Ten things I know about panic attacks...

This is you, trying to navigate the modern world with an ancient monkey brain. You're afraid of lions but there are no lions any more, so you're a bit confused, gawd bless you. 

An attractive young woman ran out of one of my events yesterday, after having what turned out to be a panic attack. She is, as so many panic sufferers are,  a highly intelligent, capable, and likeable person, and we chatted about the panic demons for a bit whilst she calmed down. She's not yet read an awful lot about this stuff, so I got to thinking about what I would like to have read when I first started getting to grips with it. Results below...   

Ten Things I Know About Panic Attacks 

1. Brilliant people have them. Oh yes. Some of the most beautiful, talented, courageous, hilarious, intelligent people who have ever stalked this earth have had panic. You're not weird, I promise. (Well, you may be a bit odd of course, but that's got nowt to do with the panic I'm afraid).

2.  They're not your fault! You've got to stop blaming yourself, and I'll give you three good reasons why...

      a) You're part-man/part-monkey (interestingly, or not, that is also the name of this not very good  Bruce Springsteen song). You're negotiating a modern landscape with an ancient ape-ish brain that is hard-wired to respond to the fight-or-flight mechanism. We are the descendants of some pretty alert and anxious chimps - the ones who heard a rustle in the bushes and thought 'it could be a lion, but then again, what are the chances, maybe it's just a stiff breeze?' all got eaten. We got the neurotic genes - tough break.

       b) Something in your past might have made this more likely. You may have had an unstable childhood, or been the victim of some trauma, or had a hypochondriac Dad. It's no-one else's fault either, but remember that outside forces have moulded you and made you the person you are today.

      c) You may just have a rubbish brain. Some people don't produce enough thyroid hormone (moi, for example), and some people don't retain enough serotonin. That's it. You didn't make it happen did you? Take it up with God when you next bump into him.

You've got to be easy on yourself. It's shit enough going through all this crap without the meta level of self-flagellation on top.

3. They go. And come back. And go again. If there's one thing I've learned I've from my boyfriend, it's how a wiggly line on a graph goes. His wise counsel is that a general upward trend on a graph is rarely straight - there are ups and downs and ups again. Whilst the downs may be lower than yesterday's ups, they're still higher than the downs a year ago - BUT - that's really hard to see from your perspective, seeing as how you're trapped in the graph.  

4. CBT really helps. My free NHS CBT course was hands-down the best thing I ever did for my panic attacks. 

5. You're not going to die. Or go mad. I PROMISE. Your heart races much faster than this when you're running (and that's considered good for you), and your breathing will not stop (your body won't allow that to happen), and will return to normal in a little while. I PROMISE. No-one has ever died of a panic attack, and no-one ever will.

6. Wishing them away makes them worse. Both in the instant they're coming, and just generally. The most suffering I ever experience is when I get furious and rail against them like a trussed up tiger, and my thrashing and rejecting ends up just tightening the knots around me. Some people get wonky noses, some people get IBS, some people get cancer, some people get panic attacks. You might have them for life, or they may go at some point. But you have to accept them for now, or you'll increase your misery exponentially. 

7. They're not all bad. All of this hardship has actually brought me a lot closer to both of my parents, and I've learned (well, am still learning) to be okay with being vulnerable. Which I've been told makes me even more likeable! Keep in mind that you're picking up some pretty good life skills here in the crucible, so you are in no way wasting your time or effort.  

8. They're funny. Learn to see the funny side of anxiety and panic (and there IS a funny side). Learn to laugh at fear rather than cowering from it, and by doing so - puncture its menace and remove its power.

9. You can cope. A large part of anxiety is fear of not being able to cope, to deal, to handle. But you have coped your whole life - all the way up until this very minute. Why would you stop now? You have the strength to cope with this, and anything else life throws your way. 

10. All of the above are really difficult to put into practise. And that's okay. As my exceptionally wise and beautiful friend told me - this is a process, it's not a solution. You may forget half this stuff, and not be able to put the other half into practise, but you're trying, and you're learning stuff all the time. Just accept that you're taking baby steps - this is not a race. 


