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A Response to ‘Your Anxiety Isn’t An Excuse to be an Asshole’

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Or ‘My anxiety may not be an excuse to be an asshole – but neither is good intentions.’

Now my personal opinion is that there is no excuse to be an asshole to anyone.  Anxiety disorder or not, being an asshole to people is not okay.  Part of not being an asshole is exercising tact and making the effort to understand things through other people’s frames of reference.  It just takes a little respect and the ability to remove your head from your anal sphincter long enough to consider that not all people are the same as you.  Mental Health Training 101 really.

Assholery is not endemic to people with anxiety disorders.  Anxiety presents with many different symptoms, the most common of which are

  • Chronic fears or thoughts that interfere with daily living
  • Panic or anxiety attacks or fear of these attacks
  • Trembling
  • Sweating
  • Feeling faint
  • Rapid beat
  • Difficulty breathing
  • Nausea
  • Numbness or tingling in the extremities
  • Inability to stay still, ‘jumpiness’
  • Avoidance behaviours
  • Sleep disorders

Being an asshole is not among the symptoms on that list.  Nor any list I have ever read or studied.

Sometimes the sheer terror associated with an attack could cause a person to lash out.  I don’t do that but I can understand why someone might.  When you can’t control your own mind, it is beyond petrifying and it is easy to lose control of your actions.  But my point is that ‘snapping at’ the people around you, treating them as your ‘your neurotypical punching bag’ or ‘taking out your stress or anger’ on friends and family are not symptoms of anxiety.  Those are reactions to the symptoms.  And how we react to the symptoms we experience is as individual as our own experience of the mental illness itself.

Depending on the severity and causation, not all of these symptoms can be controlled by force of will and management.  Sometimes none of them can.  Or all of them can.  My point is that everybody’s experience of anxiety is different.  It is hard work to manage these symptoms and function through them and sometimes it actually can’t be done without medical intervention and a whole lot of regular therapy.

When I talk about mental health solutions it is from the context of this-is-what-worked-for-us-try-it-if-you-like.  That is why it saddens me to read articles like this one, which are full of incredibly valid points but are approached from the this-is-what-worked-for-me-and-you’re-an-asshole-who-isn’t-trying-hard-enough-if-it-doesn’t-work-for-you-too school of thought.  Even though the author goes on to say that what worked for her won’t work for everyone and she ‘gets that’, the often vituperative post that follows that disclaimer points to anything but ‘getting’ other people’s experience of mental illness.  The world is full of people who have never experienced mental illness, who don’t understand it and judge those of us with it as just not trying.  We can’t be divided as a community, it is hard enough finding acceptance out there as it is.

One time I came across this picture on my Facebook.

not_at_all_helpful

I was shocked that this ill-informed, judgemental picture was shared by a girl I consider to be kind, compassionate and beautiful inside and out. After myself and another person commented that it had taken both of those things to keep us alive at various times in our lives she removed the picture and apologised.  Having never had clinical depression she only knew that nature soothed her when she felt depressed and down.  We could have used this moment of ignorance to rant and demand people see the world our way.  But we didn’t. The wonderful thing about that experience was that it opened up a dialogue on what it is like to live with anxiety and depression.  I shared with her one of my favourite, and seemingly hated by the author of the Asshole piece, comic strips by Robot Hugs that explains society’s attitude to mental health problems perfectly.

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Now, from reading the aforementioned article it appears that the author is trying to support people into being proactive in their own mental health recovery.  That in itself is a wonderful and important thing to put out there.  It isn’t going to get better unless we work towards being better.  But we don’t need to be judgemental and rude to help others achieve that goal.  Both defining characteristics of an asshole, by the way.  Weren’t we trying to avoid turning into assholes here?

Can we just start with the sentence ‘But first, some credentials, because I don’t like yelling about things I don’t understand. (Yes, I do.)’ wherein the author goes on to describe her own Generalised Anxiety Disorder.  When I was shown this article by a friend who wanted my opinion on it, my immediate response was ‘I ate a lasagne once, that doesn’t make me qualified to be a chef.’

It’s fantastic to share your experience of mental illness.  In some settings I’d go so far as to say brave and inspirational.  However, experiencing something from our own frame of reference does not make us qualified to judge other people or even give advice on how to solve something.  It just means we can empathise rather than sympathise.  We can share how we worked through the issue and offer understanding.  We can encourage others to try it our way if they think it would be a good fit for them or to use our experience to find their own solution. But credentialled?  No.  In becoming qualified to support people with mental illnesses you learn not to belittle their experience, call them assholes for not having gotten better yet, encourage people to get rid of their medication without professional support and advice or tell them they don’t deserve friends because they aren’t good enough people.  That’s how you create suicides.  Or Daleks.  Do you want Daleks?  No you don’t.

