The Day Anxiety Showed Up at My Front Desk

About 14 or 15 years ago, I was standing behind the front desk of my practice. It was just after lunch, and I had a stack of files ready for my afternoon patients. For 25 years, I had a brick-and-mortar office with functional medicine, chiropractic care, massage therapists, the whole shebang.

All of a sudden, all I could feel was dread. My heart was racing and I felt like I was going to die. Nothing had happened. My kids were fine. No weird phone calls from school.

My staff looked at me like, what's the matter? I put a weird smile on my face and said, "It's okay. We're just going to keep going." Then I saw every patient on my schedule.

I'm a Three on the Enneagram. I'm a driver. Not much gets me flustered. I keep my blinders on and keep going. So I didn't stop to explore this strange new emotional experience. It was go time.

Months later, I looked back and thought, whoa. That was anxiety. Now I know what it feels like, and it's terrible.

I had never been an anxious person.

I was 48 years old and going through a divorce, with no idea what my life was going to look like. It was probably perimenopause too. Maybe some hormonal fluctuations. Certainly elevated cortisol. Maybe I hadn't eaten enough that day, or had too much coffee because I didn't sleep enough. It was probably all of them.

So when women tell me, "I've never been an anxious person. Why am I anxious now?" I think it's a great question. Anxiety isn't the answer. Anxiety is an experience. It's not an explanation.

I'm not talking about panic attacks or an anxiety disorder that keeps you from functioning. That's a different class of anxiety. I'm talking about the low-level, irritable anxiety you can't seem to shake, the kind that has never been part of your character before.

For some women, there is a relationship between perimenopause and anxiety. The hormonal environment can be pretty erratic. Estrogen and progesterone don't make some orderly descent until one day you arrive at menopause. I wish! Those changes also don't happen in isolation from the brain. They intersect with your mood, your sleep, and the way you experience stress.

But "hormones can contribute to anxiety" is not the same as "your anxiety is hormonal." Hormones may be part of it, but it isn't just hormonal. You're not crazy. You may feel like it, but more than likely you're not.

Think about what else is happening at 45, 48, 52. Teenagers. Young adult children making decisions you can't control. Aging parents pulling you in a bunch of directions. A marriage where you think, who is this guy? A career that has become really demanding. Maybe a divorce. Maybe grief.

Then perimenopause decides 3:07 a.m. is an excellent time to be awake. So you're tired, and you drink coffee instead of water. Maybe you had too much wine last night, so you're dehydrated. You skip breakfast, go too long without eating, and your blood sugar drops.

That can feel like a racing heart, shaky, sweating, irritable, edgy. You just don't feel like yourself. Those sensations can feel an awful lot like anxiety.

That doesn't mean blood sugar is the cause, but it could be part of it. Humans are complicated. We're messy.

Sometimes functional medicine gets a little too enamored with finding the root cause. Sometimes we're looking for the whole root system of a tree. For me, divorce was in that root system. So were sleep, food, and stress. I don't need to know which one gets the trophy for causing that moment behind my front desk. I need to understand that several things contributed, because that changes how I respond.

The same is true for you. When you see what's contributing, you can change how you respond. That's the Living F.R.E.S.H. way. New information, a new response, and you stay on that health trajectory.

We have to bring faith into this too. In that season, I was thinking, "But I've been praying. I've been leaning into my Bible study." I was a little mad at God, but I was still there.

Christian women who suddenly experience anxiety in perimenopause, please don't decide your faith just isn't strong enough. No.

Don't swing so far in the other direction that you think your spiritual life has nothing to do with your anxiety either. Sometimes mine does. Sometimes I'm worried because I'm trying to control something that isn't mine to control. Sometimes I'm rehearsing every possible outcome instead of reminding myself that God has the outcome that's best for me, even if it's not the one I had in mind.

Sometimes I need to let it all go and surrender it. Sometimes I need to pray. And sometimes I need to pray and eat a sandwich, because I haven't eaten anything.

These things are not mutually exclusive. We want to know, is this physical or spiritual? What if it's both? I'm an embodied, spiritual person living in relationships, in a culture, and in a body that has needs and limitations, hormonal fluctuations, blood sugar, and sleep requirements. Of course all of those things interact.

