When Anxiety Was Running Her Life (And How She Took It Back)
Rachel woke at 4am most mornings with a list forming before she’d fully surfaced. She had been doing this since she was twenty-three. She thought it was just what being a conscientious person felt like. She was wrong, but it would take twelve more years to find out.
The list always started the same way. The thing she’d forgotten to do before she left school. The email she hadn’t replied to. The parent she’d meant to call back. The reading she’d planned to mark before Friday and hadn’t started. The question of whether she’d said something odd at the staff meeting and whether anyone had noticed and what they’d thought if they had.
By 4.30 she was usually fully awake. By five she was on her phone. By six she’d decided she might as well get up. She’d done this, with variations, for most of her adult life, and she had always filed it under: being a conscientious person. A primary school teacher. Someone who cared about doing things properly. It had never occurred to her that it might be something other than a personality trait.
She was thirty-five when her body made a different argument. She’d had, in the space of six weeks, two stress headaches that lasted three days each, a chest tightness that had sent her to A&E with what turned out not to be a cardiac event, and a full collapse in her classroom on a Tuesday afternoon in October, in front of twenty-seven seven-year-olds, which had brought her teaching assistant running and left her sitting on the floor with her back against the whiteboard, unable, for several minutes, to explain what had happened.
“A parent had come in that morning to complain about a reading level. It was not an unusual complaint. I’d handled dozens of them. That day I got to the staffroom afterwards and sat in a chair and couldn’t stop shaking. I told myself I was tired. I had been tired for twelve years.”
The appointment she’d been putting off
Her GP’s name was Dr Hollis. Rachel had seen her twice in the previous five years, both times for physical complaints she’d let develop too long before addressing. She made the appointment in October and rescheduled it once, in November, because the week was busy and she felt better and it seemed unnecessary.
She went in December. She described the chest tightness first, because that felt like the legitimate reason for being there. Dr Hollis asked about sleep. Rachel explained the 4am thing and described it as normal for her. Dr Hollis asked how long it had been happening. Rachel said: since my early twenties, probably. Dr Hollis wrote something down.
She asked about the rest of it in the way that GPs do when they’ve already formed a working hypothesis: the constant low-level alertness, the tendency to replay conversations, the preparation for every scenario, the difficulty switching off. Rachel described these things and watched Dr Hollis’s expression and thought: she’s going to say I need more sleep.
Dr Hollis said: ‘Rachel, what you’re describing sounds like generalised anxiety disorder. I’d like to talk about some options.’
“I felt two things at once: the instinct to argue that I wasn’t anxious, I was just careful — and underneath that, before I’d even finished the thought, something I can only describe as relief. Like being told the name of something you’ve been carrying for years without knowing what to call it.”
What happened next, practically
She was referred for CBT — cognitive behavioural therapy — which had a six-week wait on the NHS. She waited. She’d considered going private to shorten the wait and had decided against it partly for cost and partly because she’d thought, grimly, that six weeks was appropriate penance for twelve years of not asking for help. Her therapist, when she arrived, said that framing was worth examining.
The CBT was twelve sessions. Rachel had expected it to feel like being given tools — techniques to deploy, systems to install. It felt like that sometimes. It also felt, at other times, like being shown her own thought patterns from the outside, which was uncomfortable in the specific way of seeing yourself in a photograph and recognising something true.
The 4am thing changed in the third month. Not disappeared — it still happened occasionally. But her relationship to it changed: she recognised it as the anxiety making its first bid for the day, rather than information she was obliged to act on. She could, sometimes, note the list and decline to engage with it and go back to sleep. This sounds minor. It was transformative.
“My therapist said: ‘You’ve mistaken the alarm for the emergency.’ I’ve thought about that sentence almost every day since.”
Eighteen months later
She is thirty-six. She still wakes early sometimes. She is still, by temperament, a conscientious person who cares about doing things properly. The anxiety and the conscientiousness are not the same thing, and understanding the difference has been one of the more useful recalibrations of her adult life.
She told her sister about the diagnosis in the spring. Her sister listened and said: ‘Oh God, do you think I have that too?’ Rachel said she wasn’t a doctor, but that it might be worth making an appointment. Her sister has made the appointment. She is waiting to hear.
Rachel wants people — specifically women, specifically women who have been managing something efficiently for so long that they’ve stopped noticing the weight of it — to know that the name matters. That knowing what you’re carrying is different from just carrying it. That the 4am list is not a personality trait. That there are, it turns out, other ways to be.
If any of this sounds familiar, you’re not alone — and you’re not just ‘a worrier’. More in our Wellbeing section, including a guide to high-functioning anxiety.
