How the Diagnosis of Anxiety Disorder Changed My Life for the Better
After 4 years and 4 months, I stopped taking escitalopram that was prescribed for general anxiety disorder.
Prior to the diagnosis, I had never thought I would need to take a prescription medication for mental health. I lived a reasonably healthy lifestyle by textbook standards. Getting up at 5am every morning, eating regular plant-based meals and snacks, doing a mix of cardio and weight training for four to five days a week, daily meditation, no drinking, and no smoking. I thought I had a good work-life balance and that everything was under control.
As I went about everyday life cool, calm, and collected, my mind was the complete opposite. It was hyper-alert and restless. Like TikTok, it played, replayed, and commented on every scenario and conversation that happened in the past hours, months, and years. During the day, I would constantly assess how I did in front of my parents, teachers, and peers (which was never good enough) and making sure I would do better next time. By night, I often had nightmares in which I tried to run away from domestic terrorists and could not escape to safety. To me, these thoughts and dreams were normal and nothing out of ordinary. I had always been like this since childhood. My overthinking mind was like a trusted friend whom I thought was keeping me safe and accepted in the world.
When my family doctor raised the possibility of taking escitalopram, I was hesitant. As a pharmacist, I knew very well how psychotropic medicines worked. I educated many patients about their use and side effects, and fully believed that it’d help them. I reassured family members, friends, and colleagues that it was okay to do whatever they needed to look after their mental health, including taking medication.
But it became a different story when the table was turned. I resisted the idea of taking psychotropic medicines. How would it affect the mind? Would it slow down the thinking? Would it take away the sharpness? Losing control of the mind was the worst thing happening to someone who relied so much on her mind to make a living. More so, I was worried about potential ramifications if people found out. Would they think less of me as a person? Would I still be qualified as a leader and manager since I could not even manage my own stress?
Thankfully my doctor was empathetic and understanding. Not once did she mentioned the diagnosis of “anxiety” or pressured me into deciding on the spot. She listened to my concerns, shared the rationale of her recommendation and experiences from other patients. Then she handed me a prescription and said, “You have been so good with self-care and yet still not sleeping well and having nightmares. Look at this as an opportunity to give the brain and the body a rest. You can always stop it if it makes you feel off.”
My doctor was right. I had already tried so many different self-care practices and yet still ruminate incessantly and slept poorly. What did I have to lose? What if the medication worked? It might be exactly what I needed to continue my wellness journey. In that moment, I decided to surrender and try escitalopram for six months.
I can still remember vividly the mental clarity and calmness that I experienced after two weeks of taking the medication. My inner chatters disappeared. My train of thoughts slowed down and my concentration improved. I was able to be more present with my family, friends, and colleagues. My monkey mind was surprisingly tamed when I meditated. For the first time in a very long time, I was able to sleep deeply without any more nightmares.
As my body and mind relaxed, I finally found the space that I needed to get curious with my mind and thoughts: Where did the inner chatter come from? How did I get stuck in rumination? What was the purpose of my thoughts? With the help of the family doctor and psychologist, I started to unpack my habitual thinking patterns, develop self-awareness and self-compassion, and learn to befriend my mind. Here are three important lessons that I have learned about healing:
Mental health issues are not just about the mind
The health of our thinking mind is intricately connected with the health of our physical body and feeling heart (or soul). People who struggle with their mental health are likely to also experience some physical health challenges. Physical symptoms are manifestations of one or more basic human needs unmet over a period of time.
As Dr. Gabor Mate said, “Learn to read symptoms not only as problems to be overcome but as messages to be heeded.” When we look beyond the physical or mental health diagnosis – when it started, what happened around that time, how we felt as a result – we would often identify one or more “negative” emotions attached with the “disease” such as fear, anger, sadness, and/or disgust. Physical or mental symptoms act as messengers to alert us about people, things or situations that may hurt us or even threaten our survival. They are designed to cause discomfort or pain to get our attention, and they would intensify or shapeshift unless we listen and do something to address the need.
This helps explain why we are deep in the epidemic of addiction – whether it is a substance (drugs, alcohol, sugar) or an activity (social media, gambling, sex) – and many other medical conditions that were uncommon just over 50 years ago. It has also become evident that treating physical and mental health conditions in silo does not support recovery and healing. Instead, it creates a mass population of people who are suffering from chronic diseases and over-medicalisation, putting significant strains on families, workplaces, and social systems.
In order to heal and be well, the first step is to start paying attention to the body, mind, and soul together as a whole system through the lens of self-compassion and curiosity.
