‘Diagnosis’

Matthew Bamberg grew up in Miami, Florida. A tumultuous ride where he rode a mix of Jewish and Cuban culture in a turbulent time of social change that surrounded him defined his youth. Bamberg has completed the final edits of his novel, "Grove Chronicles,” a literary short story collection that includes a boy's experiences. In 2023, his creative nonfiction story, "Pride and Acceptance in San Francisco," was published in the literary magazine, "Gay & Lesbian Review." Bamberg's work life began as a meteorology technician at Miami Dade College and Florida State University.

Diagnosis

Your abnormal psychology class requires that you research and report on a diagnostic criterion from the DSM-5. Your choice - pick your flavor of crazy. You flip at random, pages flutter like a pulse of excitement. Or fear. But you are not afraid of anything. Anxiety disorders. The section starts with generalized anxiety disorder. You read.

“A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).”

You almost absentmindedly begin the calculations. “More days than not.” Is that more than fifty percent of days? Or more than sixty percent? Does it have to be a full day of worry or just a part of the day worrying about a specific event? What if one is worried about multiple events? Does that increase the percentage per day or decrease the overall percentage over six months?

You shake your head and send the numbers bouncing away. You scoff at the premise of the question.

Everyone stresses about schoolwork. That’s why your eyes flit over the directions four times to make sure you understand them. And then four more, just to be certain.

Everyone worries about work. You palm every mistake you made that day, weighing them carefully and wondering if the balance will tip and you will be fired. Just like every day for the last three years.

Everyone plans conversations. Rehearse entire speeches under your breath, pre-plan apologies for mistakes you haven’t made and defenses for decisions that haven’t been challenged and eulogies for people who haven’t died. Yet.

Everyone is anxious, at least sometimes. This is abnormal psychology, after all. You bounce the numbers around in your head again. Mathematically, there is no way that more than fifty percent of your last six months could have been spent worried about a specific activity or event. There’s nothing to be afraid of on your calendar.

“B. The individual finds it difficult to control the worry.”

You read the word “control” twice. Straighten your spine. Relax your shoulders. Release the breath you’ve been holding. Plant your foot to stop your leg twitching. Remove the fingernail you’ve been chewing from your mouth. Ignore the taste of iron and sweat and germs. You’re not afraid of anything you can control.

“C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months):”

The numbers begin to bounce, and the math begins again. At least fifty percent of the symptoms, at least sixty percent of the time, for the last six months.... or maybe sixty percent of the symptoms at least forty percent of the time.... How do you pass? What is the right answer? You decide to assign a point system. Just to make the numbers hold still.

“1. Restlessness, feeling keyed up or on edge.” Add one point for never sitting down in large groups; for moving and wandering; for chirping “I’ll just go find it...”, “Where’s the restroom...”, “I think I left my jacket...”; for stretching taut muscles, easing loud heartbeats, creating space; for matching roaming feet to roaming eyes as you observe all the people that don’t scare you while pondering all the hypothetical mass shootings, unforeseen building collapses, fires, tornadoes and rapidly spreading germs you’re not afraid of.

“2. Being easily fatigued.” Add another point for naps in cars on the way to school, on the way from daycare, in corners at summer camp, on scratchy paper in nurses’ offices, under desks at recess, in cars during your lunch break, in bed after class. For not being able to keep your eyes open even when
you might be afraid to miss something.

“3. Difficulty concentrating or mind going blank.”
Subtract one point for the ability to concentrate on anything, everything, focusing on all of the things that could go wrong, all the adaptations to make them go right, your mind always running to keep up with the never-ending list of things that don’t scare you, but you should still think about. Just in case. Just to be prepared.

“4. Irritability.”
Minus one more for your bright and sunny disposition, your maturity, your patience, for saying yes to all things, listening and reading and redoing until it is right, planned and executed it so that it is right, it’s always right, you always have a right answer, the right words; and even if you’re wrong, you make it right as fast as possible because you’re not afraid of people, but everyone likes to be liked, right?

“5. Muscle tension.”
Add a point again for the aches, pains, pops, pulls that became chiropractors, massage therapists, doctors, pills, acupuncture, aural therapy, heat packs, ice packs, IVs, and shots, shots, shots, shots, everybody! Take a shot and just fucking “take a deep breath and relax and have some fun, wouldya”?
Being tense is not the same as being afraid.

“6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).”
Plus one for sleepless sightless soundless stillness solitary supposing such sinking scenarios scared death disaster dismemberment memories mistakes stakes impalement impairment afraid air oxygen choking chains kidnapping kids parents disappointment deathdisaster disease mental illness depression suicide shame shudder shut eye dear god please let me sleep.

“Note: Only one item required in children.”

You read the line again.

Only one required in children? Why would children not worry about all the same things as adults? Should you be adding more points for the symptoms that have been around since....? You’re an adult, so you just move on to the next line without answering that question.

“D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Clinically significant. Clinical. Medical. Rational. Rational things are not to be feared. Even when you were afraid, it was totally rational. Afraid of high blood pressure pounding through sixteen-year-old veins. Afraid of ulcers eating a fourteen-year-old stomach. Just like being afraid of dating, being afraid of dying, being afraid of disappointing. But being cautious isn’t the same as being afraid.

“E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).” You were told once that your pain was psychosomatic. That you were afraid and that you were making yourself sick. Your illnesses were all in your head. You said that was ridiculous. Of course your symptoms were real.

And what did you have to be afraid of, really?

“F. The disturbance is not better explained by another medical disorder (e.g., anxiety or worry about having panic attacks in a panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorders, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder).”

You close the book, then open it again.

You thumb through it. Pick a different disorder. Then another. Then another.

You don’t really read any of them.

You close the book and reflect.

You’re not afraid of anything.

You’re afraid of everything.

Dana Johnson is an aspiring author whose writing focuses primarily on short fiction and humorous essays. Johnson is a native Kansan and a graduate of both the Emporia State Teachers’ College and the Johns Hopkins Creative Writing Program. She has spent the last decade teaching English and coaching competitive speech and debate; this has provided her the opportunity to generate much writing material and ponder the absurdities of humanity. Her other passions include cooking well, gardening poorly, and wrangling a house full of rescue animals. You can find her on Instagram and Threads @writebyaccident.