AMES, Iowa -- He doesn't shake hands. He swallows them.
Basketballs become grapefruits in Royce White's foot-wide bear paws.
But the pounding inside the Iowa State forward's broad chest -- the crippling rhythm of the 6-foot-8, 270-pound colossus' generalized anxiety disorder -- frightens him.
In 2010, the violent heartbeat that has symbolized the onset of his anxiety since he was a child derailed his plans to transfer to a powerhouse program.
That year, John Calipari offered to rescue White -- who hadn't played organized basketball in more than a year -- from college basketball's purgatory after a suspension and eventual departure from Minnesota.
Kentucky's head coach called the prep star from the Twin Cities one night and asked him to come to Lexington the next day to officially sign with the program.
But White's fear of flying, coupled with his anxiety disorder, ultimately triggered a panic attack.
His heart thumped as he thought about sitting on the airplane alone. He could barely breathe as fear gripped him. The episode, stemming from a condition that's severe enough to consistently interfere with the daily lives of people who have it, sapped his strength and left him in emotional ruin.
He called his mother and told her to cancel the trip on his behalf. On that day, White's anxiety seemed stronger than any defender he'd ever faced on the basketball court.
"I was on my way to Kentucky," White said. "Anxiety set in. It hurt me so bad because I have so much respect for Coach Calipari and Kentucky basketball. I almost came to tears because my anxiety had let me down in that situation."
Iowa State's Sukup Basketball Complex sits about a block off U.S. Highway 30 in Ames. The multimillion-dollar building's brick facade and glistening glass belie the cornfields scattered around it. It's a vivid contrast to the surrounding area's rural roots.
White, who grew up in Minneapolis and St. Paul, doesn't seem to fit either.
Not in the snug sweatsuit that tries to contain his imposing physique as he walks around his team's practice facility. Not in the middle of Iowa. Not in Cyclones colors.
White has burst onto the national college basketball scene this season, nearly three years after he had played his last official basketball contest -- Minnesota's 2009 Class 4A high school title game.
The state's Mr. Basketball, who was one of 20 players picked to play in the 2009 Jordan Brand Classic, appeased locals when he chose to play for the Gophers. But he drew their ire when he left school less than a year later, before he'd ever played a game. A series of high-profile legal issues preceded his departure.
The layoff -- he had to sit out last season due to NCAA transfer rules -- appears trivial now considering the immediate impact he's had on the Big 12. According to ESPN Stats & Info, he's the only player in a Big Six conference who's leading or sharing the lead for a team in scoring (13.4 ppg), rebounding (9.6 rpg), blocks (1.2 bpg), steals (1.2 spg) and assists (4.5 apg).
Two weeks ago, White scored 18 points and grabbed 17 rebounds against Thomas Robinson and Kansas. He recorded a triple-double (10 points, 10 assists, 18 rebounds) at Texas A&M earlier this month.
Plus, he's versatile enough to play power forward and point guard in coach Fred Hoiberg's offense.
"That's the toughest matchup for anybody in this league, I'm sure," said Texas A&M coach Billy Kennedy.
Like most athletes, White's on-court progression has demanded persistence and hard work.
Unlike most athletes, White's anxiety disorder has been a constant challenge, one he's learned to manage with professional help and medication.
"I'm never at 100 percent because my anxiety is going to take me down 25 percent before the game starts," he said. "Before the game, I'm still feeling sick to my stomach because I want us to win so bad that my adrenaline is getting going before the game even starts. It's hard to do it in front of 20,000 people. But I've trained my mind to deal with it."
He doesn't always escape the tension.
He wakes up three to four times every night. Sometimes, he spends an hour in Hoiberg's office discussing a dilemma. He makes middle-of-the-night phone calls to his mother just to clear his head.
If only he could sever the roots of generalized anxiety disorder, which the U.S. National Library of Medicine defines as "a pattern of frequent, constant worry and anxiety over many different activities and events."
The tone in White's voice changes, as he talks about the incidents that started his scuffles with anxiety.
After a youth basketball practice, 10-year-old White lined up for wind sprints. His best friend, LaDream Yarbrough, stood near him. Both boys raced to the other side of the floor, but only one of them made it. Yarbrough had collapsed during the run.
Perhaps it was his friend's asthma, White said he thought at the time.
But Yarbrough wasn't moving.
"His dad runs over and grabs him. He's drooling from the mouth and [his dad is] trying to keep him awake," White recalled.
White rode in the ambulance while paramedics rushed him to the hospital. He thought he'd just watched his best friend die.
But Yarbrough survived after undergoing life-saving heart surgery to correct a cardiac abnormality. Following his friend's health scare, however, White began to worry that he might have the same condition. That's when his anxiety escalated, he said.
"What we hear from a lot of anxious patients is that they often tell very compelling stories about when their anxiety starts," said Dr. Daniel Pine, a psychiatrist who researches mood and anxiety disorders of children and adolescents at the National Institute of Mental Health in Bethesda, Md.
