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17-02-17, 03:18
I can't believe it's a year since I signed up to this site already. It was around this time last year that I had my sudden anxious breakdown, contemplated suicide, ended up in hospital and generally just fell apart. They say time flies when you're having fun, but clearly it does much the same when you're breaking apart.
I don't want to repeat myself too much, and my memory of events is surprisingly hazy, but I just feel like taking a look back with you guys and then looking at how things moved forward and where I am now.
How it started
Well, you could probably go all the way back to when I was conceived and look at my neuro-development and say it started there. I was also a very anxious child, a very anxious teenager, and a very anxious 20-something. But the actual suffering - the breakdown, if you like, began in late January 2016 with a collapse at work. Going over old ground here as anyone who remember my threads will probably recall, but for those who don't, I was sat at my desk working and not feeling anything untoward. The next thing I knew, I felt a tingling in my arm, and I reacted in the wrong way. I thought it was a sign of an imminent heart attack, which caused me to hyperventilate, which made everything feel spacey and strange, and I felt like I was losing consciousness, although I never actually did.
At the time, I didn't know what had happened to me. I assumed, as you can probably understand, that I must be perilously ill. My colleagues called an ambulance out, and here is where I should have seen the first clue as to what was going on. The paramedics were relaxed from the moment they arrived. They never seemed worried and they didn't even take me in.
A more rational me would have seen this as a sign that nothing serious was wrong. Sadly, I was unable to shake off the trauma of the situation. I barely even acknowledged the fact the paramedics left me behind as a sign of anything. I sunk deeper and deeper into my own head, convinced I must be chronically or terminally ill.
It sounds like a huge leap, right? Well, things got worse from there. To try my best to cut a long story short, I still didn't know what was wrong. I certainly didn't have a clue it was anything psychological. Over the next few days, I thought about nothing else but that "collapse", as I call it. My thoughts sped up and I fell into a spiral where I convinced myself I was seriously ill, which triggered the same symptoms to keep repeating themselves. Looking back, I'd actually had a few symptoms in the weeks leading up to all this. I'd been having palpitations without worrying about them too much. Clearly, something hadn't been right, and some sort of big moment was inevitable. But anyway, over the next few days, I mostly retreated to my bedroom. I was given two weeks off work and I just stayed in the house, trembling, waiting for the moment whatever I had would take me.
I went A&E a couple of times, but was sent home confidently by doctors that told me there was nothing wrong. I was even given a blood test. I should have listened, but I just felt like the extent to which I felt ill wasn't coming across. I felt like the doctors were missing what was wrong, and that part of the reason was that I wasn't being clear enough. It was almost as if I was trying to make myself worse in order to get taken more seriously, although I didn't see it at the time.
So, what was actually wrong? And why did it get so bad?
I've mentioned this before, so I won't say too much about it, but about a week later, I got to the point where I was so scared, I decided I wanted to just end it all. I always knew that serious mental illness can lead to suicidal ideation, but I never knew that you could be driven to it through fear as opposed to depression or something like psychosis. In any case, if I'd have gone through with what I planned to do, I can tell you that I would have come out of it very much alive and looking very silly. I almost laugh at it now.
I pulled back from the bring, though, and called 999 instead. I'd called them a few times over the past few days and was told I wasn't an emergency, but yet again, this didn't sink in in the slightest. Things changed with the mention of suicide, though. Six hours later, an ambulance came and took me to hospital. I stayed in overnight, had more blood tests done, gave a urine sample, had a chest x-ray, and a CT scan and had a holter monitor hooked up to my chest. Pretty exhaustive tests. I had some really frightening moments lying in bed where I felt like life was slipping away, and the doctors seemed genuinely perplexed as to why I was in such a state.
The big shock came the next morning when they told me I was going to be discharged. I was expecting to be moved to another ward for further tests to get to the root of it. I definitely did not think I would be told to go home. But my tests came back all clear. Physically, I was in quite good shape. You wouldn't have known that to look at my at this point, though. I could barely stand up. It's the most ill I've ever felt (never doubt the extremes anxiety can take your body to physically).
The big problem was that, although I was being told I was fine, nobody was even attempting to explain what was wrong with me. Even after being discharged, nobody told me what they thought the problem was. At this point, I was still in the dark. I had no idea what was wrong, but all my mind could do was race and race and dwell on that incident at work.
The seed of an answer finally came in the hospital entrance area while I waited for a taxi. I had my discharge sheets, so I was looking through them while trying to stay conscious and upright, and although most of it didn't mean anything to me, there was a small section where the doctor states what they believe the issue was. In my case, it was something along the lines of "altered state of consciousness caused by hyperventilation triggered by anxiety." I started looking up the subject of anxiety on my phone and found my way to the subject of panic attacks, and suddenly it made sense! I knew surprisingly little about anxiety and panic attacks, but I couldn't really argue with it. Naturally, that wasn't the end of it all, but it was a nudge in the right direction.
What were your next steps?
