Onika L. Dainty

When Worry Doesn’t Stop: Let's Talk about Generalized Anxiety Disorder and Its Overlap with Bipolar Disorder - Part 1 of 5

Anxiety: The Worry That Lingers

I remember the exact moment anxiety entered my life. It was brought on by abject terror.

As a child, I had anxious moments when the anxiety-driven voices in my mind became so loud that I would have to shake my head a few times to quiet the noise. It felt normal, even manageable, until one spring afternoon outside my sixth-grade classroom when anxiety attacked me out of the blue.

To my recollection, here’s what happened.

The Day the River Threatened to Pull Me Under

It was the final few months of grade six, and everything seemed normal. We had just finished recess, and the playground was its usual discord of harshness, where bullies moved from group to group unleashing their cruel brand of humour on any kid who would listen, and especially on any kid they knew it would affect.

There was one boy in particular they reserved the worst of their venom for. That day, the boy, whom we can call Christopher, simply couldn’t take it. He let out a giant scream that echoed across the playground. Every kid stopped and turned to see where it was coming from.

It was coming from Christopher.

It’s still unclear how I got involved, but knowing me, I was always a champion of the underdog and went to his defence. I had a fixer personality even when I was young. Christopher did not seem to want me to fix things. I remember the angry look directed at me before he stomped off inside the school.

That afternoon, as I walked to my backpack cubby to get my notebook, I found a threatening letter instead. It read, “This will be you in five days,” with a disturbing drawing meant to frighten me.

That was the moment my mind began to race with thoughts of danger and death. My breathing became shallow, my vision blurred, and I collapsed on the hallway floor with the letter in my hand as my world fell off its axis and spun out of control. I remember my fingers going numb and taking on a distorted shape that can only be explained by the lack of oxygen moving through my body. My lungs felt as if they had stopped working, constricted in my chest, until eventually I could feel only the last shallow breaths I took before I fainted.

That is how my teachers and classmates found me. The ambulance and police were called once they realized what had put me in that condition. My vitals were checked, and I was given oxygen, although I still felt like I couldn’t breathe. My parents were called to take me home for the day to rest after my traumatic ordeal. It was promised to my family that the police would investigate and “get to the bottom of this.”

For the next two days, I stayed home from school. When I got home, my mother put me straight to bed, and that was when the anxiety and fear entered my sleep. I tried to rest but got very few hours, waking from nightmares of red walls and ropes tangling around me, squeezing the air out of me. My anxiety manifested as screams in the middle of the night. Screams that took my breath away. My stomach refused to hold down any meal, no matter how small. My head throbbed with agony, like a hammer beating against my brain, repeating the same rhythm over and over: “three more days until you die.”

My parents, being strict about school attendance, refused to let me stay home for the entire five days. So, on day four, I returned to school. I couldn’t concentrate. I sat at my desk in a state of hypervigilance. Sounds were too loud, lights were too bright, and my thoughts continued to spin out of control.

By day five, what I believed would be the final day of my life, I was a ball of anxious energy, no longer my cheerful, outgoing self. On that day, however, it was discovered by police and staff, after comparing handwriting samples from each student, that the culprit was Christopher. My parents were called in and told that he had behavioural problems at other schools and would be expelled as punishment for what he had done.

The punishment for me would be the beginning of a mental health condition I did not yet understand. I had no name for it, but I would experience it daily, living from anxiety attack to anxiety attack.

This blog is a reflection on my lived experience with anxiety. I will discuss living with both Bipolar disorder and Generalized Anxiety Disorder, also known as GAD, the challenges I have faced while trying to balance co-occurring disorders, and how changing my mindset helped me create a space where anxiety could exist.

This is the worry that lingers.

Some worry does not end. Instead, it loops, deepens, and stays.

When Anxiety Persists: A Bipolar Woman’s Reflection

After that incident, I started calling anxiety “the voices.” Throughout my adolescence, I would worry about anything and everything. I created scenarios in my head of negative events that were not actually happening and might never happen, but to my fragile mind, each scenario held some truth.

From the day I found that letter in my backpack, I lived in fear that something just as terrible would happen to me again. The sad part was that even my 11-year-old self knew it would be a hard road between me and regaining my peace of mind.

