Rosie Davies writes the latest entry in her Good Mental series on life, sanity, and how to keep it in a world which wants to steal it.
Anyone who has ever experienced either capital-A Anxiety or a more confined panic attack will be well familiar with the scenario in which you imagine yourself running out into the middle of the street and just starting shouting for help, and becoming exactly the sort of person that no-one wants to help because they are, perhaps rightly, afraid of getting sucked down into your desperate, grasping madness. (Also, if you’re anything like me then you’ve imagined yourself naked in this scenario; why do we always assume that when we go mad we’ll also take all our clothes off? I hate taking my clothes off; I live in Scotland, it’s freezing. I can’t imagine ever getting to a stage of madness where I no longer recognise that being cold is deeply unpleasant; a comforting thought.) The worst part is that, if someone did stop and say “how can I help, you big naked lunatic?” you wouldn’t have an answer because you’ve no idea what you need other than someone helping, right now, or… something. You don’t even know what the something is but you know it’s AWFUL.
You can see why this is a particularly difficult and supremely isolating situation to be in, never mind cold.
The really good news is that there are things you can do to help yourself, once you identify what’s wrong, in a What Type Of Undesirable Neurotic Freak Are You?! Buzzfeed click-bait kind of way, except instead of making you feel terrible by not conforming to any of the suggested answers and reminding you how unfamiliar your wavelength is to the majority of people, it could actually offer some kind of meaningful help.
I am a massive, massive fan of applying cold logic to hot, burning emotions – mainly because I’m determined that if we keep doing this, the world will some day work like this instead of being a big complicated mess, but also because a lot of the time it works. One of my biggest mistakes in trying to completely eradicate any anxious feelings whatsoever was seeing the whole thing as one big hideous monster and trying to batter it with the same stick over and over again without ever stopping to look at it, assess it, analyse its function and its type. You might come across each one separately, or a few mixed together, but isn’t it reassuring to know that by identifying a few factors about each one you can use a mix-and-match approach and, with a variety of sticks, kill the bastard once and for all.
For me, the myriad forms of anxiety can probably be boiled down into the following four:
The purely physical.
Mental fallout resulting from the physical.
Mental fallout because there’s something to be anxious about.
Mental fallout when there’s nothing to be anxious about.
Now, let’s calmly go through them step by step and see if there are any reassuring things that can be done about them.
1.THE PURELY PHYSICAL.
If you’re a self-help type Googler you’ll no doubt have read many a list on how to cope with anxiety, panic attacks, and so forth, and noticed one key thing: a lot of these lists are full of preventative, forward-planning type things to do. These things tend to nicely cross-section with the kind of January-specific articles you’ve no doubt been skimming recently – “how to make every minute of your life completely stress free and excellent in 5 easy steps!” – and will involve the following, with such inevitability that it’s a wonder people keep churning them out: exercise more. Eat healthily. Drink more water. Meditate. Learn mindfulness. Practice yoga. Practice gratitude. It’s become so prevalent that, to the sort of people who are seeking out these kind of please-someone-help-me life tip articles, it’s started to read like a 21st-century Trainspotting poster, with all the same feelings of “hang on a minute…” that Irvine Welsh’s brilliant brilliant soliloquy was meant to conjure.
The problem with all of these things is of course that, when you’re in the middle of a panic attack and you’ve not been doing any of them in any meaningful, sustainable way, they are absolutely no help whatsoever. You need a quick, dirty fix; the equivalent of a mental Mars Bar.
This is breathing – or, learning how to keep breathing when you feel like you can’t. This is just science – lovely, wonderful, rational science. If you have in your head “I’m going to do this scientifically-proven thing and then this panic attack will stop” then you’re pretty much on the road to not having one any more.
