Living with Anxiety

A Des Moines writer explores her struggles with the nation's most prevalent mental illness.

Living with anxiety has taught writer Rachel Vogel Quinn that while sorrow and fear are contagious, “so is hope. … I want anyone who’s struggling to know they don’t fight alone. No matter how isolated you feel, no matter how hopeless things seem, change is possible.”

Writer: Rachel Vogel Quinn
Photographer: Duane Tinkey

I wake up every morning wearing a suit of armor. It doesn’t protect me, though. No lances or arrows are heading my way. It’s just heavy. So heavy I can hardly move.

Of course, I’m only wearing pajamas, but my skin seems encased in steel, restricting my movements, weighing me down, dragging me back into bed. I suppose my body thinks it’s protecting me from some unseen danger. It’s caught in a decades-long “fight or flight” mode, but the only thing I’m fleeing is my daily life.

Like millions of Americans, I suffer from generalized anxiety disorder, panic disorder and specific phobias, including fear of drowning and going to the doctor.

On my most anxious days, my heart races. I can’t get a deep breath. I feel queasy and dizzy and weak. My muscles tighten, my legs shake uncontrollably, sweat pours down my face. I have an irresistible urge to lie down. Overcome with fear, self-loathing and guilt, I want to hide from the world. I see no hope for the future, only endless toil. Nothing matters, certainly not me.

Where do these feelings come from? My childhood was a happy one, and I’ve led a largely carefree life. But anxiety has dogged me for nearly 30 years, since I was a young child. When I was 5 years old, I would lie in bed at night repeating the sign of the cross over and over, increasingly frantic that only a perfect right angle would answer my prayers and keep my family safe from harm.

Family Ties

My experience with anxiety isn’t unique, even among my relatives. My mother and grandmother have both suffered from anxiety for decades. Recent research found that anxiety can be inherited, with specific genes linked to different anxiety disorders. Despite seeing my mom struggle, I didn’t recognize the signs in myself for many years. Or maybe I just didn’t want to.

By the time I was 23, I couldn’t stay home alone overnight without having a panic attack. I once showed up at a friend’s door at midnight, in tears, begging him to let me sleep on his couch. (He graciously accepted my presence, but his cat angrily farted nearby all night.) During this time, my mom’s genealogy research uncovered a family secret long kept hidden—that my great-great-great grandmother had murdered her husband and eventually committed suicide in prison.

When my mom told me, I found myself sobbing into the phone with a kind of recognition. Was this foremother of mine a harbinger of lunacy in my family? Had some strain of bad blood infected me 100 years on? Hearing her story, I finally recognized my own mental health issues, though admittedly I had less violent leanings. If I didn’t want to end up where she had, I needed to get help.

Generational Trauma

Although the logical leap I took that day was based more in fear than fact, I recently learned about research proving that trauma can be passed down over generations through epigenetic changes. I can’t blame my murderous ancestor for all my problems, but I do wonder how that traumatic experience might have been passed down to my grandmother, who lived with an alcoholic father who was also abusive. And now my mom and I might be reliving those events in our daily lives without knowing it.

Having a potential explanation for my anxiety helps me see it as a medical issue, rather than a personal failing. But it’s still a hard load to bear, especially as mine co-exists with depression and chronic migraines, a fairly common occurrence. Nearly half of those with depression also experience anxiety. As do half of people with migraines.

Many people with mental health issues also suffer from related health conditions. For me, that means I regularly fall into a migraine-anxiety cycle that can spiral out of control. Everyday stressors build up in my body and exacerbate my migraines. Down for a day with a pounding headache, I get anxious about missing work, canceling plans, skipping household chores. I imagine that people think me lazy, apathetic, entitled, weak, maybe even a faker. And that anxiety provokes another migraine, another missed day, another panic attack.

Some days, the idea that anyone would ever expect anything from me seems both terrifying and unfair.

Understandably, this predicament has taken a significant toll on my life. I’ve struggled to keep a steady job. I avoid friends and family for fear of judgment. I’m often overwhelmed by simple tasks, like calling the doctor or ordering prescriptions. I’ve had streaks of vomiting every day before work. Once, I had a panic attack on a flight over the Atlantic. (Although I screamed at my husband to “stop touching me!” after he stopped me from lying down in the aisle, no flight attendant ever came over to check on us.)

Helped by Medication

Ever since that revelation nearly 10 years ago, I’ve tried many strategies to manage my anxiety. Fortunately, medication has made a significant difference for me, reducing both the frequency and severity of my symptoms. Counselors have helped me curtail my negative thoughts, and coping strategies like deep breathing, meditation and visualization help me deal with attacks in the moment. My husband’s love and support reminds me that life is worth living.

As easy as it is to slide down the spiral of anxiety, depression and chronic pain, the reverse is possible too. One good day can lead to another, and another. I know that my anxiety will never be cured, but I believe that I can manage it, plodding along in my metal plate and visor.

At first, when I was asked to write this article, I was excited about the opportunity to share my experience. But, as you might imagine, anxiety got in the way. I had to stop often to take deep breaths and remind myself that I wasn’t in any real danger. I worried about what strangers and acquaintances might think of me, that admitting to my mental health problems might prevent me from getting another job.

I nearly gave up.

