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04-08-16, 10:37
Hi friends/acquaintances/occasional adversaries!
I don't visit this site very often these days, but I've been on a little bit recently, and I've noticed one or two users having an especially tough time, some of which has triggered quite a lot of debate about the best way to help people.
I really feel for these people and recognise the spiral that they are in, having been in it myself not that long ago. Watching these people struggle has made me grateful for the progress I've been able to make, and I just wanted to share the positive story that is my recovery from health anxiety and my continued progress through the general anxiety condition.
I'm a firm believer in finding and sharing positivity wherever you can, so please forgive me if you find dedicating such a long post entirely to my own experience self-indulgent. Maybe I'm an undiagnosed narcissist? One of the things I enjoy most in life is writing. I'm not saying I'm any good at it, but I do enjoy it, so I just thought I'd sit down (seeing as I have the day off work) and get my thoughts down and share them with you guys.
My descent into hell
I don't mean to sound melodramatic, but it really was my own personal hell. One of the things I find - and I wonder if anybody else who has achieved some degree of recovery might relate to this - is that it's actually quite hard to look back now and know what it was I was worried about, what was wrong with me and exactly what I was feeling. Sometimes I remember events out of sequence because I forget exactly when they happened, but I remember enough to explain how I ended up on NMP.
It all started one late January lunchtime at work. I always look forward to lunch as I'm something of a food fanatic, and I've usually been to the canteen by 12:30 or maybe 1:00pm at the latest. From about 11am, I'll be watching the clock. It's not just about the food - I often need a break from my desk. Looking back, I realise now that I have a problem with clockwatching at work and with trying to force the day to hurry up.
But anyway, on this day, I delayed things a little. I cannot remember why. All I know is, I felt uncomfortable that I hadn't gone to the canteen yet. It wasn't about being hungry. It was more about the upset of routine and the knowledge that my morning had been longer than usual. I didn't realise it at the time, but my thoughts were spiraling unconsciously.
Then I felt it - a tingling sensation in my left arm. I'd felt it before without worrying about it, although I think I did store the knowledge of it away to worry about one day in the future. I tried to write it off, but before I knew it, I was hyperventilating. I'd allowed the idea of a heart attack to get inside my head, which triggered the faulty breathing, and the next thing I knew, I felt like I was about to pass out. The world went fuzzy and I was fighting to stay conscious. One colleague lay me out on the floor with my legs raised, while another called an ambulance. At this point, I think I'm dying.
The ambulance crew arrived and seemed remarkable calm and unconcerned. It was almost like they knew something in advance. They gave me an EKG, checked my blood pressure and did a blood test. They found nothing. They weren't remotely worried, and after that, they left without me.
And that's when things started to fall apart in my life. As soon as they left, the same feelings came rushing back. How could I not see what was going on? I mean, I was fine while they were there! However, I seemed ill enough by this point that my boss took me to hospital. I saw a doctor in the A&E who took another blood test. He too wasn't worried. He told me that, at worst, I may have had a vasovagal attack (something he himself had experienced) or my blood pressure may have dropped due to delaying lunch, but I was fine as far as he was concerned. Notice that nobody has mentioned panic attacks yet. This is significant.
It's all very well for doctors to tell you that the scariest moment of your life was nothing, but I don't (or didn't) have the strength of character or the thought skills to accept this. I was terrified. I didn't know what was wrong. I began to suspect I had a brain tumour, and my entire body now felt ill. My legs were wobbly, my stomach became extremely unsettled, I felt dizzy and as if I would pass out or drop dead at any given moment. I also suspected epilepsy or diabetes, even though the latter one was ruled out by blood tests.
This next bit is the hardest to write. A few nights later, I was in a desperate state. I was in my bedroom, feeling like I was at death's door, just waiting for that moment. I felt like my body had failed me. My legs were like two sticks of jelly. I was scared and alone. I thought maybe I had Motor Neutrone Disease (ALS) or Multiple Sclerosis (my mum has this), and I convinced myself that if I wasn't about to die, I had a terrible illness. I won't give details, but that night I left the house at 11pm and decided I was going to kill myself. I've never told anyone that before, except for a woman on NHS 111.
I was so convinced I was afflicted with a life-threatening or life-ruining illness that I decided to just end it all before the real suffering kicked in. I should point out that I'd never been suicidal before and certainly didn't want to be dead at this point. I was just scared. I made my way to the location I'd chosen, and sat there, trying to pluck up the courage to go through with it. On the way, I'd barely felt like my legs could carry me and I could hardly breathe, such was the intensity of my anxiety.
Looking back, I think even then, somewhere deep deep down, I knew I was alright. It seems amazing to say it, but if I genuinely, 100% felt I was that ill, why did I walk away? Why did I not go through it? Instead, I began walking back to the house, and called NHS 111. I told her I thought I was seriously ill or dying, and that I was considering suicide. 999 had declined to send me an ambulance earlier in the night, clearly suspecting I was having a panic attack and nothing more. But with suicide on the table, the lady at NHS 111 wasn't taking any chances. She arranged an ambulance to come to my house.
Six hours later, the ambulance arrived... The crew were so nice, but I did have this weird feeling when they came and collected me that it suddenly seemed over-the-top. Still, it was nice to feel looked after. In A&E, some lovely nurses made me as comfortable as they could. Doctors took my bloods again and I gave a urine sample. One doctor said something about it possibly being 'neurological', which scared the hell out of me and was not a good thing for him to have said. I was hooked up to a drip, which allowed me the first bit of peace I'd had in days. I remember suddenly feeling drowsy and mellow. I was still worried, but my body had calmed. I don't know what was in the thing, but it felt great.
Unfortunately, I wasn't on it for very long. They sent me for a CT scan and then admitted me to an observation ward, so I was never hooked back up. The ward was horrible. There were some people in genuine distress, including a guy clearly suffering from emphysema, who made me very uncomfortable. I know that sounds insensitive, but I can't imagine he was long for this world, the poor guy. I'd never seen sickness of that degree close up before. On the plus side, the guy next to me was in better shape and kept borrowing my phone charger. He was a witty charmer who seemed to take his bone injury as a chance to flirt with the beautiful Irish nurse I fancied. She liked him more than me...