I also want to look at the sentence ‘it is important we talk about these things in a constructive way’.  Yes, yes, a thousand times yes.  It is more than important.  It is imperative.  I could not agree more with that sentiment.

Webster’s defines constructive as  “helping to develop or improve something : helpful to someone instead of upsetting and negative”.

While I think the intention behind the article was to help people improve their lives, this diatribe does not come off as constructive in any way.  Constructive discussion encourages people to engage, creates a space where all opinions can be heard and is non-judgemental so as not to upset people, as by its very definition.  Constructive is not using phrases like “the last thing in the world I would need is this dumb fucking self-care rhetoric that essentially tells you, “You’re a golden anxiety flower, and everyone else has to deal with you.”  with no forum for response.

Speaking of “dumb fucking self-care rhetoric”, the author states that what worked for her was “getting regular physical activity, eating a balanced diet, and working a job that does not trigger any of my stressors. I also have a dog now, which is by far the most soothing and helpful thing that’s ever happened to me.”  So, what worked for her was taking care of herself.  Do you know what taking care of yourself is called in mental health circles?  Self care.  That’s right.  Self care is the thing that simultaneously allowed her to become functioning and is the object of her disgust.  I don’t think it is self care that she is opposed to, it is a pervasive attitude of entitlement amongst a certain subset of of the population and the advice that encourages people to look after themselves in a manner that is counterproductive to recovery.  Neither of those things are self care.  Yet self care gets thrown into the same basket with other “terrible, indulgent advice.”

I completely agree that embracing the symptoms of your anxiety and consistently giving in to every desire to run, hide and withdraw from society on the whole is a very bad thing.  Giving in to the urge to yell at someone or treat them without respect is a very bad thing.  Being compassionate towards yourself however, is a positive step towards recovery.  The World Health Organisation who coined the phrase in 1998 defines Self Care as “the activities individuals, families and communities undertake with the intention of enhancing health, preventing disease, limiting illness and restoring health.”  The “dumb fucking self care rhetoric” she refers to is the type of advice that does not promote any of these goals when taken to the extreme.

To this author there is nothing worse than strangers on the internet writing opinion pieces or drawing comics that “tell us that people with anxiety are these fragile butterflies who must be catered to at every turn.” “Just take care of yourself,” this rhetoric says. “Practice self-care! Take a bath! Cancel your plans! Don’t explain yourself! If your friends can’t give you space and be totally understanding, that means they’re not your friends!!! They’re toxic! GET THEM OUT OF YOUR LIFE. You have no obligation to keep around Toxic People. If you need to throw your phone into a river and spend two weeks locked in your room eating Ding Dongs, that’s what you need!! :3”

I’m tentatively along for the ride there.  No one can sustain their real lives by locking themselves in their rooms and eating whatever a ding dong is.  Possibly a prepackaged cake that has an expiry date of 2078 if YouTube has taught me anything about American snack food.  Unless, that is, you work full time, are single and have the leave owing. Then call all your friends, tell them you care about them but you need to practice self care by giving yourself recovery time from the world so you can continue to be your amazing self in future.  Good friends who have an understanding of your illness will understand that you need to look after yourself as well as your relationship with them.  Sometimes their needs take precedence over yours.  Conversely, sometimes your needs take precedence over theirs.  Relationships are about give and take.

I agree that people don’t deserve to be treated with disrespect just because you suffer from a mental illness.  That they don’t have to be understanding if you cancel plans without explanation and neglect your friendship.  I agree that this does not make them toxic people who need to be shed from your life.

However, there is overwhelming evidentiary research pointing to the importance of self care and self-compassion in managing anxiety disorders¹.  So she lost me at the beginning there where the idea of taking care of yourself, practicing self care, taking a bath or cancelling plans was the worst advice that could be given.  Self care and self-compassion need to be a part of your life and  form the basis of a coping strategy.  They do not take the place of your life.  It is is not taking a bath instead of doing an activity that causes you anxiety, it is taking a bath to show yourself the compassion you would treat others with after after an anxiety producing activity.  Pushing yourself into situations that challenge your anxiety is necessary to fully engage in your own life, and on this we completely agree. However we need to recognise the effect of heightened and continuous levels of anxiety on a person’s well-being.