But then I got a text from a dear friend (and incredible woman), updating me on her recent depression and suicide attempt. I was crushed to the core. How could such an astonishing person feel so worthless? To consider suicide yourself is one thing, but to hear about it from someone you respect and admire is a reminder of how fragile we all are. And how much we need each other to get through life.

Hope is Contagious

Sorrow and fear are contagious, but so is hope. That’s why I’ve committed to telling my story. I want anyone who’s struggling to know they don’t fight alone. No matter how isolated you feel, no matter how hopeless things seem, change is possible. You don’t have to keep living the way you do. But you do have to keep living.

One of the Four Noble Truths of Buddhism is that we can’t escape suffering in this life. No matter what I do, I will always have some level of anxiety. But I’m OK with that now. The experience has made me who I am today. And it continues to shape me and teach me. I can’t love myself without loving my pain, my fear, my flaws. Without welcoming the weight of my armor.

One benefit of carrying a heavy load is the muscles it tones: persistence, resilience, grit. I’ve learned how to haul myself out of bed on the worst days. I’ve learned other people can pull you up. I’ve learned that nothing is ever as bad as you imagine it to be.

Yes, every day, I still face a mountain to climb. My legs shake from the effort, and sweat rolls into my eyes. I run out of breath. But I also get the satisfaction of standing atop the peak, my suit of armor gleaming in the sun.

Anxiety: Just the Facts

40 million Americans over age 18 suffer from anxiety, or 18% of the population, making it the most common mental illness.

Only 37% of those suffering from anxiety seek treatment.

25% of adolescents between ages 13 and 18 have an anxiety disorder.

People with anxiety are 6 times more likely to be hospitalized. They’re also 3 to 5 times more likely to need a doctor.

Women are twice as likely to have an anxiety disorder as men.

People with anxiety disorders are twice as likely to have a heart attack.

Anxiety often co-occurs with other physical problems, including:

  • Eating disorders
  • Headaches
  • Irritable bowel syndrome
  • Sleep disorders
  • Substance abuse
  • Adult ADHD
  • Chronic pain
  • Fibromyalgia

Sources: Anxiety and Depression Association of America, Harvard Medical School, Joseph Rowntree Foundation.

Types of Anxiety

Generalized Anxiety Disorder

  • Persistent and excessive worry in daily life.
  • 6.8 million adults (3.1%)

Panic Disorder

  • Spontaneous panic attacks when there is no danger.
  • 6 million adults (2.7%)

Social Anxiety

  • Intense fear of being judged in a social situation.
  • 15 million adults (6.8%)

Specific Phobias

  • Strong irrational fear of common places, situations or objects.
  • 19 million adults (8.7%)

Post-Traumatic Stress Disorder (PTSD)

  • Debilitating condition in people who have experienced life-threatening events.
  • 7.7 million adults (3.5%)

Source: The Anxiety and Depression Association of America.

Pandemic Increases Anxiety Levels

Marshall Abbe has struggled with anxiety most of his life. That’s partly why he became a therapist and licensed independent social worker. Since moving back to Iowa from California nearly two years ago, he has practiced at Eyerly Ball Community Mental Health Services in Des Moines.

Abbe defines anxiety as “stress that impacts our everyday functioning.” He says anxiety is becoming more common since the COVID-19 pandemic. In a survey by the Centers for Disease Control and Prevention, 31% of adults reported anxiety or depression due to the outbreak.

“People are more isolated,” Abbe says. “People have to do more with less. And people are more stressed now than ever.”

No one is sure exactly what causes anxiety, but risk factors include genetics, brain chemistry, personality and excess stress. Abbe says anxiety can also spring from core emotional needs—such as safety, autonomy, support and belonging—that weren’t met by caregivers during childhood.

Risk Factors

Past trauma also plays a role. Given that low-income households experience more stressors, such as food insecurity, poor housing and inadequate schools, marginalized communities and people of color often experience more risk factors for mental illness.

“The more traumatic events we experience and the more stress we have, the more likely we’re going to be in chronic survival mode and develop major health issues,” Abbe says.

During the “flight or fight” response, the stress hormone cortisol triggers physical reactions such as short-term memory loss, digestive disorders, sleep disorders, a weakened immune system and, on occassion, heart attack.

“Our mind and body have a major connection,” Abbe says. “Our emotions impact our thinking. Our thinking then sends signals to the nervous system, and then that’s hardwired to our body. It’s a big loop.”

Abbe and other mental health professionals harness that connection in their therapy sessions. Abbe uses EMDR (Eye Movement Desensitization and Reprocessing), where clients move their eyes or tap their hands in specific ways while thinking about past trauma. Studies have shown the technique to be effective in treating anxiety disorders, including PTSD.


Other mind-body practices include breathing exercises, yoga and mindfulness. Abbe calls mindfulness “one of the greatest and best tools.” He says it helped him overcome feelings of worthlessness and taught him to live in the present moment. But he cautions that those with severe anxiety symptoms should talk to a therapist before experimenting, as it can cause flashbacks or psychosis in rare cases.

For those with mild symptoms of anxiety, good sleep, healthy eating, exercising and deep breathing can be beneficial. Medication is often effective for people with more impairment. And getting professional help is always a good idea, especially if anxiety affects how you function, he says. Therapy can teach self-compassion and help end the cycle of negative thoughts.

“Anxiety is not your fault,” Abbe says. “Anxiety is normal. We all experience it. It’s OK to be stressed and worried. And it’s OK to get help.”

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