Since I was an infant I’ve lived with an unrelenting dread, a thick, sharp, black cartoon scribbling inside my body whose animated circles vibrated their heavy electrical pulses into me as fear. I couldn’t leave my mom without a debilitating fear she’d die or disappear. There was something always reaching for my ankles, dragging me away, toward a bottomless black hole, trying to sink me dead. Everywhere I went I anticipated someone’s death, and my own. Where others saw no danger, I’d point it out. I have a panic disorder, but for the first twenty-five years of my life no one knew what was wrong with me, we just knew I didn’t work like everyone else, which meant–according to me–that I was defective. When you go undiagnosed, you go untreated, and without treatment, anxiety grows, until it’s too big. That’s when, like a ancestral tree, it breaks up and splits off into families of new disorders. That’s what happened to me.

My everyday life was debilitating. Anxiety intruded on all of it, from letting my babysitter leave when he dropped me off at school, to staying an entire weekend at my dad’s house. It spread through my body like an infestation, and its somatic expression traveled down my arms and legs, into my face, belly and chest. And when it did leave me alone, it wasn’t for long enough. At most, a week. These sensations and fears made my life small, limited my range of actions and activities, and while I was young, that was just fine with me. The closer I could be to my mother, the better.

What I didn’t anticipate was my growing desire to become independent, to live in the world, free and wild like other young adults. And when that aspiration bloomed, I felt trapped, not just in fear but in a paradox. How could a person like me, so fearful to be on her own, become independent? How could a person like me live in the same world she’s convinced is against her, wants to dispose of her? I recognized then that I was an oxymoron: I was an outgoing personality disabled by an internal and chronic debilitating fear.

By the time I reached twenty-five, I was having so many panic attacks in a day, I can’t recall any downtime in between. I could no longer travel on the subway. In taxis, when the driver lowered the automatic lock, I knew this meant I was being kidnapped. I’d pretend I forgot something, make him stop, and jump out miles early. At parties, at bars, at concerts, I’d feel the room closing in around me and race to each tiny, dank bathroom, to throw up. Then I’d sneak out without telling anyone. Soon, just being near people made me throw up, and before long, I was unable to leave my apartment, and there I slowly unraveled, beginning to believe there was a secret about me my family was keeping. The secret was that I was crazy, and everyone knew it, had always known it, but kept it from me because obviously, a crazy person can’t handle knowing they’re crazy. What else could explain my lifetime inability to function like everyone else?

Every time I tried to work within the world’s expected parameters, it was made clear to me that I was incompatible with life and all its systems. I was on a bad date that was lasting a lifetime. For three weeks, I stayed inside and cried. I lost my job. I lost my sense of self. How could I possibly live my entire life with this constant sense that I was going to die? My fear of life had shrunken the parameters of my existence to my apartment, and then soon, my bed. My dread had immobilized me; slithered around my entire body, my organs and solidified, like Medusa’s hair. The torment was physical, emotional and existential—had I been cursed, did a God I didn’t believe in smite me? I was born into a plague and that same plague was born into me. The agony of being was simply too much. How could I accomplish all the things I wanted to accomplish when I couldn’t even breathe without hyperventilating?

I’d lived so long with profound worry, but my body was giving up and I felt I could no longer carry on. When I imagined my life without these fears, my body loosened, and I’d feel, momentarily, the ease I so wished came naturally to me. Fantasies scrolled past where I was thriving, doing what I wanted, making things, contributing to culture, but the space between where I was and where I wanted to be was too wide. My fear wouldn’t let me cross it. There were no rocks to leap from, and no person to help. Facing the fear felt more doable than remaining beholden to it. Something had to give and perhaps it was my life I had to forsake. I called my mom and told her I was scared for myself.

She sent me to her therapist, who, in under two minutes, diagnosed the disorder of my childhood and put me on anti-depressants. Slowly, I started to get better. I wasn’t panicking all the time, I wasn’t afraid of other people; I could leave my house and be a part of the world, but I was still afraid to separate from home, and still fearful to take any risks that might expose to the world my secret belief that I was defective. I kept returning to that old thought: Facing the fear felt more doable than remaining beholden to it. The only way I’d have an expansive life, the one I imagined, was if I faced my fears, or at least went toward them and made them more manageable. The choice to exist without truly living didn’t seem worth the energy. If I wanted to survive, I had to exist inside the world I wanted—I had to take risks.

