In a room full of people, your head is as light as a balloon. Your palms are sweaty, and your breathing is irregular. “Did I just forget how to breathe?” You ask yourself. “That cannot be!” But, the thing is, you are unable to think clearly as your chest tightens. You can hear your heart beating. You get hot; maybe you shake. You want to run away, but your legs are stuck, and so are you.
If you are familiar with this hypothetical scenario, you may be one of the 40 million Americans who struggle with an anxiety disorder. The National Institute of Mental Health describes anxiety as one of the most common mental disorders experienced by adults, affecting 18.1 percent of the U.S. population. Women are 60 percent more likely than men to develop an anxiety disorder, according to the NIMH.
Occasional anxiety is completely normal, NIMH reports. But anxiety disorders involve more than temporary fears and worries. Not only do people with anxiety disorders have trouble kicking their worries away, but they may also progressively deal with more and worse fears.
The negative feelings prompted by the disorders may often interfere with daily activities – such as working and meeting friends.
These disorders arise from both genetic and environmental factors, NIMH reports.
“Some studies show that individuals can inherit a ‘propensity for the disorder,’ or what we would call ‘imperfections in the correct functioning of neurotransmitters’ – especially serotonin,” said Maria Navarra, a psychologist based out of Turin, Italy. “That means that, although the disorder is not hereditary, specific environmental, social or cultural conditions may activate symptoms in those who are predisposed to anxiety disorders.”
For Tommy Lucero, a 36-year-old stand-up comedian and chef from San Diego, Calif., social anxiety, a type of anxiety disorder, was the norm growing up. Comparing himself to his peers, Lucero thought that being overwhelmingly nervous around fellow humans was universally true. He observed his friends, and he saw that they, too, did not know how to approach girls. They, too, did not really like talking to strangers.
“It wasn’t until I hit my 20s that I realized I couldn’t force myself out my shell,” he said.
But before he became aware of that, Lucero had already received a diagnosis of social anxiety – or social phobia - at age 14.
The fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association defines social anxiety as “a persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way that will be embarrassing and humiliating.” The disorder impacts 15 million Americans, the Anxiety and Depression Association of America says.
As a child and young adult, the simple act of being surrounded by people made Lucero sweat. He had panic attacks, and his chest hurt to the point of making it almost impossible to breathe. Lucero’s teenage years were characterized by failed attempts to cope with his mental distress.
In high school, Lucero developed a crush for a girl he called “Carol.” The two shared a marching band class. She was always happy to see him, he said, which encouraged him to ask her out on a date.
One Friday, Lucero worked up the nerve to go talk to Carol. Walking down the hallway, his chest felt heavier and heavier, as if someone was pushing down on it.
“. . .Along with a layer of sweat that would be normal for an Olympian, but not a teenager that just walked less than 50 feet,” he said. “She turned to see me and said hi with a huge smile as always. But when I opened my mouth, I just turned around, walked back to the restroom, vomited and went to my last class.”
He never asked her out. In fact, he transferred at the end of the semester, and he never saw her again.
Soon, he became a difficult teenager – “a public nuisance” - he said, and although his life experiences “were not so unique”– his parents divorced when he was a child; his dad was emotionally and verbally abusive – he spiraled into addiction.
“Booze got into the equation,” he said. “Drinking was a way to try to make things easier. It was a way to try and lubricate my inability to communicate with other people.”
The ADAA reports that about 20 percent of people with social anxiety disorder self-medicate with alcohol. This is because alcohol can temporarily relieve the symptoms of social anxiety by acting on psychological inhibitions.
Years later, in 2010, Lucero reflected on the dangers of his lifestyle from a hospital bed, after an alcohol-related car accident gave him the push to start actively taking care of himself.
He began seeing a therapist, who suggested keeping a journal would be a proper way to deal with the million thoughts that populated his head. At the time, Lucero reminisced, he was taking public speaking classes in college to attempt to overcome his fear of crowds.
“I started to go to [comedy] open mics. Some people thought I was funny and helped me writing jokes,” he said. “That helped me with the talking to a lot of people.”
What was happening surprised his therapist, who could not fully understand how someone who had dealt with social anxiety all his life could suddenly feel comfortable under the lights of a stage, facing crowds, trying to impress them with humor.
“I was able to relax in front of people on stage,” Lucero said. “When I do comedy - even the first time I did it - I never feel tense.”
In comedy, Lucero found self-realization and truth.
“It’s surprising how forgiving people can be of your own transgressions when you blanket them with jokes.” he said. “Maybe, someone else in the crowd has a shitty family or had an addiction problem, and [they realize] they are not alone.”
Lucero’s relationship with comedy may seem odd, but, in 1975, psychotherapist and author Samuel S. Janus analyzed the interaction between humor as a release of tension and anxiety.
