Assertiveness doesn't come easily to many people, myself included. Sometimes, the mere thought of having to express myself or make some need or another known is enough to kick anxiety into high gear. When engaged in a situation where it’s necessary to assert yourself—from speaking up to a supervisor about something you think isn’t quite right to informing a friend that you hate the restaurant she chooses every time you have lunch together, and a million other situations—anxiety can stop you in your tracks. Indeed, it’s difficult to be assertive when we’re nauseous, dizzy, sweaty, and unable to breathe properly let alone think clearly or concentrate. Happily, we’re not doomed to a life of passivity.

Most everyone engages in conversation daily. From talking to the members of our household, to answering the phone, to ordering our coffees in the morning – talking to those around us occurs often. One doesn't need to have an anxiety disorder to know that certain conversations provoke a sense of discomfort or even dread. Arguing with a loved one, consoling someone at a funeral, or even telling someone “no” can cause anyone anxiety. This, of course, makes us wonder: if it is reasonable that certain conversations or subjects cause most people anxiety, what does it do to a person with an anxiety disorder?

Humpty Dumpty sat on a wall. Humpty Dumpty . . . whoa, did you see that squirrel run across that wall, well, I guess it’s a fence, chasing . . . eggs . . . I need to go to the grocery store because we have no food because I keep forgetting to go and I’m tired of fast food . . . that squirrel was fast and he’s gone . . . I love fall . . . I keep forgetting to schedule my daughter’s senior pictures. Wait. What was I doing? Oh yeah, reading this nursery rhyme. Ugh! How am I going to be able to hold down a job if I can’t even read a stupid nursery rhyme? I guess I wouldn't have to remember going to the store then because I wouldn’t have any money. I’m so useless. How am I supposed to concentrate when there’s so much pressure in my head? Make it stop! What is wrong with me?

Anxiety can feel as though an incredibly loud and boisterous parade is charging right through your very being: blasting bands, flashy floats, animals, and announcers ad nauseam. This chaos within can cause headaches, chest pain, difficulty breathing, excessive sweating, aches and pains, and other noxious anxiety symptoms. Further, our thoughts become anxious and race with worry and obsessions. Often, panic sets in. As if this weren't bad enough, we have to live in the midst of this parade. We have to deal with parade garbage (think about it—debris, litter, road apples) while simultaneously dealing with everything else around us. With pandemonium on the inside, how do we deal with all of the stuff on the outside?

When I was younger, there was a public service announcement that ran over and over that explained that the majority of car accidents happen within a few miles from home. The purpose of this message was to encourage people to wear their seatbelts, even when travelling short distances. I was a precocious youngster and when I saw these commercials I thought to myself, “No kidding! You travel close to your home most of the time, so it’s just common sense that most of the accidents would happen there.” Anxiety and panic disorder follow a similar pattern. Since I am home more than I am away, the majority of my anxiety and panic issues occur at home. Additionally, I am more likely to have elevated anxiety before I fall asleep and I spend most nights in my own bed.

To have generalized anxiety disorder (GAD) is to worry -- a lot. While true, this is an oversimplification. “Worry” doesn't really begin to describe what happens in GAD. Everyone worries; it’s part of being human. It’s a given that people will worry about their grade on a test, for example, worry about their job security when downsizing is taking place, or worry about their child’s safety when he or she is away. But with GAD, the worry becomes too much -- all-consuming, really, and typically isn't limited to a single situation. Rather than having worries in one’s life, for someone with GAD, life itself is a constant worry.

Over the past few months, I have been experiencing more anxiety and panic attacks than I have been used to. Many people take anxiety medication to control anxiety and I am no exception. Before I was medicated, the anxiety was unbearable and uncontrollable. Many years ago, I worked with my doctor to gain as much control over anxiety as possible. Prescribing medicine, whether for physical or mental illness, is not an exact science. The medicine that provides relief for one person may not provide relief for another. Even when two people are on the same medication, they may be on different doses or need to take them at different times of the day.

By now, everyone has heard that beloved actor and comedian Robin Williams has died by suicide. His death, like all deaths, is a tragedy. The fact this was a suicide adds an extra wrinkle to this story. To most, it makes the event sadder or incomprehensible. For people who also suffer from depression or any other mental illness, discussion of his suicide is more personal (Dealing with Depression in the Wake of Robin Williams' Suicide). When a famous, wealthy, and generally well-liked person succumbs to their illness, it’s natural to wonder how we can survive our own illness when someone with all that going for them could not. Nothing creates more anxiety than wondering whether or not we can beat our illness.

Anxiety can be so overwhelming. Insidiously, it sometimes overtakes our entire being. A worry, an obsessive thought, or a fear creeps into the mind. Sometimes we notice it, and our anxiety kicks into overdrive. Other times, our anxiety kicks into overdrive before we fully notice the worry, thought, or fear. Either way, anxiety symptoms choke us physically, cognitively, and emotionally. We feel defeated. Yes, we feel defeated; however, we aren't actually defeated.

I am a people pleaser. It is nice to give people what they want and I enjoy taking part in their happiness. Over the years, I have learned that I have to say “no.” As much as I love to please people, it isn't wise to give people everything they want. Sometimes it isn't in their best interest and sometimes it isn't in mine. As someone with an anxiety disorder, it often makes me anxious when I say “no.”