"Just because I can't always make it to the party doesn't mean I love you any less."
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Credit: Courtesy Harper Collins

“Worry and the physical manifestations are part of who I am, from soul to skin. They’re an invisible strand twisted tightly into my DNA, mapping its mark on my body in hard scars I cannot stop clawing, the ragged tang of chewed-up cheek flesh, and the slump of my shoulders after another restless attempt at sleep.”

Like millions of Americans, writer and Extra Crispy editor Kat Kinsman suffers from anxiety. In the first chapter of her new book, Hi Anxiety: Life with a Bad Case of the Nerves, Kinsman recounts the moments in kindergarten when she first realized she was … “nervous.” When asked to read a passage in front of the class, she froze, biting her lips and losing control of her hands, which trembled against her will. For the rest of her life, Kinsman would be grappled with panic attacks, self-doubt, depression and the not-so-basic facets of being a human: Leaving the house. Maintaining relationships. Getting through crowds. Surviving the holidays.

Kinsman spoke with PEOPLE about what she wants people to know about anxiety, and the reality of living with it.

1. You can’t always ‘see’ it.

“You won’t necessarily see it in somebody. It’s not just like somebody sitting there acting nervous and biting their fingernails. If you’ve suffered from this your whole life, you know how to mask it. You can have somebody standing in front of you having a panic attack, and you might not know it. People wouldn’t necessarily ever think I was an anxious person until I told them. I was like, ‘No, I actually had a panic attack that lasted several hours yesterday.’ ”

2. It’s everyone.

“It is the most diagnosed mental illness in the U.S. It is not regulated to one particular group of people. It’s all over the age, gender, race, religion, sexuality spectrum. But there are some people who don’t feel as free to talk about it. I want to help normalize the conversation so people realize that it’s not just them, they don’t have to suffer in silence. I’ve seen so many friends from every walk of life suffering from this.”

3. Just because I can’t always make it to the party doesn’t mean I love you any less.

“I struggle during the holidays, like so many people do. Last year, I was feeling really crappy that I was ditching on people’s parties, and I wasn’t going out at all. I thought, ‘Oh my God, my friends probably think that I don’t love them, that I don’t care about them.’ I always think of it as a coming out. I came out to them and said, ‘Hey look, here’s what’s actually going on. I’m so embarrassed, but I can’t leave my house sometimes. The reason I’m late sometimes is because I’m having a panic attack and I can’t leave the house.’

“What I would ask for people to get from all of this is a little bit of compassion for people, because it’s not something that can easily be seen. Your friend who is late all the time – OK, they might just suck, or they might have a really hard time leaving the house. It’s a thing that is happening right in front of people, and they’re not seeing it. I think a little more patience and compassion will make it easier for everybody.”

4. It’s not always a mental thing. Sometimes it’s just physical.

“If somebody tries to explain to you, ‘Oh you shouldn’t be nervous about that because …’ Okay, well, first of all, that doesn’t help. My body is deciding to react in a particular way – it’s not necessarily even a mental thing. This is how I am wired. I do my best to manage. I never ever, ever say ‘cure’ because that puts too much expectations and pressure on people. It’s something that you manage. But if somebody is starting to say, ‘Oh you shouldn’t be afraid because…,’ they’re probably doing it out of their best impulses. They’re trying to be kind; they don’t want you to worry. But it might make you feel like a fool. And that’s the danger there – because then you might think, ‘Well, why can’t I stop worrying?’ ”

5. Getting out of bed is hard. A miracle, even.

“If somebody tells me to ‘just toughen up’ – do you understand that just walking out into the world when you’re feeling so vulnerable and scared and in pain and still managing to get out to your job to your life, takes so much toughness? It takes so much fortitude. I walk around just about anywhere and think, ‘Oh, these people got out of bed today! Good for them!’ And the people who are at home, they’re not diminished or anything! I just hope they have a really good support system that can make it safe for them to come out.

“I have a hard time leaving my house sometimes, especially when it gets into these months where it’s colder and it’s darker. I have combination anxiety and depression, and also panic disorder. I am intensely lucky for the fact that I have a job where I can be really open about this. If I had a day where I needed to work from home for a day because I didn’t feel well, I could say so. Not a lot of people have that luxury.”

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6. I can’t be well for you. That’s a lot of pressure.

“If you love someone with anxiety, know that the person you love can’t be well for you. That adds to a person’s burden tremendously, if you feel like, ‘I have to do this for them. I’m not going to be loved. I’m not going to be whatever.’ Let them know that they are loved how they are, and that your concerns is for their well-being because you love them, not because it’s a condition of your love. And let them know that you’re not going anywhere. That is so helpful to know. Set these expectations. If you can say, ‘I’m going to be home at a certain time.’ If this particular things sparks their worry, do what you can upfront to quell that. Just let them know that it’s not conditional that you’re there.”

7. I don’t want my anxiety to hold you back.

“Sometimes partners of people with anxiety can grow to resent them. Because they feel like they’re being kept apart from life. What I’ve told my husband – I’m so lucky for him, and he’s my favorite person in the world – is I let him know that if I’m feeling depressed or anxious and can’t really leave the house, I don’t want to hold him back. ‘If you still want to go to that party, go to that party. I promise not to hold that against you, and I know that I am nervous, and if for some reason I really needed you to come over, it’s on me to tell you that.’ ”

8. Sometimes, I’m not okay.

“We all have to be able to say to somebody, ‘How are you?’ And really be ready to hear the answer. People are so afraid of having an awkward conversation. An awkward conversation hasn’t killed anyone, ever. If you’re awkward for a little bit of time, fine, but at least somebody wasn’t suffering in silence because they thought, ‘Oh god, I don’t want to add to their burden.’ Be prepared for somebody to say: ‘I’m not OK.’ And be prepared to listen. It’s huge.”