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.