But this is what my life felt like: almost daily migraines, crippling neck and shoulder pain, and a nauseated stomach that sometimes forced me off the bus to keep me from fainting.
I’d long ago given up on finding a cause for these pains, so I went to my annual neurologist appointment ready for my regular dose of confused irresolution. Instead, shockingly, she diagnosed me with generalized anxiety disorder, and my life changed on the spot.
An Elusive Epidemic
Generalized anxiety is, according to the Anxiety and Depression Association of America (ADAA), a disorder “characterized by persistent, excessive, and unrealistic worry about everyday things.” Generalized anxiety is an umbrella term, meaning that there are lots of different types of people to be found under there when it rains. The statistics shared on ADAA suggest that 6.8 million Americans, or a little over 3% of the population, has generalized anxiety disorder. (I think that’s massively understated, incidentally).
Another skepticism (settle in, cause I’m full of them) has to do with just what GAD is. “Excessive worry,” as the disorder’s most common descriptor, was problematic for me, because for 39 years, I didn’t consider myself a worrier. I was an overthinker with migraines. And since I never used the words or mindset that the health industry used, I found very few examples that rang true when I searched for more information about generalized anxiety. In person and online, though, I met tons of people who were, in fact, just like me: men and women experiencing physical pain resulting from perfectionism, fear of failure, and overthinking.
The disconnect between how people talk about anxiety and what anxiety actually feels like is the engine that drives me to write about this phenomenon. Thanks to my diagnosis, what was once invisible now has shape, and I understand the world around me differently.
I hear the hum of the ambient complaints in a new way.
But First, What About the Recency Bias?
A few months after going on anti-anxiety medication, I went back to my neurologist at UCSF and explained that my once-daily headaches were now down to one per month. I was grateful. I was also curious to know if my experience was unusual. From what I could tell, it seemed surprisingly common.
But—cue the overthinking—maybe I was overestimating it. Like every good student of anxiety, I had memorized my list of cognitive biases. Was I overgeneralizing? Was my sense that people around me were experiencing physical pain as a result of perfectionism simply projecting my problem onto others?
Was I hearing only what fit my story?
My neurologist listened to my concerns and then replied, “This problem — the problem of perfectionism and anxiety — is getting bigger and bigger every day.”
She described seeing an average of three people a day suffering from some form of chronic physical pain who had one thing in common: perfectionism. “It’s extremely common in the tech industry,” she said. “These people are very successful. They want to do everything right.”
She then said something that stayed with me. It’s a statement so clear, so unwavering, that I knew I needed to reckon with it (and still do): “One of the groups that has the hardest time seeing GAD in themselves is psychiatrists and psychologists.”
Where We Came From
In the past, if you had a physical problem, you’d visit a doctor.
If you were having a mental problem, you’d visit an office like this:
Treating symptoms meant sitting in a room with an expert, looking for answers together.
If your physical symptoms spring from your intense pursuit of perfectionism, however, this method is problematic. You can visit doctors of all stripes, and they won’t find anything physically wrong with you. Therapists may enjoy your confessional insights and wit as much as you enjoy sharing them—but they won’t help you when your back gives out again.
One of the groups that has the hardest time seeing GAD in themselves is psychiatrists and psychologists.
It leads a person to wonder… why do we think the only treatment for the epidemic of perfectionism is sitting in a room alone with one other person—who may or may not be an anxious perfectionist themselves?
If Not That, What?
Anxiety, though chemically and genetically influenced, is, at its most fundamental, a system of messages the body is trying to send the mind. It’s similar to an allergic reaction where the body overreacts to stimuli. In this case, the fear of losing control causes an adrenalin and cortisol rush in the body. Our minds work to avoid negative feelings (or the stimuli that caused it). Yet the effort of avoidance ends up creating more fear—and more overreaction. Doctors have long seen a connection between the physical pain that people feel and the emotions they are repressing.
For perfectionists, the mind is trying to tell itself the truth: “I can’t live up to my own expectations.” But inherent in the perfectionist problem is an inability to accept this reality. The mind deflects the message of impossible expectations and literally pushes it into the body.
My neighbor is an example of this. Let’s call him Shane. Shane is an artist and teacher who spends a lot of time worried about what other people think about him. His standards for work are extremely high. He also has a lot of neck and back pain, sudden bouts of sweating, and dizziness. He takes 3–4 ibuprofen a night for “sore muscles.” He needs a whiskey to help him fall asleep. He knows that he has anxiety, but hasn’t yet figured out how to listen to what his body is telling him, or how to address the pain.
When I learned about my generalized anxiety disorder, I started with the treatment path of medication (Lexapro, 10 mg every day), meditation (Headspace, 20 min every day), and communication (writing, talking, all the ways). Treating perfectionism meant I’ve been forced to stop comparing myself to other people, especially on social media. I’ve had to learn how to turn up the volume on my own voice of confidence and creativity. I did this by creating a project that looks at overthinking from a bird’s eye view.
The First Social Network for Overthinkers
For over a year and a half, I’ve been working to create the first social network for overthinkers. It’s called The Beautiful Voyager. As I began working on it, with much trepidation, I comforted myself with the thought, “You gotta be gawky to get to graceful.”
I threw my real, far-from-perfect self, out into the world for everyone to see, hoping that other overthinkers might find comfort and common cause in my struggle.
My goal, however, wasn’t to be the focal point of the project. The Beautiful Voyager has always been about creating a space where it’s OK to be imperfect. It’s like training wheels for social interactions. As confidence builds, pain subsides.
This Doesn’t Mean Therapy Is Off The Table
Therapy can be a useful tool to help people tune in to their own inner strengths. Understanding that we’re in a world where the therapists themselves are dealing with some of the same perfectionism issues, however, should allow us to reconsider therapy as “one tool among many” instead of “the only answer.”
The Only Map is Buried Deep
My first thought, when I began The Beautiful Voyager, was, “There’s no one map to fix anxiety,” but that’s not true. There is a map. Each person’s is buried deep inside of them. The map is the treasure. This map doesn’t emerge all at once, though. It takes a long time to navigate your own internal terrain. Taking steps like medication, meditation and communication can help. For some of us, these steps can help us uncover signposts along the way.
I created the Beautiful Voyager because it’s reassuring to have other navigators around during the map-hunting process.
I collect overthinkers now like a little kid collects baseball cards. Wanna work with someone you trust? Hire an overthinker. Wanna talk about your fears? Same.
Going In to Go Out
Trying to connect our mental states and physical bodies is a challenging, often-daunting task. Being online only complicates the issue. But if we want to start healing ourselves of the pain of perfectionism and overthinking, we’re going to need to begin looking at novel solutions.
If you or someone you love is experiencing symptoms like those on this list from my neurologist, take a closer look at how anxiety isn’t always what it seems.
- back pain
- neck pain
- chest pressure
This is one epidemic we can do something about, but we have to work together. So as you go out into the world, or deep into the world within, in search of the map you need, know that you’re not alone.
I’ll meet you there.