In Four, Hold Seven, Out Eight

After a couple of tries, therapy has transformed how I manage my anxiety.

by Ava Wong

Credit: Tinnakorn Jorruang

As I stood in front of my 9th grade math classmates, I wished to be anywhere else. My teacher had cold-called on me to answer the question on the board. As I stood there my heart pounded, and it was so hard to breathe that it felt like a mountain had fallen on top of me. My eyes grew blurry. My tongue felt dry. 

Even though I knew the answer, my mind had gone blank as I stood. My hand shook as I tried to write the answer on the board and, almost immediately, a classmate corrected me.

Wanting to overcome the embarrassment, I slowly slid back into my seat. My breaths grew faster as my eyes shifted around wearily. 

My thoughts spun into a spiral of worries. Why did I do that? Was everyone judging me? Why did my teacher have to call on me? Why did I react so badly? It felt like the world was ending. 

Starting high school post-COVID-19 and being surrounded by people again after low-stakes, online school had overwhelmed me. 

I constantly worried about being judged by others, making mistakes, and failing. I had convinced myself that I was just having trouble adjusting, but maybe it was more than that.

It was February, and I had struggled to speak at school since the start of 9th grade. Today was a sign of how much worse it could get. Something needed to change.

I went home that day reeling from the events of math class. My eyes felt swollen, and I was disappointed in myself. As I explained the story to my mom, I admitted, “I don’t get why it’s so hard. I hate talking in class…why do I have to?” 

“You just need time,” she responded dismissively. “There’s nothing wrong with you. With more practice, you’ll learn.” 

Maybe she was right. It wasn’t like I was hopeless. I never felt the urge to run out of class or had a real panic attack. It was all inside my head.

If I kept trying, it could get better. 

Trying to Push Past My Anxiety

After talking with my mom, I decided to try to overcome my fears by putting myself out there, starting by joining the literature magazine at my school. I hadn’t been able to make any new friends, or join any clubs, publications, or teams. 

I tried with my whole heart to believe and gathered my courage.

I checked my email, scanning the club announcement while pacing outside the meeting room, trying my best to seem natural. I wanted to go inside, but even the thought made my heart race. The pressure in my chest grew. 

I wondered if everyone else in the hallway could hear the sound of my heart beating and heavy breathing. I felt light-headed as I clutched my phone, looking at the door, trying to brace myself to go in.

Was this what a panic attack felt like? I thought back to the depictions I had seen in movies and television shows: people hyperventilating, terrified that they were dying. What I was experiencing wasn’t that dramatic, was it? 

I had convinced myself that I could branch out if I just tried hard enough. Instead, I stood outside the club room, adrenaline pumping, feeling alone. After another moment of hesitation, I left.

Realizing I Needed the Help of a Therapist

I wasn’t able to participate in class, join a club, or do anything I had promised myself I would. All my intentions had failed.

So, I decided to research. I put my symptoms into a search bar and skimmed the results, reading articles about anxiety, panic disorder, and other mental health disorders. My symptoms fit with enough of the descriptions that I realized there was a deeper issue, one that I couldn’t figure out on my own. I needed the help of a therapist. 

But as a 14-year-old, to get access to the care that I needed, I had to tell my mom. I began bracing myself for the conversation. Coming from a traditional Chinese background, my mother didn’t believe in mental health disorders and treatment. Knowing this, I worried that she would react badly, judging and dismissing me.

After a couple of weeks, I worked up the courage to bring it up. When I looked at my mom, my mouth struggled to form the words. 

“I want to see a therapist,” I whispered. It felt wrong to say it any louder.

The silence between us stretched out as my mom paused, clearly surprised. I was on the verge of tears as I waited for her answer, watching her eyes search mine. Finally, she replied, “OK. If that’s what you want.” 

She didn’t say anything else. It was a resigned yes, but I still felt relieved. Even if she did not understand, she would try to support me. And maybe, finally, I would have a chance to overcome my anxiety.

Rush to Diagnosis

It took another few months until my first meeting with a therapist. My mom had asked my doctor’s office for a recommendation, and I’d finally gotten off the waitlist. 

I had no idea what to expect from the first session; I only hoped that it would help.

After introducing herself, the therapist got right down to business. I now know that the first session is always an intake—where therapists ask questions and get to know you—but her fast pace overwhelmed me. After the initial flurry of probing questions, she assigned me a few online diagnostic quizzes to take on my phone. I felt awkward as I clicked answers to questions like: 

How often do you feel anxious or overwhelmed?