In 2010 a study was conducted into the connection between anxiety and suicide². The results of this two year study of  34,653 adults in the United States is summed up and concluded as follows:

Results
Among individuals reporting a lifetime history of suicide attempt, over 70% had an anxiety disorder. Even after adjusting for sociodemographic factors, Axis I and Axis II disorders, the presence of an anxiety disorder was significantly associated with having made a suicide attempt (AOR=1.70, 95% CI: 1.40–2.08). Panic disorder (AOR=1.31, 95% CI: 1.06–1.61) and PTSD (AOR=1.81, 95% CI: 1.45–2.26) were independently associated with suicide attempts in multivariate models. Comorbidity of personality disorders with panic disorder (AOR= 5.76, 95% CI: 4.58–7.25) and with PTSD (AOR= 6.90, 95% CI: 5.41–8.79) demonstrated much stronger associations with suicide attempts over either disorder alone.

Conclusion
Anxiety disorders, especially panic disorder and PTSD, are independently associated with suicide attempts. Clinicians need to assess suicidal behavior among patients presenting with anxiety problems.

Did we all catch that?  Over 70% of suicide attempts went hand in hand with an having an anxiety disorder. With devastating figures like that, I fail to see how telling people they don’t deserve friends because of the symptoms of their anxiety is constructive.  Telling someone who has a high predisposition to suicide that self care is akin to selfishness and self-indulgence is detrimental. Possibly fatally so.  Some people with anxiety really are the “fragile butterflies” she puts down for needing to take care of themselves. For having the indecency to practice self-care. Take a bath. Cancel their plans.  Take time to enjoy space away from other people and get rid of the toxic people in their lives.

Personally, I would rather a friend cancelled on me regularly than felt so overwhelmed by living their own life that they had to take their own life.

But I concede that the thing the author is railing against in that moment is the aforementioned counterproductive coping strategies touted by a well meaning, yet ultimately misguided internet cheer squad.  I just feel that it is crucial to be unequivocally clear about the difference between healthy self care strategies and self-destructive coping mechanisms. This article consistently refers to self care as a bad thing, throwing it in with all the other advice inimical to recovery.  Healthy self care and self-compassion are pivotal in affecting positive change and keeping people with suicidal ideation alive.  Sometimes you need to take a bath or cancel a plan just to stay on top of things.

I can completely understand the overwhelming relief in cancelling plans.  Oh my lordy that is like crack to a whore for me.  Does that make me flaky?  A little, yes.  Does it keep me from pushing myself to a place where I unintentionally injure myself during a panic attack?  Hell yes.  So I cancel plans to events all the time.  But not if it will inconvenience people.  If it is a large party, I will cancel the hell out of that shit and be honest in saying that I just can’t do that.  I wanted to.  I tried.  I’ll try again next time.  Thank you for thinking of me and inviting me.  Please continue to invite me because one day I will be well enough to come.  And on that day we will celebrate the hell out of that occasion together.  There will be many drinks and much whooping.  Can we have a coffee together soon because I adore you and value your friendship.

But if someone has made an effort for just me and my family or a small gathering, I’m going to go regardless of how much I want to hide at the back of my closet and pretend the world doesn’t exist.

That is where self care and self-compassion come in.  I don’t take baths, to me that is like creating a stew of your own filth.  Not at all relaxing.  But I look at my situation and consider it from the perspective that it is happening to someone else.  What kind of compassion would I show another person going through the same intense emotional crisis as me?  How would I assist them to get through this moment and take care of themselves?  After all, I am as important as everyone else in this world.  No, that doesn’t entitle me to be a “golden anxiety flower that everyone else has to deal with”, however it does entitle me to the same respect, understanding and compassion that I would show everyone else.

I see what the author of the piece is trying to do and say and I applaud the desire to share what she has learned to help other people the same diagnosis, however it is my own opinion that it is irresponsible and injurious to go about it in this way.

So no, my anxiety isn’t an excuse to be an asshole.  But neither is the ability to put my digits on a keypad and mash out an invective against other people’s coping strategies or misguided advice.  Perhaps if a person transitions from treating family and friends poorly to treating strangers on the internet poorly then it isn’t the anxiety that was the common denominator in acting like an asshole.

 

By me.
With actual credentials.
That have fancy certificates.
Diploma of Counselling.
Diploma of Child, Youth and Family Intervention.
Diploma of Community Services Work.
Lots of professional development in mental health.
But mainly from my experience with mental illness, raising a child with a mental illness and not being an asshole.  Except for in the last sentence of this article.  That was a pretty dick move, but well worth thinking about.

