Bloom is a personal essay completed for an introductory creative nonfiction course at NC State University. This piece made me really proud when I shared it.  

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I call it my “stomach bloom.” It’s a peculiar feeling, like a flower made of ice is opening its petals deep inside my core and sending its roots up the walls of my gut. Its tendrils spread down my arms and legs, both frigid and hot, burning and itching. It sucks the feeling from my fingers and zings my jaw and scalp with subtle, aching electricity. It clouds my vision and loosens my bowels and turns my knees to liquid. It is wholly unpleasant and it is the first indicator that my day is going to be governed by my anxiety. 

Sometimes I wake up with my bloom, sometimes it settles in right after lunch, and sometimes it keeps my eyes glued to the ceiling until they feel dry and glassy and the sun peeks its cruel head above the horizon. It’s familiar and awful and it consumes me from the inside out, but I’ve gotten quite good at hiding it below a polished veneer. Still, it often finds ways to beat against my composure until it oozes through the cracks for everyone to see. 

I remember the moment when I realized that my mild, sometimes comical neuroses might be something more. I sat in my childhood bedroom, home for the summer after my first year in college, staring at my phone screen. My best friend was spending his summer in Texas and we spoke every day; however, it had been exactly 19 hours and 23 minutes since our last exchange. I formulated a number of scenarios: an afternoon nap interrupted by a carbon monoxide leak, a heap of twisted car parts smoldering in a remote field, or an apartment fire that left nothing but unidentifiable, charred remains. I finally settled on the most likely explanation: he surely took an evening walk and met a group of ruffians who proceeded to beat him bloody and leave him for dead on the side of a road. Panic seeped through my pores and filled my head until I was close to losing consciousness. My stomach bloomed and I wept. 

Then he called. He was fine. I was not. 

From that point, it took around nine months to even attempt to pursue therapy. It was hard work; I would sit on the edge of my bed, my short legs dangling, my toes just barely grazing the floor, and think myself into circles until I had just enough energy to get back under the covers. 

I don’t remember what actually got me to the doctor’s office, and I don’t remember much about the rest of my evaluation that took place that day. I don’t remember my first appointment with my counselor. I don’t remember a lot about the spring semester of my sophomore year. It is dark and hazy and blanketed in suffocating self-loathing as I failed tests and cowered in my room and hated myself for all of it. 

It took another few months to arrive at an official diagnosis, mostly because it took me a long time to acknowledge that I had a problem. I do remember that day. I remember my mouth forming the words, “generalized anxiety disorder,” and I remember them sticking to my tongue like thick peanut butter. I remember feeling my eyes go foggy and my stomach bloom, because I wasn’t just having an awful semester. I had a disorder. 

The next course of action was, of course, further treatment. 

“The recommended treatment for generalized anxiety is a combination of medication and counseling,” I heard my counselor say. “Do you want to make an appointment with a psychiatrist?” 

“Sure,” said someone other than me, someone who was not present, someone who was good at running on autopilot while bile rose in her throat and tears stung the backs of her eyes. 

The worst part of my anxiety is its exhausting cyclical tendency. I think, I push the thoughts away, and the thoughts come back. It is a grueling process. I hate it and I feel so utterly disembodied from that part of my mind. I am aware that my fears and reactions are irrational and uncharacteristic but I can do nothing to stop them from digging their grubby paws into my consciousness. They prevent me from pursuing new friendships and they make mundane decisions seem life threatening and they caused me to make, and then cancel, at least two appointments with a psychiatrist. 

Eventually, I beat my brain into submission and made it to an appointment. My doctor is a tiny man who hands me copious paperwork and cracks horrible but endearing puns. He prescribed me Zoloft, 50mg, a common drug used to treat depression and anxiety. I went home and did the one thing I had been itching to do since I walked into the doctor’s office: I opened my laptop and navigated to WebMD. 

I numbly read about some common and uncommon side effects: nausea, dizziness, drowsiness, dry mouth, loss of appetite, increased sweating, diarrhea, easy bruising, decreased libido, and bloody stools. This drug would alter my brain chemistry and make me miserable while doing it. I would be a nauseous, sleepy, sweaty, black-and-blue, blood-shitting, mouth-breathing celibate, but at least I would be happy. 

I would stare at the bottle of tiny blue pills and project my hate towards it so powerfully that the air rippled. I would hold it for minutes at a time before realizing I was gripping it hard enough to warp the orange plastic. I would read the label over and over again. I would open it, pour out the pills, cry, put them back in, and repeat. Something was preventing me from taking the medication, and it was bigger than my fear of the side effects. It was the fact that I was finally dealing with the thing that had defined a big part of me. I was terrified of what I would become without my anxiety. I was certain that my anxiety was my only motivation; panic attacks fueled my academic success and constant social calculation allowed me to make and retain friends. I was also feeling a lot of guilt and shame because months of therapy had failed. I wasn’t cured. I was cheating, copping out, leaning on a crutch that I would need for the rest of my life. 

