The Ties Between Physical and Mental Health: My Year of Anticoagulants and Anxiety
May 1, 2023 - by Jennifer Ringler, MS
As today kicks off mental health awareness month, I can’t help but look back on the past 12 months (one of the three most difficult years for my mental health that I’ve experienced in my lifetime) and be glad that chapter is behind me. It’s funny-not-funny how mental health and physical health are so often intertwined for me, and how my professional life as a health communicator and a person who understands human biology, medicine, and science both helps me navigate my personal health journey while also serving to heighten my anxiety.
The toughest year of my life for keeping my generalized anxiety disorder under control was 2016, when I was diagnosed with thyroid cancer – a journey that wound through fear and depression and culminated with a total thyroidectomy on my 34th birthday. Second or equal to that was 2020; being a life-long asthmatic and watching as a brand-new virus that impacted the lungs killed thousands of people around the world every day was horrifying, to the point where I was having daily panic attacks that kept me from functioning at work.
But this past year – April 2022 - April 2023 – has definitely been on my top-three list for anxiety-fueled-by-physical-health years. It kicked off in April of last year, when my husband got COVID, after we had both managed to avoid it for two whole years. We were now vaccinated and boosted, so my fear of dying from the disease was better than it had been when the pandemic first came to U.S. shores, but I still wasn’t thrilled about having the spiky enemy in our home. I quarantined my husband to the master bedroom for 10 days and made him wear a mask whenever he emerged, and somehow, miraculously, I didn’t catch it.
On day 10, when my husband was allowed out into the world again (with a negative COVID test and a mask), we headed out to a concert at a small, local venue for the evening. I twisted my ankle on the way to the venue, sat through the concern in pain, and went to bed, figuring it would feel better in the morning. Spoiler alert: it did not. (It took me about nine months after this event to not feel woozy and queasy every time I flashed back to that moment and the unnatural “pop” I felt/heard when I tripped off that curb.)
That journey took me to my local urgent care center the following morning, where I was told I had a bad sprain and a fibula chip fracture, given a boot to wear, and sent on my way. A few days later, my leg began to feel both heavy and empty/hollow simultaneously, with progressively worsening throbbing throughout the day. Five hours in the emergency room revealed a blood clot in the ankle near the injury, and I was put on a three-month course of blood thinners to dissolve the clot and prevent it from traveling to my lungs and killing me.
My anxiety did not take well to me being on blood thinners for months. I became convinced that I would get into a car accident, be injured, and bleed to death. I was consequently afraid to leave my house and wouldn’t even go to the grocery store with my husband. I had to miss two work events I was looking forward to – one because I was afraid to travel in a car to get there and afraid of the client’s attention being focused on me because of my boot, and the other because the hematologist (rightfully) did not want me to fly mere weeks after having a blood clot. As with the kickoff of the pandemic in April 2020, I began having panic attacks and could not function. There was also fear, depression, self-pity, and more fear. I went back to (virtual) therapy to help me cope.
My ankle eventually healed and the three months on blood thinners came to an end. But I spent the rest of last year scared to go walking outside for fear of tripping and injuring myself again, and having visual flashbacks to the moment I fell every time I went outside.
Other fun challenges life threw my way last year included a serious knee injury in my 15-year-old Jack Russell that had us carrying her around the house and me sobbing constantly because she was too old to safely undergo anesthesia to get the surgery she needed to fix her injury; an eight-month home renovation that had us kitchen-less and couch-surfing with family (while working remotely full-time and caring for an elderly, injured dog); my first trip on the COVID rollercoaster and a dose of antivirals; a breast cancer scare with lots of waiting, anxiety, and a core needle biopsy (zero stars) around the Christmas/Chanukah holiday (thankfully, it ended up being benign); a surprise layoff from the best job I’ve ever had; and most recently, an infected dog bite from my grumpy, aging dog that had me in the hospital for four days on IV antibiotics to stop the cellulitis from spreading.
That last leg of the journey just ended eight days ago. My physical health is fine for the moment. As for my mental health? I’m waiting for the other shoe to drop. Again. Because it always does. And for me, it always seems to be about health issues.
In case I'm supposed to end this on an optimistic note, here are the positives I can take away from my year of anticoagulants and anxiety:
- I got back in therapy, which is absolutely invaluable and in my opinion something everyone should do regularly
- I started anxiety medication for the first time in my life, and it has made such a difference in dampening down the constant, intrusive thoughts that I wish I had started it 15 years ago
- I have renewed gratitude for the family and friends in my life who support me when I am a mess
- I have renewed appreciation for physicians, medical assistants, nurses, and all the other care providers who keep a steady, calming presence every day while seeing people in the worse moments of their lives
It’s been a tough year. It’s May 1st, the sun is shining, and my physical and mental health are okay, at least today. Everyone faces challenges in life. But people who struggle with mental health have to face those challenges while carrying around the big, heavy, awkward burdens of their depression, anxiety, or other mental health issues.
My job as a health communicator is to tell stories about health, medicine, medical innovation, patients, caregivers, research, and more. Mental health is a part – a HUGE part – of overall health, and the only way to face it and improve the mental health of ourselves and our communities is to make sure mental health stories are told – and heard.