To this day, White fears post-practice runs because of what he saw in fourth grade. Every time his heart rate rises in conditioning drills -- even though he's been cleared medically by multiple doctors -- he has to tell himself that he's OK.
The same way his mother did when an unpredictable ex-boyfriend threatened her and her young son.
White was 7 then. And the relationship didn't last long, but White said it was extremely stressful and worrisome.
The boy and his mom lived in fear.
Perhaps the man would wait outside their apartment and harm them, they often worried. Or he might meet White outside his elementary school. He'd violated the restraining order multiple times in the past. What would keep him away now?
"I think we have to think about the fear Royce must have had, not just what he might do to me, but where he might end up because of that," said White's mother, Rebecca White.
White identified those events as precursors to the anxiety struggles he still encounters.
Before he was diagnosed with generalized anxiety disorder as a senior in high school, White would search for ways to cope.
Sometimes he'd call his mother and ask her to pick him up from a friend's house early. He didn't want to go home. He just wanted to drive along the Mississippi River.
He'd also seek his grandfather for reassurance when his worry would reach extreme levels.
"I remember a couple situations where Royce was concerned. 'Am I going to live, Grandpa?' A lot of fear," said White's grandfather, Frank White.
A team at Hopkins High School in Minnetonka, Minn. -- his high school coach, an administrator and his doctor -- helped him discover his anxiety disorder in 2008. He credits that group with giving him the initial tools to fight it.
White transferred to Hopkins that year after an academic issue led to his dismissal from DeLaSalle High School in Minneapolis.
His high school coach, Ken Novak, said he recognized White's emotional difficulties early. With the help of medical professionals, Novak steered White toward people who could help him.
"Royce is a good person that's fought against that anxiety," Novak said. "He worked with some really good people at the school."
White said he's talking about his anxiety publicly because he wants to help. He said he believes other athletes probably encounter similar struggles but refuse to get treatment.
White, however, is an example of someone who's overcoming those hurdles.
He's learning to harness his anxiety and put his energy toward positive pursuits.
Sometimes, he wakes up in the middle of the night and thinks about the businesses he wants to create in the future instead of a problem that's bothering him. He talks about starting nonprofits that will benefit urban areas, and about following his passion for music after college.
Left untreated, his anxiety would have robbed him of the ability to focus on his goals, he said.
"For that reason, my anxiety has led me to a place where it's helping me because I understand it," he said. "I want to speak out now, because not only do I understand my own anxiety, I understand that anybody who's had an anxiety disorder, diagnosed or not diagnosed, how it can affect their life."
Pine said high-profile athletes can help others deal with their psychological and mental disorders by acknowledging their personal struggles.
"Whenever anybody in a public position comes forward and says they have any mental disorder, I always marvel at it," Pine said. "I think it's a really wonderful thing."
White, however, said he's not sure everyone will believe that his efforts are genuine, because the Internet never forgets.
White thinks his past could erase a potential NBA future. No matter how many impressive stat lines he produces at Iowa State -- no matter how many double-doubles he piles up -- many will reflect only on his tumultuous time under Tubby Smith, he worries.
There's no denying it: White arrived at Iowa State last year with red flags.
During his freshman season at Minnesota, he pled guilty to theft and disorderly conduct after he was accused of shoplifting and pushing a security guard at the Mall of America in 2009. Weeks later, university officials extended a previous suspension when he was linked to a case that involved the theft of a laptop computer. White says he never participated in the latter incident.
That December, he made national headlines when he released a YouTube video announcing his decision to "retire" from college basketball. He officially withdrew from school the following February.
Once his basketball jones returned, however, he considered a handful of schools. And they all scrutinized him.
Hoiberg said he talked to multiple people before he offered White an opportunity to compete at the Division I level again. He said his research showed that White was a bright young man who had made a few, albeit serious, mistakes.
Hoiberg's gamble has paid off. He has the Big 12's top newcomer and an athlete who hasn't brought any negative attention to himself or the program.
A few weeks ago, some elderly Cyclones fans told Hoiberg about a pleasant encounter they'd had with White at a restaurant in Ames.
Hoiberg said White's character, not just his athletic ability, deserves praise based on what he's seen thus far.
"He's made a very positive impact in this community," Hoiberg said.
As White prepared to leave Iowa State's basketball practice facility and enjoy a rare off day a few weeks ago, he veered from one conversation to another.
One minute, he talked about a possible career in politics. The next, he expressed his love for music.
His anxious mind shifts like that sometimes.
Brief thoughts become discussions as his anxiety takes over and refuses to let him abandon a potentially intriguing exchange.
But then, he stopped talking.
White was in control. He wants others like him to possess the same power.
"So many people will go undiagnosed for their whole life and not understand it," White said. "And they will suffer. It's suffering."
Myron Medcalf covers college basketball for ESPN.com. He can be reached at email@example.com. Follow him on Twitter: @MedcalfbyESPN.