Hey, new girl - you're doing just fine! Everything's going to be okay. It really is. 

x 

You gotta roll with the punches of outrageous fortune (as I believe Shakespeare once said...)

  

YOU ARE BRAVER THAN JOHN WAYNE!

Yep, he may have been a big old lily-livered-lefty-hater, but I'm afraid (see what I did there) John knows his onions when it comes to cojones...if that's not a mixed metaphor too far

I was having tea (peppermint, natch) with an old work colleague of mine who also has serious GAD issues (which, incidentally, I only found out about because I 'outed' myself to him on a whim, and he shocked me to the core by revealing he TOO suffered horribly with it), and is going through a bit of a bad patch at the moment. As we swapped war stories in the meditation centre cafe (ha, natch again), he shook his head and said my advice was all well and good, but that I was much braver than him, so he wasn't sure he could take it.

And this was enough to pierce through my panicked haze and make me forget my trembling hands on my teacup (still staggering up the Prozac ramp) momentarily, and I proceeded to give him a very stern lecture about bravery - the gist of which I will outline now, but in a much more lucid and Cicero-ish manner than I managed at the time.

No. NO! Listen up, Woody! You think you're a coward because you can't do things other people do without batting an eyelid? Think about it. The very concept or definition of bravery entails fear - it doesn't make any sense at all without it. As some bright spark once said, 'bravery is not the absence of fear, it is the mastery of fear' (or somesuch) or as John Wayne had it - 'bravery is being scared to death, but saddling up anyway'. Let's be clear: there's nothing remotely brave in not being frightened at all.  Courage is peering into the jaws of the beast - whether imaginary or real - and walking forward anyway.

Consider the person who travels in to work on the tube of a Monday morning, blissfully chomping through a pain au chocolat and listening to a comedy podcast. Would you call them brave? Or courageous? Of course not; it doesn't make sense to, because they are not afraid. They may be easygoing, or relaxed, or happy, or peaceful, or any number of things. What they are not, is brave.

Contrast that with the person with panic disorder, who arrives at work at the same time as person A, and says 'hi' to them at the coffee machine. This person set out for work maybe half an hour before person A, and was pacing the house a full three hours before that. This person woke up terrified after a few hours sleep, and was so full of fear and dread they were sick before breakfast. This person cried before leaving the house, because they were so petrified of getting on the tube and of what the day would bring. This person walked to the tube anyway. This person got on the tube, had a panic attack, believed they were going to run out of air and die, and got off again a few stops along. This person took a pill, phoned a friend, cried in the corner, waited for half an hour, and got back on the tube again. And off again, and on again, until they finally made it into work to start their day.

And this person thinks they are a coward. This person berates themselves for being weak, and this person worships person A for being brave. 

This person is not a coward. What this person is, is an eedjit! This person is conquering terror and fear EVERY SINGLE DAY on top of living the life everyone else finds so hard! This person does ten rounds with a slavering hell-beast before breakfast! This person has fought more truly, genuinely courageous and brave battles than person A has had happy, hot dinners! This person needs to wake up, smell the bloody coffee, and realise they are SUPERHUMANLY, OBSCENELY BRAVE, and could by all rights wear a cape and undies on the outside by now! 

This person is you. So suck it up, SuperYou, and stop calling yourself a coward. Or I'll come round there and knock some sense into you. And you don't want that, because I've fought the kind of demons that would make Buffy drop her stake, wet herself, and run home crying to Giles.

'Just got to quickly wrestle these before work, won't be a sec....'

           

Prozac nation (is not my favourite nation)...

'YES! Yes I am!'

 

Greetings from a small, Viv-shaped Prozac nation!

