Tag Archives: Generalised Anxiety Disorder

I’m Okay…

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.

 

Anxiety, and why you shouldn’t get into a boxing match

I know I said I wasn’t going to go on and on about anxiety, but at the end of a year which began with my mental health crisis and Generalised Anxiety Disorder diagnosis, I hope I can be forgiven for looking back and taking stock of just how far I’ve come in such a short space of time. In the months that have followed my first panic attack and subsequent hospital stay, doctor’s appointments and therapy sessions, I’ve learned a lot about the nature of anxiety, the ways it affects people, the challenges it presents, the impact it has on the lives of good people, and also about myself and the reasons why I ended up in such a mess.

There is no one single way of coping with anxiety or of recovering from a period of nervous illness, and it is certainly not the case that people, like me, who suffer with anxiety just need to allow more positivity into their lives and all will be okay. That said, I personally began to get better once I started taking steps to improve my mental health, to challenge my long-established ways of thinking, and, yes, by taking a more positive approach to life in general. I hope the next few paragraphs might prove helpful to anyone currently trapped in their own spiral of suffering, and that, if you’re not an anxiety sufferer yourself, this might illuminate what it means to have a disorder of this nature.

Firstly, I want to make one thing clear to anybody who, for whatever reason, doesn’t understand that anxiety is an illness. It is. The problem is that the term “anxiety” also applies to a perfectly natural, normal, often healthy (if usually unhelpful) human emotion. We all experience anxious feelings from time to time, whether it’s over a first date, a job interview or a medical procedure, and many other things besides. This is normal and appropriate to the situation and usually doesn’t cause any extended suffering or harm. But an anxiety disorder is a whole different ballgame. I always felt that my own diagnosis should really have been “Unspecified Relentless Terror Disorder” (but that doesn’t exist as a diagnosis.. yet). An anxiety disorder is all-consuming and the worries and fears that go with it tend to lack any grounding in rationality. Even where it may seem rational to have a particular worry or fear, those worries and fears will be totally out of proportion to the situation, or the sufferer will ruminate on them constantly and obsessively and will feel as if they are unable to handle them. The may need constant reassurance from healthcare professionals or friends and family, but this very pattern of reassurance-seeking only keeps them trapped in their deepening anxiety spiral.

There are many different diagnoses that fall under the anxiety umbrella, from Generalised Anxiety Disorder to Panic Disorder to Obsessive-Compulsive Disorder (one of the most misunderstood, having absolutely nothing to do with liking things to be tidy), and many more besides. It’s not uncommon for them to overlap. Panic attacks, for example, are a common feature of almost any anxiety disorder you can name. But the point I’m trying to make is that these are potentially serious and very real illnesses that can, at their worst, leave people bedridden and miserable.

They also come with an absolute smorgasbord of grotty physical symptoms, from lightheadedness to breathing difficulties to stomach upsets and plenty more. You can spend all day and all night with a general feeling as if you’re on the verge of collapsing and dying, as if you’re literally just waiting for it to happen. They can also lead to strange psychological sensations characterised as brain fog and depersonalisation/derealisation. These are not dangerous states, but they are incredibly frightening to the sufferer, who experiences feelings of being disconnected from their own body and from a world that seems hazy, distorted and strange. All this really means is that the anxious mind needs a break, but the strangeness and unpleasantness of the sensations causes most anxiety sufferers who experience them – including yours truly – to worry that they are losing their sanity, which only makes the symptoms worse and more entrenched.

So if you ever hear of a colleague needing time off work due to “anxiety” or perhaps a friend lets you down due to feeling too anxious to do something you had planned, please bear in mind that this person needs only the best support you can offer. They are not lazy or weak. They are ill, and they are struggling. But please also remember that this person, unable to attend work or throw themselves into social activities, doesn’t necessarily want to be alone, either. If you know someone in your life who has been diagnosed with anxiety, don’t judge them. Do your best to be there for them. Remember that, in the UK and many other countries, mental health services are woefully underfunded in comparison to physical health services. Your colleague or friend might be receiving the bare minimum of treatment and care. They might be on a months-long waiting list for therapy. You could easily be the most important thing in their life and their recovery without even realising it.

A few weeks ago, I posted an analogy in a Facebook group for anxiety sufferers, in which I attempted to explain how I believe one can best live with anxiety and begin to get better, which I’d like to repeat here. It’s a boxing analogy, so please forgive me if any of my boxing references or terminology are inaccurate. It’s not a sport I follow.

