Monday, 19 May 2014

Mental health awareness week - my two penn'orth

Last week was Mental Health Awareness week, which completely passed me by. It was also British Sandwich week, which, to be honest, I am far more likely to have noticed since I love sandwiches (and don’t tend to keep on top of mental health issues). But I didn’t want it to go completely unremarked upon, especially since the theme this year was anxiety which is an issue with which, sadly, I have had some considerable dealings.

The first time I had a full on anxiety attack I thought that I was going to die. Does that sound melodramatic? It feels melodramatic writing it down like that. But, nevertheless. I became intensely aware of every single function in my body – my heart, pounding, my stomach, churning, I had to concentrate on the act of breathing because if I didn’t I thought I might just stop. I was on a train to York, a journey that I had made a hundred times, and on this occasion the ambient light and noise was almost unbearable. Every sense was heightened to an uncomfortable degree, every limb tingled and trembled. I remember sitting, rigid, eyes closed, and just counting to ten over and over and over again. I had the sense that at any moment I might lose the capacity to understand language but as long as I could count, could remember the sequence of numbers, I still retained basic comprehension and it was all I could think of to do, so I counted and I counted.

When I got home I couldn’t do anything except lie prone, counting and crying. D came and sat with me, but I couldn’t bear for him to talk because the thought that at any minute I wouldn’t be able to understand him was overwhelmingly frightening. I tried to sleep but was too edgy and the dark held too many unnamed terrors. The next day, a Saturday, I phoned NHS Direct and wept down the phone at the poor lady who told me to go to A&E where a nice doctor gave me some betablockers to try and ease the physical symptoms. To be honest, she could have given me Smarties – at that point I just needed the comfort of seeing a medical professional and receiving the tacit reassurance that I wasn’t about to keel over with an advanced case of Death.

The trouble with anxiety attacks is that once you’ve had one you live with the constant fear that it will happen again, although nothing since has ever compared to that first experience. As I have got more used to them I have found that I can recognise the symptoms fairly early and, for the most part, actually talk myself down before sheer blind panic takes hold. When it comes to anxiety issues, knowledge really is power.

Even now, having experienced it first hand, I am slightly doubtful about the ease with which the terms “depression” and “anxiety disorder” get used. Like my mother before me, I am a natural born worrier with a tendency to fret about little things – this is not an anxiety disorder. Having a stressful time at work and coming home and bursting into tears over a stiff g&t is not depression. Sometimes we need to recognise our normal emotional reactions for what they are – no more and no less.

That said, if anxiety is taking over, if the thought of getting out of bed is just too much to cope with (bed being a designated safe place) then help needs to be sought. The right doctor is a very important part of the solution, so I would always encourage people to make sure that they are comfortable with their GP – and if they are not, request another doctor. You need to be prepared to be honest and raw with them so a rapport is crucial. Equally, medications – the effects and side effects can vary massively from person to person so don’t be afraid to ask to try different ones after an appropriate bedding in period – I went through four or five before settling. Talking therapies can be a great help and are available, as far as I know, in most health authorities, although the waiting list can be significant. A lot of doctors will recommend CBT for anxiety issues, and it can be helpful, but again, a lot of it will be to do with your relationship with the practitioner – the first time I tried CBT it did nothing for me at all. As an alternative, Helen Kennerley’s book “Overcoming Anxiety” was recommended to me by several people, so might be worth checking out while you wait for a referral, or decide whether CBT is the right kind of treatment for you.

Finally, I thought I would mention in passing (it being pertinent to the blog) the now pretty well established link between obesity and mental health issues. The direction of causality does not seem to be confirmed – i.e. no one is sure whether being depressed make you fat or being fat makes you depressed or if the truth lies somewhere in the middle. In my experience it is very, very natural to want to self medicate with food and drink when you’re going through something like this; when Outside is just too big and scary then wine and Kettle Chips on the sofa are comforting and safe. But they’re false friends - I know from bitter experience that if I eat well and get regular exercise then I am less vulnerable to those anxiety demons. And I think there is some comfort to be found in the ritualistic side of planning meals and concentrating on nourishing your body in order to soothe the mind.

For more information – or rather, for information, since I don’t flatter myself that my own ramblings count for very much at all in this particular field, the mental health foundation website can be found here.  No one should ever have to suffer this alone when there are resources and people out there to help. 

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