My six months without antidepressants have been fairly hellish, so I finally surrendered and went to see my almost-hot psychiatrist who recommended a trial of Prozac. Cue much grinding of teeth and general nervousness. 'Me? On Prozac? Sounds so 'Girl Interrupted'! Why can't my brain do it itself goddamnit?! Why can't I just RELAXXX??!!' etc etc. Although pills aren't for everyone, there's no doubt that medication has provided a lifeline for millions of people around the world (myself included), and sometimes you've got to come to terms with needing a little help. See this article for a really clear-headed and inspiring take on an often maligned and misjudged thing.

I've been taking them for a week now, and...guess what?! They've made everything much, much worse! You've got to laugh - it is quite funny. Apparently they can do that (i.e. make you feel like you want to jump out of your skin for the first couple of weeks) before they make you better. If they make you better. 

I'm so bloody anxious, I could gnaw off my arm. I've been teetering on panic a number of times a day, and just feel jittery and speedy. I had two days of really bad nausea, which has now improved to simply not fancying eating anything apart from beige food. With cheese on top.

I'm persevering, because apparently I could exit the tunnel into bright daylight any day now. Please hurry up that day!

I have to remember that:

1. This will pass.

2. Sometimes the darkest night is just before the dawn.

3. Whatever happens, I can and will cope.

4. This will pass (again).

It's been a long old time in the tunnel, and I really just want to feel a bit better soon.

Whilst I'm waiting, I am consuming approximate 1kg of Rich Tea biscuits daily, laughing at the brilliant Twenty-Twelve spoof documentary, having loads of hugs, trudging into work in the snow, and crying into my decaf tea.

See? There are always bits of sunshine, even when things are shitty. 

'It'll wash your blues away! Or make you feel so anxious you feel like you can't breathe! Yay!'

Let's hope it's a good one, without any fear...

"'We all want some figgy pudding' my arse..."

Guys! It's 2013! I've been lounging around, stuffing my face with Quality Street and sweaty cheeses (thank you Mr Gallbladder-Surgeon-Who-Gave-Me-Cake-And-Thus-My-Life-Back) and I have utterly failed in my blogging duties. So my last maudlin post has been languishing there, completely unrevised and depressing - not a good way to see in the new year! Sorry chaps!

How are you, beloved anxious peeps? Did you have banging festive frolics or big fat, figgy funks? Did you fend off Uncle Bill's crushing chest-to-breast hugs and Nana's racist outbursts? Did you panic over the possibility of undercooked-turkey poisonings and salmonella eggnog manslaughters? Did you fear you and your loved ones would die in the inevitable gnarly Christmas motorway deaths, because I know I certainly did!

Here are some things I learned over Christmas:

1. Kids are a good distraction from anxious self-obsession. I always thought having children would tip me over the edge into full-throttle nervous breakdown, but my niece-wrangling efforts this Christmas actually cheered me up (admittedly I disappeared swiftly every time one of them vomited/had explosive diarrhoea, so it wasn't an authentic parenting experience. But still...)

2. Stila's new liquid lipstick in 'Beso' (thanks, Santa) is a stunningly good matte 40's red. And it lasts (i.e. stood up to my rigorous, virtually lab-condition Christmas lunch testing).  If you're starring in an upcoming WWII biopic as a beautiful, ball-breaking SOE agent, this is the one I heartily recommend.

3. Shalom Auslander's memoir Foreskin's Lament  is a superb, brilliant, amazing, fanspectaculastic must-read for all anxious folk everywhere. The man is hugely traumatised as a result of his deeply misguided (and at times, abusive) Orthodox Jewish upbringing - and yet I related to every single, fucked-up, neurotic thought he puts to paper. BUY IT NOW. Makes Woody Allen look positively stable. And read his novel Hope - both books are the funniest things I've read all year. 

4. Don't play bingo if you're feeling a bit panicky. I lost my bingo virginity this Christmas (I know, I know, I'm prematurely aged) and almost had a heart-attack as a result. How the pensioners manage to not fall down dead in high-blood-pressured droves I have no idea. 21, 6, 14, 90...WAAAIT, ARGGGHHHHH! I went in a sort of smugly ironic, post-modern way, and ended up knee deep in screwed up tables of numbers and panting with genuine excitement. BINGO!  A v. good use for excess adrenaline.