The night lasted forever. I couldn't sleep, not least because they constantly remove and introduce patients to the ward at all hours. One man arrived about 3am. He was a Russian-speaking Ukrainian who relied on his wife to communicate with staff, which meant she had to stay all night and was constantly talking and moving around (which I don't begrudge her given that she was looking after her poorly husband). I also had a halter monitor attached to me, which made for an unpleasant night on a hard bed in clothes I'd had on for about 48 hours. I had periodic panic attacks, but I still didn't know that's what they were. At one point, I was losing feeling in my arm and in my face. Then I started to feel as if I was going to swallow my tongue. It literally felt like it was happening. I had to call for a doctor, convinced that this was a stroke.
It wasn't a stroke. I was hyperventilating, and this was causing the strange facial sensations and loss of feeling. This still happens now occasionally, but I just laugh at it. My stay in hospital lasted about 24 hours. I had my heart monitored for 15 of those hours. I also had blood tests, gave urine samples, had a CT scan and a chest x-ray. A really pretty young doctor then came to me and said I was to be discharged. Every other patient on my ward had been moved to a longer-term ward, and I expected that I was next. I couldn't believe I was being discharged. The doctor said there was no sign anything was wrong with me and that although she hadn't run literally every test, she was happy to discharge me. She put her hand on my arm upon seeing how much this scared me and asked me what was worrying me so much. I told her I thought I was seriously ill, so she asked if I wanted an MRI scan. This was clearly for reassurance, and you could argue she shouldn't have done it, but I think she just wanted to do something to help me, and it's not like a busy junior doctor has time to be my therapist.
I remember leaving hospital. It was so strange. I was wobbly and unstable. It was horrible. I felt in more danger than ever. I went down to the main entrance of the hospital, which was huge and contained all sorts of shops and kiosks. I arranged a taxi and glanced at my discharge notes. Most of it was medical mumbo-jumbo that I couldn't understand or hope to interpret. But in the section where the doctor had to state her preliminary diagnosis lay the seed of my recovery, although it wouldn't bloom for a while. "Symptoms triggered by hyperventilation due to anxiety."
This was the first mention of the 'A' word. I got my phone out and started Googling the subject of anxiety. I came across panic attacks. It was like a light came on. I'd heard of anxiety and panic attacks, but I knew nothing about them. If I'm honest, I probably thought they were just something that happen to drama queens and irrational people. I didn't realise what an all-consuming experience it was and how much it affects you physically. My ex-girlfriend (who I suspect suffers from Borderline Personality Disorder), used to post about her anxiety on Facebook all the time. Would you believe I was callous enough to unfriend her? I thought she was being overly-dramatic and obsessive and seeking attention. I feel so guilty for that. She was worse than me even, and I wish I could have shown the kind of compassion and understanding I usually show people.
Sometimes things get worse before they get better
I know this is supposed to be a success story, but stay with me and I will get there! The next few days, I did feel a bit better. I had something akin to a diagnosis to hold onto. I came to NMP around this point, but I was still not right. My body was still in a heightened state of alertness. I still felt awful and as if I may pass out at any moment. The next step was to see my GP. It was six months since I moved to London, and I hadn't bothered to register, which meant I had to go through all that rigmarole before I could get an appointment. When I did get one, I explained that I just wanted the physical stuff to go away. She offered me the beta blocker Propranolol, but said it wouldn't tackle the psychological side. I was only interested in stopping the physical feelings at this stage, so I told her to just prescribe the beta blockers for now.
Depersonalisation/Derealisation
They didn't do anything. I was on a very low dose which had absolutely no effect. I carried on in a permanent state of illness, feeling as if I was on the verge of something awful. I couldn't shake the worry. Nice as it was to have some kind of diagnosis from the hospital, the fact I hadn't had my MRI scan yet played on my mind. I was full of "what if?" questions.
And then something really scary happened. I'd learned that exercise can be helpful in tackling anxiety, so I decided to go and buy some new trainers to allow me to start running again. A positive decision, but this was ruined by what happened next. I was dressed and about to leave my bedroom and head out to buy the new shoes I needed, and all of a sudden I noticed that the world looked odd. My vision had altered. It wasn't so much that my eyesight felt compromised. It was more like my consciousness had altered in some way. The world looked blurry, dreamlike, hazy and unreal. To add to this, I felt as if my emotions had been dulled, and I felt aggressive. I didn't have any inclination to actually be aggressive. I just felt as if there was aggression coursing through my body. I realise now that this was just anxious thought - a fear that this altered state of consciousness could cause me to be aggressive. I have never and would never harm anyone.
As you can imagine, I didn't know what was happening. But I took this to mean I had a serious psychological illness such as schizophrenia, or that I really did have a brain tumour. I still went and bought the shoes. It was very strange. I felt disconnected from everything around me. All my senses were dulled. The world was like some bizarre dream, one in which I could feel nothing. I would later learn that I was experiencing depersonalisation and/or derealisation, an unpleasant, unsettling but ultimately harmless sensation brought on by intense stress, worry and introspection. However, at this stage, I didn't know what it was.
I did the only thing I thought I could do - I went to A&E. I told the triage nurse "I think I'm developing schizophrenia". You have to remember I didn't know a great deal about schizophrenia at the time. I did think I was hearing voices, though. I now know I was 'hearing' my own anxious thoughts and nothing more. The nurse took my blood pressure and did a blood test and was happy I was otherwise well. She told me "I'll call out a member of the mental health team and I'm sure they'll get you out of this."
I don't know why, but I did believe her to at least a small extent. I think I needed to feel looked after, and simply being so helped a bit. Eventually, I saw a nice mental health professional who asked me a whole range of questions. I told him I was becoming schizophrenic and he asked why I thought that, and I explained that I'd lost emotional depth and that the world felt like a dream. By the end of it, he declared that there were no signs of schizophrenia. I was deeply anxious and would benefit from some diazepam (Valium). It was strange, but as he sat there telling me I wasn't going mad, the fog lifted and the world came back to me. I felt more or less normal again. When I got home, I took the diazepam, and it felt fantastic. It gave me a few hours of peace. I think I even slept well! It was the one and only time a benzodiazepine had any effect. I never felt the benefit of diazepam ever again, and when I was given lorazepam (Ativan), I felt nothing. I guess benzos don't really work for me.
