Have you ever been stuck underwater? Maybe a riptide swept you off your feet in the ocean or you jumped into a lake only to find yourself swimming the wrong way? Do you know the stabbing pain you get right above your eyes as your brain is struggling to find oxygen? Are you familiar with the fear of not knowing whether you will open your eyes again after you let them close this time?

I do.

Christmas of 2015, my sophomore year of high school. I was explaining to my older brother my decision to not return to school that spring. I would be homeschooling for a semester to spend more time with my family in a different city and, more importantly, to focus on my mental health. My brother poorly disguised his annoyance and disapproval.

“You know, the thing with anxiety and all that,” he said, his voice dripping with superiority, “is that it’s all in your head.”

I’m sorry, did I miss a third of the past semester because of something that I was making up? Did the clumps of hair fall out because I was imagining things? Did I give up being an athlete to better feed an eating disorder because I was letting my mind wander? I knew that my mental health was real, it was medical, but my brother was not the first person to essentially tell me to snap out of it.

It’s a culture. If you’re depressed, go outside and do something productive! If you have anxiety, go make friends! Do people not understand that this is the same as telling a sociopathic serial killer to just go out and empathize?

The super fun thing about anxiety disorders (the generalized term under which phobic disorders, panic disorders, obsessive-compulsive disorders, post-traumatic stress disorder, and general anxiety disorders fall under) is that they have multiple causes. Anxiety disorders are the offspring of biological, psychological, and environmental factors that leave certain people more susceptible to stress. While psychological and environmental factors fall into the behavioral sciences, biological factors for anxiety are very much medical.

The main biological factor for anxiety disorders is a neurotransmitter issue. Neurotransmitters are how chemicals are transmitted in the brain and have to be perfectly balanced in order for our brains to function properly. In anxiety disorders, there are a plethora of neurotransmitter imbalances at play: gamma-aminobutyric acid (GABA), serotonin, dopamine, and epinephrine are all related to anxiety.

Stress hormones such as cortisol also have to be perfectly in sync in order for our brains to function normally. A depletion of serotonin, in particular, has been correlated to anxiety disorders and depression.

So, anxiety partially stems from involuntary chemical and neural imbalances in your brain. I will admit that the brain is very confusing and these imbalances may not be a sufficient medical cause for you. So let’s look a little deeper.

Magnetic resonance imaging (MRI) has actually shown a relationship between anxiety disorders and the amygdala, the part of the brain that regulates fear, memory, and emotion and coordinates these with with heart rate, blood pressure and other physical responses to stress (and is also George Lucas’ inspiration for the name of Luke and Leia’s mom).

In some cases, the amygdala is physically modified in people with anxiety. Anxiety disorders seem to have a correlation with higher sensitivity in the amygdala to new or unfamiliar situations and react with a high-stress response.

So now we have a physical, tangible part of the brain that functions differently in people with anxiety disorders. That, along with the myriad of potential chemical and hormonal imbalances, seems to paint a fairly clear picture of the medical credibility of anxiety disorders. So maybe stop telling people that their medical condition isn’t real.

I am lucky to have a parent who understands the severity of depression and anxiety disorders and who was willing to support me in finding the help I needed to succeed (by “succeed,” I mean being able to make it through a whole day of school without craving Xanax). However, I still had people telling me to get over it and that I was just too weak to handle real life. If you’re one of those people, please stop.

Anxiety is real.

Depression is real.

And if you ever find yourself spiraling into the same cycle of panic-stricken paralysis and heart-racing fear that I was in for so many years, I hope someone gives you the validation that you refused to give to me.