Last week, Steven Goldman was set to board a plane to St. Louis. At the last minute, he could not bring himself to get on the flight.
I have boarded many planes, though it has never been something I enjoy doing. I used to be afraid of crashing, but except for a brief moment or two of involuntary alarm during takeoff, I no longer worry about that, and once the plane is in the air I always feel fine. My problem is that I have an anxiety disorder centered around claustrophobia. I get into any small space, like a small airplane, and my limbic system goes haywire. My heart rate shoots up. My chest tightens. The ironically named flight response is incredible.
The plane to St. Louis was quite small, not quite a puddle-jumper, but the next step up. The low ceiling scraped my head. My overly large frame barely fit in the seat. The way the aisle was blocked by incoming passengers made me feel as if there was no exit. I imagined what I would feel like when they closed the door. The thought was terrible. I did not panic… but realized I probably would if I stayed, and that even if I was able to tough out the three-hour ride to St. Louis, I might never be able to convince myself to board the plane back home. I had taken two Xanax, an anti-anxiety medication, an hour before boarding, because I have been dealing with this stupid, frustrating, annoying thing for eight years now, and I knew it was possible that I might feel this way. The pills did not help. I felt helpless.
…The frustrating thing is that I still feel like myself. I don’t feel afraid inside. Even when I was in the grips of the worst of the attacks, the rational me was still in here, trying to manage the situation. On the plane to St. Louis I was, at least mentally, completely calm. The physiological reaction was like an overlay, a computer virus that was attacking the mainframe. I wasn’t thinking, “Aaagh! Let me out of here!” I was thinking, “Okay, how do I deal with this? How do I overcome this feeling?” It was a measured weighing of pros and cons that led me, in this instance, to get off of the plane. It was the right decision, but I still felt immensely disappointed that I had not been able to push it away, to rise above.
Goldman sat at the gate and watched the plane roll away, “excoriating myself, filled with self-disgust.”
The self-disgust is what jumped off the screen at me as I read this honest and uncompromising account of what is like to have a clinical anxiety disorder. (On a slightly related note, Joe Pos has the SI cover story this week on Zack Greinke, who has managed to come to grips with his social anxiety disorder.) Frustration, anger, which Goldman felt too, that’s understandable, but self-disgust? That’s crazy talk. That’s being in love with your own masochism.
I should know. I do it all of the time. And curse myself for doing it! Most of us, even those who do not suffer from a crippling chemical imbalance, not knowing what to do with frustration, turn our anger inward. Of course these things are easier to see in others than in ourselves necessarily. It’s easier for me to say, Steve, why are you beating yourself up?, instead of changing my own behavior.
But self-disgust seems entirely inappropriate here. Goldman was actually taking care of himself, he protected himself and so, no matter how upset or disappointed he may have been (and legitimately so), he deserved to give himself some credit for his actions. Even if he still yearns to overcome his illness, which is admirable.
And if he isn’t willing to give himself that credit, I will.
I'd love to read the Greinke story, but refuse to click on any SI link now they have gone down the path of sensationalism. It's at least nice to know that some more serious issues are being tackled at SI.
Actually, Pos doesn't go into Greinke's emotional struggles very much. But it's still a good story.
As someone who has a bit of an general anxiety problem myself, and is in a relationship with a girl who has her own very serious anxiety problems I've seen it from both ends. When its on my end, I've almost always been able to just sort of push through it. Sometimes I force myself into situations that bring about the anxiety, like, I'm afraid of heights, so I took up rock climbing.
On the other end, I often find myself frustrated with the SO. Seemingly simple tasks (a cab ride to the airport, taking the subway to meet friends) become huge, huge deals. It can be draining for both of us. Almost all of our fights have been about issues surrounding this, which is frustrating as well. The best thing I've found is to get oneself into treatment, be that therapy, medication or some combination. Unfortunately, not everyone wants to be treated, to "change" if you will. And that is the impasse, the difficulty.
Its odd the status that mental disorders get in society. We want to treat them the same as any physical illness, but its hard to imagine someone being physically ill with a crippling disease and not doing everything in their power to fix that. With mental disorders, anxiety, alcoholism, anorexia, etc. it can sometimes be ok to not seek treatment. I've never understood that.
