by Sorana Mitchell
“I went for my driver’s licence, but I get so nervous and so anxious on the road that sometimes when I perceive I’m in danger, I will just let go of the wheel and just start screaming.”
Suzanne (name changed to protect identity), is a 41-year-old secondary school teacher who describes herself as a reserved introvert who enjoys fishing. But for close to 2 decades she has struggled in silence, for the most part, with anxiety.
Suzanne’s first bout with the mental health condition occurred when she went overseas to attain her bachelor’s degree and was exposed to covert racism and large crowds. “What triggered it was that I was a black person in a predominantly [Hispanic] country. Anytime I had a class, I would try to get to the class before the crowd. There was no avoiding [the crowds on] the train. I think one of the major triggers for me was the crowd. Up to this blessed day I don’t go anywhere. I go to work; I get dropped off at work and I get picked up at work and I don’t mingle at all in any crowded setting. I feel like I’m overwhelmed to the point that I struggle to speak. I start sweating. I need to get out.”
Anxiety or anxiety disorders are defined as having excessive and intense amounts of fear and worry. According to data from the World Health Organisation (WHO) from 2019, anxiety disorders affect 301 million people worldwide, making it the most common mental health condition with more women being affected by it than men.
Psychologist Dr Alisa Alvis who is based in St Vincent and the Grenadines said anxiety can manifest itself physically, behaviourally and emotionally or psychologically. “A lot of people tend to report physical symptoms for anxiety. Very common one you hear is gastric, my stomach is upset, they might feel like they want to run to the washroom, feel like they want to empty [their] bowels or they want to vomit, nausea, but something gastric. People may get sweaty, clammy, heart rate up, respiration rate up but not just faster breath but fast and shallow — panting; goosebumps, dizzy.”
Dr Alvis went on to add that in terms of the person’s internal state you wouldn’t know unless they told you. She said they often jump to the worst-case scenario. Dr Alvis noted that avoiding places, people and situations are very common behaviours of a person with anxiety, “Anxiety can be really crippling for people and some of the things people present with behaviourally when they’re anxious… can look like you’re being oppositional, or it can look like you’re being rude. Sometimes people avoiding doing something because they are so anxious and what it comes across as is they’re being obstinate, stubborn, [but really] it’s like I’m paralysed, I can’t do that. It’s not that I don’t want to, it’s just that I can’t.”
Suzanne obtained her driver’s licence and bought a car, but because of anxiety she does not get in front of the wheel, “I went for my driver’s licence, but I get so nervous and so anxious on the road that sometimes when I perceive I’m in danger, I will just let go of the wheel and just start screaming. I even bought my own vehicle, and I don’t even drive my vehicle anymore, that’s how bad it is. Every day I look at it and I’m like okay you’re going on the road, you’re taking your time and you’re going down to work. And I get behind the wheel, I sit down, I start the van and then I just can’t go any further.”
Dr Alvis said we should not dismiss a person’s anxiety when they express it and, we should ask the person how we can help. “The best thing you can do for that person is validate how they’re feeling. For example, I speak publicly all the time, it might be easy for me if somebody were to tell me I’ve got to give a presentation today and like I’m in knots about it. You know, if you only speak from the place of your experience, you’ll just be like, small scene, how long you have to talk for? But to this person it’s a big deal so kind of stepping outside of your whole experiences, to be like oh wow. Just imagine what it would be like from that person’s perspective. As they tell you those things like oh what’s worrying you about it. I’m afraid I’m gonna trip over my words and I’m gonna look stupid. Don’t just sweep it away.”
In Suzanne’s case, her close friends are aware, but she has never shared her condition with relatives. “Even if they suspect or know, they won’t approach me about it. We have a silent, ‘I know you’re going through something but it’s gonna be ok’ kinda relationship.”
She is grateful that the condition has not stopped her ability to teach, which she has been doing for the past 22 years. However, there was a time when she admitted that anxiety was affecting her daily routine and so she sought help from a counsellor who then referred her to a psychiatrist. The psychiatrist suggested medication which she declined. “I ended up there because I felt it was starting to affect my ability to work. I reached out to the counsellor and the ministry [Ministry of Education, Grenada] provided a counsellor but what affected me needed more than just counselling so that’s how I was forwarded to the psychiatrist. They actually wanted to give me medication. I just had in my mind that once you start those kinds of medications, you know something else happens. I had my reservations… and you know anything to do with mental health you kinda feel like, what if I cross the line and I don’t return.”
Dr Alvis suggested that someone with anxiety should learn to pay attention to symptoms and their bodies and develop strategies to cope. “Well it really depends on where you are with respect to your anxiety. You have to be in a state of awareness or recognition of something before you can truly address it. if you are somebody who has already kind of labelled, oh what’s happening right now is that I’m anxious, then your tool box is so much bigger even from that one acknowledgement because then you, psychologically you can separate yourself from the emotion — like I am not my feelings, I am feeling anxious right now but not necessarily I’m an anxious person. But if you’re a person who struggles with physiological symptoms which is a big deal for some people, maybe the first and best thing is seeking to develop more awareness of your body because that gives you a window into your nervous system. Being able to be more aware and conscious of your body might cue you in to when you are starting to become anxious, and you can then use strategies like diaphragmatic breathing.”
She also shared the following coping mechanism using the acronym STOP:
S — STOP
T — Take a step back
O — Observe what’s happening inside and outside
P — Proceed mindfully
Suzanne is encouraging anyone who might think they have anxiety to seek help. She declared that it could lead to loneliness. “The minute you realise you’re struggling with anxiety, seek the help that you should get because it will only get worse and then you find yourself not doing the things that you love, not going the places that you used to go and being a lonely, lonely person.”