5. We all now have an extra year's worth of intel about living with this malicious anxiety beast, so theoretically should be another 365 days cleverer at dealing with it. Go team! I've been thinking of my anxiety as a Boggart recently (HP again - please don't watch the films, they're bloody awful) - it changes shape and morphs so frequently (health anxiety to status anxiety to random phobia to depression anxiety and back again), but is the same old beast cowering underneath. It's the old Wizard of Oz behind the curtain trick - watch it and call it out!

I hope you all are feeling well and not too stressed about what 2013 holds. How about we make it the year we level a well-aimed kick at Mr Anxiety's cojones and get a bit of the upper hand back? And if we miss, let's just have some cake and gin and chat about it together. 

Happy new year!

V x

PS. You can't make me take the tree down.  How will I survive without its Prozac-y twinkly lights? Superstition is only magical thinking after all, and didn't my therapist say that was a no-no...?

Take Valium. I swear to God it's the only way you'll survive the night.

In which Viv goes a bit emo...

Can't even think of a funny caption :(

WARNING: Rambling, depressing post ahead which includes absolutely no handy tips on how to deal with anxiety! Thank the sweet lord this is anonymous...

So, at the moment, something slightly odd is happening to me, and I can't really figure it out - or, I can, but I don't really want to face the conclusions. I'm quite embarrassed about what I'm about to say, and feel like I'm letting the side down revealing this, but at the same time I'm hoping being honest may help you - and me - in the long run! Here goes.

I feel like my anxiety is shifting and changing shape - I 'fix' one thing (obsessive thoughts about panic and travel and health and dying etc) and it simply morphs into another mind-consuming obsession, which at the moment seems to be pure, unadulterated self-hatred and self-bullying (god knows what the right name for this is). I've never had this one to such an extent before, so I don't know if I'm just getting horribly depressed and need to go back on medication (this is the scary conclusion I don't want to accept), or if this is just bog-standard anxiety posing in a different costume. Maybe you can help me figure it out!

Apart from a general, base-level fear that I'm completely messing up my life and failing on every single scale and by every single measure, I'm starting to angrily analyse all of my actions - even on an infinitesimal scale. I'm comparing myself to everyone - people I know, people on TV, people I see on the train - and feeling like I am disgracefully inferior. I feel I'm horribly ugly and shouldn't be seen (and that I'm wasting my only moments of potential 'beauty' thinking that as I'll only get less and less attractive from here), that I'm not as intelligent as I thought I was, that I am awkward and pathetic, that I'm unadventurous and dull, that I'm friendless and like poison to be around, that I'm terrible at my job, and on top of all of that - that I'm wasting every single precious second of my one-and-only life with these thoughts.

I'm gazing at women I know, hungrily, wishing I was more like them. I feel bad for people who have to talk to me, even for a short while.  I'm beginning to follow myself around, mocking myself, saying 'oh, great, that was brilliant. Look at you walking like that, look at you, so pathetic and useless. Yeah, just slink over there and hide, that's so like you' etc etc. (For a brilliant take on this evil, bullying self-commentary see this amazing, wondrous cartoon about depression). 

And I'm FURIOUS with myself about all of it! I'm turning into someone I really don't like, and I'm working myself up into a frenzy of hatred and anger and disappointment and venom and I just don't know how to fix any of it.

I thought we were meant to get more confident as we grew up! I'm almost thirty, and I'm now comparing myself with a confident 11 year-old I know and am wishing I could be more like her in every single way. I feel like I'm gradually losing my certainty and sense of self with every day. I used to be a screamingly, proudly self-confident A-type personality (debating and public speaking champion, A + student, sports-mad, head girl, popular etc - just generally precociously over-the-top and certain), and now I'm slipping into EMO self-loathing just when I'm meant to be feeling my maximum levels of self-assuredness!

