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 Metro.co.uk writing a light-hearted piece about anxiety.

Metro piece - a lighter look at 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.

Talking about depression while pretty ill with it, on BBC London

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 1^st 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 4^th 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 5^th 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 6^th 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.

I Got That Summertime, Summertime Sadness: Fragments of Two Weeks of Severe Depression

This blog post is a fragmentary group of paragraphs that don't hang together. That's because I'm not 
hanging together very well. I could use a number of similes or metaphors to describe it.

Oh my God, I feel it in the air, telephone wires above, are sizzling...

I am a bag of marbles (I haven't lost them) that are clacking against each other noisily and awkwardly and painfully. I am a collection of smiles and tears and laughter and sleeping and wakefulness. I am lost. I am feeling nothing. I am feeling too much. I still am...but what I am I cannot say...

Here are some fragments. This is what I wrote last week, and below that what I wrote before.

Last week - Friday 14th August, 6:38 pm

This week was one of the worst that I've had over the last two years - nearly two years since I have been back in the UK and supposedly back to normality. It makes me sad to write that sentence, knowing that just over a year ago I came out of hospital and was filled with being rested, re-educated about the things I can do to support myself, and understanding what my 'rights' were as an individual, even if I couldn't define them for myself, and found it impossible to say what I needed at any level.

This week my husband went back to work and we gave up our enjoyable daily routine of working in our two different bedrooms/studies and 'not talking' but 'being' together in our one dwelling. I still work from home quite a bit, but have to try and find a balance between being in the office to feel connected to my colleagues and like I have a place in the world outside, and being at home so I don't have to see anyone, to feel disconnected from the world outside.

While I'm at home I stay with all of the usual trappings that entails: running (maybe, if I can get up and make myself do it), juicing, (on a good day, and if I hadn't broken my juicer like I did yesterday), making a list for the day (so that I can compartmentalise the tasks into small, manageable chunks and prevent myself from feeling overwhelmed by the entire picture by tackling one thing at a time) and then working through that list and postponing decisions on anything else until I reach the end of the day so that I can ensure that I reach the end of the day and then can do whatever I need to to feel safe, protected, and free from worry.

This week I couldn't cope. One of the things that I am most susceptible to with depression is the fact that I have developed over my entire life an inability to cope with separation from others. My subconscious (i.e. the bit of me that makes the decisions about how I'll feel about anything, which the rational me doesn't get a say in) smashes the alarm glass and sets off the sirens when I'm left alone by people who are a supportive presence in my life. Whether for this or for other reasons, I crashed back into full scale depressive symptoms:

• Waking up at 4 am without a hope of getting back to sleep because the 'On' button in my brain is stuck down permanently
• Loss of interest in doing anything other than making it through the day, in a haze of numbness where I can't feel anything
• Loss of appetite, so that even the nicest freshly-baked chocolate chip cookie might as well be cardboard going into my mouth
• Short term memory: I'm writing absolutely everything down because I can't remember what I'm saying. I frequently lose my thread mid sentence and can't get to the end of it without having to be reminded what I was saying in the first place.
• Low frustration tolerance. I cried in anger when I couldn't get the zip done up on one of my dresses. I was enraged when I dropped a plastic food box on the floor which meant I had to clean it. I felt inexplicably irritated when I realised we had run out of loo roll. 

And, for the last one, I cried and cried and cried about the fact that I was back down the rabbit hole of depression, with the medication and therapies that have been helping me to recover feeling like worthless placebos (which rationally I know they're not) and I cried because I was still alive feeling like this and there might never be an end to it.

Thursday 20^th August, 4:27pm.

I suppose I’m still alive, but …ugh what cost? At the cost of feeling absolutely crap most of the time at the moment. I hate to say that but the next thirty years don’t feel so great. Is there really any point?

I went to hospital last week and confessed I spent at least four days out of seven wanting to be dead. They worried about me and offered admission, which I didn't want, advised me to take extra sedatives, which I felt wasn't that helpful- feeling like "Let's keep her alive by making her even more numb to the world outside". That's not living in my book.

