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Why Anxiety Is Often An Unresolved Stage of Grief

I was eighteen years old when I had my first panic attack. I was on a road trip with my high school boyfriend, Jordan. We had just graduated, and it was the summer between our senior year of high school and our freshman year of college. We were headed to separate schools in New England that fall and had decided to take a trip to visit each other’s colleges, hoping to remain connected even after the summer.

The trip had gone well—we saw each other’s campuses, held hands as we walked across commons, and whispered vows of faithfulness in the face of distance. As we drove the two-day drive home to Georgia, we talked endlessly about all that was ahead of us. I stared out at the highway rushing before us, the future looming large, my sneakers propped on the dashboard, and my hair blowing in the breeze from the open window. The future seemed exciting, but also a little scary.

As I gazed out at the road, my heart suddenly did a little flip-flop. And then a bigger flip-flop. I yanked my feet off the dashboard and sat forward, breathing in deeply. My heart was racing and I felt dizzy. “What’s wrong?” Jordan asked. But I couldn’t answer him—I was too panicked to speak. Was I having a heart attack? The thought made me even dizzier. I felt as though there was a giant weight on my chest, and I couldn’t breathe.

I shook my head at him, wide-eyed. “Something’s wrong,” I finally managed to say. Not knowing what else to do, Jordan followed highway signs to the nearest hospital emergency room and walked me through the double doors.

Several hours and multiple tests later, the doctor concluded that I’d had a series of heart palpitations but that I was otherwise young and healthy, and he sent us on our way.

From that day on, I lived in fear of having another episode like the one in the car. And in fact, I began to have them quite frequently. Chest pounding, heart racing and palpitating, severe dizziness. It was an awful problem, one that I quickly began to feel imprisoned by.

Looking back on that initial visit to the emergency room, I so wish that the doctor had probed more into my psychology. If he had asked even just a few personal questions, he would have learned that I was in an extremely anxiety-provoking phase of life: I was about to move away from home for the first time, and both of my parents were battling cancer.

Unfortunately, I was too young to correlate such events, and the attacks continued to plague me. The deceiving thing about anxiety is that it can manifest in such real physical symptoms that most people do not realize that anxiety is the source of their problem.

In fact, it would take me many years to learn this for myself, but when I finally did I was able to begin climbing out of this anxious phase of my life. I now help countless other people do the same, but it is the road on which I got here that taught me everything I know today about the affliction that is anxiety—and how unresolved grief is inextricably woven into it.


I was fourteen when both of my parents got cancer at the same time. I was an only child, and the prospect of losing my family was something that loomed over me constantly throughout my adolescence. While my father’s prostate cancer was treated easily and he quickly went into remission, my mother’s late-stage colon cancer took our small family on a roller coaster of hospitals and doctors and seemingly endless treatments.

My parents were wonderful people. They’d met and married late in life, both of them each other’s third marriage. My father was an engineer and a World War II prisoner of war. My mother was a glamorous artist living in Manhattan. She was forty and he was fifty-seven when I was born, and even though my father had three grown children from his first marriage, my mother had always wanted one of her own. I was born in 1978 in Atlanta, and for a long time our lives were good.

But by the time I headed off to college, my father was in his seventies and my mother’s cancer had begun to win the five-year battle she’d been fighting. She died midway through my freshman year at a small liberal arts school in Vermont. I didn’t make it in time to be by her side during her final moments.

My mother’s death rocked me. I was absolutely floored by it. Nothing could have prepared me for it. Not the five years we’d spent helping her combat her illness, not the talks my father had with me about her potential demise, not the school guidance counselor’s sessions. The truth was I never believed she would actually die because Mothers don’t die. Bad things don’t actually happen.


I now understand that the dismantling of those beliefs became the catalyst for my anxiety. When my mother’s death disproved those two beliefs I’d so fervently held on to, the whole floor dropped out. If my mother could die, anything, absolutely anything, could happen.

I took a hiatus from school and went back home to Georgia to help my father pack up and move out of the house. I got a job as a waitress, and I struggled to relate to my old friends from high school who came around to check on me. No one I knew had experienced so significant a loss. Everyone was sympathetic, but nonetheless, I felt very alone in my grief.