Medication and therapy - time to change
I'd had enough by this point. It was no good relying on beta blockers and benzodiazepines, which I would be forced to come off before long anyway due to their dependent effects. I went back to the doctor and told her I couldn't go on the way I was and I needed help. She told me to refer myself for therapy and offered to prescribe anti-depressants. I was willing to try anything to feel better, so I agreed to the medication. She decided to put me on 50mg a day of sertraline (Zoloft), and before long I was upped to 100mg. I also referred myself to the local NHS mental health therapy team and was lucky to receive a course of CBT very quickly.
By now, you're wondering if I'll ever get to the positive stuff. Trust me, we're nearly there. But before we get there, I have to hit absolute rock bottom. Here we go...
I still felt rotten. I still thought, on balance, I may well be dying or seriously ill. I couldn't stop worrying. The DP/DR would come and go, but more often than not, it was there. Nevertheless, I decided to go through with a trip to Iceland I had planned before I fell ill. I thought I would have to cancel, but what you don't know about me at this point is that I'd discovered the book At Last A Life by Paul David not long after I entered the state of DP/DR. It's a bit of a clunky, repetitive read, but I think it helped to save my life. David is by no means a natural writer, and I want to be careful suggesting that any book is an anxiety cure on its own. However, the concept of acceptance, coupled with the reassurance that anxiety is treatable and not a sign of impending doom did make sense to me. I began to employ his suggestions and teaching. He even had a whole chapter on DP/DR, which was the first time I had ever had an explanation of that sensation. It was like coming up for air. He definitely saved my life. That's how I feel.
Because of Paul David, I decided to take my miserable feelings, my shattered mind and wobbly body to Iceland. I had three courses of medication to take with me - Propranolol, lorazepam and sertraline. It was a pain, having to constantly take all these pills. I felt awful in Iceland. Truly grotty. However, it was the best holiday I ever had. It's a beautiful country, and no amount of feeling ropey would stop me enjoying it. I would love to live there. There's nowhere on Earth like it. I'd love to go back now I feel so much better.
After getting back from Iceland, I had my MRI scan. Anyone who's had one of these knows how unpleasant they are. Around this time, I took another turn for the worse. I think the combination of waiting for the results (which would eventually come back normal) and the sertraline beginning to enter my metabolism were the cause. My DP/DR became worse than ever, and stopped being temporary. I also lost all ability to feel emotions. I went through a spell where I presented to A&E three days in a row, convinced it was schizophrenia or something horrendous. I went to my GP begging to be admitted to a psychiatric hospital. I even tried to do it privately. Nowhere would do it. My diagnosis remained Generalised Anxiety Disorder. Nobody said it at the time, but the suspicion was that this new phase was being caused by the sertraline.
A corner turned?
And then it started to get better. Once I knew I wasn't going to be admitted and that I couldn't go to A&E every day, I accepted that I had to just plough on with things. I re-read Paul David's book and bought his second one. I kicked myself for forgetting so much of what he says. I also explored Claire Weekes's work. I found less in her book that was relevant to me as she takes a very broad view and tries to address almost everything an anxiety sufferer could feel. Her work is also very old-fashioned in terms of the way she writes, but it was still a huge help. I started to just accept how I felt. My friend, whose dad was on anti-depressants, told me to stick with them and be patient. He was so right.
The evening of the day on which I'd had my final psychiatric assessment and attempted unsuccessfully to get myself sectioned, I told myself I was going to relax. I'd also been given more diazepam, so I took it. I think there was a placebo effect that evening caused by taking a pill. Just feeling like there was something I could do to feel better. I slept okay that night. Before falling asleep, I vowed to go to Samaritans, who had an office near my house. I would go and talk to them in the morning.
That morning, I got myself ready to go and see Samaritans. On the way, I passed a row of shops and businesses and decided to stop for some breakfast. I treated myself to the unhealthiest breakfast I could - bacon, sausage, eggs, beans, toast, black pudding (that's the one made out of blood, for any American readers). It was wonderful. I focused solely on the food. I took a mindfulness approach to that breakfast. I tried to find joy in the bursting of an egg yolk with a sausage and the crunch of a hash brown. Maybe my arteries won't thank me, but it was the first time in such a long time I'd been totally focused on something outside of myself. The fog lifted a little bit. Not much, but a little.
This is recovery!
I never went to Samaritans in the end. I walked out of that café and, instead, just went for a stroll. I was walking past a particularly attractive church when it started to rain. I always loved rain. I love it even more now. I love getting caught in a downpour. The heavens opened that morning and I got drenched. And it felt fantastic. I was still unable to achieve the kind of emotional response I was used to - the flat effect was still there. But something was different. The old me was visible at last. I don't know, but just standing there, in a puddle in Ealing, west London, feeling the rain soak me through and taking strength from my decision not to seek yet more reassurance was my first big victory.
I would have ups and downs over the next weeks and months. At times, my sleep is not great. I've put on weight due to the anti-depressants, although I'm confident of getting rid of it through exercise and eating well. I found myself laughing more often. I was writing blog pieces again, a clear sign that I could find pleasure in things again. I was trying to help others on NMP. I'd changed. So what helped me feel better? In my opinion, and in no particular order:
1) Medication - It's not for everyone, but it saved me. The beta blockers did eventually start to do something. I noticed that the moments of high anxiety or panic felt less intense. My heart started to feel less jittery. The diazepam and lorazepam served a purpose when I was at my very worse. The sertraline gave me the space in my own mind to start tackling the condition I do have. I'm happy with my decision to be medicated.
2) CBT - When I started CBT, I was sceptical. Some of it felt silly. But I did come to trust my therapist, who was a very calming influence on me and I credit as a lifesaver. Gradually, I became able to implement some of the things I learned, even things that originally seemed silly. CBT worked so well in fact that the health anxiety aspect of my condition is, as far as I'm concerned, cured.
3) Understanding and knowledge - Part of the problem these days is that, with the internet, we can so easily feed our condition and also inform ourselves of the various horrors that can befall our bodies. But on the flip side, I was able to uncover information that, once it sunk in, helped me to understand what was going wrong, how I was causing it myself and why I felt certain things. I had to see through the anxiety lie.
