Real People, Real Skills: Her Body Knew Before She Did

Real People, Real Skills is a monthly series on NoodleFodder. Each installment looks at a true, publicly documented story of someone navigating real hardship — and the specific coping skills that helped them through it.

Laura thought she was handling it.

She was in her early thirties, functioning, employed, keeping things moving. The anxiety was there, sure — but she was managing. She’d gotten very good at managing. What she hadn’t noticed was that managing and coping are not the same thing, and that her body had been keeping score without telling her.

Then one day at work, she was called into a meeting about her performance. Her heart started racing. She began to shake. The feeling was overwhelming enough that she closed her laptop, left the building, and went straight to a doctor.

Her blood pressure was dangerously high. Her doctor told her that if she didn’t take mental health leave, she was at risk of a heart attack — in her early thirties.

“At that point, I knew I needed to make a change,” Laura said in an account shared through the National Council for Mental Wellbeing’s Mental Health First Aid program.

The thing about high-functioning anxiety

Laura’s story is so common it’s almost a cliché — except that it nearly killed her, which is the part people skip over when they talk about being “a little anxious” or “a type-A person.”

High-functioning anxiety doesn’t look like falling apart. It looks like staying late, over-preparing, anticipating every possible thing that could go wrong, and being very, very good at your job while quietly running on fumes. It looks like fine, until it doesn’t.

The body, it turns out, does not care how competent you appear. It registers the stress regardless. And it will eventually make that known.

When Laura started talking openly about her anxiety — with coworkers, with friends — she discovered that nearly everyone around her was struggling too. They just didn’t know how to get help. Which is maybe the loneliest thing about anxiety: how universal it is, and how isolated it makes you feel.

The skills Laura’s body was waiting for

In DBT terms, Laura was living entirely in Reasonable Mind — the logic-and-function zone — while completely ignoring what her Emotion Mind was broadcasting. Wise Mind requires both. The signals from the emotional side of the equation aren’t noise to be managed. They’re information. Her body had been sending signals for a long time before she listened.

The PLEASE Skills in DBT are specifically about this: treating your physical self as part of your mental health, not separate from it. Sleep. Eating. Illness. Avoiding substances that destabilize your mood. Exercise. These aren’t wellness-influencer fluff — they’re the foundation your emotional regulation sits on. When Laura’s body finally broke through with a blood pressure crisis, it was delivering a message the PLEASE skills exist to prevent.

Check the Facts is another relevant skill here. Not because Laura’s anxiety wasn’t real — it was — but because part of what kept her in the cycle was the story she was telling herself about what it meant to ask for help. That she should be able to handle it. That other people were managing. That needing support was a failure. Checking those facts — really interrogating whether they held up — might have gotten her help sooner.

What changed

The conversation Laura started after her crisis — openly naming what she’d been through, discovering she wasn’t alone — is its own kind of skill. In DBT this lives under Interpersonal Effectiveness: the willingness to be known by people, to ask for what you need, to stop performing okayness when you are not okay.

That one meeting, that one moment of her body refusing to keep up the performance, opened something. She didn’t have to wait until she had a heart attack. She just had to stop waiting until she had a heart attack.

Try this

Do a quick honest check on your body right now. Not your mood — your body. Shoulders, jaw, chest, gut. How are you actually doing, physically, as a result of whatever is stressing you out?

If you’ve been dismissing signals for a while — the tension headaches, the disrupted sleep, the stomach that never quite settles — this is worth paying attention to. Your body is not separate from your mental health. It is your mental health’s landlord, and it will eventually raise the rent.

Laura’s story was shared through the National Council for Mental Wellbeing. For more on the PLEASE Skills and Check the Facts, visit the NoodleFodder DBT Skills hub.