One day, I was absentmindedly listening to an episode of my favorite public radio show and I heard a segment that completely shifted my mindset. The show was about the periodic table of elements, so it focused on lithium for the first few minutes. It walked me through the microscopic ways that lithium rearranges the compounds in a bipolar patient’s brain. It was fascinating and utterly relevant. Again, I went home and opened my laptop, but this time I immersed myself in scientific literature and complex concepts and delightfully dense terminology. I pulled my brain out of my head, split it open, decoded it, saw what needed fixing and what was working too hard and what was missing altogether. I learned a lot. 

Zoloft is a selective serotonin reuptake inhibitor, or SSRI; so is Prozac, Paxil, Lexapro, and a few others. They rearrange some of the naturally occurring chemical messengers, called neurotransmitters, in your brain. These neurotransmitters help brain cells communicate with each other and SSRIs focus on one particular neurotransmitter: 5-hydroxytryptamine, commonly known as serotonin. Serotonin affects mood, sexual function, appetite, sleep, and memory. All neurotransmitters interact with synapses, which allow the nervous system to control the other cells in our bodies, such as those in muscles or glands. The body transports these neurotransmitters by binding them to sodium and chloride ions and likes to recycle them when it can. Serotonin is a common reuptake protein; once it is released into the space between synapses, any unused amounts get sucked back into presynaptic neurons so they can be used later. 

Of course, as with any variety of psychotropic drug, SSRIs come with their fair share of controversy. The Journal of the American Medical Association published a study in 2010 that suggests that the use of SSRIs in patients with mild to moderate forms of depression is just as effective in improving mood as placebo pills (however, yet another study suggests that antidepressants are more effective than the placebo in the treatment of generalized anxiety disorder). In essence, the idea of medication helps people as much as medication does. This is particularly alarming when one considers the cost SSRIs as well as their prevalence; they are by far the most commonly prescribed antidepressant in America. The National Center for Health Statistics says that the rate of antidepressant use in America increased over 400 percent between 1988 and 2008. 

I read these studies in my unofficial research prior to beginning my treatment. They did not make me feel as though I had been overmedicated or misdiagnosed; I found comfort in simply knowing the information. Organizing the pros and the cons put my mind in blissful order. If I were to take an SSRI, and if it worked, it would inhibit some of the serotonin reuptake process, as its name suggests. There would be more serotonin floating around for my body to use which would theoretically improve my mood and help me handle my anxiety. It would put a butterfly net in front of my synapses and let my serotonin butterflies do what they were meant to do. 

With that in mind, I set a date to take my first dose, and it was a concrete date—the upcoming Monday. When that night rolled around, I steeled myself. I dug my fingernail into the chalky tablet and it split into two pieces, each no bigger than the tip of a freshly sharpened pencil. I took only one piece in hopes of lessening the potential side effects. Then I did that over and over again, day after day, slowly working my way up to a maintenance dosage. 

The side effects were there and they were awful. I walked around feeling drunk for a week. My vision was cloudy and I could barely stand up straight without swaying from side to side. Every time I opened my eyes in the morning, my head exploded in a dull pain that started from the middle of my brain and pulsed out and back in. I had little to no appetite and was so drowsy I fell asleep on the toilet. I was living in a thick, soupy fog that was painful and frustrating. Every time I thought about throwing all of the pills down the drain, I imagined the butterfly net in my brain, slowly taking shape, ready to catch and release chemical contentedness. 

Eventually, the fog lifted and I could see myself again. I was pretty much the same, but slightly improved. My anxiety became easy to talk about because I wasn’t waking up with it looming over my head and it wasn’t consuming my entire day. Sometimes, my fears are easier to deal with; running late no longer requires tears and a million apologies and a failed pop quiz will not lead to catastrophe. I am not sure that my mood has changed, but the medication has put my disorder into perspective. I didn’t realize I had fallen into such a deep hole because it was easy to hunker down and stay there. Now I am clawing my way back up the slippery walls with dirt under my nails and an anvil tied to my back. Some days I really wish I had just stayed put because those days are hard. 

I have been on medication for a little over a month. According to my doctor, I am on the cusp of the medication’s full efficacy, as it generally takes six to eight weeks to take full effect. I’m monitoring everything closely, but I know that this is not a magic bean and that a cure will not spring forth from my damaged mind; I will have to work hard to get better. And I am getting better. Though I can’t know whether that’s due to the medication or simply the idea of it, I am cautiously optimistic that it will nudge me in the right direction. It just might give me the chance to bloom.