4) Paul David/Claire Weekes - Again, I don't want to seem like I'm pushing as a cure something that may not be. However, if you can truly buy into what these two authors teach, and if it sinks in with you, it gives you a great chance of getting better. These two also go on my list of lifesavers.
5) Friends/Family - Everyone in my life just wants me to be okay. They're there for me when I need them. I received a card full of signatures from work when I was in hospital. I no longer hide what I feel. Everybody knows I have anxiety and depression, and I no longer feel any need to hide it. I urge everyone to be as open as they can. If you feel there's nobody in your life you can turn to, find a buddy online or call a crisis line. Do something in order to get the feelings out there.
6) Life/the world - That's it really. Once the sertraline kicked in for me and I was putting my CBT into practice, I became less inwardly focused. I started to enjoy the world again. I go out to Heathrow airport to watch the planes landing. I plan trips. I go to restaurants. I write. I laugh. I live. It feels fantastic.
Neurological Consultation
I did say there would be one! For the past six years, I've been having occasional funny turns. That's the best way I can describe them. My body floods with adrenaline, my head plays out a movie screen of memories inside my mind, the world goes briefly fuzzy and strange, and then I start to sweat. Then it all ends and I'm fine. I recently told the doctor about this, and she said that it could be nothing, or there could be some seizure activity. She mentioned the possibility of epilepsy.
Neither her nor me are convinced I'm epileptic or having seizures of any kind. My description does not suggest seizures. A few months ago, I'd be in a pit of despair waiting for this consultation, convinced I had epilepsy and would have a fatal seizure at any moment (despite having been fine with these things for years). It's a sign of the effectiveness of my treatment that I'm not worried. The worst that will happen is that I'm told I have epilepsy, a very manageable and sometimes even temporary condition. I don't believe I am epileptic, though. I believe these funny turns are panic attacks with accompanying dissociation, possibly triggered by shallow breathing. I take heart from the fact that my GP didn't insist on referring me to a neurologist, but said it was up to me. If she thought there was something seriously wrong, she'd have insisted. I'll be happy to let people know how this all works out.
So where am I now?
Things aren't perfect. I still have a lifetime's underlying depression to tackle. I still miss work a lot, mainly due to feelings of depression. But it's not severe. I don't feel worthless and I certainly have no desire to end my life. I have a desire to begin my life. I have a lot still to work on. I feel cured of health anxiety, but I'm not cured of anxiety as a whole. I still have a dodgy stomach at times. I suffer terrible GERD. I still feel dizzy at times. Occasionally, I have palpitations. The difference is that I now laugh at it. It doesn't scare me or own me. I've seen through it all and I know what causes it. I have vowed to worry less from now on and to relax more. No longer will I fret about things that might but probably won't happen. Nor will I catastrophise every challenging situation.
I'm currently applying for the chance to teach English in Georgia (the country, not the US state) and, if successful, would move in September. The fact I even want to do this shows I'm feeling things properly again. A few months ago, I wouldn't have cared if you told me Georgia was about to land on top of me. I'm underqualified, so there's no guarantee, but the old me would have seen this and said "ah, let's not bother". But now I'm giving it my best shot.
Even if I'm not successful, I intend to take a month out to travel around the Balkans. I'm out of a job in mid-September, so it's the perfect opportunity. That's another thing that would have freaked me out in the past - being without a job. Now, I rationalise that I'm a competent, well qualified individual with skills and some experience. I'll be okay. The old me would have assumed I was doomed to a life on the streets, and indeed I did spend eleven months unemployed at one time, and sunk into a deep depression as a result.
I also pay a therapist just so I have someone to talk to. The other day he asked me if I felt anxiety had played a purpose in my life. I said to him that it was a horrific experience that I would not choose to repeat even if it did serve a purpose, but that it taught me so much that I can't deny it has been an important thing to happen to me. I had to go through this to see the consequences of my thought processes and to see the damage I was doing to myself. I'm a more confident person now. I worry less. I see the futility of worry. I'm not saying I never have a negative thought anymore, but I don't attach the same importance to them. And when I do worry, I now feel that I worry proportionately and sensibly.
I've also developed a fascination with mental health. I've been watching a lot of documentaries and reading a lot of material about schizophrenia, probably the biggest fear I've had over the past few months. If I have any lingering health fears at all, it's probably psychosis. However, it's an absolutely fascinating topic. I find myself in awe of what the human brain can do. It's a tragedy for those affected, of course. I also take an interest in personality disorders. It amazes me that our species can experience these things. I've also begun to notice how often people with mental health issues are demonised. A terrible crime may be committed, but the person's psychosis will be mentioned just enough to make the person seem crazy, without removing the media's ability to portray them as evil. It's 2016, but we're a million miles from getting a proper handle on mental health.
I'm also off the beta blockers! I can state right here that I don't need them anymore. I'll feel whatever my body wants me to feel, I won't fear it, and it will eventually go away. I haven't touched a benzodiazepine in months and never will again. I'm now on 150mg a day of sertraline, having decided I would like to give myself the extra 50mg kick to see if it can help speed my recovery along.
What does all this mean for you?
Well, this was my story. If you can't use any of it for yourself, so be it. But I've gone into so much detail about my experience, I hope there is something that might give you food for thought. If nothing else, look how bad I was. Suicidal, desperate to be admitted to a psychiatric unit, unable to feel emotions, trapped in a derealised consciousness and convinced I was going mad or dying or both. And now look at me - planning to move overseas, embracing life, from the roar of an Airbus A380 as it comes in to land to the ooze of an egg yolk when pierced with a sausage. It's a beautiful world. We don't get to spend forever in it, so why waste the time you do have worrying about illnesses you don't have?
There is so much help out there. NMP can only help you to an extent. I may have said that we're a long way from getting a handle on mental health, but anxiety can still be treated. You don't have to take medication if you don't want to - Paul David recovered without it and he's my hero. I believe that I needed medication. I was too seriously ill not to try it. It made a big difference to me. But there are other things that can help. Therapy is great. I've had CBT and now use talking therapy. Exercise is great for wearing yourself out so you sleep better and burn off excess adrenaline. Other than that, the world is your anxiety cure. Connect with it, come out of yourself and give yourself distractions and interests that give you less time to be preoccupied with how you feel all the time.
But whatever happens, remember this: feelings are temporary, recovery is possible, don't suffer in silence.