I've had issues with internalizing things for a long time. Part of that was the environment I grew up in, part of it was the epileptic seizures that began in my teen years, part of it was the tragedies I've endured as a young adult and part of it is from the environment I live in now. There are quite a few factors that contribute to such issues as this, and I make a point of being secretive to people while I get to know them, but when in the public I emotionally "zone out" while keeping my senses on high alert. Here in the city, there's so much that can make you feral if you're not a part of or above the dwindling middle class (and even then...), but then you have to hold onto what you want under any circumstances. Acknowledging your own issues helps you remain human, dealing with them makes you a stronger one.
[4] "secretive"? I meant "sensitive"; clicked on the wrong word during spell check. Big difference!
I am close with several people who are bi-polar and can appreciate how overwhelming and horrible it must be to have that kind of condition. I remember reading William Styron's small book about his bout with depression, "Darkness Visbile" years ago and being moved by it.
[3] I agree with your main point. But when you say "its hard to imagine someone being physically ill with a crippling disease and not doing everything in their power to fix that" I have to point out that lots and lots and lots of people do exactly that. The cultural inertia (or stigma, or whatever) that goes along with mental illness/injury makes it even harder.
[0] Great post Alex. I've experienced something similar with Steve when I edited him at YES. One year, I think it was 2004, he was blogging the Old Timer's Day festivities and in the hubbub of the clubhouse, he fainted and needed to be carted away in an ambulance, partly due to heat exhaustion and the claustrophobia. It was scary.
Re: the self-disgust, I think Steve was mad at himself for not fighting through it. He has been through so much medically since I've known him and he works with such a sense of obligation and duty, that any foible like this, he feels like he let people down. I can relate to that. The incident I noted above, he actually apologized for not being able to post anything that day. ... It's just the kind of guy Steven Goldman is. He's truly a good dude, and a fabulous writer.
[7] Fair enough, you are right. I guess it just baffles me. If I had something so debilitating I'd be doing everything in my power to deal with it. Saying you're having problems but you're getting treatment for it is understandable. Just throwing up your hands I've just never been able to get my head around. But maybe that's just me.
[9] As a type 1 diabetic I can understand both the impulse to demand that both I and other type 1s "do everything in their power" to be healthy. On the other hand, as with mental illness, that's just not sustainable for a problem that really has no "treatment" and where, in my case the baseline is 6-8 injections, 4-6 blood tests a day.
My family has a history of classic obvious (rather than DSM-IV) mental illness including schizophrenia and manic depression ending in a few suicides and lots of institutionalization (good genes, eh?) My impression is that although I think its a natural instinct to want to try harder and for other people to want the sick to try harder, this effortfulness is itself very harmful.
I was actually thinking about his watching Joba pitch yesterday, (when I was posting a lot of pitch speeds here). Just as "overthrowing" is a typical pitcher's problem, it was a huge relief to me to see Joba throw his two-seam at 92, 93 to some and then take it up to 96 with the heart of the order. He didn't just go "all out." Which I think is typical of young pitchers (and people) when things are going wrong.
I set a sustainable, enjoyable pace with my diabetes even though that means I'll probably (if I'm lucky) lose a couple decades of life to it. Oddly, the acceptance and reduction in anxiety (and happiness) has actually made the clinical part of management easier and my clinical outcomes much better.
Finding that balance is not only personal, but can be very very difficult for other people to understand.
[10] I think we're not really that far off. I would say what you were doing was getting treatment and finding a way to manage your disease so that you can have as normal a life as possible (btw, I applaud that, a lot). I think sometimes with mental illness, it can be a lot closer to if you said, "I have diabetes, well whatever." and did nothing to very little. I've seen it happen with alcoholics, an ex-gf who had an eating disorder and others. I'm not judging right or wrong here, it just sort of baffles me. Like I said, that's just me.
Wow... people here really share. This is an amazing place.
Yeah, thanks so much for the dialogue here, y'all. Very cool.