What I know now, that I did not know then, was that I would experience a series of life-changing events until one day I found myself in a child psychologist’s office being diagnosed with depression and a mild anxiety disorder. Mild anxiety would later develop into Generalized Anxiety Disorder as I got older and continued to struggle with processing painful experiences in a healthy way.

There is a difference between everyday concern and persistent anxiety. Persistent anxiety does not simply affect your thoughts. It also affects your perception of the world, your self-perception, your self-esteem, and your self-worth. Anxiety can even shape your behaviour.

It is not just persistent. Sometimes the worry that comes with anxiety is all-consuming.

Anxiety during a Bipolar manic episode is something I can only describe as loud and chaotic. Because one of the symptoms of mania is disorganized thinking, anxiety in mania can take on a disorganized, even paranoid form. In my experience, when Bipolar disorder occurs alongside anxiety, it can feel as if the extreme worry itself triggers hypomania, the precursor to mania.

When your body is in a constant state of fight, flight, or freeze because anxious thoughts persist day after day, your mind starts to break down. If you live with another mental health condition like Bipolar disorder, that internal pressure can increase the risk of a serious mood episode.

What Generalized Anxiety Disorder Feels Like: A Lived Experience Perspective

I moved to Toronto, Ontario at 33 years old to start working in the event management industry. I was fresh out of school when I was hired by a boutique events company where the staff consisted of myself, my boss, and another woman.

At first, things went well. I was securing big accounts, much to the excitement of my boss. Then one day, there was a notable shift between myself and my co-worker. She seemed to begin a passive-aggressive campaign to undermine my work and shake my confidence. She told me that if I did not find a way to bring in more clients, my boss would be forced to fire me.

That was the moment my anxious mind took control of my rational brain.

When you have Generalized Anxiety Disorder, unless you are experiencing visible physical symptoms or an anxiety attack, people cannot see the internal war you are fighting with your own thoughts. The moment I perceived that I could be terminated, I believed I was already terminated. The worry became persistent, excessive, and all-consuming.

I couldn’t eat or sleep because I was constantly thinking about being fired. Questions raced through my head one after another:

“When am I going to get fired?”

“What is my boss going to say to me?”

“How much time do I have left?”

“Should I start looking for another job?”

“Should I quit before he has a chance to fire me?”

“Should I just work harder to get the big accounts?”

“If I get the big accounts, will he still fire me?”

“Fired, fired, fired. You are going to get fired.”

With every thought came another and another. The thoughts, or voices, invaded my mind at work, and my performance declined. I started taking two and three days off so I could try to catch up on the sleep I was lacking, but also so I could isolate myself, untangle the anxious thoughts in my mind, and come up with a plan to keep my job.

I could not see how illogical I was being. Based on one person’s thoughtless comment, I was spiralling out of control.

I began to see danger around every corner, as if the world was not meant for me, as if I was not enough. There was nowhere I felt safe or secure, not at home and not at work. I eventually did get fired from that job, but I cannot blame my co-worker. She planted the seed, and I watered it with anxiety until the thoughts overwhelmed me.

Anxiety can feel like your mind is always preparing for something that has not happened. When something does happen, like me getting fired, anxiety can become deliberate, telling you your thoughts were right and that you have every reason to constantly worry.

Bipolar Disorder and Anxiety: When They Overlap

Trigger Warning: The below section discusses suicidal thoughts in a non-graphic way.

When you have a co-occurring condition like Bipolar 1 disorder and Generalized Anxiety Disorder, the emotional complexity can present as constant mental confusion and chaos. When you are in crisis, it is hard to tell where your thoughts end and anxiety begins.

During my depressive cycles, anxiety and the intrusive thoughts that come with it have sometimes deepened my distress and contributed to dangerous thoughts about my own life. For me, those moments often begin through the lens of anxious thinking, negative self-perception, diminished self-worth, and lowered self-esteem.

When depression shifts into hypomania, mania, or psychosis, my anxiety moves into that same realm of dysregulation and can take on a voice of illogical fear, paranoia, and emotional instability.

Anxiety has always felt different depending on my internal state. During remission or baseline periods, I have a firmer grip on my thoughts, and I can recognize more clearly when anxiety is trying to overtake me. I use tools like breathing exercises, meditation, and positive self-talk to calm the waves of anxiety that pass through me, attempting to pull me under into a dark place where my life has no value beyond what my anxiety dictates.