Yes, there is a point, I know, rationally, that it must be so. But I am still all of the above, numb, frustrated, short tempered, sick of it all. I might be useful at work and get through each day with projects on track and employees supported, but I come home or leave work and I feel empty. I have nothing much left for the evening except to feed myself and then sleep. I can manage to eat (although I don’t have an appetite). I can manage to talk a little with Mat (though I lose track of what I’m saying and don’t feel I have a good grip on what’s going on in the world or that I have anything interesting to say). I can perhaps write a few tweets, respond to a couple of texts, and try to stay connected to the outside world.

Unraveling and trying to keep it together at the same time

Saturday 2nd August, 07:28am

I'm up and ready in my running gear for the park run. I've carried on doing what I can through this - I've kept going to work (from home a few days and in the office some days). This is to combine the need to hide my tear-stained face from the world at times and my need to get out there and show myself to jog myself a little back into the norms of the day and try and feel something other than nothing as I do it. I've kept running every day, and although I cried (again. So much crying these last two weeks) in anger because I managed to fall on a rainy morning and injure my elbow again, as well as develop impressive bruises all over and not be able to run the 5 miles I was planning, I didn't actually break it x-ray confirmed) so I can go and do the park run this morning. 

I've put my makeup on and met friends a couple of times, which was a struggle but probably did me a lot of good. And I have rested with books, with my beloved Netflix, and eaten sandwiches at 5pm to close the day, heading to bed to read at 6 and shutting out the world so I can draw that day to a close and rest before the next one. 

And I have done other things: I've recorded another interview for the BBC, written an article for Metro online (watch this space for that) and applied to go on Campaign Bootcamp, in spite of not being accepted last time. 

#spoonie 

I'm recognising that my depression makes me a #spoonie and I need to select what to do and not to do when I'm really poorly. Unfortunately my social life usually is the first to go as I want to make it through work as a semblance of a normal existence. It's my choice though, and I choose how to allocate whatever energy or mixture of numbness and feeling comes to me on any of those days.

So, yes, I am alive, and I'm carrying on. I have seen from Twitter that a lot of my Twitter friends with mental illness are also having a really bad time. I'm hoping the summertime sadness will pass. As always I recognise how lucky I am to have supportive family and friends around me, and medical professionals who want to help me get better, not get (even more) lost. I hope I can write a more together post for next week. But I'll just settle for what I can manage today for now.

Food For Thought. Life (or Life With Mental Health) is Like a Box of Chocolates... #VictoriaLIVE

It’s been a busy week in the media for mental health, which is very positive as far as I’m concerned, but also gives me pause to, well, pause, because I’ve been involving myself in many of the discussions going on and probably need to take a break and make sure I’m taking care of myself.

Monday morning was a bit like Christmas in the world of mental health, and my present was a whole one hour and a half programme on BBC two dedicated to the discussion of many aspects of mental health. If you missed it, the Victoria Derbyshire programme featured both a panel of medical experts and celebrity-come-mindfulness-expert Ruby Wax, and is available on BBC iPlayer for the next month.

Victoria and me. Unfortunately this was the one shot I got.

I look happy. She...not so much

I knew what was coming when Mind contacted me about potentially appearing. An eye wateringly) (more like eye-rubbing-ly) early start and no make-up artists to make me look like I hadn’t been up since 5. Imagine for a moment if you arrived at the airport ahead of your long haul transatlantic flight, only to find that a film crew was waiting to catch your (eye) bags and pallid, pre-holiday complexion. Now imagine that being broadcast to thousands of viewers. And now imagine that you have anxiety and depression, which manifests itself as feeling hyper self-conscious of everything about you that is visible and invisible.

Me - in taxi at 6am and on set at 8am. 

Purple and Pink Hair meets Purple set and shiny forehead

(Plus, can you tell I'm depressed? See, I am, but you can't tell...)

I talk about my experience. And am shiny. You can watch the full show here:

Oh, the fun we had! 80 people with some kind of lived experience of mental health, lined up in the BBC café area (not open), drinking coffee, tea and eating chocolate biscuits. I like drinking juice as much as the next person, but there’s nothing like an instant shot of cheap chocolate covered refined sugar.

The master biscuit. I salute you.