People experience hyperventilation in different ways – isn’t that nice. For me it is/was always the sensation that every breath I took got shorter and shorter until it felt like there wasn’t any more breath to draw on, which makes me feel panicked even writing it down because it is such an awful feeling. The problem though, strangely enough, is actually that you have too much breath – or too much oxygen, and not enough carbon dioxide, to be specific. To be able to use the oxygen you’re taking in, you also need carbon dioxide, but this way of breathing isn’t letting the breath stay in your body long enough for the carbon dioxide to be able to do its thing, So, you need to get in some more carbon dioxide to be able to use the oxygen. To do this you can:
hold your breath. Yes, this feels like the most counterintuitive thing ever in the moment, but if you hold your breath for as long as feels comfortable and do this a few times, you should very quickly feel like you can breathe properly again.
Close your mouth, and breathe through your nose. It is physically impossible to hyperventilate when breathing through your nose; you just can’t get enough air in that way, and as we have discovered, too much air is what’s making you freak out.
MENTAL FALLOUT AS A RESULT OF THE PHYSICAL STUFF.
As much as a list of scientifically-backed facts can be as soothing as a prayer to the rationally-minded, science lacks consolation. There can be a depressing element of anti-climax to the controlled tick-box process of calming yourself down from such a heightened experience. It smacks of badly-designed NHS leaflets you find in the doctor’s waiting room – their cacophony of fonts and weird stock images of multicoloured people smiling with needles sticking out of their veins are practical, but cold. And isn’t this an absolute bastard to realise; that even when you’ve calmed down, you’re still not satisfied. This is, I suppose, why anxiety and depression are so interlinked – many Sufferers say that when they’re not in a heightened state of anxiety, they invariably plummet the other way. (As Ronan Keating once sang, in his insufferable noughties pop hit Rollercoaster, “life is a rollercoaster just gotta ride it”. And people say that pop music is vacuous! With insight like this, maybe he suffers, too.)
No, the mental fallout from having a panic attack, or a long period of intense Anxiety, is just as bad and yet frustratingly not featured on the bullet point lists, probably for the simple reason that it’s harder to reason with because it involves the sort of genuine fear and self-loathing that makes shutting the curtains and drinking a bottle of wine with a 2-4-1-4-1 Pizza Hut deal a far more attractive and immediately soothing prospect than trying to do yoga or drinking tea that tastes like someone’s urinated in a bowl of grass.
The point here is that if you’re feeling permanently anxious because you’re waiting to have another panic attack, or waiting for some event or situation to be ruined by your anxiety, is that this is deal-able with simply because the physical symptoms are deal-able with. So, the thing you’re constantly dreading is something that has practical, proven steps to overcome in the moment. Yes, it’s not like it’s really easy or pleasant to have to deal with these feelings in the moment, but it does reduce it to something physical, like a headache. I suffer from headaches a lot, but I don’t dread them in the same way as a panic attack because I know I can take painkillers.
Great! Sorted!
… But of course it’s not, because this is all lovely and simple and allegorical, and involves you having the strength and resources to overcome something with your mind alone. I’ve already expressed my loud angry thoughts on the subset of people who don’t understand mental health problems because they don’t get when you can’t just not be like that (“Have you tried not being depressed? Works for me!”)
However: this is where the boring list of boring things comes in. If you haven’t tried adding green things to your diet (and a decent amount, not a chewy sliver of iceberg in your Tuna Crunch) then you don’t know if the problem is actually just physical – just another bog-standard case of faulty, or at least mismatched, chemical reactions happening in your brain. In which case, oh my god, fucking brilliant, you really can just tackle this with science. My problem with the boring lists has always been that, like the token strip of lettuce in your Greggs meal deal, it just feels so limp, vague and improbable. Human beings – or at least the ones you like to hang out with, who don’t get up at 6am in order to achieve things (not normal) or are motivated by long-term goals (because only psychopaths could be, quite frankly) – like quick fixes because they are immediately satisfying. See the self-soothing wine-and-pizza model, above, for reference. We also like guarantees. Imagine spending a year of your life trying to master the downwards dog and drinking vile tea (“now with extra hints of urine-sodden grass!”) only to find that you feel as awful as you did when you began? It all seems too chancey and speculative when all you really want’s a fix-all pill to take on January 1st.
