Out of the Abyss

Asking for help is difficult, but it's the key to a better life

Photo by Juan Davila on Unsplash

Author’s Note: Please share this piece with anyone who might benefit from reading it. If there’s anything I’ve learned, it’s that we all struggle to ask for help.

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The paramedic relayed my condition to the medical team waiting inside the ER lobby.

“This is Chris Anselmo. 27 years old. Has a disease called limb-girdle muscular dystrophy. His symptoms are chest pain and shortness of breath. He thinks he might be having a heart attack.”

I drew in air through my oxygen mask, but the crushing pressure on my chest kept my lungs from fully expanding. 

Doctors and nurses wheeled me into an empty room off the main corridor. A flurry of blue arms sprung into action. One nurse removed my sweat-soaked t-shirt. Another placed EKG electrodes on my bare chest. A third drew blood from my right arm.

“We’ll be right back,” said one of the nurses in a thick Boston accent. “Press the button if you need us. We’ll know the results soon. You’re gonna be okay, hon.” 

I didn’t believe her, but then again, I had never been rushed to the hospital in the middle of the night before.

I tried another deep breath. Another struggle.

Alone in my thoughts, all I could do now was wait. I closed my eyes and replayed the past hour in excruciating detail:

- Waking up at 3 am gasping for air, drenched in sweat even though my air conditioner was running at full blast.

- Dialing 911 and talking to the dispatcher, my hands shaking violently as I gripped the phone.

- Digging dirty clothes out of the hamper, a wardrobe born of convenience and desperation.

- Knocking over my forearm crutches in a futile attempt to grab both handles with one hand. 

- Riding in the ambulance through the pitch-black streets of Cambridge, Massachusetts wondering if this was the end, and if so, who would call my parents.

A knock on the door broke me out of my trance. The ER doctor — a short middle-aged man in a white lab coat — walked in, followed by the nurse with the Boston accent. The doctor held a clipboard with a printout of my results.

“Good news. You didn’t have a heart attack. This was definitely a panic attack.” 

Thank God. The pressure on my chest lifted, and for the first time in an hour, I drew in a deep breath. Sweet, crisp air filled every inch of my lungs.

“I’m so glad it’s not….wait, a panic attack?” I sat up. “But I’ve had those before. This felt much more intense. Much worse.”

The doctor looked up from his clipboard. “Panic attacks can vary. Some are severe enough, like tonight, to land you in the ER. Have you been stressed more than usual recently?”

“Yes.”

“Any particular reason?”

I hesitated. In the past, when someone asked about my emotional state, I always answered in two words: “I’m fine.” 

But this time, that wouldn’t be enough. He needed more. 

“It’s…” My voice trailed off. I knew what I was feeling, but didn’t know how to put it into words. Damn, why was this so hard? Exasperated, I pointed to the crutches leaning on the chair next to my bed. 

The doctor nodded. “Understandable. But a panic attack this bad is usually the result of accumulated stress and anxiety over a long period. Do you talk to anyone about your struggles?”

“Not really.”

“Okay, well we’re going to have to change that. Talk to a therapist, or a close family member or friend, or a trusted mentor. You need to get help, because this can happen again.”

I leaned my head back against the pillow. Although I was glad I wasn’t about to die, I felt humiliated.

How did I let it get to this point? Why couldn’t I let people know I was having a hard time?

The doctor was right. My ER trip was a long time coming, the result of years of saying “I’m fine,” when in reality, I was anything but fine.

Growing up, when I experienced stress or sadness, my default was to hide it from the world. When my parents asked how I was doing, rather than say I was overwhelmed by classwork, or that I didn’t have a lot of friends, I shrugged.

“I’m fine.” 

To this day, I’m not sure when or how this response became my answer to emotional inquiries. My parents and older sister, Jen, always showered me with love, so it wasn’t a matter of fearing rejection. Perhaps it was simply due to my introverted nature, or being a teenager who didn’t yet understand the full spectrum of emotions inherent to the human condition.

