Living In Fight Or Flight.
- 27 minutes ago
- 6 min read
When chronic illness, medical dismissal and perimenopause turn your nervous system into a one-woman surveillance department
Published 27 July 2026
By Antonia @Unremarkable Me
There is a very specific moment chronic illness gives you, and it is not glamorous.
It is not the diagnosis reveal.
It is not the dramatic scan.
It is not the heroic dash through hospital doors while somebody shouts for a crash trolley.
It is standing in your bedroom, perfectly upright, dogs asleep, house quiet, and realising you are monitoring your own breathing as though you are about to submit it as evidence in court.
Inhale.
Exhale.
Is that tighter than before?
Is that a tickle?
Should I time it?
Nothing is escalating. No collapse. No sirens. Just a mild respiratory virus doing what mild respiratory viruses do.
And yet my brain has gone full investigative journalist, with a minor in catastrophe and no editor willing to pull the story.
That was the moment I realised something uncomfortable.
I am not just ill sometimes.
I am braced. Constantly.
The Double Life of the Chronically Ill
There is the visible life.
Appointments. Prescriptions. Adjustments. Hormonal chaos. The fourth period in two months because perimenopause has apparently abandoned the calendar and decided to freestyle. The breast lumps that send you into a quiet spiral until a GP examines them and confirms they are benign fatty tissue responding to hormonal changes.
Relief arrives.
It sits down briefly, accepts a cup of tea, then leaves before the next symptom has even taken its coat off.
Then there is the invisible life.
The rehearsing before appointments so you sound informed, but not too informed.
The editing of symptoms so you do not seem dramatic.
The internal debate before seeking help because you do not want to waste anybody’s time.
The NHS says health anxiety can involve spending so much time worrying about being ill, or becoming ill, that it begins to take over your life. It can include repeatedly checking your body, seeking reassurance and fearing that a doctor or test may have missed something.
That description matters. Health anxiety is real, distressing and deserving of support.
But for many chronically ill people, the story does not begin with a healthy body misunderstood by an anxious mind.
Sometimes it begins with a body that has repeatedly sounded an alarm, followed by a healthcare system that repeatedly pressed snooze.
The anxiety may not be born from nowhere.
It may grow in the space left behind when trust has been worn thin.
The Moment You Start Questioning Yourself
The quiet terror is not always:
I am dying.
Sometimes it is:
What if they are right and I am exaggerating?
If symptoms have been dismissed, minimised or attributed to anxiety before they were properly explored, something subtle can happen.
You split.
I know what I feel.
But what if I am overreacting?
That split is exhausting.
A 2025 research review examined 151 qualitative studies involving more than 11,000 people with conditions including fibromyalgia, long COVID, endometriosis and lupus. Researchers used the term symptom invalidation for experiences in which symptoms were dismissed, minimised or not believed.
The reported effects included self-doubt, shame, loss of trust in clinicians, healthcare-related anxiety, avoidance of care and changes in how people behaved during appointments. Some patients described deliberately playing down symptoms so they would not appear dramatic.
So when you rehearse your case in the car park, remove every adjective from your pain and prepare footnotes for the fact that your own body exists, that behaviour did not necessarily materialise from thin air.
It may have been taught.
When you have had to fight for catheter support, insist that something is not right or leave an appointment feeling smaller than when you entered, your nervous system takes notes.
It says:
Fine. We will monitor everything ourselves.
That does not mean every fear is evidence of danger.
It means the fear has a history.
Add Hormones and Stir
Perimenopause deserves its own public inquiry.
Not a leaflet. Not a tasteful pastel diagram. A full inquiry, with witnesses, documents and somebody eventually admitting that “your periods may change” was doing an outrageous amount of work.
During perimenopause, hormone levels change and symptoms can shift over time. The NHS lists periods becoming more or less frequent, heavier or lighter, alongside sleep problems, anxiety, mood changes, palpitations, headaches and difficulty concentrating.
In other words, your body may alter the schedule, lighting, sound system and emergency alarm at the same time, then ask why you seem tense.
Four periods in two months is not a personality trait.
It is a reason to speak to a clinician, particularly if your bleeding pattern has changed or become heavier.
