Wake up one morning at 11 years old and suddenly be terrified that everyone is going to throw up on you. For the rest of your life people will ask you if you had some trauma that gave you this fear, never have an answer for them. Even as a child you know that this is completely irrational and a waste of energy, but be unable to prevent yourself from having panic attacks nearly daily. Start to see the potential for vomit everywhere. Someone in class says they have a stomachache, or is coughing too much, or just has a look on their face that you don’t trust; envision them throwing up everywhere and just panic. Your stomach will drop and your hands will get sweaty and your heart will palpitate and you’ll feel like you’ll die if you don’t run away. Have no idea why this is happening to you or what you’re scared of, and be too confused and embarrassed to tell anyone. Start to develop habits and rituals that will stick with you for years: obsessively check food expiration dates, constantly ask people if they feel okay, only sit in window seats.

That summer go to the County Fair with your mom. Be so overwhelmed that you sprint out of the midway crying. Your mom finds you hiding out in the horticulture building. Be unable to tell her what the problem is and try to pretend to be really interested in the flower arrangements. At 12, take a boat to summer camp on a really choppy day. Have the most intense panic attack you’ve ever had and hide on the bottom deck in a pile of luggage with your fingers in your ears for 2 hours. Hiding is really the only thing you know how to do. Still don’t know why you’re having panic attacks and still be able to tell anyone about it. Write a lot of middle school poems about it in your diary. At 13, stumble on a ‘list of phobias’ on the Internet and wonder how it took you so long to realize that you had a phobia. Feel comforted in the face that there other people who have the same problem, but find no solutions. Maybe at this point, you will tell your parents, start seeing a therapist and grow into a well-adjusted adult. Or maybe you will just wish you had.

At 14, tell your friends about your phobia for the first time. Be mocked for it constantly. At 16 develop a binge eating disorder. Wish you could purge but know that you’d never be able to and instead gain 20 lbs. Wonder if bulimia would have been easier. At 17, drink too much for the first time and cry on the front porch of a house party for 3 hours because you have the spins. Learn that by this point, your mind has made it nearly impossible for your body to throw up. Stay drunk the entire next day because the alcohol can’t leave your system and feel like you’re going to die. Go to college, but don’t live in the dorms. Skip a lot of parties. Know that your phobia has been a huge factor is all of your life decisions and feel disgusted by the fact. At 18, go to a frat party, end up too drunk (or possibly drugged), and vomit for the first time in 8 years. Feel this incredible sense of relief afterwards because you survived and realized that it just wasn’t that bad. Think that maybe after this you will start to get better. You don’t.

Lose the ability to tell the difference between a stomachache and anxiety, and feel sick constantly. Feeling sick just makes you more anxious and you feel stuck in a never-ending loop. Feel anxious for days every time you have to travel, realize that you’re feeling anxious about potentially feeling anxious and feel trapped. As an adult, tell people you “have anxiety” when you need to explain why you are acting crazy. Anxiety is just easier to admit to and somehow much less embarrassing and shameful. There is something very shameful about having a phobia. Develop more rules and habits to get you through each day. Only stand next to the door on the subway, and constantly scan the faces of the people around you, always carry Tums in your purse, never eat anywhere without reading all of its Yelp reviews first. Let your boyfriend move in with you, but make him sleep on the couch whenever he’s drunk. Feel exceptionally proud of yourself for doing things like stepping onto a boat or riding a Ferris Wheel. Wish that anyone would acknowledge how difficult it was for you do that seemingly little thing; no one does.

Be called cold because you don’t like animals and small children, but really you just can’t stop imagining them throwing up on you. Be called a bad friend because you will never take care of the girl that gets too out of control. Be called a bitch for not allowing drunk people in your car. Every time you go home for the holidays your family will ask you if you still have “your little problem” or if “you’re still weird about vomit.” Your stomach drops every time someone mentions it, and just say yes, you do; you’ve already given up on trying to explain.

At 22, realize that you have been phobic for half of your life and just give up. Feel indescribably exhausted from living your life in a constant state of heightened anxiety and low-level panic. Become a recluse for a year. Choose to stay home every weekend because the idea of dealing with drunks and bars and the L Train has just become too much for you to handle and wonder why you spend so much time alone. Strain your relationship to the point of no return because of it. Eventually you will pull yourself out of this, but not completely. Wonder who you could have been if you never woke up that day in 6th grade feeling so scared. I bet I would have been fun.

I don’t have an ending to these instructions, similar to addictions and eating disorders; phobias are something that will always be a part of you. Maybe you will one day find a way to flip the switch it your brain back into a logical place. Or maybe you’ll start seeing a therapist and things will improve. Maybe she’ll suggest anti-anxiety medication, but you’ll read that one of the side effects is nausea and refuse to try them. Maybe after a few months you’ll lose your health insurance and stop going. Maybe in your twenties you’ll take a job that requires you to travel constantly in an attempt to force yourself to face your fears, even though you’re terrified. I’ll let you know how that one goes.