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Sunday, 6 September 2015

You Make Me Sick: My Week of Anxiety

This week has been distorted with a weird whirl of media because of public appearances (even though they were staged, pre-recorded, pre-written etc. weeks ahead of broadcasting / publication). Media distorts things, whereas the reality is very different. Tuesday and Wednesday were bizarre, as I was tagged on Facebook appearing on the BBC without knowing anything was going to be broadcast that day, and being published in writing a light-hearted piece about anxiety.

Of course, as I should have realised, Anxiety likes to have the last word, horrid sarcastic words that sting and endure. Anxiety showed up with bells on for the rest of the last week. I’m still trying to ask it, as nicely as I can, to get the hell out of town.

So in case you read my Metro blog and thought I have only a humorous view of anxiety, that’s not true (would that I could see it from just that perspective, would that it never got any worse than the quirky behaviours I mentioned in that piece). There are many more serious things that come out of an anxiety condition. I will never stop making fun of myself for my quirky traits stemming from anxiety, but I will also take seriously the symptoms that debilitate me and that I must address if I am to have a chance at handling this condition in the longer term.

Tuesday 1st September
I smiled when I heard colleagues in the elevator already exclaiming pressure over too many activities and an overextended "to do" list for a four day week. I had been careful with my planning and thought I could handle it. Anxiety doesn't care about my good diary management, though, it prefers when I over book myself to turn up unannounced.

I suppose I am only providing it with good reason to show up at those times. It's when I've made every effort to plan my week sensibly, though, that it is most annoying to experience. And despite making fun of my experiences of anxiety in my blog for Metro this week, and my firm belief that it's good for me to be able to laugh at the silly things I do because I suffer from anxiety (and, as I've said before, my medication escitalopram happens to affect me with anxiety as a side effect. Great). I'm changing to a new type of medication - which will be the sixth anti-depressant I've tried in 15 years. Hey, at least I still have new ones to try!)

For the very reason that today - Sunday - I'm still feeling pretty anxious and ill - I've written a blog that again is fragmented, because I can't calm down or focus long enough to feel able to write something consistent. What I can do is present something that is true - the peaks and troughs (panics and peaceful moments) of how a week with anxiety has been, for me.

These all resonate for me. It's amazing how physical the body's repsonse to anxiety is.
I can understand the sense of these repsonses in a situation of real danger. But attending a social event or a meeting? These symptoms in these situations are debilitating and (literally and figuratively) painful.

Friday 4th September
Although I ate a salad for lunch today it may as well have been uncooked pastry or carelessly mixed cement, as far as my body is concerned. In my chest, among my main arteries and the networks of veins connecting my rapidly beating heart to the rest of me is a cold, glutinous congealing mass of something sticky that has got in there and won't budge. It nauseates me to the point where I push random fingers into my chest to try to find it and remove it; it won't go. I am breathing in and out slowly and deeply but still it doesn't move. It isn't digestible but makes me try to remove it through swallowing, gulping again and again without success. It isn't expiring with my outward breath. It is so constant that I hardly wonder why a couple of years ago I barely noticed it was there every day. This is one physical manifestation of what my anxiety feels like.

I times I bruise my chest by pushing at it trying
to shift what feels like a hard lump inside

I'm one of the lucky ones who isn't anxious all the time. In my past life living alone in New York in a very pressurised and stressful job, as I realised today when I felt the physical symptoms described above, and realised it had been at least three days without a let up.

This happens to me again and again, so I have
 to step in and stop it until I unravel completely

The worst time this happened was at my job interview for KPMG. I was really, really ill at the time with depression / anxiety. I have always made the effort to ignore my anxiety and go for things anyway (I suppose, that cliche "Feel the fear and do it anyway" applies perfectly to one of the ways that I operate (see below - overcompensate), It was in the very first exercise that I was presenting back to a large panel at my assessment centre when I needed to refer to the consulting firm in a 'mock client proposal pitch' that the word "Del- " (Deloitte) slipped out of my mouth in my mock-confident pitch patter. Even though the director observing said, "We'll pretend we didn't hear that", I was absolutely horrified. 

Me at my interview in reality. 

How I presented myself at interview. 
Hiding behind a suit and a smile

Every physical response - the fight or flight mechanism in its rawest form - suddenly invaded my body and overwhelmed me. I felt dreadfully sick and wanted to leave immediately, but it was only 10am and the first part of a whole-day interview. I couldn't leave. I had to stay. My brain does not work properly in a period of intense anxiety. My brain needed to work for me to get the job. Worry. Stress. Sweat. Nausea. Trying to ignore all of these and carry on through other case studies, partner interviews, even through 'lunch'. I have no idea how I got the job given how unwell I was. I did go back for a final interview another day, and at that point I was not in the primal phase of panic, thank goodness.

