The middle finger on my right hand looks nothing like the other nine. Its skin is always a little raw, a little dry, lightly scabbed, but somehow still manages to blend in with the rest.

The same can’t be said for the deep scar on the inside of my left leg. Once an epidermal cyst, it had to be surgically removed, leaving behind a gaping hole that slowly filled itself in with flesh. A healing that began, but never quite finished. I’ve thought about asking my surgeon to take another look, but after ten years of putting it off, I’ve learned to live with its glaring imperfection. I’d be lying if I said it didn’t bother me.

The quiet truth is: both the finger and the leg are outward signs of a shadow I’ve carried for as long as I can remember. My earliest, sharpest memory is of sitting in the church pews at twelve, restless and obsessed with the hair growing out of that one finger. Just that finger, and no other. And so began the ritual. For the next twenty years, I plucked at it. I’d run it against my lip, so sensitive now it can detect even the softest, finest strand. With or without tweezers, I’d squeeze, scrape, dig until it was gone. Even now, I feel a small wave of pride whenever I win the battle against a single stubborn hair.

My leg followed the same story. It started with a single ingrown hair. But over time, I fought it so hard it became something else entirely – a lump of trauma turned pulsating flesh. A swollen, throbbing growth that begged to be cut out of me.

Lately, I’ve been wrestling with the shape of anxiety. How much of it is as real as the scars I carry? And how much of it is just me feeling more than I need to, aching more than the moment calls for? But then again, isn’t that also the gift? To feel life so fully, so fiercely, that it reverberates through your entire body in a way that is impossible to fight.

Medically, I have a diagnosis: my psychiatrist says I have generalized anxiety disorder with a side of mild to moderate depression. I take one milligram of Clonazepam and ten milligrams of Doxepin every night, just to give myself a shot at six hours of sleep. Clonazepam is a benzodiazepine – the same family as the better-known Xanax, though supposedly less addictive with a longer half-life. Doxepin is a tricyclic antidepressant, the kind that’s supposed to nudge your serotonin levels back up toward normal.

The rows of amber prescription bottles in my cabinet should make it all feel real, right? And yet, my rudimentary understanding of how the American healthcare system works only leads to an underlying distrust that makes me second guess it all.

The truth is, all this feels like a dark dirty secret. On the outside, I’m sure it seems like I lead a charmed life. That’s what social media is for, isn’t it? Highlight reels, not hidden bruises. Gloss over grit.

No one sees the moment I pause at the “emergency contact” field of a form, unsure who to write down. What use is a name if they’re 10,000 miles and 12 time zones away? Or the way comparison whispers when I realize how far I’ve fallen behind my peers financially, choosing passion over paycheck again and again, in a wandering pursuit of purpose. A purpose I can only loosely define by the idea of impact. And maybe hardest of all: the grief of recently deciding to do life alone, even as my heart longs to stay open. Even as it fears all the times it has broken and the times it has yet to.

Yet to live with such agency is to live with privilege. Every tension my mind tangles itself in is a choice willingly made. Sometimes the dissonance is so quiet it’s deafening. Other times, it’s so loud it’s a hum only I can hear.

Today, I still pick at my finger. It soothes my nerves for a moment until I break the skin open and whisper, “why Debbie, not again”.

I keep most of it to myself. Even when a tear escapes as I walk down the streets of Manhattan, I wipe it away with the haste of a passing train, thankful that my Tarte eyeliner stays on as advertised.

Then there are nights when it breaks through. I curl into a ball, knees to chest, sobbing into a pillow as I repeat like a chant “I just want to go home”, even though I no longer know where home is. These are the hardest spells. The ones that turn tears into nausea, nausea to a coughing fit, until I’m gasping for breath in a room no one has the key to.

Still I ask myself, again and again, how much of this is real? How much of this is imagined pain dressed as romanticized distress? Am I the damsel tucked away from view, or the queen who steps into daylight, poised and in control? Is someone out there meant to save me or have I been the heroine of my own story all along?

Only time will tell. Until then, I soldier on. Pills in hand, and a kind of determination louder than any cry could ever be.