When your biology becomes unpredictable, uncertainty gets louder.
The tickle in your breathing may still be mild. It simply feels as though it is auditioning for something sinister because your nervous system is already standing under a spotlight holding a clipboard.
Growing Up Braced
Here is the part that sits deeper.
Some of us did not learn hyper-awareness in adulthood.
We learned it early.
In complicated families. In difficult dynamics. In cultural spaces where reading the room was not a party trick but a safety mechanism.
You learn tone shifts. Micro-expressions. The tiny change in atmosphere before an argument ignites.
That wiring does not disappear because you now have a mortgage and a repeat prescription.
When healthcare feels inconsistent, the surveillance turns inward.
Your body becomes the room.
You scan.
You anticipate.
You prepare your defence before anybody has accused you.
The Cruel Loop Nobody Mentions
Real symptoms.
Delayed validation.
Heightened vigilance.
Anxiety appears.
Anxiety is then cited as the explanation for everything that came before it.
Round we go, on the least enjoyable carousel ever commissioned with public money.
It is entirely possible to have genuine physical illness and genuine anxiety at the same time.
One does not cancel the other out like a particularly unhelpful maths equation.
Anxiety can intensify physical sensations, encourage repeated checking and make uncertainty harder to tolerate. Physical illness can also give a person entirely rational reasons to pay attention to their body.
Both truths can occupy the same room.
Support for anxiety should widen the care you receive, not become an administrative trapdoor through which every physical concern disappears.
NHS Talking Therapies can help with health anxiety and with the emotional impact of some long-term physical conditions. Adults in England can usually self-refer without first obtaining a GP referral.
Seeking that support does not mean you invented your symptoms.
It means your nervous system has been on duty for too long.
What I Noticed in That Quiet Room
When I caught myself scanning my breathing, I did not discover that I was unstable.
I discovered that I do not fully trust somebody else will catch it if something becomes serious.
That is the core of it.
When you do not feel held by the system, you become your own early-warning system, case manager, records department and out-of-hours helpline.
The salary is terrible. The pension is worse. Apparently, you are also expected to provide your own stationery.
It is heavy.
It is exhausting.
It is understandable.
The dogs were asleep. The room was still. Nothing was escalating. Yet my body was preparing for a battle that was not happening.
The fear was loud.
Reality was steady.
Both existed at the same time.
You Are Not Imagining Your Life
If you see yourself in this, let me say something clearly.
You are not dramatic.
You are not attention-seeking.
You are not manufacturing a narrative because your Tuesday lacked content.
You may be tired of fighting for validation.
Tired of hormone roulette.
Tired of scanning because nobody else feels reliably on watch.
Tired of life feeling paused while everybody else appears to move.
That is not weakness.
It is what can happen when your nervous system has spent years doubling as security, research assistant and press officer.
A Small Act of Rebellion
We are not fixing the NHS tonight.
We are not untangling decades of survival wiring in one Sunday.
We can do something smaller and quietly radical.
We can ask:
In this exact minute, what is happening, and do I need help now?
If there are new, severe or rapidly worsening symptoms, seek medical advice. If there are not, noticing that is not denial.
It is a foothold.
Safety does not have to feel permanent before it counts. Sometimes it is thirty seconds at a time.
Sit in the bedroom.
Notice the dogs breathing steadily.
Let your shoulders drop by half a centimetre.
If it feels comfortable, slow your breathing rather than interrogating it.
You do not have to win every battle your mind prepares.
You are allowed to stand down for a moment.
You are not making it up.
You are navigating a complicated life with a nervous system that learned vigilance early and has not yet been shown enough evidence that it is safe to rest.
Rest is not surrender.
It is repair.
Love,
Unremarkable Me
A Note From Unremarkable Me
This article shares lived experience and general information. It is not medical advice and cannot determine whether a symptom is caused by anxiety, infection, a chronic condition or something else.
Seek medical advice for symptoms that are new, concerning, persistent or worsening. If you are seriously unwell or think there may be an immediate threat to life, call 999 or attend A&E. If you need urgent medical help but it is not a life-threatening emergency, use NHS 111.