Instead of confronting my negative emotions head-on, it was easier to ignore them or change the topic.

And, for a long time, this approach worked. 

From childhood through college, I was able to bottle up my struggles without long-term repercussions. Sure, I’d have periodic bouts of depression or weeks when I was stressed out by a looming exam, but I always navigated through rough patches without needing to talk to anyone. I just figured this is how life works.

But self-sufficiency only lasted so long.

When I first noticed muscle weakness six weeks after graduating college in 2008 — the onset of a rare disease called limb-girdle muscular dystrophy type 2B — I did what I had always done whenever I encountered adversity: I told no one.

Eventually, I had to let my family and friends know that I was getting weaker. (My parents knew about the disease from when I was diagnosed after a car accident in 2004; but at the time, we were told symptoms would manifest later in life.) The disease was becoming impossible to conceal; it turns out that struggling to climb stairs sets off alarm bells in peoples’ minds.

Everyone was concerned by my physical decline and wanted to help in any way possible. My parents offered to make the trip from Connecticut to Boston every two weeks to help me grocery shop and cook meals. My roommates volunteered to do my laundry so I wouldn’t have to trek up and down three flights of stairs. Jen, who lived in North Carolina, invited me to visit her any time I needed to escape Boston.

My family and friends made my life much easier, chipping in whenever I needed assistance. I am forever grateful for how they stepped up to the plate in those early days. But they were only aware of the physical symptoms. My emotional turmoil was a different story.

They didn’t know it was eating me up inside that I could no longer shoot a basketball.

They didn’t know about the piercing stares I received anytime I got on an elevator to go up one floor. 

They didn’t know about the corrosive envy I felt as I watched my friends achieve all the life milestones I wanted for myself — falling in love, having kids, buying homes in the suburbs.

They didn’t know about the self-loathing for who I had become, how instead of facing my challenges head-on, I withered under the pressure.

They didn’t know about the panic attacks that occurred any time I contemplated the future.

They didn’t know any of it — and yet, I wanted them to know.

I wanted to offload my burden onto someone who cared. But years of shrugging and deflecting had come back to haunt me. I lacked the experience to lay bare my emotions and let people know what was going on.

“What’s wrong, Chris?” my mom asked when my parents came to visit three weeks before my trip to the ER. “You’ve been so quiet. Is everything okay?”

“I’m fine.”

My mom could tell I was lying. “Did something happen? Did you fall? Are you in pain?”

I wanted this to be the moment. I was ready to tell my parents that I was struggling. I knew they wanted to help.

The words were inches from spilling out.

I’m overwhelmed.

This disease has taken over my life.

I hate how I’m handling it.

I hate that I’ve equated my self-worth to how strong I am.

I’m envious of my friends advancing in their lives and careers.

I’m tired of seeing people enjoying themselves.

I resent everyone’s success.

I’m mad at the world.

I’m scared of the future.

“I’m fine. Just tired, that’s all.”

If only I had known the relief waiting for me on the other side.

I was released from the hospital at daybreak, my path forward as clear as the orange sunrise sneaking up behind the Boston skyline.

I needed to change.

I had to find a way to push through the discomfort, to open up and ask for help, whether to a therapist, friends, or my parents. To someone, anyone.

“I’m fine” wasn’t going to cut it anymore.

When I returned to my apartment, I collapsed on my bed, still donning the dirty t-shirt and sweatpants dug out from the hamper three hours prior. 

Although exhausted, my mind raced. I had to find the root cause of why my mind and body melted down so suddenly. So severely.

In retrospect, my previous panic attacks were warning signs, internal pleas to reverse course and seek help before I tumbled into the abyss. Warnings that I ignored.

The disease shared some of the blame, but, deep down, I knew it was just fanning the flames of an existing fire. Years of suppressing my feelings and avoiding uncomfortable conversations pre-dated my muscle weakness.

