Over a year into this pandemic, I think a lot of people have become painfully aware of mental health issues, theirs or other people’s. Frustration, anger, despair, ennui, listlessness–people have come to recognize these as symptoms of a condition, however passing or permanent.

For years I suspected that I had anxiety and depression, and finally last year I sought help. But before that, I struggled for years, unable to name my feelings, and I felt helpless. I didn’t know what to do, how to ask for help, or what kind of help I needed.

One sleepless night, I had an anxiety attack, and I was sobbing and hyperventilating. Neither my husband nor I knew what to do.

I realize now that anxiety can look and feel very different for each person. If you’ve never experienced anxiety yourself, or if you’ve never seen someone have an anxiety attack, it can be so hard to figure what to do or how to help.

Fidgeting. A sick feeling in my stomach. An inability to focus. Tears threatening to fall.

Sometimes I start shuffling my feet and rubbing them against each other, so much that the skin starts to become raw and my toenails scrape my skin. Sometimes I close my hands into fists, nails digging into my palms. Sometimes I cry so hard that I cannot breathe.

It’s hard to think, and even harder to speak.

By now I have come to recognize the thought patterns and the feelings that precede these anxiety attacks. When something feels like it’s out of my control, when I feel helpless or overwhelmed, when I feel the burden of other people’s expectations, when I feel like I’ve made a mistake. I replay conversations and events over and over in my head. I agonize over every decision, and I think of all the things I could have or should have done or said. I list all the things I should have done better. Every mistake feels like a catastrophe. Anything less than perfect is simply unacceptable, tantamount to utter failure.

It’s like there are two voices in my head. One is telling me I’m mediocre, terrible at my job, a failure, while the other can only say, over and over, “It’s okay, you’re okay.” The first one is loud, desperate, and very insistent. The second one is unsure, but it’s there.

A year of antidepressants. Yoga. Meditation. Journaling. Painful honesty. An abrupt change of home environment.

It has taken so much for me to work through my anxiety, and occasionally I still have anxiety attacks. Thanks to recent conversations with my doctor, I have recognized some of my current feelings as anger, a response to trauma accumulated over the years. I still feel melancholy sometimes, listlessness, fear.

My anxieties are different now, but they attack much less frequently too. And when they do, I think I am in a better position to tell myself, voice a little louder and more confident, “It’s okay, you’re okay.”