Thank you for reading.
I don't visit this site very often these days, but I've been on a little bit recently, and I've noticed one or two users having an especially tough time, some of which has triggered quite a lot of debate about the best way to help people.
I really feel for these people and recognise the spiral that they are in, having been in it myself not that long ago. Watching these people struggle has made me grateful for the progress I've been able to make, and I just wanted to share the positive story that is my recovery from health anxiety and my continued progress through the general anxiety condition.
I'm a firm believer in finding and sharing positivity wherever you can, so please forgive me if you find dedicating such a long post entirely to my own experience self-indulgent. Maybe I'm an undiagnosed narcissist? One of the things I enjoy most in life is writing. I'm not saying I'm any good at it, but I do enjoy it, so I just thought I'd sit down (seeing as I have the day off work) and get my thoughts down and share them with you guys.
My descent into hell
I don't mean to sound melodramatic, but it really was my own personal hell. One of the things I find - and I wonder if anybody else who has achieved some degree of recovery might relate to this - is that it's actually quite hard to look back now and know what it was I was worried about, what was wrong with me and exactly what I was feeling. Sometimes I remember events out of sequence because I forget exactly when they happened, but I remember enough to explain how I ended up on NMP.
It all started one late January lunchtime at work. I always look forward to lunch as I'm something of a food fanatic, and I've usually been to the canteen by 12:30 or maybe 1:00pm at the latest. From about 11am, I'll be watching the clock. It's not just about the food - I often need a break from my desk. Looking back, I realise now that I have a problem with clockwatching at work and with trying to force the day to hurry up.
But anyway, on this day, I delayed things a little. I cannot remember why. All I know is, I felt uncomfortable that I hadn't gone to the canteen yet. It wasn't about being hungry. It was more about the upset of routine and the knowledge that my morning had been longer than usual. I didn't realise it at the time, but my thoughts were spiraling unconsciously.
Then I felt it - a tingling sensation in my left arm. I'd felt it before without worrying about it, although I think I did store the knowledge of it away to worry about one day in the future. I tried to write it off, but before I knew it, I was hyperventilating. I'd allowed the idea of a heart attack to get inside my head, which triggered the faulty breathing, and the next thing I knew, I felt like I was about to pass out. The world went fuzzy and I was fighting to stay conscious. One colleague lay me out on the floor with my legs raised, while another called an ambulance. At this point, I think I'm dying.
The ambulance crew arrived and seemed remarkable calm and unconcerned. It was almost like they knew something in advance. They gave me an EKG, checked my blood pressure and did a blood test. They found nothing. They weren't remotely worried, and after that, they left without me.
And that's when things started to fall apart in my life. As soon as they left, the same feelings came rushing back. How could I not see what was going on? I mean, I was fine while they were there! However, I seemed ill enough by this point that my boss took me to hospital. I saw a doctor in the A&E who took another blood test. He too wasn't worried. He told me that, at worst, I may have had a vasovagal attack (something he himself had experienced) or my blood pressure may have dropped due to delaying lunch, but I was fine as far as he was concerned. Notice that nobody has mentioned panic attacks yet. This is significant.
It's all very well for doctors to tell you that the scariest moment of your life was nothing, but I don't (or didn't) have the strength of character or the thought skills to accept this. I was terrified. I didn't know what was wrong. I began to suspect I had a brain tumour, and my entire body now felt ill. My legs were wobbly, my stomach became extremely unsettled, I felt dizzy and as if I would pass out or drop dead at any given moment. I also suspected epilepsy or diabetes, even though the latter one was ruled out by blood tests.
This next bit is the hardest to write. A few nights later, I was in a desperate state. I was in my bedroom, feeling like I was at death's door, just waiting for that moment. I felt like my body had failed me. My legs were like two sticks of jelly. I was scared and alone. I thought maybe I had Motor Neutrone Disease (ALS) or Multiple Sclerosis (my mum has this), and I convinced myself that if I wasn't about to die, I had a terrible illness. I won't give details, but that night I left the house at 11pm and decided I was going to kill myself. I've never told anyone that before, except for a woman on NHS 111.
I was so convinced I was afflicted with a life-threatening or life-ruining illness that I decided to just end it all before the real suffering kicked in. I should point out that I'd never been suicidal before and certainly didn't want to be dead at this point. I was just scared. I made my way to the location I'd chosen, and sat there, trying to pluck up the courage to go through with it. On the way, I'd barely felt like my legs could carry me and I could hardly breathe, such was the intensity of my anxiety.
Looking back, I think even then, somewhere deep deep down, I knew I was alright. It seems amazing to say it, but if I genuinely, 100% felt I was that ill, why did I walk away? Why did I not go through it? Instead, I began walking back to the house, and called NHS 111. I told her I thought I was seriously ill or dying, and that I was considering suicide. 999 had declined to send me an ambulance earlier in the night, clearly suspecting I was having a panic attack and nothing more. But with suicide on the table, the lady at NHS 111 wasn't taking any chances. She arranged an ambulance to come to my house.
Six hours later, the ambulance arrived... The crew were so nice, but I did have this weird feeling when they came and collected me that it suddenly seemed over-the-top. Still, it was nice to feel looked after. In A&E, some lovely nurses made me as comfortable as they could. Doctors took my bloods again and I gave a urine sample. One doctor said something about it possibly being 'neurological', which scared the hell out of me and was not a good thing for him to have said. I was hooked up to a drip, which allowed me the first bit of peace I'd had in days. I remember suddenly feeling drowsy and mellow. I was still worried, but my body had calmed. I don't know what was in the thing, but it felt great.
Unfortunately, I wasn't on it for very long. They sent me for a CT scan and then admitted me to an observation ward, so I was never hooked back up. The ward was horrible. There were some people in genuine distress, including a guy clearly suffering from emphysema, who made me very uncomfortable. I know that sounds insensitive, but I can't imagine he was long for this world, the poor guy. I'd never seen sickness of that degree close up before. On the plus side, the guy next to me was in better shape and kept borrowing my phone charger. He was a witty charmer who seemed to take his bone injury as a chance to flirt with the beautiful Irish nurse I fancied. She liked him more than me...
