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By unveiling how anxiety impacts people’s lives, we hope to spread empathy, ideas for coping, and a more open conversation on mental health. This is a powerful perspective.

Emily, a 34-year-old graduate student in Philadelphia, always had anxiety, but didn’t realize what it was until she was diagnosed with cancer in her 20s. Intrusive thoughts, such as the idea of her house burning down or her cancer returning, are one defining characteristic of her anxiety.

Here’s her story.

When did you first realize you had anxiety?

Now I see that anxiety is something I’ve struggled with my whole life. But I didn’t know what it was called necessarily — I thought it was just the way I was. I was diagnosed with cancer in my 20s, which naturally threw my anxiety into high gear, and I became aware of all the different ways anxiety can manifest itself.

How does your anxiety make you feel physically?

When I was a kid, it would manifest itself as stomach issues. One summer, my stomach problems got so bad, I ended up in the hospital and needed to get all kinds of tests. Now, the physical sensation is in my chest. I get tachycardia and my hands shake. When it’s really bad, I’m very jumpy.

How does your anxiety impact you mentally?

One way my anxiety manifests itself is through intrusive thoughts that are violent and scary, and that I just can’t shake. It’s like the worst horror movie is playing inside of my head, and I can’t turn it off.

Another thing that happens is that I grab onto one troubling thing, like a pain in my ribs, and then follow it to its worst-case scenario conclusion, which in this case would be that my cancer is back and I’ll die. This mental manifestation happens most often with medical stuff.

What kinds of things trigger your anxiety?

Cancer-related stuff is still big, even years later. Fire, and the possibility of my house burning down, is also a trigger. Work stress exacerbates it a lot, particularly when things feel chaotic or not well-planned.

I’m a planner, so when I see something I haven’t thought through, it can put me in a tailspin. For instance, my senior dog (who’s been with me through a lot of hard times) was showing some symptoms that might have been indicative of heart disease. I’ve been very thoughtful about his health, planning out what kinds of care we’ll do at the end of his life.

I’ve thought a lot about his last moments, and how to make him happiest. But in reading about heart disease, it dawned on me that his end might not be how I planned. He could die suddenly. He could even die alone. That realization triggered a major anxiety attack.

How do you manage or cope with your anxiety?

I’ve tried a lot of different things. Medications like Ativan and Zoloft, talk therapy, body-based therapy, meditation, yoga. When it’s bad, I cut out stimulants like coffee. Being with animals, gardening, and generally being in nature are very healing.

I left my job recently, in part because the anxiety it caused me was unsustainable. I got very lucky and was accepted into graduate school. If I hadn’t been accepted into graduate school, I probably would have stuck around at my job a bit longer, but it wasn’t sustainable long term.

Do you have any unique habits or behaviors associated with anxiety?

A few years ago, during a particularly bad time, I developed a twitch/flinch. First, it was a startle-type response, but then it became internalized to the point that when I have an intrusive thought, I physically flinch as if it’s painful.

What would your life look like if your anxiety was under control?

I would get rid of social media and my cell phone. That would help me could cut ties with my career obsession and let go of caring about what others think about my life choices.

Jamie Friedlander is a freelance writer and editor with a passion for health. Her work has appeared in The Cut, Chicago Tribune, Racked, Business Insider, and Success Magazine. When she’s not writing, she can usually be found traveling, drinking copious amounts of green tea, or surfing Etsy. You can see more samples of her work on her website. Follow her on Twitter.