Following that, I also contributed to a forthcoming Buzzfeed article – watch this space for that – and also then attended a workshop with @LatimerGroup to discuss ideas for a new advert for Time To Change. It’s so good to meet people who do and don’t have lived experiences of mental health and share our ideas for what would work as a concept to help people to seek help or just find out a bit about what mental health means.

It has been a great week for mental health, but I felt down as early as Tuesday and at that point I knew I had to make adjustments to make things work. I felt tired on Tuesday morning so benefited once again from my “reasonable adjustments” at work, choosing to work my full day from home instead of in the office, which helps me avoid a three hour roundtrip commute. I took a 1 hour thirty minute lunch break so I could have a midday nap.

(Note, this is against doctor’s orders, I’m not really meant to nap during the day.) I got to the end of the day. I got to my workshop, despite still feeling tired and starting to feel low because of the tiredness added to the things that make me sad from time to time – loneliness, stress, negative thoughts about friends, hating my body, hating my stupid illness, and so on. Love the thought process of depression. Really I do. I made it back in time for bed and slept. (And I had eaten four sliced of Domino’s for dinner. Carbs help with sleep. But if you’re reading this for health tips for eating, this is not the post for you!)

The pizza was healing.

I don't care what they say about additives.

These slices were just what I needed.

Sleep, enough medication and, yes, pizza, helped put paid to my anxiety and depressive mood in time for Wednesday, so I made it through the day with a run, full day of work, therapy, dinner and a movie (at home, though, I was pretty tired again!). And I ran again on Thursday and went into work (with cupcakes (see comment above. Not the healthiest week), had a (near) fight with a guy in IT who tried to order me around. (Note to all: this is never a good idea! Cue Jessica death stare con 5. That baby doesn’t usually emerge outside the classroom when year seven need to know to stop. To stop right now.) I had a series of good meetings (that’s because the team I work with are all so lovely) and then came home and rested again.

Mini oreo cookies. Small things come in beautiful 

(sometimes with gooey icing) packages

I have to try to take breaks even when my head is all over the place and when my body feels twitchy all over from the medication side effects or whatever else is going on. I don’t feel like doing it. I feel like stepping outside my body and outside my mind. How bad I feel changes from episode to episode, but this week I never reached the terrible place, not quite, because I was able to recognise enough in the calendar to see I really did have to stop frequently. Otherwise that terrible place might be here again. And it might come without my help, so I’ll do everything I can. And Forrest Gump’s mother was right about the box of chocolates, too, in case you’re wondering.

You said it Sally

It sounds so simple, take a break. (Have a KitKat. Oh, I don’t mind if I do!) If I’m honest, though, I’m just not good at taking breaks. I tell myself, go on, keep going, you can do it, just a bit more, just another hour, just another email, just another half a mile, just another phone call. All those “just anothers” add up to a whole lot of “too much” if I’m not careful.

Just another half a mile. Just another juice. Just another 'just'

On the flipside, I wrote an email to a good friend today where I expressed my frustrations at the things I can’t do:

“I remark on the things I still don’t do – like cooking for example – which I used to love and now find little energy left for after managing with work…”

Kind of ironic. I clearly haven't lost interest in food if this blog is anything to go by. But I reflect and I see that there are positives and negatives. Balance. It's about balance.

Details of this poem are here

I’ve said it before and I say it today: cognitive behavioural therapy is for me, in part, a constant process of trying to be more reflective and mindful of what I’m doing. It’s a double edged sword. I have to do this to get better; but doing it makes me feel terrible. If I can take joy in small things, I will. If I can notice that I got to the end of the day, feeling absolutely horrific, I still did get to the end of that day. (At this point I’d probably have buried my head in the duvet, into the pillow, having shut down the light in the room as much as I could, having cleaned all my makeup off, my mask, from my face, scrubbed my teeth so the mint taste distracts me, and having surrendered myself to bed and oblivion.)

Blurring into Oblivion

So here’s another end of the week. It was a great week for discussion on mental health. It was a terrible week for funding cuts. It was an alarming week for statistics on mental health and men’s suicide figures. It was a good week at work. It was an okay week for running. And it was a week. It was.

See you next week?