, and consider any symptoms of illness with suspicion. In the empty, gray world of January, my hypochondria and anxiety were bountiful.
But now, standing in the kitchen and repeating the word September, I could feel it all rise up in my throat.
Two years ago. Tuesday morning. Again, puttering around my kitchen, packing a diaper bag, filling a sippy cup and looking for sunscreen. It’s a beautiful day. God, it’s gorgeous. My three-month-old daughter is snoozing in the next room in her stroller, my two-year-old daughter is coloring at the table. We’re getting ready to meet our friends and walk to the Philadelphia Public Library on Market Street for story time. The phone rings. Dang, where is the other sippy cup…hold on, hold on. It’s my husband.
Turn on the TV, he says.
Why? I’m getting ready to leave the house, I can’t find the sippy cup, I’m going to be late…
Just turn it on. Any channel. Two planes hit the World Trade Center.
Two planes hit the…what? That’s weird…were they bi-planes doing some kind of numbskull tricks and they ran into the towers?
Just turn on the TV.
I hang up the phone. Baby still sleeping. Older daughter still coloring. I walk upstairs to the guest room and turn on the television. CNN. A picture of both towers smoking. Looks like a pretty big fire. And each plane ran into a different tower? Why were they spinning barrel rolls so close to the towers anyway? I’m about to turn off the television when suddenly one tower isn’t smoking and I realize I’m now watching a replay…a plane heading toward the tower. And it’s a big plane. A jet. Holy shit. That’s a jet. What is this, some kind of slapped-together special effects replay and they couldn’t pull up a computer graphic of a bi-plane? This is a bad joke. Holy shit…that plane, that jet…just hit the building. For real. Oh my God…this is real. My mind starts racing, adding, subtracting, formulating and analyzing every possible equation in which two jets fly into the World Trade Center and finding only one possible solution. One jet plus one jet equals two jets. Two jets. Two jets fly into the World Trade Center. Two jets fly into the World Trade Center…on purpose. They do it on purpose. It wasn’t an accident.
I turn off the television and walk downstairs and find the sippy cup. Then, I call my friend. Did you see what happened? Yes. Yes. I don’t know…let’s…yes, let’s go out with the kids. But no, I say, let’s not go to the library…too close to the federal building. I hang up. Then I wonder…where did that come from? Too close to the federal building? I am not having a panic attack. I’m keeping it together. But my fingers are buzzing.
Here’s another thing to remember about anxiety – anxiety is a double-dealer. Anxiety says “there might be chemicals in the water, and the chemicals might kill you, so you need to think long and hard before diving into the swimming pool”. And while you’re distracted by possibility of a man-made danger, you’ve failed to notice that you are taking a nose-dive into an empty lake. Anxiety tries to confuse with the subtle chaos of three card monte. And after you’ve spent a few years losing to a con-man, you may not learn the tricks, but you steer clear of the game, sometimes giving too wide a berth. And that’s what I was doing that day…ignoring the dealer.
Terrorist strike, thousands dead, thousands who were just having their morning coffee, minding their own business, and suddenly they’re gone. Or suddenly they’re making the decision to leap to their death. Or living moment by moment wondering whether they’d live to the next moment, a stray thought flashing between the moments …”if only I had taken the 9:15 train today…if only I’d stopped for a donut like I usually do…if only I hadn’t been lucky enough to get an express elevator”…
And that, finally, is the wicked voice of anxiety.
Anxiety tells us that we always have control over chaos if we just make the right decisions. And that the information to make the right decision – the decision that averts pain, the decision that anticipates grief, the decision that prevents death - is always there, somewhere, in front of our eyes if we’d just look hard enough. If we are aware. If we calculate the odds and cheat the cheater.
If only…if only…if only…
Anxiety is a psychological sadist. And anxiety knows that the greatest mental anguish is regret.
And so I strode toward the playground with my children, ignoring the black government vans that sped by toward center city, sirens blaring. I disregarded the fragmented emissions from radios of the parked cars we passed on our walk…”plane hit the Pentagon”…”…a plane unaccounted for….” At the playground, I refused to acknowledge the little boy who was flying his Matchbox airplane between the other children, making the plane crash into the swing set. More pieces of information from the moms on cell phones…
”…there is a plane somewhere over Pennsylvania…”
“…the Pentagon is on fire…”
“ …one of the towers just collapsed…”
“…the World Trade Center is gone…”
Of course, I don’t know what the victims were thinking during those moments before the planes hit. Or after they hit. Of course I don’t know. To guess and wonder, well again, that’s anxiety talking. That’s anxiety trying to convince me that if I play it through in my head a thousand times, a thousand different ways, that faced with a like situation I would be able to save myself. That I could cheat that painful moment of if only. But anxiety doesn’t save you in any one moment. Fear does. Fear is the animal inside that kills the thinking brain with one giant chomp, and then commandeers the solar plexus, energizing the body with a primal directive. Fear is the true animating force that carries you through the fire, away from the tigers, out of harm’s way.
Or through to some other side.
A valid fear can be a great gift; anxiety is terror’s child.
When the city emptied into the streets and men and women began hurrying by, cell phones ringing, we mothers silently gathered our children and quickly abandoned the playground. I did not glance over my shoulder to the Philadelphia skyline, and I did not look to see whether the twin towers of Liberty Place were still standing. My friend and I did not speak. The children were not crying. The air was still. The only vibration that afternoon was the pulse in our bones. There was something coming for us – something overwhelming and awful coming to tear us apart and pull our stomachs out through minds.
Those next days and weeks, I did what almost everyone else was doing: watching the television, reading the papers, calling friends and loved ones. Are you alive? Are you okay? Just wanted to make sure you didn’t decide to take an spur-of-the-moment trip out of Boston. Hey, did I tell you lately how much I love you? I love you… My three friends in New York City were all safe. One friend was on a photo shoot out of town that day. Another friend was fired from work the day before. Another who worked near the World Trade Center had called in sick that morning, playing hooky.
If only…if only…if only…
The world changed that September morning. But to say it out loud, it’s almost a cliché, already a given after two years. The daily replay of the tragedies, the terror so heightened that anxiety was raking in sucker bets hand over fist, the mysterious images and furious faces, the new, exotic words stuttering from our tongues: purdah, burka, Al Qaeda. The prevailing terror of knowing that we were being tracked in the sights of an enemy who was a proven shot.
Anxiety distracts. Fear can save. But is it also fear that sends you over the edge when there is no other way out? That’s what I want to believe. Fear overpowering intellect. No awareness, only animal response. My anxious mind can’t handle the alternative: the terror of a final, conscious if only.
It’s September again.
And as I finish another cup of tea, I flip through my Physician’s Desk Reference scanning the antidotes for all the ills of the world. My own medicine cabinet is about as well-stocked as the Rite Aid down the street. But to be honest, for my intents and purposes I’m usually not much interested in cures. Once you are diagnosed, any worry over becoming ill is moot. And it’s the worry that’s important. It’s anxiety that I dote on.
But this September, my trifling anxiety is sick with malaise, defeated and depressed with an infection of a terror larger than itself. My anxiety is useless to me and I have to find a way to cure it.
I don’t want to think about planes crashing around me. I don’t want this overgrown and mutated terror.
I’m a good hypochondriac.
I just want to worry a little.