I Am Always Anxious

A patient walked into the examination room for the first time in my office. Let us call her Beth. Her blood pressure was 140/85 and the heart rate was 102 per minute. She was breathing slightly faster than one would expect, and her facial expression said it all. She was anxious.

When asked the reason she came to see me, she told me that it was her abnormal blood counts which prompted her primary physician to refer her to a hematologist. I usually ask new patients why they come to see me, so that I have an understanding of what they perceive the visit is about.

Based on Beth’s blood test results, I recommended a bone marrow biopsy for further evaluation. Immediately, I could sense the apprehension in the air. Beth did not want to do the bone marrow biopsy unless she absolutely had to. She heard that it was very painful and she did not want to experience that. She was concerned that the biopsy would reveal something very serious.

I discussed with Beth the benefits, risks and the procedure of bone marrow biopsy. I also informed her that I had performed hundreds if not thousands of bone marrow biopsies, and most people tolerated the procedure well. We also talked about how I would administer adequate local anesthesia to minimize her pain during the procedure.

The day came for Beth to undergo the bone marrow biopsy. She requested for an anti-anxiety medication to be taken before the procedure. Beth said that she was up at 3 am thinking about the biopsy and was not able to fall back to sleep. Her main concern was the pain she might experience. She thought she would have unbearable pain. Not to mention what possible diagnoses she could come up with when the biopsy results were available.

I reassured Beth that I would guide her every step during the procedure. All she had to do was to stay still and breathe. We would continue with our casual conversation. I announced to her each step of what I was about to do so she would not be surprised. In between those announcements, we talked about her family, her grandchildren, food, anything but medicine. The needle was in the bone and she did not flinch. She continued to talk as if nothing else was going on. At one point, she experienced slightly more pain for 2 seconds and then it subsided.

“How are you doing?” I asked.

“I’m doing alright,” she replied.

“That’s great, because we are done!” I said.

She could not believe her ears. Done? She was thinking about this procedure and how she might feel and all those negative thoughts. She told me that the biopsy was not bad at all. Not that she would volunteer to do it again, but she would tell her friends that the bone marrow biopsy was not such a bad experience.

Oftentimes we feel anxious about something, especially something we have not experienced. Anxiety stems from us thinking about the future, the not-so-good possibilities – usually the worst case scenarios. It gives us restlessness. Anxiety is a gift that keeps on giving. The more you think about one thing that makes you anxious, the more you will come up with other things which may make you even more anxious.

Most of us deal with anxiety by resisting it. We think that we should not have the anxious feeling. By resisting or arguing with its existence, we are creating more tension within us. We may end up experiencing even more anxiety.

By acting out your anxiety does not mean that you are allowing its existence. Crying, screaming, or being short with other people do not mean that you are actually experiencing the emotion in your body.

Some of us also try to avoid anxiety altogether. Instead of facing the emotion and experiencing it in our body, we do something else to make us feel better. Some examples are overeating, overdrinking, retail shopping, etc.

It is important to realize that anxiety itself is a feeling. It does not harm you although it does not feel pleasant. It is part of being human. Though anxiety is part of our lives, it is not essential. Anxiety is something that will not completely disappear from our lives, and we can learn to accept it and allow it.

Awareness is the first step to explore that you are anxious and what you are thinking is causing it. It is helpful to be in a quiet place to process your emotions. Write down all the thoughts which is causing you to feel anxious. Nothing has gone wrong. Acknowledge your emotions. Breathe it in and do not push it away.

Be curious and pay close attention to what anxiety feels like in your body. What part of your body is experiencing it? What kind of sensation? Is there a different temperature? Is there a particular color?

Allowing anxiety in your body is to let it sit in you without pushing it away, without just acting it out, and without avoiding it by substituting it with some other actions. We are in control. We get to let anxiety sit in our body for as long as it needs to sit. Then we can decide if there is any other way to think of the same situation. After processing the anxiety and realizing it is an emotion we generated based on our thinking, we get to move forward.