My City, My Money, My Anxiety
I. My Anxiety
It started off like any other morning four years ago. I got up, washed my face, brushed my teeth, and scanned the news headlines before I headed downstairs to make some coffee. But when my feet hit the last step, everything changed.
Suddenly, my house looked different. Everything seemed brighter, more menacing. My heart was pounding, and I was gasping for air. Alarm bells sounded in my head. For a second I thought, “Is someone in the house? Am I in danger?” but I knew that wasn’t it. I slowed my racing thoughts down just enough to hear the thump, thump, thump of my heart and I realized, “That’s it. I’m having a heart attack.”
I raced back up the stairs, screaming for my partner. I needed to go to a hospital right now.
He jumped out of bed and scrambled to get dressed, repeatedly asking me what was wrong, but I didn’t know how to describe it. All I could think to say, over and over, was, “terrified.” When we got to the car I insisted on driving. He tried to talk me out of it. I wouldn’t have it.
I pulled out of the driveway of my Mid-City rental house in New Orleans and headed to the first hospital that came to mind. It was in the middle of downtown and I was fighting traffic to get there. At the first stoplight, I thought I might throw up my heart was pounding so hard. By the second, my partner was gently prying for information. What was wrong? What did it feel like? How did I know I was having a heart attack? By the fourth light, I started to talk. I told him my hands were shaking, my stomach was in knots, and I couldn’t seem to suck in enough air. He agreed that sounded pretty bad and sat quietly while we headed to the ER.
When I got within a few blocks of the hospital, my heart wasn’t pounding as much and I could breathe again, but I still felt shaky, lightheaded, and nauseous. Yet I could see things more objectively: I didn’t have a crushing pain in my chest, arm, or jaw. I didn’t really have any heart attack symptoms at all.
When we got to the hospital, I couldn’t explain why, but I felt too embarrassed to face the hospital staff. So, I didn’t. I drove right on by.
As we drove away from the medical district, my partner asked, “Are we not going to the ER?” While I no longer thought my life was in danger, I struggled with whether or not I needed immediate medical attention. I told my partner that something was still really wrong. “I know,” he said. “But you’re not having a heart attack, hun. You’re having a panic attack.”
When we got back home, I collapsed on our bed and cried, partly from exhaustion and partly from embarrassment. I’d never been so emotionally drained in my life. And when I looked at the clock I realized: it had only been 45 minutes since I’d left the house.
II. My City
My first experience with anxiety was terrifying, confusing, and surprisingly common here in New Orleans.
Mental health in New Orleans—like much of the Gulf Coast—came into focus after Hurricane Katrina. In a 2006 Time article, psychiatrist James Barbee noticed an alarming trend. At first, in a city laser-focused on recovery, spirits seemed high, but as time wore on, the trend shifted downward into cases of severe depression and anxiety.
As Barbee put it:
“There's no 'post-' to the post-traumatic stress syndrome in this situation.”
With a population in constant fluctuation as longtime residents move out and new residents move in, pegging down hard statistics among adults is difficult. However, two locally conducted studies on the mental health of New Orleans’ children shed light on how widespread the problem is.
In 2012, the Institute of Women and Ethnic Studies conducted interviews with predominately African-American middle school students in New Orleans. Nearly 25 percent showed symptoms of depression. A third had symptoms of post-traumatic stress disorder at some point, while 21 percent showed PTSD symptoms at the time of the study. In another study in 2015, the IWES interviewed more than 1,000 pre-teens and teens. Nearly 20 percent showed signs of PTSD.
These statistics are strikingly higher than what’s being recorded at the national level. Only 8 percent of 12- to 17-year-olds reported suffering from depression, according to a 2012 study by the National Institute of Mental Health. In another study, PTSD occurred in only 4 percent of children nationwide, nearly five times lower than what was recorded in the IWES New Orleans studies.
Years later, those statistics still speak to a post-Katrina life, one where New Orleans’ longstanding challenges—poverty, crime, and slow progress (social and otherwise)—have resurfaced. In the 2015 study, 48 percent of the adolescent respondents knew someone who had been murdered, and 49 percent worried it would happen to them. In a state with the highest murder rate and in a city with the fourth highest as of 2015, that fear isn’t uncommon among adults, either.
Just a few months before my panic attacks started, my friend had been murdered, a victim of a random and senseless crime. Maybe that was it? Or was it the worry of another flood? Or just the pressure of getting squeezed out of my rental to make room for another tourist Airbnb?
My panic-inducing fears of ending up homeless may have been overblown, but they weren’t entirely unfounded. In 2013, vacancy rates fell below 8 percent. Between 2012 and 2015, rent prices in New Orleans increased by 20 to 25 percent, roughly 6 to 8 percent per year, according to the Center For Community Progress. In a city whose population is 55 percent renters earning a median household income of $24,000 per year, getting priced out is a looming problem. And that’s certainly not helping anyone’s mental health (unless you’re a landlord).
