How A Missing Tampon Helped Me Find Answers About My Mental Health

When you do the same task all the time, sometimes your brain turns off (yes, that's the medical term) while you do it. Did I set my alarm? I obviously don’t know. Did I lock the door? You’ve got to be kidding if you think I have any idea. Did I put in a new tampon when I took the old one out? One Sunday night when I was 23 I couldn’t answer that last question.

I went into the bathroom to change my tampon, but when I went to take the old one out, there was nothing there. There were two possibilities, a likely one and a life-or-death melodrama. Either I had forgotten to put a tampon in, or the tampon was so far inside my body that I couldn’t reach the dangling string to remove it, and I might already be developing toxic shock syndrome and going into organ failure. I couldn’t feel anything there, so I just put in a new tampon and tried to forget about my worry — something that as a person with anxiety I have not traditionally excelled at.

At my first ever therapy session, my therapist said she was writing “generalized anxiety disorder” on my forms as a sort of placeholder until she got to know me better, but I knew she wasn’t going to take it back when she saw all the creative ways I could freak out. And after she heard me give an apology speech for potentially hovering while she unlocked her office door, spent many moments sitting across from me silently staring at her because I was too paralyzed to talk about my life, heard about my history with disordered eating, and noticed my hobby of catastrophizing, the diagnosis stuck.

At work the Monday after I noticed the missing tampon, I started to feel nauseous, and my mind immediately flashed through tampon doom scenarios. It says on tampon boxes that you shouldn’t keep one in for more than eight hours, and if there was after all a tampon somewhere deep inside me, it had been there for at least 18. And what exactly does toxic shock syndrome do? I reflected on all the horror stories I’d heard from camp friends and read about in teen magazines, and remembered that symptoms could be as benign as a fever or as severe as a beautiful young woman who made just one innocent mistake facing an untimely death.

I needed to get the tampon out of my body, or at least figure out if I had one in. But it was hard for me to get away at work. I’d gotten my job as a copywriter at a tech startup the week after I graduated college, and the work environment lacked these abstract things that I now know are called “boundaries.” I had said at my job interview that I was available to start immediately, so the cofounder asked me to stay and work the rest of the day. I got notes by someone looking at their computer in our open plan office and loudly asking, “Wait what?” until I walked over. Sometimes one of my male superiors would walk up behind me when I was sitting at my desk, place his folded hands on top of my head, and just apply pressure. I didn’t know how to talk about it, and never did. Spending day in and day out in an environment where coworkers were butting into my mental and physical space every few minutes turned my anxiety way up, which in turn made it almost impossible to put the brakes on catastrophizing, especially when it came to the phantom tampon.

So I dashed into a stall in the work bathroom for a quick, secretive tampon exploratory/retrieval mission. After feeling around as far as I could reach, I finally touched something that I thought was the rounded bottom end of the tampon. Relieved, I realized I just needed to maneuver it out and everything would be fine. But I couldn’t. Every time I felt like I had a grip on it, it would slip out of reach and I would need to start the process again. I would feel a tiny portion of what I was sure was the tampon, get a hold, and start pulling, slowly working it out of my body until I’d suddenly lose my grasp and feel nothing. At one point I gave up and went back to my desk because I’d been at it for almost an hour, but I couldn’t stop thinking about the phantom tampon. I was feeling a lot more nauseous, probably thanks to all the internal dragging and (sorry) scraping, so my body was all I could focus on. Whatever I was looking at on my computer screen, I was also thinking about the queasiness I felt, and mortality. It was exhausting to hold everything in my mind at the same time, so I returned to the bathroom for more frantic clawing at my insides. I still couldn’t find the tampon, but I couldn’t accept that it wasn’t there.

I realized the only way I would be able to get out of my nerve-racking thought circles was to get reassurance from an expert. And while I didn’t feel comfortable leaving work in the middle of the day, I felt less comfortable with the idea of my family members whispering at my funeral about how it’s really better to use a menstrual cup. I steeled myself before telling my editor I was having a “medical emergency” and prepared for pushback, but she had the more grounded response of offering to call an ambulance. I declined, walked a few steps out of the office, and tried to figure out where to go.

I didn’t yet have an OB-GYN in New York and didn’t know if my GP attended to tampon horror stories, so I ended up making many phone calls that inevitably lead to me stating, “I have a tampon lost inside my body.” That seemed the most socially acceptable way to describe it — I wasn’t embarrassed then and I’m not now, but I didn’t want to make others uncomfortable. The way I was able to get through repeating that sentence to so many strangers was simple: I wanted to live. On some level I knew I probably wouldn’t die. But what if I did?