Over the next few days, I sought out the source of my hesitation. If I could better understand why I struggled to open up, then I might feel more comfortable reaching out to someone.

What choice did I have? One trip to the hospital was enough.

After days of soul-searching, my self-examination identified three barriers that kept me from asking for help: pride, fear, and shame:

Pride - I took pride in being self-sufficient. Before my disease, I thrived as a young adult. I did well in school, had many close friends, and loved living in Boston. Then the symptoms started, and it made clear just how much I could accomplish on my own. By needing help, I felt like a failure.

Fear - I didn’t want my family to worry about my health more than they already did. I was also afraid that, by sharing my struggles, people would think less of me.

Shame - I was ashamed….of everything. I was ashamed I was so insecure. I was ashamed that I attached my self-worth to what people thought of me and what I looked like. I was ashamed that I didn’t handle my challenges better. I was ashamed that I didn’t open up sooner.

These were sobering conclusions, but they were necessary to shine a light on the darkness within me. 

Once I surfaced these barriers, I sought to dismantle them:

Pride - I was only a failure if I didn’t ask for help. Suppressing my struggles to the point of a panic attack was ludicrous. By asking for help, I’d be exercising my independence. I’d be admitting that I didn’t have all the answers, which was a level of maturity and self-awareness that most people never reach.

Fear - What if something worse happened to me because I didn’t open up? How would my family feel then? That would be much scarier. As for rejection: would they really think less of me? Of course not. I had many people in my corner rooting for me.

Shame - My value and worth came from God, not from what people thought of me or whether I could climb a staircase. My insecurities were understandable — no one likes being stared at — but my disability didn’t make me inferior. There was also no shame in making mistakes; no one handles adversity perfectly. And everyone struggles to ask for help.

I knew that these barriers were paper tigers, but for transformative change to happen, I would need more time.

In September, my parents came to visit a few days before my 27th birthday. When I opened my apartment door, they were taken aback by my condition. My hair was unkempt. I had bags under my eyes. I hadn’t shaved in days. Instead of being in a celebratory mood, my mom could see, once again, that something wasn’t right.

“What’s wrong?” she asked as she settled into my leather desk chair.

I looked over at my dad, who was standing in the kitchen pulling groceries out of plastic bags. They both looked at me with concern, deciphering my body language, waiting for a response.

Habit implored me to resist. I’m fine. But I knew, deep down, that this was my chance. This was the moment I had been working so hard to overcome.

I took a gulp of water on my nightstand. Before I had a chance to stop myself, the words finally, mercifully, tumbled out:

“I’m struggling.”

“How so?” My mom was concerned but composed. I would later learn she was relieved I finally expressed what they had known for months.

I took a deep breath.

“Just….the weight of everything that’s happened the last few years. The weakness. The falls. Carly passing away. I’m about to turn 27, and I don’t feel like I have much to show for it. No girlfriend. My job has stagnated. I keep thinking about the future, all the uncertainty. I’m not sure how I’m going to deal with it.”

An uneasy silence lingered in the air. Finally, my mom spoke.

“You’re going to face this with us, with Jen, with your friends. You don’t have to face this alone. You know that, right?”

“Yes.”

“How long have you felt this way?” my dad chimed in from the kitchen.

I sat down on my bed and sighed. A wave of relief rushed over me.

“A long time. A really long time.”

And with that, the weight of the world lifted.

In the weeks after my parents’ visit, whenever we talked, they made it a point to ask me detailed questions. Even if they couldn’t solve every issue I faced, they at least knew what the issues were now. They vowed to help me in any way possible. But most importantly, they validated my feelings.

I didn’t realize how much I needed the validation until I received it. For so long, I thought my struggles were unique, that they were the byproduct of errant thought processes, deep-seated insecurities, and dumb mistakes.

Hearing that I wasn’t crazy made all the difference.

Opening up to my parents provided a blueprint I could use with other relationships in my life.

Whenever a friend or coworker asked how I was doing, instead of saying “I’m fine,” I let them know about my fear of getting new adaptive equipment or that I was concerned about an upcoming strength test at the hospital.

