Managing Anxiety & Sleeplessness during a Pandemic

Photo of African American woman dressed in gray tank and tan pants, seated on a kingsized white bed with a dark brown wall-mounted wooden headboard.

Image courtesy of CreateHerStock. Copyright 2019 Neosha Gardner

I don’t feel anxious when I’m anxious, not in the classic sense. But I have a pretty strong pretty disposition to anxiety. We could argue about whether it’s biological or a result of conditioning, but it’s definitely a pattern in my family.

Even as a clinical psychologist, it took me a long time to identify my anxiety for what it was. Because I don’t feel anxious when I’m anxious. I don’t have the telltale symptoms of uncontrollable worry, nervousness, difficulty concentrating, persistent feelings of fear or dread. Those are the classic cognitive and emotional symptoms of anxiety. I rarely, if ever, have those.

It’s part of the legacy of being a StrongBlackWoman, that cultural myth that so many Black women – in the Americas, in Europe, in Africa, and in the Caribbean – strive to live up to. In Too Heavy a Yoke: Black Women and the Burden of Strength, I describe the StrongBlackWoman as a “scripted role into which Black women are socialized, usually beginning in childhood. Rather than being a genuine expression of personality, it is a mask that stifles authenticity.” The StrongBlackWoman takes who we really are and hides it behind a mask of emotional stoicism, self-sacrificial caregiving, and extreme independence. In other words, the StrongBlackWoman is the woman who constantly extends herself on behalf of others, always striving to identify and take care of the needs of her family, her friends, her church, and her workplace. It is not that she doesn’t feel the burden of constant multitasking and overcommitment. It’s that she has learned to repress it, to not feel it. She has learned to push through, to keep going.

I have learned to repress it, to not feel it, to push through, to keep going. Like my mother and my grandmothers and all the women before me, I have learned to use strength as a mask that covers anxious thoughts and feelings. Being two generations removed from sharecropping and just a few more from slavery in the deep South makes it even easier for me to ignore, deny, and repress feelings of worry and fear. “I’m not afraid. I’m a StrongBlackWoman! I come from strong stock and I can handle anything.” Anything but fear it seems.

I have been StrongBlackWoman-in-recovery for over 15 years. In that time, I have actively worked toward releasing the myth’s hold on me, learning to be more open, more vulnerable, more…human. And still, I don’t feel anxious when I’m anxious, at least not mentally. But my body, it tells a different story. That story often comes in the form of insomnia, difficulty falling or staying asleep.

I have struggled with insomnia since childhood. Back then, going to sleep wasn’t the problem; it was staying asleep. I often woke up with nightmares, running into my mother’s room and begging to sleep with her. When I was six years old, my mother said to me, “You can’t sleep with me every night.” From that point on, I pointedly decided to only go into her room every other night. On alternate nights, I stayed in my room, staring into the darkness, often in terror. My mind played horrible tricks on me in the night, turning innocuous household objects into demons and witches who would be ready to pounce the moment that I closed my eyes.

Over the years, my battle with sleeplessness waxed and waned depending upon the stresses in my life. When it became clear that my lack of restful sleep and my chronic pain issues were feeding each other, my rheumatologist prescribed a low-dose sleep aid. Finally, after four decades, I was sleeping well on a regular basis. Eventually – and with the help of lots of complementary therapies, the care of good naturopaths and psychotherapists, and several years of strengthening healthy nutrition, exercise, meditation, and work patterns – I was able to ween off the medication. My anxiety was under control and so was my sleep.

And then came #TheRona.

Anxiety is a highly triggering emotion. Anxiety about one particular issue easily triggers any other latent anxieties, gathering small concerns into a giant rolling ball that rapidly overtakes us. In early March, as COVID-19 became the focus of nearly every conversation, every newscast, and every social media post, the sense of anxiety was palpable. I felt it then. There was no repressing the sense of disruption, the obsessive amounts of time reading news articles, watching television, and checking email to figure out what was known, what was happening, how my institution was responding, and how we needed to adapt. Still, though, I thought I was turning off those worries at night. My body told a different story.

A few nights into the shelter-in-place order, I had multiple nights of restlessness. I tossed and turned, trying to find a better sleeping position. I tried some sleeping meditations, only to find myself wide awake the moment that they ended. I tried reading until I got tired, but felt alert the minute that I put the book down and closed my eyes. My chronic pain and GI issues flared up, too.

With the help of my naturopath and psychotherapist, I realized that the anxious little girl inside me had awoken, and I needed to take care of her. That meant that I needed to structure my pandemic life in ways that would keep my stress response system under control, instead of allowing it to run rampant under the threat of constant change.

The biggest change has been the way that I spend my evenings. Since our biological stress response is designed to keep us awake and alert, I have to minimize activities that will trigger it in the hours before sleep. That means no news and very little social media after dinnertime. In fact, lately when I receive invitations for podcast interviews and webinars, I ask that they be scheduled by 4pm to ensure some distance between talking about heavy topics and going to sleep. I limit my evening entertainment to reading fiction, doing puzzles, crafting, or watching lighthearted tv shows or movies. And while quarantine offers the opportunity to stay up late at night and sleep in each morning, I’ve tried to maintain a regular sleep-wake schedule. I know firsthand the struggle of having an irregular circadian rhythm and I don’t plan on going back there.