[11] I think you're right that we're not far off at all. I too have a hard time with the crazy self-indulgence that some seem to use to not deal with what seems to me like the basic difficulty of life. But there's no way Goldman's initial plane reaction and his coping response could fit into my definition of self-indulgence. And so I also agree with Alex that Goldman's self-disgust is probably not productive, but I'd cut a guy a lot of slack in that situation.
Other people's subjective experiences are hard to judge.
and ps, after a couple of years all the type 1 "I have diabetes, well whatever" people - they're dead.
[14] Oh, if you thought I was ragging on Goldman at all I can see the confusion. No, no, not at all. He made the right decision for him at the time. Now, knowing Steve from afar, my guess is that his next order of business is to go to a doctor and ask what he can do to try and avoid that happening again. Its the people who would go, "Ok, I just won't ever fly anywhere again," that I can't understand. There's a large gap between throwing up your hands and being a globe hopping adventure seeker, the analogy with your diabetes I think works well. You do what you can to have as normal and enjoyable a life as possible without avoiding the problem. That may be different for different people, the point is you do something .
[15] Yes, sure, but that's the point of many mental issues - they inhibit clear thinking. The emotional response to just thinking about the problem is so overwhelming as to make one just bury it, don't think about it at all. Rinse and repeat. it becomes self-reinforcing, covered up, and self-sealing.
To construct a (crappy) physical analogy, imagine that you get this debilitating physical problem, and every time you try to go to the doctor to get it dealt with someone runs out from the shadows and punches you in the nose, or shoots your kitten, or busts your kneecaps, or all three. So trying to solve the problem, which may not be solvable anyway, has resulted in immediate and real pain. Pretty soon you just convince yourself it's not worth the trouble, it won't work anyway, and maybe you're just not worth it anyway. And oh by the way, you're terrible for thinking that way, and pathetic for not doing something about it. When the asshole kneecapping you on the way to the doctor is really some asshole part of your brain you can't call the cops on, it's hard hard hard.
I'm not at all saying you're being insensitive or anything, just trying to aid understanding. It took me a while to start to be empathetic to this kind of thing also.
[16] Yes, I can totally see that. I've been struggling with that a bit myself, and some of the things you say sound eerily like excuses that the SO makes when I bring up treatment or when she has tried. Its actually our main source of conflict now, because she has figured out a way to live a sort of constrained life within her comfort zone, but that doesn't really work when I get involved (e.g. sitting at home all the time isn't really my thing). Honestly, its a tough nut to crack, but sometimes I dunno. Thoughts are most welcome if you have any (ok I'm now on the Yankees blog asking for relationship advice ;) ).
I think my perspective might be a bit skewed. I've had major surgery multiple times for various things, I've been through physical therapy/rehab for almost a year, learning to walk again etc.. I have vivid memories of literally blacking out from the pain. So after dealing with those things, seeking help for anxiety, or things like that seems a lot easier. But I realize that I'm a bit unique (fortunately) in that way.
For years I dreaded and feared flying, decades in fact, to the point of trembling uncontrollably, hyperventilating, and enduring an elevated heart rate. It was practically a panic attack. I also cannot stand tightly enclosed spaces. To overcome these serious issues while traveling, I played games within my head such that I talked myself out of the mental trauma, focusing on looking out of the window constantly, like a small child, who had never flown before. This constant view of everything outside the aircraft, coupled with focusing on what was going on there, the ground crew, the luggage handlers, fuel crew, anything I could see, took the perceived feelings of being closed in out of my mind. Then I could simply fall asleep after watching the takeoff and climbing to cruising altitude, which is the secret to air travel, period. Gary Player taught me of the value of being able to sleep on a plane, and I've never suffered from jet lag ever since. I can now take my seat, and if I begin to feel ill at ease, I automatically look out of the window, and watch everything I can, to keep those vicious and traumatizing thoughts at bay, where they belong.
I certainly hope this helps any of you who deal with such terrible and debilitating feelings while in an airplane. It most certainly works for me, to this day...
: )
Interesting and informative comments from everyone, thank you very much.
Living in a society in which there is little (if any) open discussion of mental illness (and not surprisingly, one of the world's highest suicide rates), it is very refreshing to read such open commentary here at the Banter.