When I talked to my boss, I didn’t shy away from the fact that it was getting harder to commute to and from work every day. She suggested I work from home more often.

When I grabbed drinks with my former roommates before Thanksgiving — the ones I hadn’t told about my disease for two years — I knew I had to be more open. By hiding my symptoms from them for so long, I caused unnecessary drama when I had to break our lease because I could no longer climb stairs.

“I should have told you sooner, you know?” I said in a contemplative moment, beer aiding in my courage. “I made things so much harder than they needed to be.”

I don’t blame myself anymore for how I handled the early years of my disease. So much was changing, so quickly. Although I wish I had built an infrastructure of support and love from the get-go, once I realized that everyone wanted to help me, once I realized that my struggles and challenges weren’t unique, I was able to course correct.

But it wasn’t all smooth sailing. It was one thing to tell people I needed help; it was another to take them up on it.

Soon, life would give me the chance to see how much progress I had made.

In early January, I slipped and fell in the middle of an intersection near my apartment in Cambridge. Good Samaritans helped me to my feet, but the incident left me bloody and shaken up. Another few seconds and I would have been flattened by oncoming traffic.

I thought about holding it in, hiding the event from those closest to me. Instead, when I called my parents that night to discuss their upcoming trip, I told them what happened, details I would have left out in the past.

“I’m glad you told us,” my dad said. “Perhaps the treads on your sneakers have worn out. Do you need us to go shoe shopping when we come up?”

I turned my sneakers over. The tread was smooth on the right heel, where I slipped. I was so consumed by the incident that I hadn’t thought of why it happened. 

“You’re right. It was the shoes.”

Sometimes, the most effective help is walking alongside someone’s hurt and brainstorming solutions. My dad was always a problem-solver; it felt good to let him do what he did best.

The more I shared my struggles, the faster I climbed out of the abyss.

The tough moments continued, but by talking to people, by letting them know that life was a grind, a funny thing happened: my panic attacks disappeared. 

I still hit walls. I still had bouts of depression. I still had moments when I wasn’t able to verbalize my feelings. But instead of clamming up, I resolved to tell people. Even if I didn’t feel comfortable sharing every last concern and fear, telling them something was better than nothing.

Every incremental ask for help strengthened my relationships. I felt closer to my family now that I knew we were in this fight together. I also grew closer to my Boston friends, who ran errands, bought me food, and texted me periodically to check in.

My support system grew, brick by brick, to the point where, in early February, I felt comfortable enough with my progress to take arguably the biggest risk of my life: leaving my job in the fall to get my MBA.

Business school would be the ultimate test. There was no way I could get through a 2-year, full-time MBA program without relying on multiple people — family, friends, and classmates — for support. It would take a village to help with the logistics of getting to and from campus, going to social events, navigating group projects and classwork, and interviewing for jobs.

In my not-asking-for-help days, this goal felt unattainable. But now? With the right support, I at least had a chance.

I applied and got into several schools in the Boston area, ultimately deciding on Boston College. 

But it wasn’t a done deal.

The night before I had to let BC know my decision, I barely slept. I couldn’t figure out if this was an achievable goal, or if I was leading myself headlong into disaster. 

Could I really do this? Would my mind and body hold up?

I went into work — deadline day — unsure what decision I’d make. Now that I had to choose, I felt the consequential weight of the moment. Either way, my life would never be the same. 

The web portal was open on my browser for several hours. Not only was it two years of my life I would be signing over, it was also a hefty non-refundable deposit. I didn’t want to say yes, only to reverse my decision a week later.

At lunch, a few of my coworkers gathered around my desk. The deadline was only three hours away.

“Well? What did you decide?”

I felt the familiar urge to recoil, to run away from a challenge beyond my strength. But I knew that if I was willing to rely on others for support — including my friends standing next to me — I would be just fine.

I looked up from the screen and smiled.

“I’m going.”