Disease. I’ve been using this word frequently. Not out loud, but in my head. And always pertaining to myself. Disease: not meaning ill, tainted or disordered. But literally the opposite—the reverse of—ease. Pronounce it dis-ease.

[Dis: a Latin prefix meaning “apart,” “asunder,” “away” or having a negative, or reversing force—used freely, especially with these latter senses, as an English formative: disability; disaffirm; disbar; disbelief; discontent; dishearten; dislike; disown; disease.]

“Unease is a word” you might say. “Maybe you should just use that instead… less confusing.”

It’s not the same. Unease is weak, middle-ground. Not-at-ease. Unease breeds caution. I’m uneasy walking on that bridge.

Disease is powerful. It bears anxiety… or fear. Disease settles in like a cold, dense fog. Tightens your chest, sinks your stomach, clouds your brain. Disease is felt when things clearly aren’t right.

For the past five weeks, I’ve been immersed in a world of domestic violence and sexual assault. Battery and rape. Education: thirteen hours per week. Stories and theory, on-the-job-training. We’re a survivors’ nonprofit. I’m learning what to say to a woman who was just assaulted. Or was assaulted years ago and still suffers. I’m learning to treat these women with respect and compassion. To not blame the victim. To not doubt her story.

This is rough stuff—not what I signed up for. I’m an accountant, not a counselor, or an advocate as we call them around work. When I got my job, this part never occurred to me. I’d fix the finances. Someone else would fix our clients.

Most days I do OK. I’m appalled by how easily I can endure stories of child abuse and spousal abuse and rape and prostitution and stalking and human trafficking. In our training classes, we’re cautioned to watch for triggers. Reminders that bring up disturbing feelings of our own. The possibility of spiraling into disease. I’ve sailed through my training sessions without any problems. No obvious triggers.

Except I’m unwell. I have been for a few weeks. In me, disease is easy to spot. I scrape my teeth together. Not my molars, my front teeth. Bottom against the top. I do it all day. At times I think I can taste the dentin leaking out. What’s dentin? The dense, bony tissue beneath the tooth enamel.

I blink my eyes—hard. I squeeze my eyelids together and roll my eyeballs around. It seems to release built-up pressure behind my eyes. Pressure I feel when I’m stressed.

And I grunt. Low and sustained. But not all the time. I only do this when I’m alone.

These are all outward symptoms of Tourette Syndrome. They call them tics. Uncontrollable movement and sound. It’s been a while since I’ve displayed obvious tics. Sure, I’m twitchy. And I periodically scrape my teeth together, but the grunting and the eye-thing: those have been gone for years. Until now.

Susan thinks it could be the schedule. Five days of work and then all-day training on Saturday. My workload hasn’t diminished, but I have an extra six hours of online training to squeeze into my workweek–in addition to the Saturday class. Of course I’m feeling stressed.

Yesterday was my worst day. Lips closed, teeth scraping, my chin moving back and forth. Sometimes I wonder if anyone can hear it. Do they question what I’m doing with my mouth? In my moments alone, in the car, in the restroom, I’m grunting. A release of disease building up inside me—a purge. In a work meeting, my eyes scrunched together, grimacing. In my new workplace, I haven’t told anyone about the Tourettes. I don’t know the people well enough yet.

My training topic yesterday was working with older victims of abuse. Older? They gave several examples. The median age where older starts is apparently fifty-five. I’m fifty-five. This hits home. Last weekend, Eli told me that “old” starts at seventy-five. I took comfort in that. Now I’m told I’m already there.

I learned that older adults are more susceptible to abuse due to social isolation. Older adults are less likely to have close relationships. And just like that, I found my trigger. Here’s the thing that bothers me. I’m not distraught about the rape and violence and abuse. I’m afraid to be alone.

As a person living with anxiety, I feel disease frequently. I worry about my past. I worry about my children’s futures. And I worry that I isolate myself from others. This has been a concern of mine for decades. In the past, I’d often take stock of my relationships and periodically make adjustments. I’d put in some additional effort. Make some short and mid-range plans with friends, and I’d immediately feel better.

But when I quit drinking two years ago, it seems I gave up. Without alcohol, the thought of socializing is uncomfortable. I can do it, but it isn’t fun. It’s a chore to endure, something to complete. My conversations are awkward and unsteady. And rarely satisfying. So instead of making plans, I sit at home and read. Or I sit at home and write. It’s more comfortable. And it’s isolating.

The cumulative effect of my training is clearly overtaking me. The schedule, the subject matter, the introspection. It’s leaving me stressed and anxious. I’m over-reacting to concerns I’ve had for years.

In each training class, we talk about self-care. Those things we need to do for ourselves to make us feel better. Rewards for addressing the hard stuff. We go around the room and take turns describing what we plan to do for ourselves. My go-to is always exercise: “Sweat out the yucky stuff.” This weekend, I’ll say “Think about disease.”