What's happening?! Is this anxiety, or depression, or am I just losing my marbles?! Please help me get my mojo back...

V x

Wrap up your anxiety and walk away...

'NO-ONE SHOULD SEE THEIR OWN LIVER!!!'

Well, the entire global anxiety community can finally lift their ragged nails from between their teeth and heave a sigh of almost-relief - I'm back! 

Sorry for radio silence - have been desperately catching up on work and life after my convalescence, and mainly recovering from the shock of seeing my own gnarly internal organs in Kodachrome technicolour.  My surgeon insisted on proudly showing me evidence of how he managed to laboriously pick my diseased gallbladder off my liver. 'See the swelling and adhesions here? All terribly sticky and difficult. Here's where I cauterized the liver to stop the bleeding after I pulled the gallbladder off'' (me, inwardly, raging:  'WHAAAT? You seared my f-ing liver you f-ing maniac?! Is one of my internal organs now medium rare?') Outwardly, eyes wide and ingenue-ish: 'Hmmm, fascinating, how intriguing to see the mark it makes!''

And it kept on coming. 'And here's me avoiding the artery there' (inwardly: 'WHAAAAT?! There was an f-ing artery nearby?  You want me to congratulate you for missing it, Sweeney Todd?') Outwardly: 'Marvellous, just thrilling, gosh, thanks, how skilled you must be!' etc etc ad infinitum. Surgeons, note, anxious patients do not relish hearing or seeing such lurid details of their near-deaths and battered remains. Patients, note, no-one should have to see their own liver. You may have to book a 6-week course of counselling to get over seeing INSIDE your own skin, so poke your eyes out before a surgeon ever offers to show you a photo. 

Anyway, onwards and upwards my friends.

Today I went to my lunchtime meditation, and - double-whammy of joy, not only was my old friend Barry White on the desk (sadly not leading the meditation) but I also think I'm vaguely getting the hang of it again. 

There's a long, tree-lined driveway leading up to the meditation centre, and we were instructed to visualise leaving all our worries, fears and plaguing thoughts in little parcels under the trees before we came in, and we could pick them back up when we left.  For some reason this really cracked me up - I imagined parcelling up all these weird little phobias and obsessions in shiny paper, labelling them, and placing them under the trees like presents, saying 'aah, Fear of Death and Disease! This one's a good one, worked quite hard on this on, very proud of the size of this one', and 'ah! My old friend You Have No Friends! I weaved you so big; you're truly magnificent!' and 'Big Box Of Vague Dread About The Future! It hurts to leave you here when we've had so many wonderful nights together!'

We were then told to try to keep our mind with our body, and not let it run off back to the parcels under the trees. And for some reason this really clicked with me. The mind is not tethered to the body, and that's an incredible, miraculous, astonishing thing - our imagination can take us anywhere in the universe. But this is really not bloody helpful if your imagination is morbid and anxious, and takes you to nightmare-ish places you don't want to go, and ends up driving you slightly round the twist.  

So I loved the idea of keeping the two together, for a while, like a couple of old lovers on a bench. For some reason I immediately visualised my mind like a red balloon tied to an old bike  (slightly odd that I visualise my body as a bike...). And it just felt really...restful, and right to finally have the two together - like when Harry and Sally finally got together for good.

And, as cheesy as it sounds, as I walked back down the wooded drive and looked at all my virtual packages of worries and dreads and neuroses and fears and prepared to collect them, I suddenly thought - 'What if I just leave them here? What if I just walk out and leave them right here?' And I strode down the drive toward my life, the sun beating down on me, and I felt light and weirdly free, and (seriously, it was like a film) a tear actually rolled down my cheek.

So, awesome readers, I think you should go for a walk somewhere wooded and hippy-ish, and put all your discrete bundles of worry and fear and anxiety and dread under the trees there. Look at them, think about how much you sat on them and brooded on them and nurtured them. Be proud of the baby horrors you've created! Think of all of them, sitting there, all knobbly and covered in bows - and just walk away.

Free!