And so, when a comedy show I was working on as a writer, hired me to be the co-host, live onstage, I accepted, despite my instinct to say no. For months leading up to the show, I had stage fright. And backstage, on opening night, I was immobile, unable to look at anyone or be near others. When I saw another performer, or a crew member, I ran to the bathroom to throw up. I hovered near the stage, trying to lower my high-decibel terror. What if I got onstage and was so afraid I vomited, or had diarrhea, or fainted, or accidentally spoke in another language like I was being saved at a very inopportune time, or worse, died? I felt the lights, the hot breeze as I crossed the stage, the audience clapping, the chair under me, the floor under the chair, my dry mouth saying its lines, the audience laughing, and then, I was very instantly better. They were with me, not against me. The night continued on and I did not die onstage. I lived. But, for the entire run of the show, every night was the same thing: vomit, don’t come near me, leave me alone, onstage, hot light, hard seat, applause, dry mouth, say lines, laugh, do okay, don’t die, go home. I was throwing myself into the fire, night after night, and every time I discovered I wasn’t flammable, the routine became tenable. And apparently, I wasn’t terrible because Chris Rock’s manager wanted to represent me, and I got a job as an on-air host for a cable network Lorne Michaels had just bought. The universe was expanding, and I was the force pulling galaxies apart to make space for the world I wanted. That’s how it felt.

Six years later, I started my own live event, thinking I’d conquered my stage fright, but to my horror, I hadn’t. The pre-show fear routine was relatively the same, but the more events I did, the easier it became. So long as I don’t bomb, I’ll survive I’d think every time I walked onstage. One night though there was a different energy in the audience. It was a new crowd, and the second I stepped out onstage, I sensed they were not with me. They didn’t laugh when I expected them to, and that made me palpably nervous. I self-deprecated about how I was bombing—nothing. I self-deprecated about how I was bombing talking about bombing—nothing. They hated me. They were in my space, and they didn’t like being there, and we were only in the beginning of the event. But then something happened. I felt myself, under those spotlights, being as exposed as I’d always feared, and I was not dying. I was standing. I was failing and living at the same time. It was glorious, and I told them so. I said, “This is the worst possible thing to happen in a show, and I’m pleased to announce that I’m living through it.” Crickets. But I didn’t care. I was over it. What I feared would happen was, and I persisted (BECAUSE THAT’S WHAT WOMEN DO!)

Not long after that I read something about Exposure therapy, or Flooding. This is when a person faces their fear by going toward it, not running away, and I realized that’s what I’d been doing, and was doing, only now I had a name for it. I was a flooder (and I didn’t even require diapers.)

In 2001, my boyfriend at the time got cast in the European tour of Cirque du Soleil and asked if I wanted to spend the year with him there. I was still afraid to leave NYC, despite being a grownup, and while my instinct again was to say no, I can’t do it, I won’t survive, I thought about it, talked it over with family and friends, and started to tally up all the things in the past I was convinced I couldn’t do and had then gone and done. I understood that not thinking I could do it and wanting to do it were two different things, and I suffered from them both, at the same time. I said yes. Before I left, I wrote a letter to each family member, as though it were 1870 and I was about to embark on a voyage atop a pioneer steamer ship. The beginning was bumpy, but it turned out to be the best year of my life.

My therapist and I often talk about how some people become the story of themselves that other people have told. That’s what happened to me. Because my panic disorder was ignored for so long, and other things about me were attended to instead, the story I was raised to believe is that I’m not good enough, that who I am is defective. If I don’t do something perfectly, this defect will be exposed, so best not to try at all. While she’s never called it Exposure Therapy, my therapist urges me to continue on the way I’ve been, to go toward every fear, reminding me of the last thing I got through, reminding me that the life I want is wide, not narrow. And so, when I began writing my memoir about my lifelong panic disorder, and I wanted to give up, I pushed myself harder than I’ve pushed myself before. The thing I was facing this time was me, and my entire life.

I wanted to give up many times. I imagined the reception the book would get: authors gathering together to mock me, the New York Times eviscerating me, everyone laughing at me when I entered a room. But I knew choosing to not do something I needed to do because of my fear would limit my life, and regardless of my ruminations, I want to be able to live with myself, to feel proud that when I’ve failed it’s because I’ve reached, rather than sunbathe in success at having done nothing.

Here’s what I’ve learned about exposing myself to fear: Do the hard thing first. Always. Don’t save the painful bits for last because then it will hang over you and cloud everything leading up to the worst thing. Do it first, face it, get it over with, acknowledge it, and then bask in the full cycle of each breath that tells you every day, “I’m alive, I’m alive.”