A diagnosis of generalized anxiety disorder (GAD) or having panic attacks doesn’t automatically mean there will be a co-occurring diagnosis of depression. However, many people with an anxiety diagnosis do suffer from clinical depression, even if only from time-to-time. In my case, I have both bipolar and anxiety disorders. Like many others, I have found that serious anxiety can lead to depression.

Mental Illness Awareness Week 2014 continues. The week means slightly different things to different people (as in specific awareness, the attitude behind the desire for awareness, etc.) To me, it means something relatively simple. It means looking at people in a new way, leading to a new understanding of them as human beings. Mental illness happens to be part, just part, of who they/we are. Awareness of the whole package brings understanding of the whole person.

As of this writing, I live with my wife. But before I lived with her, I had a variety living situations, including living alone and with a roommate. Anxiety and panic attacks occurring at home are fairly common for many of us with anxiety disorders and disorders don’t much care what your personal living situation is. Panic and anxiety attacks in public present a special kind of frustration because, in addition to the attack, we have to deal with the embarrassment of being sick in public. Even during my worst panic attack in a public forum, I was still concerned with what others thought of me and whether or not they were judging me.

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?

Over the weekend, my wife was bitten by a dog. It was a serious bite, costing her the tip of her right index finger. I was present when it happened, watching in horror as she stepped in between two angry lab-mixes that were fighting over a bone. We went from watching college football to panic in less than 30 seconds. As my wife sat down, holding her bloody hand, there wasn't time to think about much. My only concern was how to help her. My mother-in-law had separated the dogs, placing one in a cage, and raced over with napkins and began to apply pressure to my wife’s wound. At that moment, we had no idea how serious the injury was.

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.

I must confess; I’m a bully. But not to others. I tend to bully myself relentlessly, criticizing what I do and don’t do, say and don’t say. It’s a nearly endless stream of self-denigration that runs always in the background, often in the foreground, of my thoughts. This harsh self-criticism is entangled with all types of anxiety.

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.”

As a speaker and blogger, I answer a lot of questions about recovering from mental illness. I am asked many different things, from the technical, to the personal, to the deeply personal. I sincerely enjoy the conversation, and leading group discussions is one of my favorite activities. Answering comments and emails is a close second. It is because of my love of interaction that I decided to write an interactive blog. Every blog on HealthyPlace is technically interactive, in that they all have a comments section. This is a little different, however. The goal of those blog posts is to be read and the goal of this blog post is for you to participate. This won't be an interactive blog if you don't.