But it’s not just conjecture, it’s actual science – behind each monk-like activity is a physical and/or chemical explanation of why this will stop your mind – and, in turn, your body – doing the anxious things. Maybe you’re one step ahead of me in already knowing this, which seems likely as it’s really quite obvious and I’m constantly having mini-epiphanies that turn out to be well-known truths (“being cold is unpleasant!” “Russia is a large country!”). Or, maybe you have the cleanness of mind to be motivated by long-term goals. Well, my mind is filthy and broken so, for me, the only way to make sure that I actually do a few of the healthy things is knowing that there is an actual physiological reaction because of it.
Of course, some will still seem unpalatable, which means that a far more useful way of seeing the boring list of boring things is by reminding yourself that you don’t have to use it as an 100% guide on how to live your life and that, actually, there are a few more less boring things which can have the same effect as kale (kind of – mind that none of this rambling is scientifically proven but experience-driven). On the list of things which will actually change your brain chemistry to feel better and less freaked out are:
Seeing a really good friend who is sound and who gets you and doesn’t just look embarrassed and awkward when you say odd things; walking from one place to another place, which has the same mind-benefits as going for a run (and isn’t it just great when you find out that you don’t have to take the maximum effort approach to something); having some green things alongside the food you enjoy; drinking more water in between glasses of wine, preferably drunk in the company of the really good friend.
MENTAL FALLOUT BECAUSE THERE’S SOMETHING TO BE ANXIOUS ABOUT.
If you’re aware of the nature of your faulty, overactive, confused brain, it’s easy to fall into the trap of acting like Anxiety is some sort of private-members club (albeit the kind that no-one wants to be invited to join). Please do not confuse me for one second for saying that awful thing about people enjoying having something wrong with them – absolutely no-one could enjoy proper Anxiety and would give anything not to have it. I just mean, sometimes it’s quite nice to have a mental budget code to assign things to and feel a bit misunderstood and sorry for yourself. Like a teenager. And as with not being a teenager any more and looking back and thinking “oh lord, what an absolute whining, self-absorbed little prick I was for 9 years of my life”, once you have come out of the depths of Anxiety it’s easier to see how self-absorbed it can make you. Again, not in the “people with depression are selfish” way (don’t get me started), but in the way that you do come to assume that normal people simply do not experience any feelings of anxiousness.
I have on many occasions not particularly believed someone with a more cheerful disposition when they say they’re worried about something because I couldn’t imagine them worrying like I worried. But why?! As previously mentioned, it’s not necessarily written all over your face like you think it is when you’re churning inside about something; no, you’ve been sitting there in front of them, in the office, in the pub, wherever, acting like you’re absolutely fine and probably convincing everyone.
The fact is that, in life, there are sometimes things to feel anxious about and it is completely and utterly normal to feel upset, worried or scared about something, either practical or emotional. Whilst this is one of the worst things you can remind someone with Anxiety, because when you’re in the depths of it this realisation makes you want to end it all, the reason I am stating it so blithely is because there is a positive flipside: we all have to deal with it. There are, therefore, normal and understood and comforting methods of dealing with it until the anxiety-inducing situation passes (which it will. All things pass. And having an actual thing to worry about means you can envisage a singular, practical end point).
I know this doesn’t help with the practical situation – worrying about paying your rent, or thinking your boyfriend’s cheating on you, or having to face a job interview, or contemplating the fact that the people you love will at some point die (is this an age thing?) or deliberating whether it’s normal to have so much fucking body hair and whether if you died it would keep on growing and they wouldn’t even be able to identify the corpse – but it does help with being able to mentally compartmentalise your feelings as an expected reaction. Situation X = Feeling Y. This means that you can (a) talk about Situation X with other people without that look of awful embarrassed distaste edging into their expression, and (b) know that the world has a framework in place to offer help and sympathy towards the categorisable situations and feelings you are experiencing.
Which leads neatly on to…
MENTAL FALLOUT WHEN THERE IS NOTHING TO BE ANXIOUS ABOUT.