The night lasted forever. I couldn't sleep, not least because they constantly remove and introduce patients to the ward at all hours. One man arrived about 3am. He was a Russian-speaking Ukrainian who relied on his wife to communicate with staff, which meant she had to stay all night and was constantly talking and moving around (which I don't begrudge her given that she was looking after her poorly husband). I also had a halter monitor attached to me, which made for an unpleasant night on a hard bed in clothes I'd had on for about 48 hours. I had periodic panic attacks, but I still didn't know that's what they were. At one point, I was losing feeling in my arm and in my face. Then I started to feel as if I was going to swallow my tongue. It literally felt like it was happening. I had to call for a doctor, convinced that this was a stroke.
It wasn't a stroke. I was hyperventilating, and this was causing the strange facial sensations and loss of feeling. This still happens now occasionally, but I just laugh at it. My stay in hospital lasted about 24 hours. I had my heart monitored for 15 of those hours. I also had blood tests, gave urine samples, had a CT scan and a chest x-ray. A really pretty young doctor then came to me and said I was to be discharged. Every other patient on my ward had been moved to a longer-term ward, and I expected that I was next. I couldn't believe I was being discharged. The doctor said there was no sign anything was wrong with me and that although she hadn't run literally every test, she was happy to discharge me. She put her hand on my arm upon seeing how much this scared me and asked me what was worrying me so much. I told her I thought I was seriously ill, so she asked if I wanted an MRI scan. This was clearly for reassurance, and you could argue she shouldn't have done it, but I think she just wanted to do something to help me, and it's not like a busy junior doctor has time to be my therapist.
I remember leaving hospital. It was so strange. I was wobbly and unstable. It was horrible. I felt in more danger than ever. I went down to the main entrance of the hospital, which was huge and contained all sorts of shops and kiosks. I arranged a taxi and glanced at my discharge notes. Most of it was medical mumbo-jumbo that I couldn't understand or hope to interpret. But in the section where the doctor had to state her preliminary diagnosis lay the seed of my recovery, although it wouldn't bloom for a while. "Symptoms triggered by hyperventilation due to anxiety."
This was the first mention of the 'A' word. I got my phone out and started Googling the subject of anxiety. I came across panic attacks. It was like a light came on. I'd heard of anxiety and panic attacks, but I knew nothing about them. If I'm honest, I probably thought they were just something that happen to drama queens and irrational people. I didn't realise what an all-consuming experience it was and how much it affects you physically. My ex-girlfriend (who I suspect suffers from Borderline Personality Disorder), used to post about her anxiety on Facebook all the time. Would you believe I was callous enough to unfriend her? I thought she was being overly-dramatic and obsessive and seeking attention. I feel so guilty for that. She was worse than me even, and I wish I could have shown the kind of compassion and understanding I usually show people.
Sometimes things get worse before they get better
I know this is supposed to be a success story, but stay with me and I will get there! The next few days, I did feel a bit better. I had something akin to a diagnosis to hold onto. I came to NMP around this point, but I was still not right. My body was still in a heightened state of alertness. I still felt awful and as if I may pass out at any moment. The next step was to see my GP. It was six months since I moved to London, and I hadn't bothered to register, which meant I had to go through all that rigmarole before I could get an appointment. When I did get one, I explained that I just wanted the physical stuff to go away. She offered me the beta blocker Propranolol, but said it wouldn't tackle the psychological side. I was only interested in stopping the physical feelings at this stage, so I told her to just prescribe the beta blockers for now.
Depersonalisation/Derealisation
They didn't do anything. I was on a very low dose which had absolutely no effect. I carried on in a permanent state of illness, feeling as if I was on the verge of something awful. I couldn't shake the worry. Nice as it was to have some kind of diagnosis from the hospital, the fact I hadn't had my MRI scan yet played on my mind. I was full of "what if?" questions.
And then something really scary happened. I'd learned that exercise can be helpful in tackling anxiety, so I decided to go and buy some new trainers to allow me to start running again. A positive decision, but this was ruined by what happened next. I was dressed and about to leave my bedroom and head out to buy the new shoes I needed, and all of a sudden I noticed that the world looked odd. My vision had altered. It wasn't so much that my eyesight felt compromised. It was more like my consciousness had altered in some way. The world looked blurry, dreamlike, hazy and unreal. To add to this, I felt as if my emotions had been dulled, and I felt aggressive. I didn't have any inclination to actually be aggressive. I just felt as if there was aggression coursing through my body. I realise now that this was just anxious thought - a fear that this altered state of consciousness could cause me to be aggressive. I have never and would never harm anyone.
As you can imagine, I didn't know what was happening. But I took this to mean I had a serious psychological illness such as schizophrenia, or that I really did have a brain tumour. I still went and bought the shoes. It was very strange. I felt disconnected from everything around me. All my senses were dulled. The world was like some bizarre dream, one in which I could feel nothing. I would later learn that I was experiencing depersonalisation and/or derealisation, an unpleasant, unsettling but ultimately harmless sensation brought on by intense stress, worry and introspection. However, at this stage, I didn't know what it was.
I did the only thing I thought I could do - I went to A&E. I told the triage nurse "I think I'm developing schizophrenia". You have to remember I didn't know a great deal about schizophrenia at the time. I did think I was hearing voices, though. I now know I was 'hearing' my own anxious thoughts and nothing more. The nurse took my blood pressure and did a blood test and was happy I was otherwise well. She told me "I'll call out a member of the mental health team and I'm sure they'll get you out of this."
I don't know why, but I did believe her to at least a small extent. I think I needed to feel looked after, and simply being so helped a bit. Eventually, I saw a nice mental health professional who asked me a whole range of questions. I told him I was becoming schizophrenic and he asked why I thought that, and I explained that I'd lost emotional depth and that the world felt like a dream. By the end of it, he declared that there were no signs of schizophrenia. I was deeply anxious and would benefit from some diazepam (Valium). It was strange, but as he sat there telling me I wasn't going mad, the fog lifted and the world came back to me. I felt more or less normal again. When I got home, I took the diazepam, and it felt fantastic. It gave me a few hours of peace. I think I even slept well! It was the one and only time a benzodiazepine had any effect. I never felt the benefit of diazepam ever again, and when I was given lorazepam (Ativan), I felt nothing. I guess benzos don't really work for me.
