When people know my diagnosis of bipolar and anxiety disorders — and given my line of work, most do — they tend to assign all of my actions to said diagnosis. Confrontation and disagreement, as an example, turn into signs that I am escalating to a manic state state or having an anxiety or panic attack. But anxiety disorder and confrontation don’t exactly go hand in and hand.

Living with anxiety can be at best uncomfortable and at worst debilitating. Naturally, we want to overcome it. While there are no quick fixes, happily there are fixes. Anxiety treatment is quite personal, and there's a wide variety of approaches that people can explore to kick their anxiety to the curb.

When I am having a panic attack, I have a medication I take to help me calm down. I carry these prescribed pills with me and keep a supply in my house and car. I only take this medication when I am positive a panic attack is occurring. It is an acute treatment, not a daily regimen. As you’d expect, the panic and anxiety medication has side effects.

Perfectionism. It’s a common term in our society. We accuse people of (or, depending on one’s opinion of perfectionism, applaud people for) being perfectionists. Is perfectionism a desire to succeed and excel in one’s field? I’d call that ambition, but not necessarily perfectionism. Perfectionism includes this desire for success, yes, but it goes beyond a desire to succeed. Perfectionism is not just a desire to do well; it’s a need to do the perfect job or be the perfect person to the detriment of your wellbeing. And perfectionism contributes greatly to anxiety.

I am a strong person, physically. At six-foot-three inches tall and 250 pounds, most people wouldn't waste their breath arguing that assertion. And, whether because of, or in spite of, my bipolar and anxiety diagnoses, I consider myself to be strong mentally, as well. I am intelligent, accomplished, likeable, and successful. Despite the mountains of evidence of this, my brain works diligently to convince me that every interaction I have with another person is a misstep. If I text someone and they don’t reply back, it is obvious they are mad at me. If someone doesn't answer the phone when I call, say hello when they pass by, or reply to my email, then my mind goes into what can only be described as an emotional roller coaster.

Mindfulness is an amazing tool for all types of anxiety. Except when it isn't. Wait. What? Mindfulness is touted, rightly so, for its ability to lower blood pressure, reduce the amount of stress hormones in the blood, relax tense muscles, quiet racing thoughts, and soothe roiling emotions. Experts from all disciplines, from the sciences to the spiritual, offer solid evidence of the ability of mindfulness to decrease anxiety. Yet there are times when it does more harm than good. What do we do then?

Many people who suffer from anxiety and panic disorder, me included, have trouble explaining to others why we are having anxiety. Folks understand the traditional “butterfly in the stomach” analogy as to what anxiety feels like and can relate to feeling anxious about visiting the dentist. However, the part the really confuses people is how one can be anxious about something when the “something” doesn’t appear to exist.

Anxiety: worry, concern, apprehension, uneasiness, fear, agitation, angst, nervousness, tension. Anxiety: an awful state of being that encompasses our very being -- mind, feelings, actions. The Mayo Clinic describes it as “intense, excessive and persistent worry and fear about everyday situations." Many of us live with it; few, if any, of us want it. What do we do about it?

What’s worse than a panic attack? Having panic induced publicly. In many cases, the public display of anxiety is more troubling than the attack itself. Having an anxiety attack is quite a bit to worry about and adding in the concern for how you are perceived by the people watching is another level entirely.

Things like depression, anxiety, and posttraumatic stress disorder (PTSD) are insidious. We work hard, sometimes for years, to take away their power so they no longer control our lives. And we do it! We’re going along, innocently living our lives, anxiety and such at a tolerable level, when, bam - these beasts spring up and give chase. When this happened to me recently, it took me a while, but I finally realized what was happening.