Aka, the absolute worst.
I think this can best be described as a changing response to the Friends theme tune. You know that way that when you were young, you’d listen to it on repeat and go into a weird fantasy over exciting sounding words like love life and job and broke and imagine yourself living in an apartment with your friends and getting upset over things like being fired from your waitressing job and not being able to meet the right guy despite being really attractive and wearing effortlessly great outfits all the time.
Well. When you’re older and your life in no way resembles this you realise that this jaunty pop song, with all its promises of people being there for you, has all the comforts of washing yourself with a Brillo pad – which is a more realistic vision of your adult life because you’re so hungover you mistook it for a flannel and you’ve left yourself eight minutes between waking up and leaving the house for work so there’s no chance you’re going to be turning up looking like Rachel, a fact also scuppered by the reality of what your face and body look like under artificial strip-lighting (why do we always imagine we’re going to emerge, swan-like, from our teenage years despite the unlikeliness of the inbuilt genetic contours of our faces and bodies changing?)
The basic premise of the Friends theme tune is: when Conventional Life Situation X occurs, it will be OK because you will have moral support and, if that fails, a great haircut. The problem with this is of course that it’s so neat, and the whole problem with the kind of free-floating fear and dread that can affect you with Anxiety is that it lacks any definition. It’s easy to be there for someone, or to be comforted by someone, when “your love life’s DOA” because they can say all the right things. It’s not so easy to feel like this when there’s nothing that anyone can say because there’s nothing that you can define. If we’re going to apply the equation in (3), it would be something more like X = Feeling Y and we’re all trying to define X.
This is, admittedly, the part where I have to apologise to anyone who has been skim-reading all of the above thinking “yes, yes, kale, whatever… what about that one where your life’s actually fairly fine but you still feel like you’re permanently waiting for a horrible surprise and every situation in life, big or small, gets you in a mental tangle SOMEBODY HELLLLLP PLEASE” because ultimately, really, I don’t think there is a good answer or solution to this. I know, what a misleading piece of crap article this is!!! I’m genuinely sorry.
Except; well, see (3). I think what actually saved me from jumping off a bridge just to stop having these thoughts was realising that other people had been there. We just don’t talk about it as much. Part of the condition is that you feel utterly alone and like it will never end, but the biggest consolation of all comes from knowing that other people have and do experience these thoughts, and that they have passed in the exact same way that they appeared (weirdly, even though we have experienced both states of Being Anxious and Not Being Anxious, we can never quite imagine the despairing cruelties or calm joys of the other state when we’re not in it).
The practical manifestations of this are conversation and art. And I don’t mean art in a wanky way: I mean music, books, comics, good TV. Anything that has been created by a person because they have felt something and needed to express that to other human beings. Despite having been obsessed with music and books from an early age, it was only actually after going through a particularly painful break-up in later life that I realised, with a kind of sudden “oh my god” type realisation, that the lyrics to some songs could offer genuine, real, useful consolation and help (weirdly enough, it was in Poundland, buying an assortment of cheap out-of-date confectionery, as this song was coming in over the Tannoy. I mean, come on! They really shouldn’t play this in Poundland).
The same goes for that free-floating feeling of dread and fear. Musicians and writers and filmmakers have been there and have consolidated those feelings in objects that can help you feel less alone. I find it helpful to have a list of music/books/TV on hand for both anxiety-inducing practical and emotional problems. To know that there are people who have and still do experience the same things is wonderful, in a selfish kind of way. Use it! That’s what it’s there for.
As for conversation… This is, really, our way of creating art out of the simple act of speaking. Now that DOES sound wanky, but bear with me: you don’t have to be a mad artist to be able to console yourself through the simple act of expressing something to another human being. That action, of putting something into the universe that was once previously only in your head, has a therapeutic value that is too easy to ignore or doubt when you feel like nothing will help.
Use it! That’s what it’s there for.
[Rosie Davies]
Read the rest of Rosie’s Good Mental columns here.