I pull up to the house, park out front (not t0o early, I hope), and sit for a moment. I consider briefly taking off again, I’m pretty sure that no one saw me. I’ve known Ken for several years, but that doesn’t take away the gnawing feeling of being out of place. I take a couple of deep breaths, take another Xanax, and step out of the car. I gather my dice and books, and step inside. It seems I’m not the first and my heart drops as the anxiety cranks up to 11. Dani arrived before me, and she’s in the kitchen with Josie, making something (shit, was I supposed to bring something?). Ross is on his way (I don’t recognize that name, is this someone new?), and Cat is running slightly late (crap, I need to remember to use the correct pronouns, I can’t risk offending someone). Ken asks me to help set up the microphones (ah hell, we’re recording this), and I take the opportunity to place my books at the spot that gives me the quickest and easiest access to the doors. The game goes pretty well (I didn’t sound like an idiot on the microphone did I?) and everyone has fun (I didn’t say anything wrong did I?). After everything, I pack my things, say goodbye, and leave (I must have said something stupid, I’m certain I’m not getting invited back). The next day I apologize for anything dumb I might have done, and Ken reassures me that everything went well.
Some of these may appear to be normal fears. Some of these may seem ridiculous. And largely, sitting here now, I might be inclined to agree. But there is a twist. A twist that complicates things.
My name is Michael, and I have anxiety.
To be more specific, I have a generalized anxiety disorder complicated by PTSD. Things that seem mundane to most are ordeals for me. Things that most people just blow off cause me sleepless nights. Anxiety isn’t well understood, despite our best efforts. Those of us who deal with anxiety can identify causes, treat symptoms, and lessen the impact, but anxiety never really goes away.
Why do I game?
Gaming is important to me for several reasons. It is essentially an exercise in creativity, allowing me to stretch my creativity. Creativity is a vital skill; a 2010 survey of global executives from 60 countries and 33 industries identified creativity as the most important trait in business. Gaming can also serve as a form of escape, releasing us from the doldrums of everyday life and letting us imagine different worlds and lifetimes. It is also incredibly important to helping develop and practice social skills, as demonstrated and discussed by Gnome Stew’s own John Arcadian (https://johnarcadian.com/vsat/i-did-a-dungeons-and-dragons-ted-talk-tabletop-roleplaying-games-as-social-practice/ ). I have also developed several good friendships through gaming. Ken has been there for me, and helped me through some of my own problems. He helped convince me to begin going to therapy to better myself and has always encouraged me, no matter what situation I found myself in. I have also developed friendships in a larger community; those community members have been good friends, good sources of advice, and very supportive when life seemed unmanageable
So what do we do when the hobby we love is also a major anxiety inducer?
There are several options. The best, and one I would highly recommend, is just talk to someone. Therapy is an amazingly underrated resource that can provide a lot of benefit. With my therapist I was able to identify what caused my PTSD and what triggers anxiety attacks now. I’ve also been able to lessen some of the effects of those anxiety attacks with his help. He’s given me multiple tools that I can use to mitigate the worst of my condition. If you want to find a therapist you can try here: https://www.networktherapy.com  or https://www.e-counseling.com/,  or search for a therapist through your insurance directory
Meditation helps. I’ve never been good at sitting quietly and clearing my thoughts, and anxiety has only made my tendency to overthink things worse, but I sometimes am able to actually meditate, and I do have friends who swear by it. If you are interested in meditation, I might recommend starting here: https://www.gaiam.com/blogs/discover/meditation-101-techniques-benefits-and-a-beginner-s-how-to 
But how do I deal with gaming? The short answer is: not well. The long answer is quite a bit more complicated. Gaming online helps some of the worst parts of anxiety, but I am a big fan of gaming around a tabletop with friends. I have approached this in a variety of ways.
You might have to make arrangements with your host, but it’s always easier to deal with a new situation and the stress it causes when you’re the first one there. As people arrive you can better acclimate to an environment with new and/or more people. This has been one of my best personal tools
Talk to your host.
My closest friends know about my anxiety issues. Ken (our host) has been supportive and understanding for the entire time we’ve known each other. He invited me to his home game and was supportive leading up to the game day. I believe it was important that he was aware of the fact that I was dealing with anxiety, because he was able to support me before and during the game. Before the game we talked about what I could expect. He reassured me that I was welcome, and he checked on me when we took breaks to make sure I was still doing well.
Take a breath.
If it gets to be too much, take a minute to step away. Going to another room or taking a step outside can help. Take a couple deep breaths, close your eyes for a moment, and relax. Removing yourself temporarily from the situation can be good for you. It helps to remove some of the strain and stress. You can deal with the stress a lot better by taking breaths here and there, and your gaming day should be a lot better overall.
None of these are sure-fire ways to manage the anxiety. What works for some may not work for others. Sometimes you can’t just step away. But these are good starts. Understanding your own anxiety, how it affects you, and what you can do to mitigate it is valuable, and can help beyond just gaming. Most of all; if you struggle with anxiety just know that you’re not the only one. It is possible to be involved with gaming and successfully manage anxiety, and I believe you are capable of doing so.