Medication and therapy - time to change
I'd had enough by this point. It was no good relying on beta blockers and benzodiazepines, which I would be forced to come off before long anyway due to their dependent effects. I went back to the doctor and told her I couldn't go on the way I was and I needed help. She told me to refer myself for therapy and offered to prescribe anti-depressants. I was willing to try anything to feel better, so I agreed to the medication. She decided to put me on 50mg a day of sertraline (Zoloft), and before long I was upped to 100mg. I also referred myself to the local NHS mental health therapy team and was lucky to receive a course of CBT very quickly.
By now, you're wondering if I'll ever get to the positive stuff. Trust me, we're nearly there. But before we get there, I have to hit absolute rock bottom. Here we go...
I still felt rotten. I still thought, on balance, I may well be dying or seriously ill. I couldn't stop worrying. The DP/DR would come and go, but more often than not, it was there. Nevertheless, I decided to go through with a trip to Iceland I had planned before I fell ill. I thought I would have to cancel, but what you don't know about me at this point is that I'd discovered the book At Last A Life by Paul David not long after I entered the state of DP/DR. It's a bit of a clunky, repetitive read, but I think it helped to save my life. David is by no means a natural writer, and I want to be careful suggesting that any book is an anxiety cure on its own. However, the concept of acceptance, coupled with the reassurance that anxiety is treatable and not a sign of impending doom did make sense to me. I began to employ his suggestions and teaching. He even had a whole chapter on DP/DR, which was the first time I had ever had an explanation of that sensation. It was like coming up for air. He definitely saved my life. That's how I feel.
Because of Paul David, I decided to take my miserable feelings, my shattered mind and wobbly body to Iceland. I had three courses of medication to take with me - Propranolol, lorazepam and sertraline. It was a pain, having to constantly take all these pills. I felt awful in Iceland. Truly grotty. However, it was the best holiday I ever had. It's a beautiful country, and no amount of feeling ropey would stop me enjoying it. I would love to live there. There's nowhere on Earth like it. I'd love to go back now I feel so much better.
After getting back from Iceland, I had my MRI scan. Anyone who's had one of these knows how unpleasant they are. Around this time, I took another turn for the worse. I think the combination of waiting for the results (which would eventually come back normal) and the sertraline beginning to enter my metabolism were the cause. My DP/DR became worse than ever, and stopped being temporary. I also lost all ability to feel emotions. I went through a spell where I presented to A&E three days in a row, convinced it was schizophrenia or something horrendous. I went to my GP begging to be admitted to a psychiatric hospital. I even tried to do it privately. Nowhere would do it. My diagnosis remained Generalised Anxiety Disorder. Nobody said it at the time, but the suspicion was that this new phase was being caused by the sertraline.
A corner turned?
And then it started to get better. Once I knew I wasn't going to be admitted and that I couldn't go to A&E every day, I accepted that I had to just plough on with things. I re-read Paul David's book and bought his second one. I kicked myself for forgetting so much of what he says. I also explored Claire Weekes's work. I found less in her book that was relevant to me as she takes a very broad view and tries to address almost everything an anxiety sufferer could feel. Her work is also very old-fashioned in terms of the way she writes, but it was still a huge help. I started to just accept how I felt. My friend, whose dad was on anti-depressants, told me to stick with them and be patient. He was so right.
The evening of the day on which I'd had my final psychiatric assessment and attempted unsuccessfully to get myself sectioned, I told myself I was going to relax. I'd also been given more diazepam, so I took it. I think there was a placebo effect that evening caused by taking a pill. Just feeling like there was something I could do to feel better. I slept okay that night. Before falling asleep, I vowed to go to Samaritans, who had an office near my house. I would go and talk to them in the morning.
That morning, I got myself ready to go and see Samaritans. On the way, I passed a row of shops and businesses and decided to stop for some breakfast. I treated myself to the unhealthiest breakfast I could - bacon, sausage, eggs, beans, toast, black pudding (that's the one made out of blood, for any American readers). It was wonderful. I focused solely on the food. I took a mindfulness approach to that breakfast. I tried to find joy in the bursting of an egg yolk with a sausage and the crunch of a hash brown. Maybe my arteries won't thank me, but it was the first time in such a long time I'd been totally focused on something outside of myself. The fog lifted a little bit. Not much, but a little.
This is recovery!
I never went to Samaritans in the end. I walked out of that café and, instead, just went for a stroll. I was walking past a particularly attractive church when it started to rain. I always loved rain. I love it even more now. I love getting caught in a downpour. The heavens opened that morning and I got drenched. And it felt fantastic. I was still unable to achieve the kind of emotional response I was used to - the flat effect was still there. But something was different. The old me was visible at last. I don't know, but just standing there, in a puddle in Ealing, west London, feeling the rain soak me through and taking strength from my decision not to seek yet more reassurance was my first big victory.
I would have ups and downs over the next weeks and months. At times, my sleep is not great. I've put on weight due to the anti-depressants, although I'm confident of getting rid of it through exercise and eating well. I found myself laughing more often. I was writing blog pieces again, a clear sign that I could find pleasure in things again. I was trying to help others on NMP. I'd changed. So what helped me feel better? In my opinion, and in no particular order:
1) Medication - It's not for everyone, but it saved me. The beta blockers did eventually start to do something. I noticed that the moments of high anxiety or panic felt less intense. My heart started to feel less jittery. The diazepam and lorazepam served a purpose when I was at my very worse. The sertraline gave me the space in my own mind to start tackling the condition I do have. I'm happy with my decision to be medicated.
2) CBT - When I started CBT, I was sceptical. Some of it felt silly. But I did come to trust my therapist, who was a very calming influence on me and I credit as a lifesaver. Gradually, I became able to implement some of the things I learned, even things that originally seemed silly. CBT worked so well in fact that the health anxiety aspect of my condition is, as far as I'm concerned, cured.
3) Understanding and knowledge - Part of the problem these days is that, with the internet, we can so easily feed our condition and also inform ourselves of the various horrors that can befall our bodies. But on the flip side, I was able to uncover information that, once it sunk in, helped me to understand what was going wrong, how I was causing it myself and why I felt certain things. I had to see through the anxiety lie.
