“It’s okay. It’ll get better. Everything will be all right.” I hate when people casually say those words to a distressed friend—and, usually, I am that distressed friend.

Photo by Andy Sutterfield

Looking back on my teen years, filled with moments of extreme sadness and anger over my body-image issues and my limitations, it’s tempting to say that my panic attacks and depression started then. I think, however, that I was just a regular moody teenager. But I do know that it was around this time that I adopted habits that later led to my anxiety disorder: I stayed silent, I ate my feelings, I avoided talking about it when others broached the subject, and I became resentful of my friends for their “easy” lives.

Anxiety disorders are the most common mental illnesses in the U.S., affecting 40 million people, roughly 18% of the population. There are a wide variety of them: generalized anxiety, OCD, PTSD, phobias, etc. If you’ve never experienced depression or a panic attack, here’s a rundown: We all experience anxiety, but those who do not have a disorder can rationalize their fears, work through them, and come out with a plan of attack for any issue they’re facing. But when you have an anxiety or panic attack, the fear takes over. You can’t step back, you can’t shake yourself out of that place of fear, and you can’t force yourself to “just not think about it.” I’ve heard people say a panic attack feels like having a rubber band pulled across their chest, or having an elephant sit on them. The first time I felt it, I thought it might be a heart attack: the shortness of breath, the erratic breathing, the tears. After the attack passes, then comes the self-admonishment, the feelings of inadequacy, the thoughts that you must be weak and inferior to those around you because they don’t go through this—all of which feed into depression. And when you’re depressed, you can’t lift yourself out.

Depressed isn’t just sad or frustrated or down. Depression is detached, and that feels worse than the sad times or the panic-stricken times. You hear people say that if you put on a happy face, the good feelings will come. It’s not true. I’m putting on the happy face, I’m being my perky self. I’m at work, I’m with friends, I’m joking, I’m laughing. But there’s a cold layer around me. I feel as though all my movements are jerky and disjointed as I’m internally debating and debasing myself. You try to pull yourself out, wanting to feel something because anything is better than nothing. You try to talk to friends and family about it but you can’t get the words out or, when you do, they don’t know what to do. So they just offer the only comfort they can—“It’s okay.”

Anxiety disorders and depression do not always go hand in hand, nor does one predispose an individual to the other. However, studies show high co-morbidity rates: in a study of 3,000 patients in clinical trials for generalized anxiety or depression, about a third of anxiety disorder patients had severe enough depressive symptoms to enter the depression trials, while two thirds of the patients in the depression trials had anxiety disorders that warranted joining the generalized anxiety trials. I’ve gone through periods of both anxiety and depression, and because I have—because I’ve sought help—I know I’m likely to go through them again. I know it’s not an instance; it’s a cycle that’s repeated and feeds on itself. But I’ve also learned I’m not alone.

When you live with anxiety or depression, you might feel like you’re the only one, until you meet another ‘only one.’ When my attacks clustered closer and closer together and I started distancing myself from friends, I was scared about where I’d end up if I didn’t get help. So, I started talking to friends who I could trust. It helped me to vent and their comfort kept me from feeling like less of a person. But I still felt disconnected from my peers who all seemed to excel, unhindered. Then, a friend confided in me and told me about her own struggles. A coworker revealed the truth about her battle with the same illness. Suddenly, I wasn’t an imperfection in a perfect world; my struggles weren’t proof of my inadequacies as a human being. I was normal, beautifully and imperfectly normal. It seemed weird and maybe even wrong to feel legitimized by other people’s struggles. But I was. And that was worth something.

I’m not saying talking about it always helps, but not talking about it never does. I’d talked to friends mid–panic attack, either calling them or tracking them down at school to explode at them. They weren’t prepared for it, nor did they have the knowledge or skills to deal with it. But as I became more comfortable telling friends about the imperfect areas of my life, they reciprocated that comfort. I found safe zones to talk and let off steam before I reached attack mode.

So, how can you tell if you’re near this precipice? If any of the above resonated with you, you may want to talk to someone (yes, actually voice the thing you’re most desperate to quell). There’s a stigma associated with “not being able to deal.” A coworker who’s faced similar struggles told one of our peers and was discouraged from telling anyone else. But what we’ve experienced is real, and so is the connection I now have with this amazingly strong and beautiful woman. If she hadn’t told me about her situation, we might not have ever had this connection.

Okay, so what should I do? Again, talk about it. I couldn’t afford a therapist, so I looked into group programs I could join, which are cheaper. The people I met there provided me with a support system. If that doesn’t help, maybe one-on-one sessions are a better fit for you. Bear in mind, however, that it can take a couple of tries to find the right therapist or support group. You have to feel as though you’re in a safe place. Don’t settle until you’ve found that.

Aside from the importance of talking about it, I’ve also learned the value of the following:

Don’t Assume

The perception that your friends and family have it easy builds negative emotions and increases your feelings of being different. It’s hard to remember that those around us suffer too, that the grass isn’t always greener on the other side, but try. Resentment only distances you from the positive influences in your life.

Sleep

This can be hard when you lie awake at night for hours thinking of what’s to come. But if you’re prone to missing sleep, don’t go to bed when you have to be up in eight hours. It sounds weird, but budget for the freak out. You’ll cry and you’ll stress, but eventually you’ll be so drained emotionally and physically that you will drift off to sleep. However, if you suffer from insomnia, consult your physician.

Exercise

To quote Elle Woods, “Exercising gives you endorphins. Endorphins make you happy. Happy people just don’t kill their husbands. They just don’t.” I’ve always hated when people suggested exercise to help with mood, cramps, whatever. But it does help. Exercising results in an increase of serotonin and endorphins, which are chemicals that alleviate depression. But even if that twenty-minute walk around your neighborhood doesn’t do much for you chemically, it at least allows you to have some time alone. You have the opportunity to think things through, to be away from the pile of bills waiting for you on your desk, or your spouse who you just had a fight with.

Stress Less

Easier said than done, I know. But map out the major stressors in your life, talk it through with someone if it helps, and formulate a plan of attack to deal with each one in turn. Try not to think negatively. It’s hard but doable. Instead of thinking of “I can’t get a better job,” say to yourself “I’m going to revamp my resume by the end of the week.” Turn your fears into a to-do list. When you make a mistake, instead of obsessing, take a step back and see what you learned from the mistake and do your best to accept it.

Focus on the Happy

I love journaling because it’s a great way to document milestones and see how far I’ve come. However, when I’m upset and want to gain perspective, looking at old journal entries from when I was down can actually increase my feelings of anxiety or depression. For my New Year’s Resolution, a friend and I started a little yearlong project. We each bought a mason jar and pretty stationary. Every time something good happened or we stumbled upon something random that made us happy, we would write it on a piece of paper and stick it in the jar. Whenever I’m down, I open the jar and read through some of the anecdotes. Remembering those moments and how happy I was when I wrote them down helps to lift me out of my funk.