In some ways, I long for the days when I thought I was “just” anxious — when my anxiety simply fueled my perfectionism.

Sure, I’d have plenty of late nights completing school projects at the last minute due to the weight of my own high expectations. But overall, it felt like my anxiety helped me. It gave me the drive to achieve and the drive to care about everything. It was my identity.

However, after a while, “just” anxiety became something far more insidious.

While I am genuinely glad that so many people now feel comfortable sharing their experiences with anxiety — and there are no “mental illness awards” where only people with certain symptoms get to be heard — an anxiety disorder is more than perfectionism. It is more than being shy or quiet. It is more than worry or not feeling good enough.

An anxiety disorder can be serious. It can be debilitating. It can affect your body in ways you never would have imagined. It can make you feel like your life has been taken away from you.

This is what anxiety is for me:

It’s Extreme Fatigue

I’m tired all the time. It’s a function of a couple different things, the first of which being the more well-known side effect of anxiety: insomnia. As soon as your head hits the pillow, no matter how tired you feel, you are plagued by fears about the past, the present and the future that keep you wide awake. No worry is too small or too great to remind you that sleep won’t be happening anytime soon. Repeating this pattern over the course of 10 or 15 years takes its toll.

What’s talked about less, though, is the profound fatigue you get from simply going about your day with a brain that doesn’t know how to relax. Every single moment is consumed by the thoughts in your head that you can’t seem to stop. Your mind is constantly “on.” It’s exhausting.

Do my friends think I’m funny? Am I being too quiet? Did I offend someone? Should I have put on more sunscreen? Am I going to give myself wrinkles? Am I going to give myself a blood clot? Should I have chosen a different college major? Are my parents okay? Why aren’t I more social? Did I eat too much food? Am I wasting my life thinking about all these things? How do I fix it? How do I make it stop? Why am I like this? Would another shirt have matched my outfit better?

These are just a few of the questions I ask myself each day. Not only am I tired, but my brain is tired; burnt out from incessant use. On top of its normal functions, my brain is thinking about 7,000 things at the same time. And as powerful as the human brain is, that’s a lot to handle.

This combination of insomnia and rumination means that I don’t remember what a “good night’s sleep” is. I don’t ever feel refreshed or recharged or ready for the day. Despite being an active person who loves sports and running and going places and doing things, my energy levels are extremely low and very easily depleted. Gearing myself up, even to see my own friends or do other activities I enjoy, can feel like an insurmountable task.

And if I do manage to jump that initial hurdle, I know the rumination isn’t going to stop. Instead of fully enjoying myself, I am stressed and anxious, trying desperately to pull myself into the moment and be present with the people around me. It’s incredibly taxing. It’s not that I can’t have fun. I do. But I also know that I will be tiring myself out with each additional moment. And sometimes it feels like all that effort isn’t even worth it.

I’m not lazy and want more than anything not to be boring — I’m just chronically mentally exhausted.

It’s Concentration And Memory Problems

Another symptom of anxiety that we don’t talk about enough is the effect on your concentration and memory. I never struggled with concentration or comprehension. But as my anxiety has gotten worse, I find myself re-reading things repeatedly, catching my mind wandering to some intrusive thought entirely unrelated to the task at hand.

It happens when I’m talking to people I genuinely care about, saying things that are genuinely important to me. I still can’t focus without mentally interrupting myself. And when I notice I’m doing this, it just increases the panic. I start to worry that I’ve somehow personally ruined my brain and my cognitive capabilities; which of course is unlikely, but that’s not a convincing argument to someone with anxiety.

Because it can be so difficult to concentrate, my anxiety has also affected my memory. There are significant parts of my life over the past few years that I don’t remember. Someone can mention a place we went or a movie we saw together, giving me all the details they can, but it doesn’t ring a bell. And it makes perfect sense. If I’m not really all there when something is happening, how can my memory recall it later?

I’m not flighty or careless or uninterested — sometimes my thoughts are just too loud to concentrate.

It’s An Inability To Trust My Body

For me, one of the worst aspects of severe anxiety is health anxiety. You are constantly searching for a new pain or a funny feeling that could mean you are danger. Maybe you think you’re sick or having a stroke or need an appendectomy. But what’s truly fascinating is that this experience is not solely mental.

I can induce my body into feeling anything just by worrying about it. Because of my anxiety, I constantly experience weird pressures and tingles, stomach pain, chest tightness and heart palpitations, numbness and headaches; all while being an extremely healthy 26-year-old who has been tested for every possible condition by some very kind and understanding doctors.

While our bodies and brains are supposed to work together, alerting us to potential threats and keeping us safe, I feel like mine don’t do that. My bodily experiences go through so many filters because of my anxiety that I don’t know what’s real anymore. I don’t know when to go to the doctor. I don’t know when to wait something out. It feels like there’s some special code I have to crack just to know whether I’m actually in pain or whether my anxiety is taking over.

This makes me feel like a burden, both to the people around me who I pester about my liver or my spine or whatever body part it may be, and to the doctors who hear my laundry list of concerns every few months.

But real or not, these experiences feel real to me — and I can’t just make them go away.

I don’t have any answers. I wish I did. I would love to be one of those people who has found a way to live with anxiety in a healthy way. I am not. At least not yet. It’s confusing and scary and surreal to feel like the person you were has disappeared, all because of such an “ordinary” condition like anxiety. But it happens.

If you know people with an anxiety disorder, know that they are not lazy. They don’t want to be boring or lame or seem flighty or careless. They don’t want to feel like a burden. Their brains are working so hard just to do the things most people take for granted.

And while they may be perfectionists, that serves more to hide what they actually go through on a normal day, rather than a reassurance that their condition isn’t a big deal.

When you live with an anxiety disorder — it’s not “just” anxiety.

Jessica Walthall is Manager, Research & Quality Assurance at NAMI.