MIA FREEDMAN'S SUNDAY COLUMN: This is what high-functioning anxiety looks like.

It was mental health awareness week recently. What a great thing. Like so many people, I have mental health challenges – about six years ago I was diagnosed with generalised anxiety disorder after an 11-day panic attack that my therapist later described as a ‘near total nervous breakdown’.

I was put on medication – a drug called Lexapro – and began a very slow process of recovery from one of the most distressing experiences of my life.

Mental health issues are rarely cured. Rather they are treated. And they require a lifetime of vigilance and care. Mostly, with the help of drugs and lifestyle modifications, I no longer have anxiety day to day. But occasionally I do. This hasn’t been a great year for my anxiety. And I think it’s important to be honest about that.

The medication I take isn’t a cure-all. Sometimes, due to hormones or events in my life or the world more generally (Trump’s little hands near the nuclear codes for example), my anxiety will poke its nasty head through my carefully maintained buffer zone and curl up in the pit of my stomach like an irritated ball of barbed wire.

Anxiety can be hard to describe. It’s different from stress. It’s different from feeling overwhelmed although those things can play a part sometimes. And it’s different for everyone who experiences it. Each of us will have a unique experience even though many of the physical symptoms and the runaway thoughts are common. We will all use different words to describe it if we describe it at all which we probably won’t because you probably won’t ask and we’re unlikely to volunteer that we’re experiencing anxiety.  Because there is still shame and stigma attached and also because it usually takes all our strength to try and wrestle our anxiety into submission as we go about our daily lives and we don’t have any strength left to talk about it. We’re too preoccupied with the wrestling.

I have what’s known as high-functioning anxiety. It’s more common than I ever suspected until I first wrote about it publicly a few years ago and was overwhelmed by the number of people who, ever since that day, have reached out to me to say “me too”.  Being high-functioning means you would never know when you met me that I had it. The truth is that most days I don’t have it. But on the days I do, you still wouldn’t know. 

I can be talking to you quite normally if we're meeting each other for the first time or if we've known each other for decades and unless I volunteer it, you'd never guess.  I can be doing a live TV interview, hosting a podcast or sitting in a meeting, contributing quite normally. I can be at a BBQ or making small talk on the sidelines of my son’s cricket game or my daughter’s touch footy training. I can be smiling and even laughing and you’d never suspect that I feel scared and bad and like the world is all wrong somehow in ways I couldn't explain to you or even myself.

Most days now, though, most days I’m free of it. This requires work – not to say that those who aren’t free of it aren’t working hard enough.  I’m just fortunate enough that my anxiety is the kind that can be treated effectively with drugs and lifestyle. For me, the lifestyle bit means three main components: routine, exercise and sleep.

My happiest work days have a routine about them and even when I travel for work, I bring the key parts of my routine with me. I take my own big tea cup with me (very important – the ones at hotels are so tiny it's like drinking out of a bellybutton) and my own teabags and I have my earphones and my podcasts that I cocoon myself in and I only stay in hotels where there is a gym.

Exercise is a non-negotiable. I do it every morning 7 days a week. It’s not a punishment , it’s a sanity-saver and I never even consider missing it.

Sleep also. I am a gold medal sleeper and I need 7-8 hours a night. Now that my kids are older, this is very doable. When they were young, I made sure that I sleep-trained them at six months because even though I hadn’t been diagnosed with anxiety back then, I instinctively knew I could not function as a human let alone as a mother without sleep. Very few people can, anxiety or not.

So where is this going?

I always take every opportunity I can to talk about my mental health and to emphasise that it’s not a linear ‘journey’ of diagnosis and cure. It’s on-going. You have lapses. Struggles. Set-backs.

Earlier this year, during a particularly difficult time, my anxiety came back with the force of a tsunami. No amount of sleep or drugs or exercise or big cups of tea could soothe my rattled mind. I felt I might never be OK again. But I was, even if the next few months were patchy.

POST CONTINUES BELOW: Are we living in the Age of Anxiety?

Do you know what helped?

Kindness. The kindness of my friends and my family and the kindness of strangers.

At a time when it felt like the world was a frightening, aggressive place, kindness was the only thing that kept me from sinking even further under than I already had.

Kindness literally held me up and made me feel like I was going to be OK.

At a time when so much emphasis is placed on being reactive and outrage seems woven into the fabric of so much of the media we consume and social media we embrace, kindness has become woefully underrated as a core societal value.

It can be hard to know when someone in your life is going through a hard time with their mental health.  It's rarely broadcast as a status update. There are many types of serious afflictions that can be invisible from the outside if the sufferer is high-functioning: alcoholism, drug addiction, eating disorders and, of course, a host of mental health challenges including grief. It's possible to mask great suffering, especially when you have no choice but to soldier on at work, at home, as a parent.  And there is no privilege that makes you immune to mental health challenges.

Be kind. And most especially to yourself. Try to shush the inner voice that says you're hopeless and helpless and you'll never feel better again. You will. It might just take some time. Until then, choose kind.

Mia Freedman is the co-founder of Mamamia Women's Media Company. She is a proud patron for Rize Up, supporting women fleeing from domestic violence, an ambassador for Share The Dignity, supporting homeless women and an ambassador for Sydney Dogs and Cats home. She is also the founder of Ladystartups, a Mamamia initiative to support women who have started their own business.

She is the author of the best-selling book Work Strife Balance  and is the host and co-host of three podcasts: No Filter, Mamamia Outloud and Tell Me It's Going To Be OK