During episodes, however, it has always been difficult to distinguish mood shifts from anxiety symptoms. It becomes a constant question: which came first, the shifts or the symptoms?

When I reflect on my past experiences with Bipolar 1 disorder and GAD, I come to the conclusion that although Bipolar 1 disorder is my primary condition, Generalized Anxiety Disorder often acts as a trigger and causes my moods to shift.

For example, although I experience anxiety throughout the day, at night the voices often become louder and more persistent, disrupting my sleep. When I have insomnia for days at a time, when my thoughts will not quiet and prescribed medication does not have the desired effect, lack of sleep can lead to elevated mood and eventually mania.

Anxiety does not always stand alone. It often moves through mood states differently.

Living With Both: Emotional Weight and Exhaustion

There is an emotional fatigue that happens when living with overlapping mental health conditions, especially when each has its own dialogue inside your head. You become constantly alert, fearing relapse and living with uncertainty.

My past experiences with both conditions often creep into my present-day anxieties, especially when my mood shifts from elevated to low, or from low to elevated. The emotional weight and exhaustion of living with both Bipolar disorder and Generalized Anxiety Disorder can be overwhelming at times.

Then I remind myself that my mood disorder and GAD are both part of the lived experience that has shaped who I am today, both good and bad. Managing more than one internal experience can make even calm moments complex, but the calm moments, though rare, do exist.

At present, I practice self-awareness. When possible, I do not allow the voices inside my head to lead me. Instead, I show myself compassionate grace and remember that with inner strength and time, the voices can move from a loud roar to a dull silence.

I still hear and feel my anxiety when it creeps in, but with the self-care tools I have acquired, the emotional weight and exhaustion of living with anxiety has become less and less. It is not about ignoring my inner dialogue. It is about making space for it inside my head, a space where I can choose to listen to the anxious roar or turn it down to a dull silence I have learned to live beside.

Final Thoughts

Finding a Name for the Worry, Reclaiming Peace

Many years ago, the writer inside me decided to take control of the narratives in my head, the voices in my mind that I called anxiety. I realized one day, as I listened to the worry, that it often came in the form of a storyline. There would be one worrisome thought, and then that thought would build upon itself, creating a full story of anxiety.

Calling my worry one of the storylines in my head helped me untangle whether it was fiction or non-fiction, real or imagined. Although this has never been the solution to my anxiety, it was definitely a turning point in how I experienced it.

This new awareness created a space of understanding rather than a resolution to my condition. It allowed me to reflect on my ongoing relationship with anxiety.

Understanding anxiety does not end it, but it can change how you carry it.

To my readers: Have you ever experienced worry that felt constant or hard to quiet, and what helped you begin to recognize it for what it was?

Psychiatric Hospitals vs. Psychiatric Units in Ontario: Where Healing Happens and How - Part 4 of 4

Two Systems, One Journey

I have entered both psychiatric systems in very different ways. I have been restrained on a gurney, placed in isolation, and moved from one unit to another without control. I have also walked into a psychiatric hospital voluntarily, supported and hopeful for healing, and been met with kindness.

Despite these differences, one truth remained. Once the doors closed, I felt trapped. My autonomy was gone, and strangers controlled my path forward. My life paused, often indefinitely, without a clear roadmap back to myself or to freedom.

Whether in a general hospital psychiatric unit or a specialized psychiatric hospital, the emotional experience begins the same. Fear. Anxiety. Uncertainty. A sense of entering a world where your autonomy is no longer yours.

Psychiatric units became familiar to me. They followed a predictable pattern. A 72-hour hold, often involving restraints and isolation, followed by involuntary admission, medication, stabilization, and eventual discharge. A cycle that felt repetitive and transactional.

My first experience in a psychiatric hospital was different. While fear was still present, I did not feel unsafe. It took time, and a few emotional outbursts, to realize that restraints and long-term isolation were not part of the hospital’s approach. That realization created a sense of safety and allowed me to begin regulating my emotions.

I learned that environment shapes emotional experience. The same vulnerabilities existed in both settings, but the outcomes felt very different.