There is no one-size-fits-all approach to mental health and wellness
We experience life in our own unique ways. While our basic human needs are the same, what and how we meet these needs would depend on the environment, resources, and culture. Therefore, a personalised approach is essential when it comes to recovery and healing. Some people may find psychotropic medicines helpful, and some may not. Other people may prefer traditional or non-invasive healing modalities, and some may refuse to try anything outside the realm of scientific research. Giving people the space and autonomy to choose how to heal is just as important as (if not more than) the methods of choice.
When I was taking escitalopram, I was also trialling alternative therapies such as traditional Chinese medicines and psychospiritual energy healing. My doctor was always open-minded and non-judgemental about my choices. Rather than telling me to stop these non-evidence-based therapies, she encouraged me to listen to my intuition and do whatever I needed to feel better, as long as I maintained regular medical reviews. Her unwavering trust and support had given me the agency and empowerment to take care of myself in my own way.
Modern medicines and ancient therapies, when chosen and used with care, can catalyse recovery. Personal safety is paramount as we are in a more vulnerable state during the healing process. Seek help from people who you trust and feel safe with. Build a support network of qualified professionals and reputable practitioners who genuinely care about their client’s wellbeing. Establish appropriate boundaries. No one should force us to do anything that we do not want to in the name of healing. If someone or something does not feel right, we are probably right. Keep an open mind, do our research, and let our intuition guide us on this journey.
Both suffering and happiness are of an organic nature, which means they are both transitory; they are always changing. The flower, when it wilts, becomes the compost. The compost can help grow a flower again. Happiness is also organic and impermanent by nature. It can become suffering and suffering can become happiness again. — Thich Nhat Hanh
Healing starts when we are willing to be vulnerable and share our stories
Having worked in healthcare for many years, I was well aware of the public and institutional stigma around mental health conditions. I had observed so many people displaying negative or discriminatory attitudes – consciously and unconsciously – toward those who struggled with mental health issues. When I first started escitalopram, no one knew except my doctor, my psychologist, and my sister. I chose to keep quiet about my anxiety to minimise the risk of discrimination and marginalisation, particularly in the workplace. But unknowingly I also chose to carry the beast of internalised shame with me everywhere. Over time, this beast grew bigger and heavier, weighing me down and holding me back from getting better.
Then the pandemic shut down the world in March 2020.
My first and foremost priority as a manager was to support the health and wellbeing of all staff in the department. Knowing that uncertainty, the lack of information, and the perceived loss of control could contribute to significant stress, I started a daily email to keep staff informed of our departmental plans, service changes, and tips of workplace health and safety. When the pandemic dragged on for months after months, I realised that the communication of mere facts was not enough, and we needed something more to sustain our staff through tough times.
One day, as I was eating another lockdown burger, I watched Brené Brown sharing Theodore Roosevelt’s “The Man in the Arena” speech on her Netflix show:
“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”
That was a major light-bulb moment for me. If I could not be open and honest about my struggles with anxiety, how could I expect my family, friends, and colleagues to practice self-compassion and embrace their mental health conditions?
From then on, I started to write my daily email differently, acknowledging difficult feelings my staff might experience in the deep of the pandemic, as well as sharing different self-care tips, particularly practice that were often stigmatised such as talking therapy and short-term medicine therapy. For staff who I knew had pre-existing mental health conditions, I shared candidly with them my own challenges and reassured them that it was okay to seek extra support during this difficult time.
Anxiety, depression, and other mental health conditions are not caused by neurochemical imbalance, but rather the diminished or misaligned connections with one’s own self, other people, and the world. The abnormal level of neurochemicals is merely a reflection of one or more basic human needs not being met. The more we keep our mental health struggles a secret, the more we keep ourselves away from love, joy, and belonging – all the ingredients we need for recovery and healing.
As I close this chapter of my healing journey, I have come to a realisation that my anxiety was not a beast but a helping friend. It was trying so hard to stop me from crumbling into poor health and misery and show me an alternative and better version of living. I want to honour my experience and learning with two quotes from Thich Nhat Hanh’s book “No Mud, No Lotus: The Art of Transforming Suffering”:
“Most people are afraid of suffering. But suffering is a kind of mud to help the lotus flower of happiness grow. There can be no lotus flower without the mud.”
“Both suffering and happiness are of an organic nature, which means they are both transitory; they are always changing. The flower, when it wilts, becomes the compost. The compost can help grow a flower again. Happiness is also organic and impermanent by nature. It can become suffering and suffering can become happiness again.”