Interviewing 55 professional comedians, Janus found that there is a close relationship between the suffering comedians experience and the way audiences perceive them.
“There are numerous indications that many of our top comedians are really crying out loud,” Janus wrote. “It is our contention that the comedian-audience relationship is based on mutual needs; the successful comedian is one who is able to verbalize the fears and anxieties of his audience and carry them to absurdity, the point at which it becomes possible to laugh at them.”
Besides, more recent studies show a connection between psychological well-being and humor, according to Navarra.
“Humor favors creativity, and it helps reduce tensions,” Navarra said. “Through humor, anxious comedians can take a distance from themselves and their uncomfortable reality, improving their ability to tolerate frustrations and rejections.”
But laughing and making others laugh also has positive effects on the body, Navarra continued. It favors the production of endorphins, and it distends muscles. It increases blood oxygenation and creates an electrical cerebral activity that is similar to the one your brain experiences when you are in charge of your own environment.
“This is linked to positive self-esteem and stress reduction, all things that are compromised by anxiety disorders,” Navarra said. “Today, some therapeutic approaches – such as ‘comic therapy’ - look at humor as a way to treat psychopathologies and are even inserted in psychotherapy sessions.”
A San Diego native, twenty-six-year-old stand-up comedian Jaime Gamblin saw her anxiety-induced fears take the best of her for the first time in 9th grade, long before comedy relieved some of those fears.
Sitting in her class, Gamblin awaited her turn to read during a “ping pong” reading game. She should have felt confident, she said. After all, she had been testing as a 13th grade-level-reader for four years.
But she did not feel calm. She scanned the room, trying to anticipate whether someone was going to call her name. At that point, she had already developed “the inability to breathe properly” in situations where she felt under stress, she said.
In 2013, Gamblin got diagnosed with generalized anxiety disorder. Defined by the DSM-5 as “excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least six months, about a number of events or activities (such as work or school performance),” generalized anxiety disorder affects 6.8 million Americans, according to the ADAA.
“GAD is similar to social anxiety in which affected subjects worry about being negatively judged by people,” Navarra said. “But people who have generalized anxiety disorder constantly worry about their performances, even when nobody is around to judge them.”
As years went by, Gamblin feared that any interaction she had with other people could make them feel uncomfortable. Was she making appropriate eye contact? Had she been looking at her interlocutor for too long? Not long enough? Did she really have to introduce herself?
Sometimes she would stand for too long, she said, and if that happened while she was feeling anxious, she risked slowly passing out as her head became lighter and lighter.
“I never wanted to be the one having to order pizza as a kid,” Gamblin said. “Sometimes, I’d rather stab myself in the toe than having to talk to people.”
But a week before her 23rd birthday, something changed. Gamblin decided to set foot on stage and try stand-up comedy. She wishes she had tried that as a teenager. She said she had used humor to control her anxiety before.
She had always thought that being funny could help her improve her relationship with others. That it could make her “weirdness” go unnoticed. Mad at her condition for preventing her from fully expressing her potential, Gamblin often forced herself to do things she would not normally do. Comedy was one of those.
“When you are anxious, you know exactly what is making you anxious, and why it shouldn’t,” she said. “And even if it’s ironic, since I hate public speaking, I choose to go on stage because I am stubborn about my anxiety.”
A slender and charming brunette who, sometime in her 20s, decided to turn blonde, when she is on stage, she controls the crowd with improvisation and confidence. Looking at her, standing tall up there, you would never guess how worried she can get. She interacts with her audience; she creates a point of contact.
“I want to get up there and connect to people,” she said. “[For me] it’s not just ‘here are the jokes that I prepared, and you’re going to enjoy it.’ I try to be dynamic because I like the ideas behind a joke more than the mechanics of comedy.”
Yet, Jaime Gamblin has not performed in a while. Five months ago, her health got in the way, she said, and on top of that, she had lately been feeling down. The connection was not there anymore. The fun was not there anymore.
“I wasn’t feeling clever on stage,” she said. “I didn’t have that blissful moment of pure creativity. I wasn’t being a comic.”
As her link to people progressively thinned, it stripped away her identity. It relentlessly destroyed one of her few sources of certainty: when everything else seemed meaningless or overwhelming, being funny could be her anchor.
Gamblin was experiencing typical signs of depression, a condition that can go hand in hand with anxiety, according to the ADAA. Consequently, she withdrew from the external world and started spending most of her time at home, desperately at first - watching TV, letting the hours slip by - then slowly trying to find her balance again.
“I woke up to my dog licking my face,” she said during her interview, on a sunny and warm March afternoon. “Usually, I don’t get out of the house at all unless I go to the dog park.”
With support coming from family and friends, and with the help of medications, Gamblin is rediscovering her worth, striving to push those fears away. She is almost ready to go back on stage, she said. She knows she will soon be ready to go back on stage.