Attempting to Explore the Incoherent Mind-Body Connection of Anxiety

Right now I’m hunched at my computer, desperately chugging a medium Dunkin’ cold brew. I’m wearing my shlumpiest oversized tee to hide the Iron Man-like contraption taped to my chest. What I’m trying to do is simple — induce my oft predictable heart palpitations. I am dejected to report that there is nothing to report. That’s because, despite years of questionable cardiac activity either spurred on or catalyzed by my snowballing anxiety, my body is finally behaving itself under the watchful gaze of my panoptic heart monitor. Which is infuriating.

My therapist tells me that anxiety is fueled by avoidance. I spent years trying to ignore the chronic “fluttering” in my chest, which in turn only heightened my anxiety, which in turn only increased the incidences of “fluttering” in my chest. With the pause of the pandemic rendering this vicious feedback loop unavoidable, I decided to confront the issue from a hybrid mind/body approach:

The mind component: Zoloft. To quote everyone from my primary care physician to my roommate, “we love Zoloft.”

The body component: a cardiologist. Remember that part about how anxiety is fueled by avoidance? Going to the cardiologist, for me, was like walking into a burning building that I’d been staring at frozen dead in my tracks for the past five years.

Inside the burning building is a sterile waiting room with at least one nice old lady on a walker and her caretaker, reminding me that as a 24-year-old who looks like a 16-year-old, I’m wholly out of place. Even the heart monitor instructions show a kindly old man in the shower.

The first appointment is a simple checkup involving a blood pressure reading and an electrocardiogram (EKG). My heartbeat predictably spikes to around 150 beats per minute, rendering my blood pressure unreadable courtesy of the “white coat syndrome” that developed coincident with my Generalized Anxiety Disorder. I see later that the nurse inputs these biometrics into my portal with not one, but three, exclamation points.

The second appointment is a “stress test,” where my blood pressure and EKG are continuously monitored as I walk, and then run, on a treadmill. They shave all three of my chest hairs as they attach the electrodes, and then attach those electrodes to the wire tendrils of the machine. I feel like Frankenstein at the world’s worst gym as I trudge nowhere on the treadmill. All I have to look at is a tiny picture of a generic mountain-scape. In a pale attempt to ease the tension, I tell the doctor I am trying to reach the other side of the lake but don’t seem to be getting anywhere. His eyes remain glued to the computer screen. The test reveals no abnormalities.

I am hoping and praying for a palpitation. Just one lousy irregular beat of the heart to show the doctor what I’ve been dealing with for the last few years and justify the inordinate medical costs. Alas, despite having at least one questionable palpitation per workout (pre-Zoloft, at least) my body is behaving. I may have performance anxiety, but my heart steals this show with an Oscar-worthy presentation. Any solace I feel is shallow as I grapple with this sudden shift in my mind-body.

I was always predestined for anxiety. My mom has had a severe case since she was a young girl. Both of my younger siblings have had their own bouts with it. That’s 3/3, a win for motherly genetics. I only wish I inherited her muscular arms instead.

Growing up, my anxiety was mostly social. I didn’t have many friends, but I did have greasy long hair and a questionable understanding of personal hygiene. I’ve since shed the social anxiety almost completely. I’m also rocking a fresh haircut and I’m really good at showering. However, entering into my last year of college, the familiar clutches of anxiety began to manifest in strange new ways. Two crises immediately come to mind:

First, a summer health scare in which I convinced myself that I had been exposed to HIV (and ended up having a much more minor, and itchy, STI instead).

Second, the Unite the Right rally in Charlottesville, VA, which happened as I was returning to the University of Virginia as a fourth year student. I had emailed a friend and collaborator about our work for the upcoming year multiple times with no response. She finally returned my emails to inform me that she was hit by the car that killed Heather Heyer and would be out of school for the semester. A Jewish friend, who I sat with at Hillel multiple times over the years, struck down by a Nazi.

Returning to school that year, I decided to make use of the university’s free counseling services. Though the therapist’s sole piece of advice over six sessions was repeatedly recommending the Headspace app (this is not a paid advertisement) I did have a surprising moment of catharsis when I broke down in tears over the rally at my intake session. I realized that the two incidents over that summer took a battering ram to the dam holding back the rushing rapids of my anxious predispositions.

Shortly after these events, my anxiety generalized and my pesky palpitations showed up. I no longer lived inside the safety of a fully functioning human meat suit. This new one felt like heaviness and barbed wire and clapping off beat. I won’t bore with the details, because as my cardiologist says, “there’s as many ways to describe palpitations as there are people who have palpitations.” All I’ll say is that they showed up when I moved, when I was sitting still, when I was drunk or caffeinated, when I was sober, when I was anxious, when I was calm, when I was tired, when I was wide awake. They lasted anywhere from one second (more often) to a couple minutes (way less often). And I learned to swallow every single one. For years. Because I was convinced this was my lot in life — an anxious brain and a restless heart.

Sometimes my anxiety pays off. In September, two friends and I moved into a ramshackle row house in D.C. that we found on Craigslist. From the start, my lizard brain survival instinct had me nervous about drinking the tap water. My roommates didn’t seem to care and didn’t take me up on my suggestion to pay for premium water delivery. But months into our tenancy, the water got funky for a couple days. After emailing the water provider, we discovered that the water line feeding our house was, in fact, lead. Did it feel relieving to know that my constant perseveration on the quality of our water yielded this disturbing yet necessary discovery? Even as my roommates sipped it with glee and ignorance? No, it wasn’t relieving. Drinking lead is never a relieving activity. But without my nagging anxiety, we would never have checked the quality of the pipe at all.

I’ve spent much time in therapy over the past year dissecting this history of my anxiety. Perhaps my ability to recount it now is proof that I have gained some perspective on the peculiar nature of my mind-body. Or maybe I’ve surrendered to these cosmic unknowns completely and simply accepted the fact that I can feel safe once again in a body that felt like it was working against me for so long.

I should be ecstatic that, whether through Zoloft or sheer willpower, I can confidently say that residing inside my body doesn’t feel like hell right now. My therapist tells me I’m allowed to credit both. As folk songstress Maggie Rogers might say, “I’m back in my body, oh.” The cardiologist has cleared me with “excellent aerobic capacity.” I can finally fall asleep without the thump-thump-thumping of my chest. But after accepting for so long a diminished quality of life, deciding that I somehow deserved it, I’m having a hard time accepting that the answer was so…simple. That popping a little blue pill once a day, in conjunction with guided introspection into my fractured psyche, can protect my body from my mind’s constant noise. And maybe, I concede, it’s a little comforting to know that no matter how hard I tried to fix myself for all these years, I quite literally couldn’t do it on my own.

I finished my coffee, by the way. It’s my second of the day. I’m wired for sure, but my heart feels normal. My therapist told me to stop trying to induce a Dunkin’ fueled heart attack to prove a point. So I probably won’t have another cuppa, but it’s nice having the assurance that, for the first time in a long while, I can if I want.