And on the third day, she crashed (with apologies to Jesus and ELO)

No ruby slippers, no wonderful wizard; just terror and bright backlighting...

Well, talk about talking too soon. After the general 'I'm alive!' joy of days one and two, I plummeted like a burning, nervy, post-chop Icarus tangled in charred plumage and mixed metaphors. 

Wednesday morning I woke up, and suddenly all was not well. I felt anxious - really, really anxious -  I didn't want the operation to have happened, and I was almost fainting with squeamishness about the wounds on my body and the notion of what had gone on internally when I was not there to see it. It reminded me of my poor childhood cat when he had an abscess on his back - he kept on twisting and turning and shivering his skin along his backbone to try and slide it off and get out from under it somehow. I wanted it all not to have happened, and I wanted to get out from under it. 

I fell into a massive, familiar pile of panic and anxiety, and took a Lorazepam to try to dull the edges, but somehow it combined with the leftover anaesthetic and took me in a horrible way - all wide-awake crazy thoughts and palpitations and trembles.

I couldn't sleep, I couldn't sit still, I couldn't breathe. I couldn't listen to my post-surgery relaxation CD because it made me want to faint, I couldn't take a Lorazepam because I was frightened of making it worse, I couldn't lie still because I was petrified of clots forming in my legs, and I felt absolute, complete, suffocating despair. I tried all the old tricks, and they didn't work. I got disassociation - my whole familiar world started looming and stretching in sinister ways, and I felt trapped in a waking nightmare. It was like a big, fat, supersized Ecstasy comedown (apologies for mature references!) but without the ecstasy (with a small or a big e). All agony, no ecstasy?

I convinced myself I had post-surgery trauma syndrome, that I had clots in my legs and internal bleeding, that I had an infection, that I was going mad, that I would have to have another surgery to fix this one and this would all happen again, and above all - that I was a colossal, self-indulgent hypochondriac who couldn't handle a routine operation like the rest of humanity. My thoughts were just completely and utterly out of control - the horse was galloping away towards the inferno and the rider was just freaking out on the sidelines with wet jodhpurs and a frayed whip. 

Needless to say, it wasn't a vintage few days. It turns out that it's not such an unusual reaction after all - apparently the body's hormonal and endocrine systems go haywire after surgery - and couple that with the general anaesthetic wearing off and some anxiety about recovery and you have a perfect recipe for panic-a-go-go. I just wish I knew that beforehand! 

It, however, remind me of a couple of panic-related things that are worth repeating:

1. Nothing REALLY works in a panic the way you want it to - because the body is specifically designed to create terror that is virtually impossible to override.  The whole point is that you're not meant to easily cognitively disassemble it - you're meant to fucking RUN. So I was reminded, at a cost, that the best thing to do is to grab on to something and hold on, and wait it out. To weather the storm and try desperately to hear the tiny, squeaky voice a mile off that stutters 'this will pass' in the face of the terrifying succubus screaming 'IT WILL NOT' in front of your face.

2. It does pass. I felt like I was in a horror film last week, and I'm calmly typing this now after a relatively happy couple of days. Yes, I'm still a bit quivery, but that always happens for a while after a storm of panic - I know I just have to wait it out until it completely passes again.

3. Anxiety and panic don't make you weak. This one is thanks to my stepmother, who came downstairs and wrapped me in a tight hug when she found me sobbing uncontrollably on my own, and told me about her experiences with panic and anxiety (she's also hard as fucking nails, and you would never, ever characterise her as weak or even approaching it) and shook me back to reality and self-respect. Everyone is flawed. Everyone has their vulnerable moments. But that's not what people remember of them, and that's not what they should remember of themselves. 

So. That's it. I think I've earned a bit of a relax at long last, so if you'll excuse me, I'm off to watch Ingrid Bergman give weird, face bruising non-kiss kisses to Cary Grant - I've got a week's worth of recovery DVDs to catch up on...

Nope, that's still not it - we can clearly see your lips aren't touching, guys...