In Philippians 4, Paul tells us not to be anxious, but to bring everything to God in prayer and thanksgiving. Then he speaks about God's peace guarding our hearts and minds. There's no condemnation there. When something feels uncertain or out of my control, I can bring it to God.

And if you're waking up every night drenched in sweat and sleeping four hours, you can talk to a health care provider about it. If you haven't eaten since 7:00 this morning, you can eat. If you've had four cups of coffee because you only slept four hours, you might want to reconsider that strategy. If your marriage is in trouble, give it some attention. This is not an either/or situation.

I'm going to step on a few toes. I know anxiety can be debilitating, and I'm not shaming anyone who has panic attacks or an anxiety disorder. But we can't become so afraid of making someone uncomfortable that we stop talking about agency.

I see people slowly give more and more of their lives over to anxiety. They stop going places. They stop traveling. They avoid situations and people and turn down opportunities they really want. Their world gets smaller and smaller. Eventually, anxiety isn't something they're experiencing. It's the way they organize their life. That is so sad to me.

Anxiety is an experience. It is not an explanation or an excuse.

If it's crippling you, please get some help. Take it seriously enough that you care about yourself enough to get the help you need. Maybe you need some meds for a little while. Maybe you need therapy. If you think, "I'm not a therapy person," what if you were? If you didn't like your therapist, try a bunch until you find the right one. The right therapist is worth gold. So is the right coach. Maybe hormones are part of it. Maybe there's trauma that needs to be addressed. Maybe your physiology needs some attention through functional medicine.

There will be things you genuinely can't do right now, and that's real. Not long ago, I got sick and missed a couple of workouts. I needed my body to rest. But there's a difference between recognizing a current limitation and turning it into your identity. "I'm experiencing anxiety" is different from "I'm an anxious person." If you've never been anxious before, something has changed. Respect that enough to get curious.

That brings us to regulation. The wellness community has done regulation a bit of a disservice. It has almost become the same as calm, like the healthiest woman wanders peacefully through life with a perfectly regulated nervous system and nothing ever gets under her skin. That's not regulation. That's avoidance. I don't know what life these people are living, but I'd like to visit.

You're alive. You're going to experience anxiety, fear, anger, all the emotions. You're going to get overwhelmed. Some circumstances legitimately deserve a stress response.

Regulation is how you respond when the alarm goes off. When the smoke detector goes off, you pay attention. You don't sit on the couch and say, "I refuse to acknowledge the alarm because I'm a very regulated person." Maybe the kitchen is on fire because your teenagers tried to make mac and cheese. You're not going to sit there doing box breathing. You're going to get out of the house! Or maybe you just burned the toast. Either way, the alarm is real. It doesn't tell you why it's sounding. It tells you to pay attention.

Can I notice what's happening inside of me without becoming afraid that it's happening? Can I give myself a little room to understand it and respond? Can I go to bed earlier? Take a walk? Cut my caffeine? Eat better? Do I need a therapist? And sometimes the response is, "God, I cannot control this. You need to take hold of it." That's not passive. You're looking for the solution. That's stewardship.

Most of us women already have plenty of lists. You don't need someone else standing over you saying eat this, don't eat that, exercise more, lose weight, lower your stress, sleep eight hours, have you tried meditating? Thank you. Very helpful. Not really.

I want you to understand your body well enough to become confident caring for it. What worked 10 years ago will probably have to change, and that doesn't mean you failed. We're going to learn to pay attention to what's happening, understand the body you're living in, support it, build capacity, and make choices that work in real life, not some imaginary life where nothing ever goes wrong. We'll do it from a place of stewardship. Not obsession. Not punishment. Not shame.

So when your heart is racing, the dread comes, and you think, I've never felt like this before, what is happening to me? Remember the woman behind the front desk. Forty-eight, going through a divorce, her body changing, life complicated. She didn't know enough to ask what might be contributing. I know now. God allows things to happen to us so that we can help others in the future.

Anxiety may be part of what you're experiencing right now. It doesn't get to become all of who you are.

That's regulation. That's part of learning to live F.R.E.S.H.