Psychiatric Hospitals vs. Psychiatric Units: Defining the Difference

One of the clearest differences between these systems is how they respond to crisis, especially during acute psychosis.

PICU vs. PICA

In a general hospital Psychiatric Intensive Care Unit (PICU), I was often restrained and placed in isolation when my symptoms escalated. These experiences left me feeling dehumanized and emotionally raw. They did not support my ability to regulate or move toward clarity.

At Ontario Shores, I was introduced to the Psychiatric Intensive Care Area (PICA). While it serves a similar purpose, the approach is different. There are no restraints or long-term isolation. Instead, patients are placed in a low-stimulation environment with one-on-one support, allowing time and space to stabilize.

I spent 10 days in this environment before transitioning back to the general unit. It was one of my shortest stabilization periods. That experience showed me how structure and environment can change how a crisis feels and how quickly healing can begin.

More broadly, psychiatric units are typically part of general hospitals. They are designed for short-term, crisis-focused care. Psychiatric hospitals are standalone facilities that provide longer-term treatment in a more structured, therapeutic environment.

Crisis vs. Continuum: The Emotional Pace of Care

The pace of care in each setting plays a significant role in emotional stability and recovery.

Psychiatric units operate with urgency. The goal is stabilization. Patients move quickly through assessment, medication, and discharge. This can feel efficient, but it often lacks a bridge between crisis and long-term recovery. I came to see this as a cycle. Stabilize, medicate, discharge, repeat.

In contrast, psychiatric hospitals move at a slower, more deliberate pace. There is space for reflection, participation in care, and rebuilding. The focus extends beyond symptom management to include structure, routine, and sustainable habits that support long-term mental health.

In one environment, the priority is crisis. In the other, it is continuity.

What the Environment Feels Like

The physical environment deeply impacts emotional wellbeing.

Psychiatric units can feel overwhelming. Bright fluorescent lights, constant noise, and a clinical atmosphere can heighten anxiety and disrupt sleep. The energy is often chaotic, which can be difficult for someone already navigating a mental health crisis.

Psychiatric hospitals feel different. They are quieter, more structured, and designed with healing in mind. Natural light, calmer spaces, and a slower pace create a sense of stability. These elements support emotional regulation and allow the nervous system to settle.

Environment alone does not create healing, but it can make healing more possible.

The People You Meet Inside Each Setting

Relationships within each setting also differ.

In acute care units like the PICU, patients are often in crisis. Emotions run high, and connections can be intense but unstable. Interactions are shaped by proximity and shared distress rather than long-term compatibility. These relationships are often temporary and driven by survival.

In psychiatric hospitals, connections can feel deeper. Patients are more stable, more present, and able to engage meaningfully. However, even these relationships are often temporary. Once discharged, lives diverge, and connections fade.

In both settings, shared experience creates moments of understanding. But ultimately, each person is navigating their own path to recovery.

What Healing Feels Like in Each Environment

Healing is not linear, and it is not tied to one setting alone.

In psychiatric units, healing often looks like stabilization. It is intense, urgent, and sometimes uncomfortable. In my experience, it has included restraints and isolation. While difficult, these moments did bring me out of acute psychosis and into a space where healing could begin.

In psychiatric hospitals, healing feels different. It is slower, more intentional, and focused on rebuilding. Structure, routine, and consistent support create the conditions for emotional stability and long-term recovery.

Both environments play a role. One interrupts crisis. The other supports growth.

Final Thoughts

Psychiatric Units vs. Psychiatric Hospitals

Both Places Hold Trauma and Hope

My experiences in both settings have been complex. Confinement, whether short-term or long-term, is never easy. There are practices within the system that must evolve, particularly the use of restraints and isolation.

At the same time, I recognize that both environments have contributed to my recovery. Each has played a role in stabilizing my mental health and guiding me back toward myself.

What made the greatest difference was not the system alone, but the people within it. The nurses, doctors, and fellow patients who showed empathy, understanding, and humanity during some of my most vulnerable moments.

Mental health care is not perfect. It is evolving. But within its complexity, there are still opportunities for healing, growth, and connection.

Different environments. Shared humanity. Both shaping my journey toward recovery and emotional stability.

Question to my readers: