Managing Anxiety & Sleeplessness during a Pandemic

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.

Recent Articles on the StrongBlackWoman

Breakdown: The StrongBlackWoman in Crisis
This week, I guest-authored an article, “Breakdown: The StrongBlackWoman in Crisis,” for ForHarriet.com. In the article, I narrate the true-life story of a StrongBlackWoman who arrived at the point of physical breakdown after failing to care for herself in the midst of crisis. Here’s an excerpt:

Without realizing it, Veronica had been caught in the vicious stress-health cycle of the StrongBlackWoman. Rather than giving herself the space to feel and express her emotional distress, she repressed it. She distracted herself by directing her energies to taking care of the needs of other people and institutions. She crammed even more activity into an already hectic schedule. And she devoted even less time to engaging in self-care behaviors. She had already had difficulty getting an exercise routine going. When cries set in, she began skipping meals and when she did eat, she relied on fast food and sweets. She sacrificed her sleep and leisure time to keep up with all that she had going on. Together, it was a perfect recipe for breakdown. With no outlet, her emotional distress became embodied in physical form. Her existing health problems were exacerbated and she developed new ones: headaches, dizzy spells, fatigue, fainting. 

In Too Heavy a Yoke: Black Women and the Burden of Strength, I devote a chapter to describing the link between embodying the myth of the StrongBlackWoman and health problems among African American women.

Farewell, StrongBlackWoman
 
Be sure to check out Christena Cleveland’s excellent article, “Farewell, StrongBlackWoman.”  Cleveland is a social psychologist and the author of Disunity in Christ: Uncovering the Hidden Forces That Keep Us Apart. In her article, Cleveland reflects upon her own embodiment of the StrongBlackWoman and her commitment to healing.  She writes:

My name is Christena and I am a StrongBlackWoman. I am beatable and human, and I am okay with that.  I give myself permission to scream when I am angry, cry when I am hurting, ask for help when I need it, and remove myself from communities that can’t or won’t care for and nurture me as a black woman. Every day is a struggle to put down the StrongBlackWoman façade and take up authenticity, true strength rooted in God and community, self-love, and mutual love. But today I choose to face that struggle and receive the help I need to overcome it.

What’s your commitment to healing as a StrongBlackWoman? Or to supporting the recovery of a StrongBlackWoman? Join the movement and claim your right to a life of authenticity, love of self, and relationships based upon reciprocity. We can do more than survive. We can thrive!

A Time to Grieve

It was effortless, really, the way the tears rolled down my face. In the six days since my breast cancer diagnosis, I have not really cried. I have been a StrongBlackWoman in recovery for nearly twelve years.  And even though I vowed not to play the role of the superhuman sister who hides her emotions behind a brick wall, old habits are hard to break.  I’ve had a hard time connecting to the grief that I knew was there.  I shed a few tears here and there, but never for more than a minute or two.

In part, it was because I was still in shock. But there was something else:  I don’t want to be comforted.  I don’t want anyone trying to staunch the flow of my tears once they start.  Grief tends to make other people intensely uncomfortable.  And often they try to deal with their discomfort by shutting down its source. I don’t want anyone trying to cheer me up so that they could feel better, especially not with meaningless cliches like “God won’t give you more than you can bear.”

I need to grieve, and not because I feel hopeless.  My mother is a 20-year survivor of a Stage IVB breast cancer.  Mine was caught much earlier and I have no doubts that I will fully recover.  I’m already picking out the soundtrack that I will dance to when my doctor pronounces me cancer free. But the path to being cancer free is a really arduous one. It is going to disrupt every facet of my life and at a time when life seemed to be on the upswing after several years of major losses and transitions. It will be physical and emotional hell, not only for me, but for my family as well. And for that I need to grieve.

So this Sunday morning, when the tears finally began to flow just moments after I sat in the church pew, I didn’t fight them.  I let their cleansing power work, giving release to the grief and anger that need to escape for my healing journey to begin.

Photo credit: Detail of Mary Magdalene crying in sculpture Entombment of Christ (1672). “Sépulcre Arc-en-Barrois 111008 12” by Vassil – Own work. Licensed under Creative Commons Attribution 3.0 via Wikimedia Commons

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.

A StrongBlackWoman Goes to Therapy

“How did I get here again?” That was the question that I asked myself as I drove away from my therapist’s office. Processing the session, I realized that I was once again in the full throes of StrongBlackWomanhood. I was trying to be all things to all people and I was suffering for it: I was having trouble sleeping, my chronic pain had intensified, and my blood pressure had gone up.

The irony is that I am writing a book about the StrongBlackWoman. You’d think that spending my days reading and writing about this phenomenon would somehow inoculate me against it. At least a little. Right? Wrong. This most recent relapse has further convinced me that being a StrongBlackWoman is so ingrained in many Black women that it is an addiction. It requires constant vigilance. And it also requires getting help.

Some time ago, I posted a 12-Step Program for StrongBlackWomen. Over the past few months, I’ve been working the program. Right now, I’m on step 5: “We admit to God, to ourselves, and to another human being the exact nature of our compulsions and the traumas and fears that drive them.”

For a long time, I thought that I could keep my own counsel. After all, I’m a clinical psychologist and a minister. And I’m fairly psychologically healthy. I’ve spent a lot of time in introspection – journaling, meditation, and reflection. To be fair, I haven’t been alone in the journey. My spouse and best friend have been sounding boards. And I have repeatedly brought the issues to God in prayer.

It’s been a productive process. Yet I realized that I needed something else, or more accurately, someone else. I needed someone who could listen to my processing with a professionally trained ear, to help me to see the connections between my past and my compulsion to be a StrongBlackWoman. I needed someone who would listen for as long as I needed them to listen. I needed a therapist.

The director of my doctoral fellowship program, Dr. Israel “Ike” Tribble, used to say: “Everyone is of your color is not of your kind, and everyone who is of your kind is not of your color.” African Americans are often very reluctant to seek help from a therapist and when we do, we usually want an African American therapist. My therapist – a white man in his late 60s – is certainly not of my color. But he is of my kind. Since he’s an ordained Episcopal priest as well as a licensed counselor, I thought that he’d have both spiritual and psychological insights that could aid me in my healing. And so far, I haven’t been disappointed.

My therapy sessions provide two gifts: a dedicated and uninterrupted space in which to remember and process my life experiences; and an empathetic and nonjudgmental person who listens with his whole being and provides insight just where it’s needed. Each week, I unfold another part of my life story. I notice the connections between my past experiences and my current struggles. I feel affirmed, supported, and empowered to heal. And I feel the chains that bind me in the yoke of the StrongBlackWoman breaking away, one link at a time.

Every StrongBlackWoman in recovery needs multiple mechanisms of support and accountability. Some of these can be found among our family and friends. But sometimes, we need professional support as well. Admitting that we need help is difficult. But refusing to seek the help we need could be deadly.

Paint the Town Purple (and Pink)!

For as long as I can remember, pink has been my favorite color. Nearly everyday, you can find me sportin’ some shade, even if it’s just my carnation pink leather briefcase. Every once in a while, though, I get so inundated with pink that I need a break. In the year or two after I pledged Alpha Kappa Alpha, almost every gift from my relatives was pink or green – fuchsia suede shorts, emerald leather coat, rose-colored shirts, mauve sweaters, pink…pink…pink. For about 10 years after, I essentially purged my closet of all pink. It was still my favorite color; I was just sick of it.

This year, with Breast Cancer Awareness Month underway, I am starting to feel the same way. The entire city seems adorned with pink, from shopping centers to funeral homes. There was a time that I loved purchasing merchandise with that pink loop. My mother is a breast cancer survivor. She was only 41 when she was diagnosed with stage 4B breast cancer. When I tell that to doctors, they look at me like I’ve got an expiration date stamped on my forehead. That, together with my first lump scare at age 28, has had me going in for a breast smash annually for ten years now. And still, I’m getting tired of seeing the town painted pink.

Maybe it has to do with the commercialization of breast cancer. A few days ago, I passed a Rue 21 store with the display window full of ribbon-adorned shirts that had more to do with breasts than cancer. What percentage of this junk actually goes toward finding a cure? Or perhaps providing aid to the victims of this disease who are poor and lack health insurance? Saving ta-tas is nice, but saving lives is much, much better.

I think, though, that my frustration has more to do with the invisibility of the other symbol for this month. October is also Domestic Violence Awareness Month. The month is almost over, and I’ve yet to see a single purple ribbon (much less a 10-foot-high one mounted in front of a shopping mall). I’ve seen no races, no marches, and no men, women, or children cheerfully declaring their status as survivors. The only acknowledgement that I’ve seen was a spoken word performance at the church my family attends in Birmingham (and I’m deeply grateful for the prophetic ministry of East Lake UMC).

