“I usually start my day off with a panic attack instead of coffee.”

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

C, a public relations and marketing support assistant in Greensboro, North Carolina, first realized she had anxiety when the sensations of a school pep rally sent her over the edge. She’s since struggled with severe, nearly constant anxiety that prevents her from living the life she wants.

Here’s her story.

When did you first realize you had anxiety?

It’s hard to say when I first realized I had anxiety. I was always anxious, even as a baby, according to my mom. I grew up knowing I was more sensitive than most people, but the concept of anxiety was foreign to me until I was about 11 or 12. At this time, I had to undergo a strange, daylong psychological evaluation after my mom found out about some of my self-injury.

I think that’s when I first heard the word “anxiety,” but it didn’t fully click until about a year later when I was unable to find an excuse to skip a school pep rally. The sounds of yelling students, the blaring music, those painfully bright florescent lights, and the packed bleachers overwhelmed me. It was chaos, and I had to get out.

I somehow managed to retreat to a bathroom on the opposite side of the building where I hid in a stall, sobbing and banging my head against the wall in an attempt to “knock myself out of it.” Everyone else seemed to enjoy the pep rally, or could at least sit through it without fleeing in panic. That’s when I realized I had anxiety, but I still had no idea it would be a lifelong struggle.

How does your anxiety manifest itself physically?

Physically, I have the usual symptoms: struggling to breathe (hyperventilating or feeling like I’m choking), rapid heartbeat and palpitations, chest pain, tunnel vision, dizziness, nausea, shaking, sweating, muscle pain, and exhaustion paired with the inability to sleep.

I also have a habit of unknowingly digging my nails into my skin or biting my lips, oftentimes badly enough to draw blood. I also end up vomiting almost every time I begin feeling a hint of nausea.

How does your anxiety manifest itself mentally?

It’s hard to think of how to describe this without sounding like I’m just regurgitating the DSM. It varies with the type of anxiety I’m experiencing.

In the most general sense, which I just consider my standard operating mode since I spend most days at least mildly anxious about something, the mental manifestations are things like difficulty concentrating, feeling restless, and obsessive thought loops of what if, what if, what if…

When my anxiety gets more severe, I’m unable to focus on anything except for the anxiety. I begin obsessing over all of the worst-case scenarios, no matter how irrational they may seem. My thoughts become all or nothing. There’s no gray area. A feeling of dread consumes me, and eventually I’m certain that I’m in danger and going to die.

At its worst, I just shut down and my mind goes blank. It’s like I exit myself. I never know how long I’ll be in that state. When I “come back,” I get anxious over the lost time, and the cycle continues.

What kinds of things trigger your anxiety?

I’m still working on identifying my triggers. It seems like once I figure out one, three more pop up. My main (or at least most frustrating) trigger is leaving my house. It is an everyday struggle to get to work. I usually start my day off with a panic attack instead of coffee.

Some other prominent triggers I’ve noticed are a lot of sensory-related things (loud sounds, certain smells, touch, bright lights, etc.), large crowds, waiting in lines, public transportation, grocery stores, escalators, eating in front of others, going to sleep, showers, and who knows how many more. There are other more abstract things that trigger me, such as not following a routine or ritual, my physical appearance, and other things I can’t put words to yet.

How do you manage your anxiety?

Medication is my main form of management. I attended weekly therapy sessions until about two months ago. I intended to switch to every other week, but I haven’t seen my therapist in a little less than two months. I’m too anxious to ask for time off work or an extended lunch. I do carry Silly Putty to occupy my hands and distract me, and I try stretching to relax my muscles. Those provide limited relief.

I have less healthy management methods, such as giving in to compulsions, avoiding situations that have the potential to make me anxious, isolation, suppression, dissociation, and alcohol misuse. But that’s not really managing anxiety, is it?

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

I genuinely cannot imagine my life without anxiety. It’s been a part of me for possibly my whole life, so it’s as if I’m picturing what a stranger’s life is like.

I like to think my life would be happier. I’d be able to do the most mundane activities without even thinking about it. I wouldn’t feel guilty for making others uncomfortable or holding them back. I imagine it must be so free, which is in a way terrifying.

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.