Not long ago, Mardy Fish was spiraling into a world of full-scale distress.
"I was at the bottom, man," Fish told ESPN.com earlier this week. "I was in a deep, deep place. It wasn't like I needed a little bit of medication and a couple therapy sessions and we're back."
After Fish lost to Juan Monaco in the Sony Open quarterfinals in early 2012, his heart started to race violently. Fish went to the emergency room and was later diagnosed with severe cardiac arrhythmia. A couple of months later, he underwent a procedure to correct faulty electrical connections in his heart, but the mental scars led to severe anxiety, and it was accelerating.
In September that year, the situation became so critical that Fish was experiencing panic attacks every 15-30 minutes. He had no answers, no escape from the assault of debilitating heart palpitations. He was helpless, as was his wife, Stacey, along with his inner tennis circle, those who knew Fish primarily as a world-class athlete.
Those dire days since being diagnosed with extreme anxiety disorder have since passed, and this week, he'll return to Indian Wells -- his first rendezvous with tennis since he retired in the third round of the Winston-Salem Open in August 2013.
He has now educated himself on the cause and effects of the disorder and is making an effort to bring awareness to those who suffer from mental illness.
"This is a personal triumph for me and for the people around me who know the situation," the 33-year-old Fish said. "The people who know where I was and how bad I was, how long this went on for and what I have been through. But also for those who appreciate the direction I am headed in."
Fish finds comfort in discussing the perils of a disorder that, as he notes, affects 30 million Americans a year. He calls it a world that completely opened up his eyes.
"There were times I felt I'd never get my life back," he said. "Am I ever going to be normal and go out with my friends and have a beer and not think I am going to wake up at 3 a.m. and have anxious thoughts about what normal people are doing? Can I sleep by myself? Can I travel by myself?
"I was a guy who loved to be on my own at times and to travel and some of the most comfortable times were in the middle of my career flying overseas, where you have to turn your phone off and no one can get to you for 10 hours. It was just a really comfortable place for me."
Comfort on court has a different meaning now. With everything he's endured emotionally, wins and losses seem more or less superficial, Fish said. His success will be gauged on how he fares health-wise.
In a fiercely individual sport where conclusive outcomes are inevitable, Fish isn't focusing on the bottom line.
"Frankly," he said, "I don't really care what my results are."
At his worst
At first, Fish was too ashamed to speak of the demons. For a professional athlete, the inability to function on the same level as the average person was humiliating.
In 2012, just after he withdrew from the US Open in the fourth round against Roger Federer, a panic-stricken Fish experienced what he calls his personal low point.
"We tried to get on a plane that afternoon to go home," Fish said. "They closed the doors and I couldn't go. Thank god my wife was with me because I'm not sure I would have had the nerve to tell someone I needed to get off this plane. We had left the gate and actually had to go back. It was embarrassing. We just left our bags on the plane and figured we'd get them another time. I actually had to rent a plane to get home because I didn't think I could get home commercially."
"There were times I felt I'd never get my life back." Mardy Fish
Fish made it home, but his condition declined.
He ventured out of his house, but only to see his psychiatrist. For 3½ months, Fish isolated himself from the chaos of real life.
Fish's former coach and 55-time ATP doubles champion, Mark Knowles, remembers Fish at his worst.
"Forget tennis, it was about finding the joy in each day and being able to get through it without the anxiety," said Knowles, who teamed up with Fish in February to play a Challenger event in Dallas. "Mardy is a truly gifted athlete who was blindsided by [this] condition."
Fish's incessant bouts with anxiety attacks made him question his sanity.
"Am I breathing OK?" he recalled. "Am I going to stop breathing? Do I need an ambulance? Did I eat too much? Drink too much?
"Your heart starts racing to the point where you think it's going to stop."
Simple things, such as going to the movies with his wife, required summoning his courage, but Fish had to establish strict parameters simply to feel comfortable.
"We had to go during the day and we had to sit next to the door," Fish said. "And I told her if I'm not feeling well we have to leave. I had to have a Xanax in my pocket just in case something happened."
Fish doesn't recall which movie it was, but he mercifully managed to sit through the entire showing.
A minor moment for most of us; at the time, a massive win for Fish.
The slow road to recovery
Fish didn't pick up a racket for nine months after his Winston-Salem withdrawal. The idea of resuming the sport he had flourished in for his entire life seemed foreign.
But he also admitted he kept close tabs on the game and aspired to one day be back on the court, his longtime sanctuary. Ultimately, though, Fish found refuge elsewhere.
"I played as many golf tournaments as I could," Fish said. "I killed time by playing and practicing. It's something I love to do; it's fun and I was good at it."
Fish shot in the sub-70s on occasion and for some time envisaged a professional career on the greens but was drawn back to tennis, which he believed offered him the best chance at rehabilitation.
Slowly, Fish began to noodle around with his game again. On occasion, he'd hit with friend and 2003 US Open champion Andy Roddick, "but only to break a sweat," Fish said.
Those hitting sessions eventually parlayed into something more. As he became more comfortable on the court, Fish realized he needed to leave on his own terms; not let his career end the way it had -- under a cloud of anxiety.
"This game has given me a lot," Fish said. "I feel very blessed to play a sport for a living. But at the end, I feel the game owes me the luxury of going out when I'm ready. The way I did leave, it wasn't because I was injured. It wasn't an Achilles or an ACL or anything like that. It wasn't just a freak, random thing."
Spreading the word
The healing process has taken not just time but a good deal of learning.
It's too soon to speculate what the next few days hold for Fish, who plays fellow American Ryan Harrison third on Center Court in the first round at Indian Wells on Thursday, but Fish is optimistic.
ESPN analyst Brad Gilbert, who formerly coached Andre Agassi and Roddick, among others, believes the current landscape bodes well for Fish.
An L.A. resident, the commute to Indian Wells is short and seamless for Fish. His entire family will be there -- his 1-year-old son, Beckett, his wife, parents and his wife's parents. And, as Fish was quick to point out, his dog.
Once ranked as high as No. 7 in 2011, Fish isn't sure whether he'll return full time to a trade that requires rigorous globetrotting through various time zones without taking a breath.
"The tour can be very stressful, but it is also important to know that we all manage things differently and they can manifest themselves in many ways," Knowles said. "There are many levels of pressure that a player must endure throughout their career. As it is an individual sport, you bear most of this pressure on your own shoulders regardless of how great your support system is around you."
For now, the back-to-back Masters 1000 events at Indian Wells and Miami are enough.
"I want to get my life back, and this is the next step in doing that," Fish said. "It's educating the mental illness community and the people who have gone through anxiety or panic disorders or depression.
"These issues are overlooked in our society. It's important, very important, for me to tell people who are going through this that I am, too. And hopefully they can relate to me and see a success story."