Long before my mother was diagnosed with breast cancer, she was involved in a physically abusive relationship. I saw and heard the abuse on more than one occasion. I have a distinct memory of being about 5-years-old and throwing myself between my mother and her abuser, yelling at him, “Don’t you hit my mommy!” But I was well into my 30s before I thought of it as domestic violence. My mother was not a passive victim. She fought back. She called the police. And when she was overpowered, she grabbed whatever she could to defend herself. She was nothing like those women on Lifetime movies, who cowered and hid behind sunglasses. So for years, I simply did not recognize her victimhood, even as I was a passionate advocate on behalf of women’s issues.

Domestic violence is one of those things we don’t like to talk about. Few people are eager to claim their status as victims or perpetrators. And even though 1 in every 4 women in the United States experiences domestic violence during her lifetime, those experiences often go unnamed as such. This is especially the case in the African American community. Growing up, I often heard African Americans dismiss domestic violence as a white issue: “No sistah is gonna let a man beat her. Black women are too STRONG to be victims. They fight back!” Collectively, we liked to pretend that a woman’s attempt to defend herself against violence actually nullified the existence of that violence, even though the perpetrator was usually larger and stronger. We allowed ourselves to believe the lie that Black women are less likely to be victims of abuse than women of other races, when in fact, approximately 29 percent of Black women have suffered violence at the hands of a romantic partner. We hid our heads in the sand while Black women, who comprise only 8 percent of the U.S. population, accounted for 22 percent of all intimate partner homicide victims.

If those of us who are survivors remain silent, how can we ever expect those who are still victims to find their voices? It’s time to end our silence. Let’s paint the town purple!

Time to Unplug

Two weeks ago I discovered a writer’s haven – an internet café at a public library. It’s got tables, plenty of power outlets, restrooms, vending machines, and even a microwave. Walled off from the rest of the library by glass doors, it opens into a private courtyard, with benches, picnic tables, and yes, more power outlets! It’s been a great spot to work. Armed with a thermos full of coffee, a lunchbox, and a laptop, I can work there all day – without spending any money!

This morning, though, my haven keeps getting interrupted. Every few minutes, a young man dressed in a sports store uniform, pops in with his cell phone to his ear. A longtime lover of library silence, I’m impressed that he is respectful enough of the patrons in the main space to take his phone conversations elsewhere. I just wish that “elsewhere” was somewhere else. Doesn’t he see me working?!

Cell phone conversations are loud, even when people think they’re speaking quietly. So it didn’t take long for me to get a sense of what was going on. He was being called repeatedly by his job. More than three hours before his shift was supposed to start (like I said, cell phone conversations are loud), his co-workers were tracking him down, asking him when he was coming to the store. By the fifth call, he walked straight through the café to the courtyard. Even with the doors closed, I could hear him giving instructions to someone. By that point, my frustration with the noise had turned into sympathy for this man, who couldn’t enjoy his morning off without constant interruptions.

I couldn’t help but think of a few of my friends in ministry. I have been to a few ministry retreats and conferences this year where I’ve watched colleagues who could not get away from issues back home. Every few minutes, they got a call, text, or email from someone who ostensibly needed their help. And every few minutes, they were responding. It was nearly impossible to have conversations with them without them pausing to take a call or answer a text. “Hold on, I need to respond to this” was the frequent refrain. Their busyness took on a manic element as they rushed from task to task.

If it were just conversations with me that were being interrupted, I wouldn’t be bothered. But I knew that their addiction to busyness was all-encompassing. It impacted their health and their relationships. Is it ironic that it happened most, actually always, with African American men and women? Probably not. My guess is that it’s the StrongBlackWoman/StrongBlackMan thing rearing its head. Layer that with Christianity’s emphasis upon “bearing the cross” and you’ve got a full-scale case of ministry overload and eventual burnout.

A few months ago, my husband and I imposed a blackout period on electronic devices in our household, a two-hour evening time slot in which we would not utilize our cell phones or computers. Miraculously, it was doable. The world didn’t come to an end. Our lives did not turn upside down. Instead, we had two hours each evening when we read, talked, or played games rather than checking Facebook and playing Angry Birds. Over the past few weeks, though, there’s been a gradual erosion in our observance of the blackout. It probably began around the time of a deadline when I “just had” to work on something for a few hours. It’s a slippery slope. I better scramble back up before I fall too far. I encourage you to do the same. Make a commitment to “unplug” for part of your day – even if it’s only one hour. And for that hour, be present to the world in other ways. Spend time with your partner. Play with your kids. Read a book. Take a long, hot soak in the tub. And trust that God is in control of everything else.