I was living in London at the time and hadn't been there that long, so I registered with a GP and made an appointment. By this point, the symptoms had taken hold too deeply that one document, albeit an authoritative and reliable one, was going to make everything better. I was struggling badly. I knew what was wrong now, but I feared it immensely. And there was always a niggling doubt in the back of my mind that it might be something else.
This is where things start to get hazy. I don't remember everything exactly in sequence, and nor do I care to. But what I do know is that things took another turn for the worse when, out of the blue, I developed a sense of derealisation. Again, I didn't know what it was, so it became my new problem that triggered a whole new wave of anxiety and panic. I actually believed I might be developing schizophrenia. I look back and chuckle now. Schizophrenia doesn't present this way, and it certainly doesn't start with a random collapse at work! But that's what had happened to my mind. I'm convinced I was beginning to develop agoraphobia by this point. My legs would turn to jelly at the thought of leaving the house. If I did make it outside, it felt dangerous, as if I was on the verge of another collapse.
I went to the doctor, though, and explained everything and she saw my notes. She told me to refer for counselling, which I did, and offered to give me antidepressants. At the time, I was wary of psychoactive medication (uninformed, basically) and said I just wanted something to kill the physical symptoms. My mind was in a place where the physical symptoms were the problem as far as I was concerned, and it was that that needed to be addressed. She prescribed me some propranolol (beta blockers) and said I should come back if things don't improve.
In the early stages, the beta blockers didn't really help. Part of the problem was that I was now in such a thick state of depersonalisation and derealisation that all my attention had latched onto that and I was convinced I was seriously mentally ill. Things continued to spiral downwards and, to try once again to cut this long story as short as possible, I agreed to go on sertraline. I also got some diazepam. I was lucky in that my therapy appointment came through very quickly, as well.
So things started to get better from there?
At first, no. The therapy was good in that it made me feel safe and looked after, but I didn't have a good start-up experience on the sertraline. It worsened my depersonalisation/derealisation even further, and before I knew it, I couldn't feel emotions anymore. Except for fear, if that's an emotion. It was like a wall had been built in my mind and my emotions were stuck on the wrong side of it - still present, but inaccessible. I didn't know, or even suspect at the time, that the sertraline was the cause, but I'm adamant it was now. It just fits together. This was really serious, because I was now more anxious and scared than ever, still concerned that I was becoming schizophrenic. I presented to A&E on three occasions, turned up at my GP surgery with no appointment and even tried to get myself admitted to a private psychiatric hospital! Yeah, it was desperate.
And then something changed. One morning, I got up, and I was fed up of chasing around for something or someone to save me. I was fed up of being scared and waiting to die. My diagnosis from several psychiatrists was Generalised Anxiety Disorder. In essence, something had to give, and that something would have to be. So instead of going back to the doctor or to hospital or just lying quivering in my room, I went for breakfast at a local café. And then I went for a walk in the rain. I felt it. Just a semblance of normal feeling. It was like the old me was trying to poke through.
It was fleeting at first. I still relied on the beta blockers and I had quite a decent supply of diazepam, both of which were doing something by this point. Over the next few days and weeks, I also noticed the sertraline starting to do its job. I'd had to come through a hell of a start-up, but I was bouncing back. I also had an amazing therapist, for which I feel very lucky, as CBT on the NHS is incredibly hit-and-miss. I learned some useful techniques for challenging my thought processes, but the most useful aspect for me was simply feeling looked after. My therapist was also superb at helping me learn to relax again. I also found a handful of books that really resonated with me and helped point me in the right direction towards recovery (Claire Weekes, Paul David, Matt Haig).
How are you now?
I'd be lying if I said I'm 100% symptom-free. But I can tell you that, when it comes to the symptoms of anxiety, I'm 100% fear-free. I still get the odd bout of palpitation, but I don't care. I still have mini-attacks of derealisation which are basically attempted panic attacks, but I don't care. None of it escalates anymore, because I no longer feed it that secondary dose of fear. I also listen to my mind and its irrational nonsense a hell of a lot less. I also manage my mental health better. I run a lot. I eat better. I sleep... okay-ish, but better than I used to. And I don't worry anywhere near so much. If I find myself expecting the worst, I challenge it. I live in the moment more, which takes so much pressure off your shoulders when you really get good at it. In other words, I'm progressing and I think I'm growing into a better person precisely because of what I went through. I'm genuinely excited about the future and I believe in my ability to make something of it. I never used to feel that way about myself. I'm going to Bratislava for a few days with my best friend from my university days next month and could not be more excited. Not bad for a guy who, only a few months ago, was creeping towards agoraphobia.
Things aren't perfect. I had to give up work and move home with my parents, and I'm still out of work. At 32, it doesn't feel great. But then again, I no longer look at it through the judgemental eyes of others. This is part of my recovery process. I'm also in a bit of a financial mess, but even that is looking up now, and my reaction to the situation is so much calmer and more measured than it would have been were I still the old me. I don't consider myself an anxiety sufferer anymore, because I don't suffer.