I now try to deploy the measures that I've learned can help of course. I do breathe deeply because at least I can reassure myself that there are genuine physical and mental benefits to this, even if it doesn't remove or lessen my anxiety: I know rationally that I'm supplying my brain with oxygen, which means that I am giving myself the best chance of being able to think and operate even though I feel physically so unwell.

I do practise mindfulness, which means I put my brain to work focusing on things other than the physical feeling of anxiety. It's a distracting technique that requires effort and a discourse with my brain where I ask it to pay attention to a single thing at my command, and politely wave or tap it in the shoulder when it drifts off to thinking about the fact that I need to send off the proposal tomorrow, that I need to go for a run, to the bank, to get the car through its MOT and buy more loo roll and answer my emails and update my time sheet and so on and on and on.

It is hard for me to practise mindfulness lying down without falling asleep- largely because if I do manage to get my mind to focus on some one thing then my brain has a chance to sense my body's total exhaustion and takes advantage of the time to shut down and rest. I have to try to sit up, and then I struggle so much to keep my mind on one thing, even for ten minutes. In anxiety I find my mind rushes here and there and everywhere but on the body scan or shape to which I'm meant to be paying attention.

Also I know mindfulness is what I should be doing, but mid-anxiety I find I often feel overwhelmed and that in adding mindfulness to my list of things to do I will cope even less well with an even longer list of expectations.

However, “I should I should I should” isn't helpful. I need to be well. I need to look after myself. I need to provide some comfort and support to myself.

Saturday 5th September
I am now sitting here on Saturday evening wishing today had been what I thought it might be: an anxiety-free day. I’m not working; I haven’t had to spend ages cleaning the house or doing other admin chores; I even went to have my hair cut (which is usually enjoyable not stressful since I see the same person each time). Unfortunately it hasn’t worked out that way, and the physical nausea of my anxiety, my shakiness, my racing thoughts, and every other symptom, are still with me to quite a significant degree.

What else do I do when I'm anxious? Panic. It is not an exaggeration to say that it affects the brain in the same way as if there were a genuine fire, an attack or another calamity.

We are programmed to respond primitively in these situations and what that means is a release of adrenaline and cortisol to the brain. This allows us to flee or fight- giving us a spur of energy and stamina for a period of time. What happens to me is that this reaction occurs when I am in a variety of situations where this is completely unhelpful. In place of the rational person who can make decisions and lead teams, organise the house sale, my career, my blog and volunteering, among other things, appears a vastly debilitated version of myself, paralysed by fear and stress to the point where rational thought is almost impossible and the ability to do anything other than flee (whether from the office or under the duvet or whatever) is massively limited.

It repeats and repeats and repeats unless I work at fighting it. 
Unfortunately if I'm already exhausted by it it feels an impossible task.

I have to soothe myself first. Breathe, rest, walk, eat, take a moment. I can’t do anything until that’s done. When it is, that’s when I can do is split things up into manageable chunks. Maybe one small thing from the to-do list. The one thing I can do. Then the next. Then the next.

Sometimes it's more like 25% calm. At that point I could potentially achieve something.
Beforehand, nothing's going to happen unless I bring my anxiety levels below 80%

I do these when the countering, healthy behaviours I know are better but which are just too bloody hard to do at times. The closest I come to helping myself when I’m really panicking is – at best - to climb into bed and shut out everything that is causing me such stress and worry.

Also, no caffeine. I have caffeine once in a while, but 
any more than once a month or so and it negatively affects my mental state

I’m trying to learn to do this in advance of anxiety reaching its full force. I know that I am prone to pushing myself so hard in many directions that anxiety can paralyse me. I have to try to plan ahead so that I’m less likely to have an anxiety attack with the above, with a balance between work, life and rest, with the right amount of exercise (not too little, not too much).  

Sunday 6th September
I made it to today. Doing the right things today were: 
  1. Going for a run and loving seeing the deer. (Exercise also helps digestion, raises my endorphin levels, uses up some of that nervous energy, and gets me out into the fresh air to breathe.) 
  2. Eating lunch with my husband. Burgers. Chips. Chat. 
  3. Having a rest: this is controversial (as sleeping during the day can disrupt sleep at night), but since I cannot catch up on tiredness at any point in the day during the week, it's a real luxury for me to be able to lie down and read, watch a film or listen to a podcast without the need to go back to my calendar and prep for the next meeting.

Bushy Park today. It was glorious, and I'm happy I made it out
 and won a small victory over my anxiety

On the other hand, the horrid lump in my chest is still there. I'm trying not to worry about it! I'm still breathing. I'm still here. Small victories, even if the war with anxiety isn't over.

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