The anxiety attacks continued to surface and even worsen. I lived in fear of having them, and I navigated a constant undercurrent of panic. I worried that my father was going to die at any moment. I worried that I would die. And less concrete than those fears, I simply felt a yawing dizziness at the idea that life was completely out of my control.

I turned to alcohol to quell the anxiety, and I attached myself to a young man who had also recently lost a family member and was deep in the throes of his own grief. Together we made our way to New York City, and it was there, in a college psychology class, where I realized for the first time what had happened all those years ago on the road trip with my high school boyfriend: I’d had a panic attack.


Understanding this was the first step in my healing process. Recognizing that I had anxiety as a result of my mother’s death actually helped me to better face the loss and enter into my grief.

Losing someone we love is so deeply painful that we often turn away from the feelings rather than letting them course through us. But when we choose to push away difficult emotions, they don’t just disappear; they simply fester beneath the surface, causing anger, frustration, and . . . anxiety.

But just because I finally understood what was happening didn’t simply make it go away. The anxiety lingered, and the panic attacks continued to surface now and then. When I brought up the idea of seeing a therapist, both my father and my boyfriend encouraged me to just push through and not to indulge further my feelings—which is what they thought would happen were I to enter into therapy. I now understand that the opposite would have been true. Grappling with anxiety is like driving a car on an icy road. When the car begins to skid, you need to turn with it in order to gain control rather than trying to veer away.

But at age twenty, that’s exactly what I was doing, veering away, pushing myself deeper into my studies and also into my relationship with alcohol. The anxiety continued to simmer.

When I watched the Twin Towers fall from the roof of my East Village apartment building in 2001, my anxiety reached an all-time high. It was no longer just my little microcosm that was at the mercy of mortality, but the world at large.


I moved to Los Angeles after I graduated from college in New York, intent on being a writer. My father was living in Southern California by then, and I got a job as an assistant at a glossy magazine and spent my free time driving my elderly father to doctor appointments. His cancer had returned, this time in his bones.

He eventually grew so ill that I quit my job and moved in to care for him during his final days. I was twenty-five years old. His passing was much more peaceful than my mother’s had been. He spent considerable effort facing and accepting his death, which enabled me to do so as well.

But then he was gone, and I was very much alone in the world. I moved into an apartment by the beach and contemplated what to do with the rest of my life. Following the loss of my father, I felt an aching loneliness and an existential doubt about the purpose of life. While most of my peers were in the throes of their postgrad jobs, concentrating on their careers and partying on the weekends, I was hurtling into a deep depression.

At the urging of a friend, I finally entered therapy, and it was there, in the therapist’s office, with the whole last decade of my life splayed out before the both of us, that I was finally able to see that I’d had a hard run of it. I began to understand that I had been forced to confront mortality and loss much earlier than most. And because we live in a society that is fearful of death, I’d been encouraged to push away my grief rather than process it.

Therapy proved an invaluable experience. Reviewing and understanding my losses greatly served to calm my anxiety, and I learned coping strategies for facing my pain and fear and also gathered tools for further self-evaluation and exploration. In fact, therapy left such a positive impression on me that three years after my father’s death, I decided to get a master’s degree in clinical psychology and became a therapist myself.


I’ve learned that, in grief, we must walk a path of fire and pain, of deep sadness and crippling anxiety, in order to get to the other side, to a place where we can experience the beauty life has to offer and to find a renewed appreciation for our time here. It is by understanding this journey and stopping to take stock of what it means to live and die in this world, that we can emerge more peacefully on the other side, having been transformed into a person with greater compassion and empathy, not just for the world at large but for ourselves as well.

We will never get over the death of someone we love, but we can learn to live with it. We can learn to connect with our lost loved ones in new ways, we can free ourselves of anxiety, and we can open ourselves up to the world again.

Adapted from Anxiety: The Missing Stage of Grief by Claire Bidwell Smith, LCPC. Copyright ©2018. Available from Da Capo Lifelong Books, an imprint of Perseus Books, LLC, a subsidiary of Hachette Book Group, Inc.

This book excerpt was featured in the Sept. 16th edition of The Sunday Paper, Maria Shriver’s free weekly newsletter for people with passion and purpose. To get inspiring and informative content like this piece delivered straight to your inbox each Sunday morning, click here to subscribe.