Several years ago, I visited my doctor with some disturbing symptoms - most notable of which were a recurring rapid heartbeat and chest pains. At my age and physical condition, a heart attack seemed unlikely – but after several days of this I naturally began to worry. Well, let me rephrase that. I actually began to worry the minute the chest pains started, but it took several days for me to get worried enough to go to the trouble of see my doctor.
My doctor agreed, based on my symptoms, that a
heart problem was probably not the cause, but he ran tests just to be safe. One
clean EKG later, it was clear that something else must be wrong.
“Have you been under any stress?” he inquired.
I laughed. My whole life has been one giant ball
of stress.
It was true, though. I had taken on an additional
job (on top of my other two) and was working way too much. Besides that, one of
my employers was in an extremely precarious financial position, which put a lot
of strain on the person who managed the money – namely me. In addition, in the
course of our conversation, I revealed that I had had a near-death experience
several months before. Well, once my doctor heard that, he was quick to arrive
at a diagnosis – anxiety.
It seemed plausible. I was under a lot of stress,
and had little time for anything but work which I no longer enjoyed. It was also
true that I had been profoundly affected by my near-death experience. Still, it
seemed strange. Although I’m certainly what one might call a “worrier,” I had
never suffered from anxiety – in the clinical sense - before. Not when my
mother developed her mental illness, not when I ran away from home, not even
when I was homeless and starving. But perhaps the effects were cumulative, I
reasoned. Perhaps all the years of stress had finally caught up to me. I was
getting older, after all. Maybe I just wasn’t able to handle things the way I
did when I was young.
My doctor prescribed Lorazepam. I normally avoid
medications except when absolutely necessary, but after a few weeks, I was so
unnerved by these ongoing issues that I agreed to take it. And I did. It was
frustrating, though, because it didn’t seem to do much. Yes, the tightness in
my chest lessened slightly. Yes, I worried less about the symptoms I did have
because my mind went a little hazy when I was on it. But it didn’t solve the
problem. It didn’t fix me or return me to normal. I still had that tension,
that pounding in my chest and I wondered – would it ever stop?
You can therefore imagine my immense relief when, four
months later, my symptoms suddenly vanished as quickly as they had begun. It
was over, I thought. Whatever had triggered the anxious response was gone, gone
from inside me at last. I could go on with my life.
And I did. I went about my business. More than
that. I began thinking about working my way towards a new life – a life that I
really wanted.
Several months later, for no apparent reason, my
symptoms returned, even worse than before. I’d go to work in the morning, and
within a few hours, my heart would be pounding, I’d be sweating profusely, and,
of course, totally freaking out that this could have happened to me again. Panicked,
I refilled my long-depleted Lorazepam prescription. But again, it had little effect on my symptoms.
I was stunned, and more importantly, puzzled. I
simply couldn’t understand it. The first time, sure. I could see where the
combination of stresses I was under would have caused this kind of reaction.
But why would it go away and then come back? Had there been a new triggering
event of which I hadn’t been consciously aware?
It was at this point that I decided to start
keeping a diary to see if I could discern a pattern as to when my intense
feelings of nervousness were at their worst. I never even got that far. Because
once I had decided to do that, I realized that my anxiety did indeed have a
very definite pattern. It would start in late morning, peak mid-afternoon, and
finally start tapering off after that.
This made no sense. Yes, I had a heavy workload,
and one of my jobs was incredibly nerve-wracking. But I didn’t see how that
anxiety could be tied to a particular job, because my work schedule was
different every day. Even on weekends, when I worked from home, I had the same
symptoms. What else could possibly be provoking this daily – and seemingly
cyclical – response?
My mind turned at once to food, as I knew that
blood sugar could affect mood. But since eating in the afternoons makes me
exceedingly groggy (falling-asleep-on-my-desk groggy), I have long made a habit
of skipping lunch. Therefore it couldn’t be something I ate – could it perhaps
be the fact that I wasn’t eating? But if that was the case, then why did my
symptoms always go away before dinnertime? If lack of food was the cause, then
logically, it seemed as if I should have gotten better only after a meal, not
before.
I only had one other habit that I could think of
that was tied to particular times of day, and that was coffee. Yes, I did drink
a lot of coffee. Mind you, I’d always drunk a lot of coffee. In fact, at this
time I was consuming far less than I had at other points in my life – even in
spite of having multiple jobs and a correspondingly crazy work schedule. But I drank
it very consistently, eight six-ounce cups a day, according to my little
coffeepot. I’m a sipper, not a chugger, and it took me from the time I got up
around five until noon or one o’clock to finish all that, but I usually
did.