How often do you feel hopeless, defeated, or can’t get out of bed?

Once I finished, she looked through my answers. 

“It looks like you have severe anxiety,” she told me. “And possibly mild depression.” 

I shifted in my seat. Did she get all that from an online quiz? 

“The best way to deal with this is by confronting your fears, one by one. We’ll start with this, and move on to group work so you can meet some other teenagers your age too.” 

She handed me a worksheet, and as I skimmed over it, an uncomfortable feeling settled in my stomach. She explained that we would start with assignments that would expose me to anxiety-provoking situations so I could learn to overcome them. (This, I later learned, is an approach called “exposure therapy.”) The first would be to approach some of my school friends and ask them to hang out.

I stared at her blankly. Already? So soon? 

I had known her for barely 30 minutes, and here I was, holding an assignment. The pit in my stomach grew as I tried to imagine myself following her instructions. I gripped the paper tightly, crushing the edges of the text as I walked outside to talk to my mom. 

“I don’t think this is going to work out,” I said, disappointed, my voice shaking. 

Therapy wouldn’t work if I didn’t trust the therapist, and I intuitively knew that I didn’t trust her— she had pushed me into an uncomfortable situation without even getting to know me. I needed to feel safe enough to be vulnerable and make mistakes. I knew if I met with her again, I would lie instead of completing the assignments.

Trying Again With a New Therapist

A few months later, as I neared the end of 9th grade, I was ready to try again. This time, my mom had gotten a recommendation from a friend, a therapist who, my mom promised, would be more personable.

She started the session by getting to know me, and we got along immediately. We took our time, and she asked me what I wanted to get out of the session and made me explain what I needed. She didn’t immediately try to diagnose or give me the fastest way to “get better.” She took her time and slowly introduced me to techniques and strategies to manage my anxiety.

When anxious moments came up at school, instead of giving in to my fears… I responded with a question

It clicked. After a couple of sessions, I began to trust her more, learning to become vulnerable and honest. 

As time went on, she taught me techniques to deal with the physical sensations of anxiety, and strategies to challenge my anxieties and identify where they came from. When anxious moments came up at school, instead of giving in to my fears of the worst that could happen, I responded with a question like, “Is it really the end of the world? Or is there evidence that I can get through this?” 

While questioning my anxious thoughts, I also used the calming techniques I had learned in therapy. The most comfortable was paced breathing. Breathe in for four, hold for seven, and out for eight. With this technique, I could regulate my breathing and calm down at any time, and any place, without anyone even having to know. 

It wasn’t always perfect. Anxiety doesn’t just go away. It’s something that I have to keep managing. From time to time, I still had intense moments of anxiety—which my therapist taught me to recognize as panic attacks—but now, when things got worse, I had techniques to prevent my anxiety from getting out of control. 

Using My Tools

As 10th grade started, I finally had the coping mechanisms to start joining clubs, making new friends, and branching out socially. It was still hard, but I slowly became comfortable doing new things.  

That October, I was assigned to give a personal speech. On the day of, as I stepped to the front of the class, my hands trembled as I clutched the edges of my script. The paper was just to help with my nerves—I had practiced so much that it was almost memorized. 

Noticing my anxiety rising, I tried to keep calm. I took a breath in for four, held for seven, and out for eight, repeating it for a minute, just like I had practiced. I refocused on the moment and tried to block out any worried thoughts as I readied myself to give my speech.

It was four minutes long, perfectly in range, and I told myself it would all go OK. My voice wouldn’t tremble. I wouldn’t run out of the classroom. And I could do the speech. 

Setting my hands on the side of the standing desk, I set my timer and opened my mouth. My heart was racing, and I still felt the anxiety, but it was different this time. I knew how to recognize it, knew how to calm myself down. I knew that after I finished my speech, I would quickly head to the bathroom and let myself take a moment to recover. I knew to process and move past the moment. I knew how to take deep breaths. I knew to use cold water. 

And, most importantly, I knew that it wouldn’t be the end of the world if I messed up. I had full confidence that I could get through this.

Ava Wong is a junior at Hunter College High School in Manhattan. From an early age, they have had a passion for storytelling and writing. If they aren’t writing, Ava can usually be found doing taekwondo, listening to music, or reading. Through their writing, they hope to engage and connect with fellow teens.

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