Researchers are increasingly finding links between poverty and mental health. In a 2010 review of 115 studies, for example, nearly 80 percent showed a link between mental illness and poverty. While New Orleans’ issues with poverty pre-date and extend far beyond the recent rent hikes, hustling, scrimping, and saving just to afford to stay in the same old neighborhood definitely causes financial stress.
But the more I looked for reasons, the more I realized I’d never really know why my anxiety happened. Anxiety, unlike PTSD, isn’t something linked to one specific moment, and it’s not necessarily helpful to try to pinpoint a cause and “solve” it. Once my anxiety was there, it was just there to stay. I’d have to learn to live with it—and keep it from wrecking my future—because I was already starting to feel the financial toll.
III. My Money
In the first few months following my first panic attack, Dr. Google was my best friend. Anxiety isn’t just about feeling worried, it often takes a more physical form. Anxietycentre.com, a website I found during one of many late night searches, lists over 100 known anxiety symptoms. I’d feel pain in my jaw, my face would flush, or I’d get a shooting pain in my stomach, and I’d head to Google. Everything could always be either anxiety or cancer, and I’d always assume the latter, which would trigger a panic attack and I’d be useless the whole day.
I wasn’t anti-therapy at all. I was very pro-therapy, but my crappy healthcare plan didn’t offer a co-pay for psychiatric care and I couldn’t afford to pay out of pocket. While there are some free or sliding scale options in New Orleans, rebuilding the mental health system in the area has been slow going. Pre-Katrina, there were 196 psychiatrists for 480,000 residents, according to Modern Healthcare. After, there were between 22 and 42 psychiatrists for an estimated 230,172 residents. In 2010, the numbers had only increased to an estimated 65 psychiatrists for 347,987 residents. I didn’t feel right taking limited space away from people who potentially needed it more and had less income than I did.
Meanwhile, the sheer exhaustion of coping was taking its toll. A lot of my anxiety happened at night, so I’d stay up too late worrying. The next day, I’d be too worn out to be productive. My work started to suffer. It was either well done or on time, but I could rarely manage both. Eventually, I lost my biggest freelance client and a third of my income.
I was also spending way too much. Sometimes, to make myself feel better, I’d shop online for home décor, vinyl records, or books. Other times, my anxiety interfered with making sensible choices while running errands. It is hard to compare the per unit price of cereal when you’re worried you might die at any moment.
I’m not alone in that. After reviewing 65 studies, researchers from the University of South Hampton determined those with debt are three times more likely to suffer from a mental illness. But studying the cause creates a sort of chicken and the egg scenario. Some researchers think worrying about debt leads to a lowered ability to address mental health problems. Others believe mental health issues make it more difficult to manage money, effectively creating personal finance issues.
IV. My Healing
All I really knew was that the only thing keeping me from living in a box under the Crescent City Connection bridge was getting a handle on this thing.
So, I started talking. I compared notes with everyone I knew with anxiety. Are you having the same symptoms I’m having? Is this jaw pain normal? Why do I feel like my face is burning? Is it usual to feel the worst around the same time every day? The more I talked, the more normal I started to feel.
And I read, a lot. Any peer-reviewed journal I could get my hands on, first person stories, even anxiety message boards. The more I learned, the more I realized everything I’d been feeling wasn’t the end of the world. I probably didn’t have nine cancers and a heart condition. I probably wasn’t going to go insane or bankrupt.
Around the two-year mark from panic attack zero, I started to focus on not just living with anxiety, but living well. I came to realize that some things were triggers for me. I worried a lot about my safety, so we moved to a new neighborhood, where I sheepishly opted for the alarm system, the chain locks, and the motion detector lights. Overkill? Maybe. But the less I have to feed my worry, the better.
Money was another trigger. I don’t always make rational financial decisions when I’m anxious. I knew I couldn’t just fix that, so I give myself a pass. I start work projects early to give myself a cushion if a panic attack does strike. I automate deposits from my checking to my savings account to make sure I don’t blow too much money on self-care via Amazon. But I also give myself a buffer for dumb, anxiety-induced impulse purchases because I still make them. When I start to feel panicked about my rising rent or the high cost of auto insurance, I talk it out or take a break to calm down.
Things in New Orleans have started to improve, too. There is still a long way to go and the city—like most—needs to do more, especially where mental health is concerned. But New Orleans has taken steps to reach out to those affected by mental illness. A volunteer-staffed Mobile Crisis Unit responds on-the-ground to people in need. According to Nola.com, as of 2014, the mobile unit responded to around 300 to 500 calls per year. After a federal mandate, the New Orleans Police Department also created a Crisis Intervention Team to better handle police interactions with those suffering from mental health issues.
For me, the anxiety will always be there, but the more I started to admit it and deal, the less of a monster it seemed. It is a process, but now, most days it’s downright manageable.