Talk to any career writer, and you’ll hear a lot of anxious worry about sales, about events, about what to say or not to say online, about bad reviews or no reviews, about sexism and table placement and pub­lishers who don’t invest enough in their authors’ careers. You’ll hear about health concerns, about checks that don’t come on time or don’t come at all, and books that never earn out their small advances. You’ll hear about le­gal battles, about agents who don’t return e-mails, about careers that started, slowly petered out, and now no one wants to buy anything from that writer anymore.

It’s no wonder that so many writers come across as anxious and neurotic, and I’m no exception. This has been a good year for me when it comes to book contracts and sales, but it’s also the year I was sud­denly in the position of having to deliver three books on deadline while holding down an increasingly un­certain day job. While a lot of people with their eye on the pulse of the genre saw my career as a possible rising star, I saw it as a fluke hinging on the success of a single essay, that had to make the leap to the next big thing or it would tank hard. It’s all very well and good to have a big break, but it’s what you do with your big break that makes your career, not just the opportunity. I had to deliver exceptional work that kept wowing people. And every time I thought I’d cleared another hurdle – I published my first novel, I published a trilogy, the work was nominated for some awards, it won some awards, I got some better advances – the bar seemed to keep getting higher. The higher I got, the more aware I was of how far I’d be falling when it all got pulled out from under me.

The idea that everything could be over tomorrow, or that my career would be over with one bad book showing, is not a totally irrational fear. The truth is, I’m surrounded by writers whose careers faded in just such a manner. But living with, and trying to operate under, that reality was taking its toll. Since my first book came out in 2011, I have had two publishers sold, entered into my first (and ongoing) legal dispute with a publisher, had a series fail, had another series barely get picked up, had a series succeed, and signed something like six book contracts. My entire career is a gamble, and living with that gamble while being em­ployed at day jobs that were equally precarious and laid off their staff every four to six months meant I lived a never-ending rollercoaster of uncertainty.

It was no wonder that I teetered at the edge of sanity this summer, culminating in me running off to a cabin in the woods with no inter­net and a six pack of beer to just be alone with my essay collection so I could hit my deadline. I had to completely cut myself off from everything that put stress on me – my job, the publishing world, even my household. Everything had become a source of stress. I had panic attacks every time I went to see the doctor. I didn’t want to leave the house to go out. It had been months since my spouse and I had even gone out to the movies. When I wasn’t working, I was thinking about what a terrible person I was for not working. The work itself started to become a way for me to avoid the stress and anxiety, because I could pour it into the work. But the work was becoming relentless. It was eating my life.

I knew that if I broke, this would be the year that broke me. And it was, and I did.

I made an appointment to see a doctor about my anxiety, but had to wait three months for the appointment. When the day finally arrived, I drove around for an hour, trying to decide if I’d go to the doctor’s office or not. It was the day before my fifth book, Empire Ascendant, was to launch. I had something like 30 articles to write in 30 days as part of the promotional blog tour. I had another book due November first, and a story due for an anthology, and edits due on my essay collection, and as I drove around I realized I wasn’t going to be able to do it. Not any of it. I was going to have to cancel all the blog posts. Cancel the story. Push back the book. When my essay collection came back with editorial notes, I strongly considered just sending back the advance and canceling the whole thing.

And that scared me more than anything – to think that I was so far gone that I was willing to give up everything I’d spent my life trying to achieve, be­cause I just couldn’t manage it any longer, because the relief of getting out from under the work, and the expectations of the work, felt like freedom.

I parked outside the doctor’s office and realized that this terrible, ongoing stress and anxiety was go­ing to destroy everything I’d worked my entire life for. I needed help. If I didn’t get help, this whole precarious castle of a career I was trying to build from the ground up would tumble down around me.

So I got out of the car and I went to the doctor. And when I sat down and explained things to her, fear­ing she would tell me I just needed to exercise more and destress my life, I heard myself saying things out loud that sounded like a crazy person talking. Things like, ‘‘I was so anxious I couldn’t get on the plane to go to an event, so I had to cancel it. I had to cancel an article I was asked to do for a prestigious collection. I cry and shake and sob every time I get out of the doctor’s office. I never want to go out with people because I just want to yell at them. Going to the grocery store is exhausting because I want to scream at everyone. I exhaust myself just trying to keep this all tight inside of me, so no one knows how hard it is. But it takes everything I have to manage this, and it leaves me nothing for anything else. I have no other life but managing to seem sane. And I am so tired. It’s exhausting.’’

To my surprise, the doctor did not tell me I just needed to lose weight and join a gym and take a hot bath. She simply nodded sympatheti­cally and gave me a prescription for an anti-anxiety and anti-depressant combination. I always thought I’d feel guilt for taking medication, but the truth is I have always believed that medication is the last resort, and the reality is I’d been falling and falling and falling for a long time, and this was my last chance to salvage my life before everything fell apart.

It was my only hope. And I took it immediately, and gratefully.

Within a day of starting the medication, I was already climbing out of my panic-stricken fog. I saw how filthy my house was. I marveled at how I’d been able to stand the overflowing trashcan in my room. I stared out at the weed-choked gardens around my house and realized it looked like a mentally ill person lived there. I looked at my tattered clothes and tangled hair and wondered how on Earth I’d let things go this far. But when you have to spend all of your energy just trying to survive, you can let a lot of things slide. You have to.

So I took out the trash. I cleaned the bathroom. I went clothes shop­ping. I had my hair done. I washed the dogs. I weeded the gnome gar­den. I looked at my deadlines again and I pushed out the worst of them. I turned in my essay collection edits. I wrote 25 of the 30 scheduled blog posts for my blog tour, canceling just five of them instead of the whole lot.

I worked at getting better, instead of just surviving. By the time you read this, I’ll have been on that path for a few months. I have spent the last four years trying to forge a writing career from scratch, hoping that the next book will be the book that hits. But I couldn’t sprint for four years and maintain my health and sanity. I am here for the long haul. And like every writer in this for the long haul, I need to manage my writing, my health, and my sanity like I’m a going to be around for a long, long time.

I hope you will too.