That’s how my anxiety often feels. I know in my mind what makes the most sense, but I can’t stop obsessing on a negative thought. In this case: Will I die by tampon? This wasn’t the only time my anxious thinking had crept into my daily life, or had been focused on my body. I’ve spent therapy sessions planning outfits to wear for important moments, because my worries glom together into overwhelming panic about how people see me and how that could irrevocably change the course of my life.

On my way to the startup job, I would often stare at my reflection in the F train window until I talked myself down from the unrelenting uneasiness I was feeling about my appearance. The bad dreams that really shake me feature body horrors: a chimney growing out of my head, mushrooms extending out of my armpit, strings attached to my cheeks. I get these dreams when I’m particularly stressed out, and they stick with me for days afterward, popping into my mind at unwanted times along with a distracting feeling of dread. And the anxiety doesn’t disappear when I go to sleep. I’ve had months go by where every night as I’m drifting off, I suddenly wake up gasping for air.

At that point, almost two years into my startup job, all these symptoms were in rotation on my anxiety playlist. Plus, I’d leave work with a sort of residual buzzing that I eased by drinking every night, and eventually drinking instead of feeding myself properly. I would stay up until all hours and then, running on anxiety, adrenaline, and caffeine, was able to wake up for work every day and do it all again. So when I realized I wouldn’t be able to let go of my tampon thought spiral without proceeding through a number of humiliating steps, I just accepted it. I was used to living in constant discomfort and pushing through whatever I needed to do to keep going. And I was living in such a heightened state that I couldn’t help but filter everything through emergency-tinted glasses. It was like my emotions were controlled by a light switch; they were either all the way off, or blowing a circuit causing a citywide blackout. When the fourth doctor’s office receptionist on the phone told me to go to the emergency room, I decided to google the nearest hospital.

I didn’t want to talk about what was wrong with me anymore, but I was comforted by the fact that people who work in a hospital see all kinds of afflictions. I imagined a job orientation where employees practiced empathetically and nonchalantly welcoming patients with poles impaling their chests or tiny fish stuck in their urethras. (I was mostly thinking about Grey’s Anatomy.) There were other people waiting to check in with the ER receptionist, so I quietly said, hoping it would be the last time, “I have a tampon lost inside my body.” She blurted, “What?”

“I have a tampon lost inside my body,” I told her again, and then the nurse, and then the doctor. Finally, I sat with my feet in stirrups while two medical professionals told me to please calm down because my body was “spitting out the instrument.” I had spent the day wondering if I was dying, picking at the inside of my body, and talking to many strangers about my vagina while trying not to say the word “vagina.” I couldn’t just suddenly be chill. Finally the doctor asked if she could use her gloved hand. She reached in and felt around both sides of my uterus while I tried not to scream, and then said she didn’t see anything there. Was it possible I had just forgotten to put a tampon in? As she gently explained, “There’s nowhere for it to go.”

Turns out, women’s bodies actually aren’t mysterious black holes you can just lose stuff in. Where are my keys? Did I throw them on the counter when I walked in the door, or are they floating around inside the deep female abyss?

I left the hospital as the sun was starting to set. I resisted the urge to check in with work, which felt very radical. The doctor had told me she was glad I came to the hospital just to be sure, and didn’t make me feel ashamed for letting my anxiety overwhelm me to the point that I thought a ghostly menstrual hygiene product might be trying to murder me. That empathy was a relief as I tried to process my behavior from that day. I was relieved to officially not be dying, though that also meant I was perhaps losing it.

Since my tampon meltdown, I’ve become more aware of when my anxiety is taking over. That doesn’t make it go away, but does cut down on embarrassing death scares. Sometimes a well-meaning friend will try to soothe me by saying I’m just having anxiety. Yes, I am, and it feels very bad. But I’m working on it, as sort of a freelance gig I didn’t apply for or want. When I get overwhelmed by a crowd, I’ll walk away from the rest of my group. To practice boundaries, I’ll decide before a social event specifically what I’m willing and not willing to share. I’ve even learned how to prevent a body nightmare by refocusing my thoughts and breath when I’m going to sleep. Yes, I can incept myself.

My therapist once had me put my harmful body perspectives in an imaginary box, which felt really silly at the time, but I’m obviously willing to do anything to ease my troubling thought patterns (remember the tampon thing?). It actually turned out to be a memorable ritual, and I imaginarily left the box in my New York apartment when I quit my job and moved to LA. Hopefully my bad thoughts are not bothering the new tenants. ●

Ariel Karlin is a writer and comedian in Los Angeles.

To learn more about anxiety, check out the resources at the National Institute of Mental Health here.

And if you need to talk to someone immediately, you can reach the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Suicide helplines outside the US can be found here.