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An insufficiency of enoughness: a doctor’s reflections on anxiety

Valentine Esposito, MD
Conditions
August 29, 2020
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My college graduation was approaching, and I was slated to start medical school in the fall. I was happy. You could find me with an impossible smile, singing along with the windows down to my favorite song — Beat of the Music by Brett Eldredge — as I made my way through menial errands. Everything felt like sunshine.

Before I knew it, the metaphorical firehose of medical school was underway.  I sat in the library staring intently at my laptop, willing my brain to absorb a modicum more of information while my right foot tapped feverishly.  I was petrified.  I thought loudly to myself: What if I can’t do this?  What if my best isn’t going to cut it?  What if I’m not good enough to be a doctor?

This unrelenting self-inquisition began to haunt me. It was making me sick, but without a tangible chief complaint to address, I decided to just dig deeper.  I filled my life to the brim with more, but no matter how much more I tried to be, I still felt unwell. I was tired. A heaviness collapsed my lungs and forced reverse peristalsis of my intestines.

Eventually, I sought help for this problem I could not name.  I was referred to a therapist and psychiatrist.  I was diagnosed with generalized anxiety disorder.

I learned that it wasn’t healthy to constantly feel unsettled: to watch my favorite movies but be unable to stop spinning the silver heart ring on my middle finger.  It wasn’t healthy to wake up physically aching for unknown reasons. It wasn’t healthy to feel like I had to constantly work to prove my worth to other people, and to myself.

But by myself, without the objective insights of a medical professional, I had a difficult time naming my anxiety, because, at times, my anxiety just felt like me.  While unknowingly struggling with anxiety, I became president of my medical school, taught classes, wrote and directed a goofy musical to raise money for charity, published research.  I baked cookies on a whim, slow cooked Italian red sauce while dancing around my kitchen, went on what seemed like a million bad first dates, and joked about them with my sister.  Despite my anxiety, I lived, I smiled, I achieved, but it was often unclear where my anxiety ended, and I began.

Before I fully noticed, the final months of medical school slipped away, and I started pediatrics residency at my dream program. Though a new chapter of my life had begun, anxiety was still part of my story.

A few months into residency, I was on a walk around the lake near my tiny Seattle apartment when I realized I had forgotten my headphones. Accompanied only by the gentle chatter of passersby, I felt an effortless stillness wash over me.  This was a milestone.

You see, since 2013, Brett Eldredge has been the soundtrack to my life.  His songs gifted me a sense of calm when I needed it most: college finals, the MCAT, board exams, the lowest lows of my anxiety.  In times when my brain felt like it was betraying me, I would blast his music on long hikes to nowhere in an effort to find some sort of relief.  For whatever reason, his voice put my mind at ease and plastered hope on my soul so that I could keep showing up to my life every day.

In the uncustomary quiet of this waterfront walk, in the distinct absence of a Brett chart-topper, I was finally able to see my struggle with anxiety for what it was.  My anxiety was never just a diagnosis: it was also a symptom.

My true underlying diagnosis was the fear of not being enough. The feelings of electricity jolting my body, my racing thoughts, tapping my foot, and fidgeting with my jewelry were all ways of processing what I believed to be an insufficiency of enoughness.  My whole life, I had wondered: Am I accomplished enough so that people value me?  Do I work hard enough so that people respect me?  Am I fun enough to be around so that people want to be my friend?  Am I enough for someone to love?  Am I enough for myself to love?

Time, therapy, medication, and, even, Brett Eldredge, helped me find answers to those questions.  I was enough.  I am enough.  Beyond that, my mental illness has no impact on my enoughness. I can have a mental illness and still be extraordinary, because my mental illness is not who I am.

I am a pediatrician, a viciously proud big sister, a compassionate friend, and a terrible karaoke performer.  I like to make kids smile with funny faces while waiting in line at the grocery store, and I can never hold back my giant laugh.  I love printing pictures just like my grandma used to and surprising co-workers with a kind note.  I think I am impossibly funny and a phenomenal baker, even though my jokes and cakes often fall flat.  I am someone that believes being the vulnerable, authentic version of yourself is the biggest gift you can give.  That is me, and who I am is unquestionably enough.

To my knowledge, there is no DSM-5 diagnosis for “self-perceived insufficiency of enoughness,” but I know that I am not alone in this experience.  Our wonderfully imperfect lives can often call our enoughness into question, and this transient self-doubt, even shame, can be normal. But when a lack of enoughness becomes a steady state, we can’t push that aside. We deserve to feel whole and know that the world needs us precisely as we are.

If you find yourself struggling with enoughness, please reach out to a trusted friend, health care provider, or mental health professional.  I also highly recommend Brett Eldredge’s latest album; I promise it will help.

Valentine Esposito is a pediatric resident.

Image credit: Shutterstock.com

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