I hear an anxious voice in my head. The voice I hear is not related to psychosis, but speaks to me loudly and clearly nevertheless. The anxious voice in my head belongs to anxiety, and its running commentary on what I'm doing wrong never seems to shut up.

Last weekend, I had a conversation with a good friend. The conversation involved a disagreement, and I honestly thought I might have a heart attack. I don’t disagree well. Doing so increases my anxiety, sometimes to panic attack proportions. Typically, I change the subject or, better yet, excuse myself and run. This time, though, I stuck it out. One, the woman is a good friend who is used to me, and two, the subject was anxiety. I wanted to stick around for that discussion. The essence of the debate was this: can anxiety be accepted as part of who one is and thus shoved to the background of existence and be practically ignored, or is anxiety bigger than that, something that cannot, will not, be accepted and ignored?

Managing an anxiety disorder is a bit like navigating a minefield. There are safe places to step and there are dangerous places to step. The trick to navigating a minefield successfully is to not step on any mines, which is made easier by being able to detect where the mines are buried. The trick to navigating anxiety is much the same. Avoid the anxiety and/or panic attack by knowing how to avoid the triggers.

As of this writing, I live with my wife. But before I lived with her, I had a variety living situations, including living alone and with a roommate. Anxiety and panic attacks occurring at home are fairly common for many of us with anxiety disorders and disorders don’t much care what your personal living situation is. Panic and anxiety attacks in public present a special kind of frustration because, in addition to the attack, we have to deal with the embarrassment of being sick in public. Even during my worst panic attack in a public forum, I was still concerned with what others thought of me and whether or not they were judging me.

Anxiety can be beastly. It can take hold of our thoughts, feelings, and behaviors. Anxiety seems to take control of our physical body, too. How on Earth do we combat such a beast? How about with bubbles?

Assertiveness doesn't come easily to many people, myself included. Sometimes, the mere thought of having to express myself or make some need or another known is enough to kick anxiety into high gear. When engaged in a situation where it’s necessary to assert yourself—from speaking up to a supervisor about something you think isn’t quite right to informing a friend that you hate the restaurant she chooses every time you have lunch together, and a million other situations—anxiety can stop you in your tracks. Indeed, it’s difficult to be assertive when we’re nauseous, dizzy, sweaty, and unable to breathe properly let alone think clearly or concentrate. Happily, we’re not doomed to a life of passivity.

Most everyone engages in conversation daily. From talking to the members of our household, to answering the phone, to ordering our coffees in the morning – talking to those around us occurs often. One doesn't need to have an anxiety disorder to know that certain conversations provoke a sense of discomfort or even dread. Arguing with a loved one, consoling someone at a funeral, or even telling someone “no” can cause anyone anxiety. This, of course, makes us wonder: if it is reasonable that certain conversations or subjects cause most people anxiety, what does it do to a person with an anxiety disorder?

Humpty Dumpty sat on a wall. Humpty Dumpty . . . whoa, did you see that squirrel run across that wall, well, I guess it’s a fence, chasing . . . eggs . . . I need to go to the grocery store because we have no food because I keep forgetting to go and I’m tired of fast food . . . that squirrel was fast and he’s gone . . . I love fall . . . I keep forgetting to schedule my daughter’s senior pictures. Wait. What was I doing? Oh yeah, reading this nursery rhyme. Ugh! How am I going to be able to hold down a job if I can’t even read a stupid nursery rhyme? I guess I wouldn't have to remember going to the store then because I wouldn’t have any money. I’m so useless. How am I supposed to concentrate when there’s so much pressure in my head? Make it stop! What is wrong with me?

Anxiety can feel as though an incredibly loud and boisterous parade is charging right through your very being: blasting bands, flashy floats, animals, and announcers ad nauseam. This chaos within can cause headaches, chest pain, difficulty breathing, excessive sweating, aches and pains, and other noxious anxiety symptoms. Further, our thoughts become anxious and race with worry and obsessions. Often, panic sets in. As if this weren't bad enough, we have to live in the midst of this parade. We have to deal with parade garbage (think about it—debris, litter, road apples) while simultaneously dealing with everything else around us. With pandemonium on the inside, how do we deal with all of the stuff on the outside?

When I was younger, there was a public service announcement that ran over and over that explained that the majority of car accidents happen within a few miles from home. The purpose of this message was to encourage people to wear their seatbelts, even when travelling short distances. I was a precocious youngster and when I saw these commercials I thought to myself, “No kidding! You travel close to your home most of the time, so it’s just common sense that most of the accidents would happen there.” Anxiety and panic disorder follow a similar pattern. Since I am home more than I am away, the majority of my anxiety and panic issues occur at home. Additionally, I am more likely to have elevated anxiety before I fall asleep and I spend most nights in my own bed.