4) Paul David/Claire Weekes - Again, I don't want to seem like I'm pushing as a cure something that may not be. However, if you can truly buy into what these two authors teach, and if it sinks in with you, it gives you a great chance of getting better. These two also go on my list of lifesavers.
5) Friends/Family - Everyone in my life just wants me to be okay. They're there for me when I need them. I received a card full of signatures from work when I was in hospital. I no longer hide what I feel. Everybody knows I have anxiety and depression, and I no longer feel any need to hide it. I urge everyone to be as open as they can. If you feel there's nobody in your life you can turn to, find a buddy online or call a crisis line. Do something in order to get the feelings out there.
6) Life/the world - That's it really. Once the sertraline kicked in for me and I was putting my CBT into practice, I became less inwardly focused. I started to enjoy the world again. I go out to Heathrow airport to watch the planes landing. I plan trips. I go to restaurants. I write. I laugh. I live. It feels fantastic.
Neurological Consultation
I did say there would be one! For the past six years, I've been having occasional funny turns. That's the best way I can describe them. My body floods with adrenaline, my head plays out a movie screen of memories inside my mind, the world goes briefly fuzzy and strange, and then I start to sweat. Then it all ends and I'm fine. I recently told the doctor about this, and she said that it could be nothing, or there could be some seizure activity. She mentioned the possibility of epilepsy.
Neither her nor me are convinced I'm epileptic or having seizures of any kind. My description does not suggest seizures. A few months ago, I'd be in a pit of despair waiting for this consultation, convinced I had epilepsy and would have a fatal seizure at any moment (despite having been fine with these things for years). It's a sign of the effectiveness of my treatment that I'm not worried. The worst that will happen is that I'm told I have epilepsy, a very manageable and sometimes even temporary condition. I don't believe I am epileptic, though. I believe these funny turns are panic attacks with accompanying dissociation, possibly triggered by shallow breathing. I take heart from the fact that my GP didn't insist on referring me to a neurologist, but said it was up to me. If she thought there was something seriously wrong, she'd have insisted. I'll be happy to let people know how this all works out.
So where am I now?
Things aren't perfect. I still have a lifetime's underlying depression to tackle. I still miss work a lot, mainly due to feelings of depression. But it's not severe. I don't feel worthless and I certainly have no desire to end my life. I have a desire to begin my life. I have a lot still to work on. I feel cured of health anxiety, but I'm not cured of anxiety as a whole. I still have a dodgy stomach at times. I suffer terrible GERD. I still feel dizzy at times. Occasionally, I have palpitations. The difference is that I now laugh at it. It doesn't scare me or own me. I've seen through it all and I know what causes it. I have vowed to worry less from now on and to relax more. No longer will I fret about things that might but probably won't happen. Nor will I catastrophise every challenging situation.
I'm currently applying for the chance to teach English in Georgia (the country, not the US state) and, if successful, would move in September. The fact I even want to do this shows I'm feeling things properly again. A few months ago, I wouldn't have cared if you told me Georgia was about to land on top of me. I'm underqualified, so there's no guarantee, but the old me would have seen this and said "ah, let's not bother". But now I'm giving it my best shot.
Even if I'm not successful, I intend to take a month out to travel around the Balkans. I'm out of a job in mid-September, so it's the perfect opportunity. That's another thing that would have freaked me out in the past - being without a job. Now, I rationalise that I'm a competent, well qualified individual with skills and some experience. I'll be okay. The old me would have assumed I was doomed to a life on the streets, and indeed I did spend eleven months unemployed at one time, and sunk into a deep depression as a result.
I also pay a therapist just so I have someone to talk to. The other day he asked me if I felt anxiety had played a purpose in my life. I said to him that it was a horrific experience that I would not choose to repeat even if it did serve a purpose, but that it taught me so much that I can't deny it has been an important thing to happen to me. I had to go through this to see the consequences of my thought processes and to see the damage I was doing to myself. I'm a more confident person now. I worry less. I see the futility of worry. I'm not saying I never have a negative thought anymore, but I don't attach the same importance to them. And when I do worry, I now feel that I worry proportionately and sensibly.
I've also developed a fascination with mental health. I've been watching a lot of documentaries and reading a lot of material about schizophrenia, probably the biggest fear I've had over the past few months. If I have any lingering health fears at all, it's probably psychosis. However, it's an absolutely fascinating topic. I find myself in awe of what the human brain can do. It's a tragedy for those affected, of course. I also take an interest in personality disorders. It amazes me that our species can experience these things. I've also begun to notice how often people with mental health issues are demonised. A terrible crime may be committed, but the person's psychosis will be mentioned just enough to make the person seem crazy, without removing the media's ability to portray them as evil. It's 2016, but we're a million miles from getting a proper handle on mental health.
I'm also off the beta blockers! I can state right here that I don't need them anymore. I'll feel whatever my body wants me to feel, I won't fear it, and it will eventually go away. I haven't touched a benzodiazepine in months and never will again. I'm now on 150mg a day of sertraline, having decided I would like to give myself the extra 50mg kick to see if it can help speed my recovery along.
What does all this mean for you?
Well, this was my story. If you can't use any of it for yourself, so be it. But I've gone into so much detail about my experience, I hope there is something that might give you food for thought. If nothing else, look how bad I was. Suicidal, desperate to be admitted to a psychiatric unit, unable to feel emotions, trapped in a derealised consciousness and convinced I was going mad or dying or both. And now look at me - planning to move overseas, embracing life, from the roar of an Airbus A380 as it comes in to land to the ooze of an egg yolk when pierced with a sausage. It's a beautiful world. We don't get to spend forever in it, so why waste the time you do have worrying about illnesses you don't have?
There is so much help out there. NMP can only help you to an extent. I may have said that we're a long way from getting a handle on mental health, but anxiety can still be treated. You don't have to take medication if you don't want to - Paul David recovered without it and he's my hero. I believe that I needed medication. I was too seriously ill not to try it. It made a big difference to me. But there are other things that can help. Therapy is great. I've had CBT and now use talking therapy. Exercise is great for wearing yourself out so you sleep better and burn off excess adrenaline. Other than that, the world is your anxiety cure. Connect with it, come out of yourself and give yourself distractions and interests that give you less time to be preoccupied with how you feel all the time.
But whatever happens, remember this: feelings are temporary, recovery is possible, don't suffer in silence.
Thank you for reading.