 

Citations

¹Van Dam, Sheppard, Forsyth and Earleywine
‘Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression’
Journal of Anxiety Disorders, 2011-01-01, Volume 25, Issue 1, Pages 123-130, accessed 30/8/16
<https://www.clinicalkey.com.au/#!/content/playContent/1-s2.0-S0887618510001751?returnurl=http:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0887618510001751%3Fshowall%3Dtrue&referrer=https:%2F%2Fscholar.google.com.au%2F>

²Nepon, Belik, Bolton and Sareen.
‘The Relationship Between Anxiety Disorders and Suicide Attempts: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions.’
Depress Anxiety. 2010 Sep; 27(9): 791–798, accessed 30/8/16
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2940247/>

 

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Use your child’s passion to engage them in their mental health recovery

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“Hi, Mum.  I’m not doing so good.”
“No?  What’s up, Hon?”
“I’m feeling really anxious.”
“Where on a scale of ‘Hobbit in his hole’ to ‘Smaug thinking all this treasure has been stolen’ is your anxiety?”
“Dwarves invading Bilbo’s hole.”
“Sooo… coping on the outside, but running around on the inside making sure they’re not destroying your furniture and eating everything in the larder?”
“Yeah… did you know that in the book Bilbo invites them to dinner and….”

My daughter has barely been to school this year.  I’d say it is fair to say that she has done about 7 classes in total outside of the first day of school.  It’s not because she doesn’t want to be there.  God knows she tried her hardest to get there every day.  And she made amazing progress with her anxiety disorder on the holiday we went on.  But the first day of school for term 2 this year wasn’t exactly a good day for us.  I’d go so far as to say that life put her in a Vulcan Death Grip and gave her an overacted Shatner-esque death scene that morning .  (On a side note, I am unsure what is worse, Spock being pissed off at you or having to watch Shatner act).

So back to her doctor and psychologist we went to try and get things under control.

The conversation at the beginning of this post was a spur of the moment way to ask her to discuss her anxiety while keeping it light yet descriptive.  It worked.  And after using her Hobbit anxiety scale for a week or two I realised it had become an invaluable tool.  Finally we had a known scale to communicate an abstract concept with. One that she could embrace and not roll her eyes at as she sometimes does with the professionally made scales and cards used in counselling.  These often come off as either too generic and sappy or childish.  Now we could use fantasy and metaphor to describe the feelings that weigh her down every day.

“Hi, Hon”
“Hey Mum”
“I’m just calling to check how my little hobbit is doing.”
“Bilbo left his hanky at home.”
“So, feeling anxious about everything ahead and trying to find any excuse to go home where it is safe?”
“Yeah.”

Her psychologist had suggested she try to imagine her anxiety as a monster at her last appointment, and this tied in nicely to her new Hobbit Anxiety Scale.  Together we worked on a predefined scale that she could visualise her anxiety on.  She wrote the scale then I drew it up and had it printed as a poster for her room so she would always have a reminder; she now didn’t need to stress about remembering or creating in the midst of her panic.  And we never need to get back on this carousel:

“How bad is it?”
“I don’t know.”
“Imagine it is a scale of 1 – 10”
“I don’t know.”

Sound familiar?  We had been going around on the same carousel for about six months before my daughter and I found our way to step off of that spiralling roundabout of pointlessness.  After all that time I had begun to navigate our situation by blending my training and experience as a youth worker with my love and knowledge as a parent.

As a parent, I wanted to do everything I could to work within the parameters given to me by trained professionals.  My fear and desperation to keep my daughter safe had blinded me to the fact I had skills and knowledge of my own to bring to the table which were every bit as valuable.

Skills as a youth worker and knowledge of the things that my daughter was passionate about as a parent.

About 18 months previously I had been participating in a train the trainer course for the anger management course RAGE.  Drawing heavily, in fact, I’d go so far as to say exclusively, on Cognitive Behavioural Therapy, it used scaling as its central theme.  The majority of participants worked with teens as the course was primarily designed to deal with.  However, one woman worked with 5 – 8-year-olds.  We got talking during a participatory exercise, she was concerned with her charges being unable to rationalise their anger on to an abstract number scale.  I suggested replacing the numbers with superheroes instead.  One being Bruce Banner, two being Ironman, all the way up to ten being The Hulk.  Her face lit up with excitement with this simple change, she knew the children she cared for would be able to identify the intensity of their anger far better with this change to the scale.

So today I would say this to you.  You know yourself and your children better than anyone else.  Find the thing that helps them connect with their anxiety.  To define it and understand it.  And run with that.  It doesn’t matter if it falls into the predefined categories or standardised boxes that professionals have already created to manage the disorder you’re fighting together.  Take the framework that they have laid out for you and give it the twist it needs to engage your child.  Life is to be lived and loved, the battle does not have to be a long dark tunnel.  Take your child’s passion and bring light and colour to the tunnel you’re in.

My daughter has given me permission to share her scale with you and provide a printable version for your own anxious geeklings.  She hopes it helps.

I’d love to hear how you’ve faired using this yourself below or the individual flair you’ve brought to supporting your own child.

Hobbit Anxiety Scale.  Click to print.
Click for a printable PDF of our Hobbit Anxiety Scale