Picture yourself being confronted by an angry heavyweight boxer. Let’s go with Mike Tyson, because I can’t think of anyone else right now. For whatever reason, Tyson has taken an exception to you, and has decided to confront you. You find yourself with three possible responses:

The first response is to step into the ring with him. He’s a boxer (okay, he was a boxer) and it seems like the obvious thing to do. But there’s an obvious problem. You’re not a boxer (if you are one, please just go with me on this). You can fight and fight as hard as you like for as long as you like, but Tyson is bigger, stronger, and knows all your weaknesses. All your fighting will do is wear you out and grind you down. Tyson, meanwhile, is still standing, still tormenting you. Was it worth all the expended effort? I don’t think so.

The second option is perhaps the most obvious – try to run away. But this has something in common with the first option: it’s exhausting. While you might feel better temporarily, having escaped the thunderous uppercuts of the erratic heavyweight pugilist, you’ll still be worn out at the end of it all. And he’ll always catch up with you eventually. So this is really no option at all.

Then there’s the much less obvious third option – the one that offers you the best hope of results: realise that Tyson just wants to be friends. He isn’t going anywhere fast, so instead of inviting him into the ring or trying to run away from him, welcome him into your home. I mean, yes, it might be incredibly inconvenient. He’ll crash about and demand your attention and generally make life difficult for you. But at least you’re still living your life while Tyson’s around. You’re living even while he prepares in his room for his next bout or stomps around the building in his enormous boxing shoes (if such things exist). And then, one day, once you’ve gotten used to your new routine and have figured out how to tolerate it, you notice that you’re seeing less and less of Tyson. He’s gradually moving on and getting bored of life with you. Oh sure, he still comes home from time to time to torment you with his cacophonous ebullience, but at least you get the occasional break. And then you realise that you’re seeing even less of him. At long last, Tyson has moved out! He might call in occasionally to pick up his things and see how you’re getting on, but before long, it becomes apparent that he’s gone for good! You get your life back. Tyson is no more.”

If you can’t see what I’m getting at, Mike Tyson is anxiety, your house represents your life, the general noise and inconvenience of having Tyson for a roommate are your anxiety symptoms, and the consequences of running away or fighting him are what happens if you try to run away from anxiety or to fight it. Oh, and you… are you.

It was late January into early February when I had my breakdown. I don’t mind calling it that. That’s what it was. It came out of the blue with a massive panic attack while at work, which was a winning combination of terrifying and embarrassing. I don’t want to focus too much on what I actually experienced as I’ve covered it before and it’s history now. But I did end up in hospital and went through a spell of deep, deep fear and desperation for some kind of release from my suffering. I went through a three-day spell where I presented to A&E each evening, convinced I was developing a severe mental illness and begging the doctors to admit me to a psychiatric ward. All I came away with each time was a diagnosis of Generalised Anxiety Disorder and a handful of diazepam (Valium).

I began to get better only once I achieved some insight into what was actually wrong with me, combined with Cognitive Behavioural Therapy and an SSRI antidepressant (specifically sertraline, also known as Zoloft and Lustral, among other things). I was very lucky to get into therapy so quickly as even people deep in despair can be forced to wait six months or more before a slot becomes available. I only had to wait two weeks after referral. I built up a rapport with my therapist who helped me understand what was happening to me and taught me ways to relax, to calm my mind and to tolerate and accept the way I was feeling. His help was invaluable.

I recently returned home to live with my parents again. At 31 years of age, I could, if I wanted to, feel insecure about needing to do this. However, I feel it’s important to be honest about mental health. Anxiety is one of the most commonly-diagnosed conditions, and anyone can get it. I am not currently convinced of my ability to handle the day-to-day stresses and responsibilities of work, so moving home and focusing on my continued recovery in a caring and relaxed atmosphere (where all my meals are cooked for me by my ever-dedicated mother) is the best thing for me right now.

I’ve also picked back up my running hobby, something which I got into while in Belfast, but which fell away completely as my mental health declined and collapsed. In a very short space of time, I’ve noticed improvements in the way I feel both physically and psychologically. It’s great to have a challenge to focus on, something that draws me away from ruminating on how I feel and whether or not I’m about to die. Exercise is not an anxiety cure, but science shows that it plays a part in mental health management – and everybody, no matter how well they are, manages their mental health. I’ll be running the Liverpool Spring 10K in Sefton Park in May, which means I have something to look forward to and to devote my energy and effort towards. Am I back to full health? No, but I’m on the right road.

Thanks for reading. Please be kind to people. It’s been a shit year, hasn’t it?