It’s 3am in late November 2017 and I’m lying awake in my little bedroom in my parents’ house. I’m a week away from my 33rd birthday, and I’ve been living with Mum and Dad again for two years. On this particular night, the deafening silence is oppressive, like a weight closing in around my head, attempting to crush me. The heating has been off for four hours and there’s an icy chill in the air – or at least it feels like there is. It’s a scary place to be. There might be two other people in the house, but it feels as if they’re an entire universe away at this moment in time.
I pick up the phone and dial 111. If you’re not familiar with 111, it’s basically a way for people in Britain to dial 999 without dialling 999 (if you’re not familiar with 999, it’s basically a common-sense version of 911). It’s a hypochondriac’s dream. A way to call 999 without actually calling it and clogging up the real emergency line so people having actual heart attacks (as opposed to the imagined kind) face an increased risk of, well, death. Medical advice on tap, 24/7. You’re never more than a phone call away from being told you need to see a doctor because nobody can possibly diagnose you over the phone. Superb.
Fast forward to 6am and I’m leaving the house. The weather is a good metaphor for my state of mind – angry, wintry gusts, and spasms of sideways hail. I’m headed for the train station on my way to see the only available out-of-hours GP I can find. Without a car, all I can do is get the train to Southport and then walk a (mentally) agonising half an hour to what I hope will be salvation. I should know by now that salvation isn’t doled out in ten-minute appointments. To cut a long story as short as I can do, I’m told I probably don’t have Multiple Sclerosis or Motor Neurone Disease or any of the other terrifying diseases I’m convinced have befallen me, handed a prescription for some diazepam, and told not to worry. Some chance!
Before I developed this obsession with my own mortality (because that’s what health anxiety really is), I used to think of hypochondria in clichéd terms to do with “attention seeking” and “irrationality”. Hypochondriacs were people with nothing better to do and were just desperate to be noticed. If that doesn’t sound very empathetic, think of how hypochondriacs are depicted on TV. Here’s a hint – it’s never kind. I remember the Harvey Corman character in hospital-based sitcom Scrubs, who used to frequent Sacred Heart convinced of his imminent demise at the hands of all manner of outlandish diagnoses, including, at one point, kuru, a degenerative brain disease not seen outside of tribal Papua New Guinea. His repeated visits and baffling worries illicit mockery and eye-rolling incredulity from those obliged to treat him. Reassuringly, during a medical exam ordered by the taciturn Dr. Cox in an effort to scare poor Mr. Corman off, he is eventually diagnosed with a very rare form of cancer. Even hypochondriacs get unlucky sometimes. I forget what became of him after that.
The truth about hypochondriacal breakdowns is that they are about far more than wanting attention. The all-consuming fear of imminent doom – the certainty that imminent doom is coming – is a huge distraction from thoughts about whether or not people care enough about you or not. In fact, if it were possible, you’d probably accept a bargain in which people stopped caring about you, if it meant you could feel well again. To put it simply, hypochondria – health anxiety if you prefer – is hell. It’s a spiral of torment and despair and, in my case, MRI scans and endoscopies, in which each symptom triggers more worry, which triggers more symptoms, which trigger more worries, until you can’t see a way out.
I guess you could say I’m a lucky guy. I have parents prepared to put me up and look after me almost as if I were a child again in my early thirties. I’m sure they felt powerless to help, but I’m much better now, which suggests otherwise. I got better the way countless people get better from anxiety and panic – therapy, medication, patience, and time. I still experience similar thought patterns, but I’m in control of it now. I’ve found some degree of comfort and happiness again. In many ways, my relapse followed a similar pattern to my previous anxious collapse – panic attacks, fear of death, worsening physical symptoms, medication initially making things even worse, therapy, a small chink of light, room to breathe, some semblance of normality, recovery. Perhaps it will happen again, perhaps it won’t. Who knows? I’m not going to worry about that right now.
In a previous post, I rationalised that there was no shame in anxiety disorders because they are illnesses that we don’t choose and we can’t fully control. I absolutely stick to the view that there should be no shame or stigma attached. However, when thinking about my own experiences, I wonder if the notion of anxiety as an illness is insufficient. I am not expert enough to say one way or another what anxiety is. At the end of the day, the mind is a part of the body, and if a part of the body begins to function in a way that leads to suffering, that’s illness, isn’t it? Anxiety has severely limited the last two years of my life. In fact, it’s caused me suffering ever since I was a child. And brain scans show that anxious people tend to have larger amygdalae – the amygdala being the fear-processing centre in the brain. It’s also been shown that there are weaker connections between the amygdalae and the part of the brain responsible for rationalising our instinctual thoughts and feelings. So it must be a mental illness, right?
Well, yes, I accept that it must be. However, when I think of my own experiences with anxiety, I sometimes struggle to see it – and to feel it – as an illness. To me, it feels like a natural part of who I am – a consequence of genetics and environment that mean that this is one way my personality manifests itself. Yeah, I might have an enlarged amygdala, but does that mean having a brain difference means having a mental illness? I do sometimes feel that anxiety – a feeling and an emotion that everybody experiences to some degree or another – is not like schizophrenia or bipolar disorder or depression, where there is so obviously something chemically and neurologically wrong.
If you’re reading this and feel that I’m devaluing anxiety as an illness or as a source of suffering, please know that that is not my intention. I am not a psychiatrist or a psychologist or a neurologist. If thinking of anxiety as an illness helps you, then stick with that belief. You’re probably right. And rest assured that I know only too well what it is to suffer with these debilitiating feelings. I’ve felt so overwhelmed with fear that just getting off the bed feels herculean. Some days, the idea of taking a shower is akin to wading across a lake filled with treacle. Mental energy and physical energy – can they really be prised apart?
Almost a year on from that horrible episode (trust me, I’ve only skimmed the surface here), I’m back on my feet, back in work and doing my best to function like a normal human being (whatever that means). I live in Belfast again, which is a place that seems to be good for me and the hamster-wheel that is my brain. My parents can breathe a sigh of relief that, for now at least, their 33-year-old son has found something to enjoy and be happy about and isn’t running back and forth to the hospital looking for the magic words that never come. I have good and bad days. Sometimes the bad days are still quite bad. But they aren’t torture. They’re something to be gotten through by focusing on work or breathing the fresh Irish air or listening to the rain or eating a giant cheeseburger. Things are looking up. And they will for you, as long as you remember to breathe.