Sleep is also impacted by overall health. It’s hard to sleep when you’re in pain or having stomach pain or an allergy flare-up. Good rest is part of an overall approach to wellness that includes eating right for my body, staying active, stretching and doing yoga, meditating, staying hydrated, taking all my medications and supplements, and following up with healthcare – all of which contribute to a healthy immune system.

Feeling anxious is an inevitable – and appropriate – part of a global health crisis. The key to managing it is not to repress it, but to take care of it.

Anxiety and the StrongBlackWoman

I’m anxious. There, I said it. Ironically, saying it publicly is not as freeing as I’d hoped it would be. In fact, it’s somewhat anxiety-producing. Perhaps I should stop writing now, delete this line, and move on.

No, it must be said. It is part of my recovery as a StrongBlackWoman. You see, a SBW isn’t supposed to be anxious. At least, most people think she’s not supposed to be. A SBW is supposed to be…well, strong. Impervious to fear, worry, and anxiety. She’s supposed to have everything – especially her emotions – under control. Her strong religious faith (a SBW is usually religious) is a prophylactic against worry. She stands on platitudes such as “God won’t give me more than I can bear” and “If God brought me to it, He’ll bring me through it.” And if she is an especially good Christian, she can quote or paraphrase off actual Biblical verses such as the one about lilies and sparrows (cf. Matthew 6:25-34). And if those don’t work, she is simply to immerse herself in more busyness and keep her feelings to herself.

That’s precisely what I’ve done for most of my life – kept my fears and anxiety to myself. About ten years ago, I realized that I probably have a strong biological predisposition to anxiety. A lot of people in my family have a lot of fears: dogs, scary movies, lightning, New York cabbies. Some of my relatives (who shall remain nameless) practically jump out of their skin at the least provocation. Some of us are pretty open about our fears, prompting the rest of us to label them “scary,” as in “Chile, you kno’ she ain’t goin’ to that movie. She so scary.” Others suffer silently. Since I’m a clinical psychologist, some of my relatives have come to me over the years to talk about these issues – the panic attacks, obsessions and compulsions, the prescriptions. And all the while, I’ve thought that it was strange that I didn’t have an anxiety disorder given my familial predisposition and my personal history of trauma.

Somehow, I overlooked a lot of symptoms – the nightmares and insomnia that started by my sixth birthday, my fear of the dark, my refusal to walk alone in my suburban neighborhood during the day because it seemed too deserted, my self-consciousness, and my chronic mental multi-tasking. The symptoms have appeared – and disappeared – at different stages in my life. And most of the time, they’ve been subclinical, meaning that they were not severe enough to require professional intervention. Mindfulness-based activities such as yoga and meditation, along with good nutrition and exercise, were sufficient to keep the symptoms in check.

Then came parenthood. The hypervigilance required of parents during the first few years of a child’s life is enough to trigger any subclinical anxiety problems into a full-scale clinical syndrome. Next came a one-year period of tremendous loss, trauma, and change, the cumulative effects of which created multiple cracks in the dam of strength that I’d built over the years. Finally, two months ago, I came home to discover that someone had broken into our house, just the right trauma to unleash a Katrina-like flood of anxiety over my already weakened defenses.

The typical SBW reaction would have been to act as if all were okay. If I were operating in full SBW mode, in response to queries about how I was feeling, I would have offered some heroically faithful retort like, “God is my fortress and my shield!” But I haven’t been in full SBW mode for a long time. In fact, I have been in recovery for almost ten years. Granted, there have been a few relapses, but at this point in my journey, I have no interested in being a myth. I am committed to discovering and embracing my authentic, fully human self, including my needs and vulnerabilities. So I told the truth: I’m not okay. I’ve had problems with anxiety for a long time and this just puts me over the edge. I am afraid, more afraid than I can tolerate on my own.

For the first time, rather than suppressing my fears, I owned them. Instead of trying to deny my anxiety (to myself and others), I decided to make sure that my anxious self received the care that I needed. I continued my weekly therapy sessions, made sure that I exercised and ate well, and went for a massage. But when, after a few weeks, my anxiety level remained sufficiently high enough to jeopardize my sleep and my blood pressure, I took another step: anti-anxiety medication.

As a psychologist, I tend to favor “talk” therapy over medication. And in this case, I knew that my symptoms would eventually decrease and return to their normal levels. Yet I also agreed with my therapist who, as both a licensed counselor and priest, reminded me that God does not require us to suffer needlessly. Suffering anxiety was not doing me, or anyone else, any good. In fact, with every day of elevated blood pressure increasing my risk of eventual stroke, a few months of untreated anxiety could have a much worse long-term impact.

I wish that more of my SBW sisters would recognize their problems with anxiety and seek treatment, whether it be counseling (with a properly trained and licensed therapist), medication, or both. Despite the myths about our mental and spiritual fortitude, SBW are actually quite anxious. Epidemiological research consistently demonstrates that Black women in the U.S. have a relatively high rate of anxiety disorders. Nearly 1 in 5 Black women has a diagnosable phobia, higher than any other racial-ethnic group. Black women also have significantly higher rates of post-traumatic stress disorder (PTSD) than Black men or women of other racial/ethnic groups. It turns out that hidden behind the myth of strength is a lot of unnecessary suffering.

The first step in releasing our fears is to admit them. Huh, this is starting to feel liberating, after all.