It seemed unlikely, I’ll admit. Why would I be able to drink all the coffee I wanted one day without a problem and then feel as if I’m having a heart attack the next? It made no sense. But I was desperate – so desperate that I decided to give it a try, even if it meant messing with my precious morning ritual. I bought some decaffeinated coffee and the next day I made my coffee half-and-half. And that, unbelievable as it sounds, was the end of my anxiety.
How could this be?? Months and months of strain and worry and nervousness that I feared would never go away, and it could all be explained by something as stupid as too much caffeine. But if my coffee-drinking habit was so consistent, then why did my symptoms vanish and then return?
This, it turned out, was the key to the whole
problem, and the one that convinced me that I was right. My favorite coffee is
actually Costco’s Kirkland Signature Colombian Blend, which is very strong and
bold, just the way I like it. However, the Costcos where I live are so crowded
that I very rarely go to one, so I don’t always have this coffee on hand. Well,
when I went back and examined my receipts and mileage logs, it was plain to see
what had happened. Around the time my symptoms first started, I had made a Costco
run and bought the Kirkland coffee I liked. When that ran out, I drank a
different – and presumably weaker - brand from the grocery store for a while. Some
months later, I made another Costco run and went back to the Kirkland. And bam!
That was when I started having “anxiety” again.
So what is the lesson here? Anxiety is a very real
problem for large numbers of people, and undoubtedly for most of them, it does
have a psychological cause. But we as a society are perhaps a little too quick
to assume that our physical problems result from emotional stimuli. Look at my
doctor – what did he see? A high-stress person. A difficult personal history.
And unexplained heart palpitations and chest pains. Naturally he jumped to the
conclusion of anxiety. But did he ever even ask me if I was taking any
stimulants, even the ordinary kind? Did he ask me if I was taking allergy
medications, some of which, as I’ve learned since, can also cause heart
palpitations? No. He ruled out the obvious potentially serious physical causes
and never bothered to dig any deeper than that. Look at you, you poor dear –
you must have anxiety. Now hush up and take your medication.
It’s been four years since then, and I have not experienced
even a single day of anxiety in that time. Not one. I drink much less coffee
now, but I do notice that if I overdo it on the caffeine that the symptoms
threaten to return – my chest tightens, my heart rate increases, and I sweat
more than usual. But that’s it. It’s not anxiety – it’s physical tension caused
by overstimulation of my system. But can you imagine if I had not figured this
out? I would have spent the rest of my life choking down worthless chemicals,
having god-knows-what long-term effect on my body, and constantly feeling as if
my mind’s about to spin out of control. Unlike purely physical ailments, mental
illnesses feed off of and reinforce themselves by creating fear and creating worry.
It’s not like when you break a leg and you know you just have to wait six to
eight weeks for it to heal. You can’t know when or if you will ever recover
from an emotional condition. It’s almost enough to give you anxiety.
I suffered for nearly a year – for nothing. From a
so-called illness that didn’t even exist. The miracle is that I came out of it more
or less emotionally unscarred – and with a healthy skepticism towards the
medical profession. I don’t blame doctors. They’re human too, after all, ordinary
people trying to do their jobs as efficiently as possible, just like the rest
of us. But that’s what makes it so important for patients to be their own
advocates. I trusted my doctor because he knows his profession, and I don’t.
But he was wrong. And who finally arrived at the right diagnosis? I did.
Without any medical training at all. Not because I’m smarter or better educated
than he is. No, but because I know my body in a way he never will. I know the
intimate details of my life in a way he never will. And ultimately, because I
care more about my body and my life than he – or anyone else - ever will.
I decided to put this story out there because it
simply horrifies me when I think of how many people there must be who, like me,
have been diagnosed with anxiety, but are really suffering from a case of too
much Starbucks – or any of the many other readily available modern products
that contain stimulants. How will they ever know? Their doctors will probably
never even know. And it does make one wonder what effect this misdiagnosed
population has on patients with genuine anxiety disorders. Have their treatments
been altered or affected because of these other folks who are sadly unaware
that there’s nothing actually wrong with them? How does one judge the true
efficacy of a medication if it’s also being used on individuals who aren’t
really sick?
This, to me, is a very sad situation, one that
people should know about. Of course not everyone can be cured of anxiety by
reducing or eliminating caffeine – but what a difference to those who can. I’ll
be the first to admit that one of my great pleasures in life is the joy of
waking up to a freshly brewed cup of coffee. But even that can’t compare to the
happiness I felt in discovering that my “anxiety” wasn’t real.