One thing I used to say was that health anxiety was not a main aspect of my condition. I always saw it as a sort of overarching fear of life - of work expectations, of social situations and just anything that required anything of me. I was right insofar as that's how I grew up and how I've always operated and how I've always lived. It led to major depressive episodes in the past that I shouldn't have kept to myself. At the age of 22, while studying for my Masters, I had a really bad bout of prolonged depression that sucked all the enjoyment out of that year. I should have gone to a doctor. I didn't tell a soul, and look how things eventually transpired. But when I look at this specific breakdown, it's clear that health anxiety and existential angst were actually at the heart of it. It was the next stage of my anxiety, if you like, and it really took me down.
Nevertheless, I'm slowly learning techniques and ways to manage those thoughts and feelings. It's been a really challenging year, but I've climbed out of hell and I don't intend to go back.
Any advice
A few short bits of advice to share with you. Bear in mind, I'm not a doctor, a scientist or a mental health expert. I'm just a sufferer who found his way out. This is what helped me and some combination of these things should, I believe, help you too:
1) Get help. Anxiety disorders are eminently treatable, but they often become chronic, and one of the main reasons is that people don't seek help quickly enough. Take your mental health seriously. Be prepared to push for a better therapist if you're not happy with the one you have. It may take energy you feel you don't have, but it's very important. It's your health.
2) Consider medication. They don't work for everyone, side effects, start-up problems, yadda yadda yadda. I'm aware of the downsides (very aware). That's why I don't say "take medication". And you can recover without it. But do consider it. Think carefully about it, and if you do take the plunge, be prepared to stick with it. It does get better eventually.
3) Stop trying to figure it all out. Assuming you've been checked out and your diagnosis is some form of anxiety, don't treat the symptoms like separate issues in their own right, to be fretted over individually. Shove it all under the anxiety umbrella. When you have a cold, you don't individually worry about the stuffiness, the muscle aches, the runny nose, the sore throat etc. You just accept it as part of your cold and move on. Do the same with anxiety. Those palpitations, sweats, stomach issues, shakes, tingles and whatever else you have, it all goes under your anxiety umbrella, and it all requires the same response.
4) Remember - you can do anything. I'm not saying you should take your agoraphobia or OCD or GAD and drag it, kicking and screaming up Mt. Kilimanjaro (at least not right away). But what I am saying is that, despite how awful anxiety makes you feel, it can't stop you doing anything. And nor can panic attacks. You won't come to any harm. Furthermore, your brain retains the ability to actually create new neural pathways, so by getting on with your life, you actually give yourself a chance to physically eliminate your anxiety disorder from your brain. You don't have to be strong to do this. You just have to be accepting of the way you feel in the now, because it's temporary, and it will pass, no matter how long or how severely you've suffered.
5) Find some books and other literature that resonate with you and help you and make you feel that you're being pointed in the right direction. And then stop. By this I mean, don't fill your bookshelves with anxiety literature. All you'll do is make the subject a massive part of your life. When you find what feels right, that's where you stop the search. You don't need anything else.
6) Look after yourself as best you can. This is really hard when you're mentally ill, especially if depression is thrown into the mix. But it makes a difference. Surround yourself with the right people. Discard people who contribute to your illness. They aren't worth it. Get some exercise. I know it's a bit of a cliché, but there is solid data to show that exercise is good for mental health. I was even offered a running course on the NHS. But you don't have to run. Just get out into the world, get your heart beating (yes, you are meant to be able to feel it!), and get a bit of a sweat on. Eat right. I'm as guilty as anyone of not doing so. To some extent, I think I believed I was having a heart attack that day because I'd been so badly for so long. You'll be amazed how much better you feel just by eating a little better. You can still have whatever enjoy (did you know you get a release of dopamine just by thinking about food you like?), but try to factor in more of the good stuff.
I think I'll stop here before this turns into my memoirs. It's a long read, I know, but I had a lot to say! I hope something in here helps somebody find their way back. Anxiety does not have to be forever. It's up to you whether it will be or not.
I don't want to repeat myself too much, and my memory of events is surprisingly hazy, but I just feel like taking a look back with you guys and then looking at how things moved forward and where I am now.
How it started
Well, you could probably go all the way back to when I was conceived and look at my neuro-development and say it started there. I was also a very anxious child, a very anxious teenager, and a very anxious 20-something. But the actual suffering - the breakdown, if you like, began in late January 2016 with a collapse at work. Going over old ground here as anyone who remember my threads will probably recall, but for those who don't, I was sat at my desk working and not feeling anything untoward. The next thing I knew, I felt a tingling in my arm, and I reacted in the wrong way. I thought it was a sign of an imminent heart attack, which caused me to hyperventilate, which made everything feel spacey and strange, and I felt like I was losing consciousness, although I never actually did.
At the time, I didn't know what had happened to me. I assumed, as you can probably understand, that I must be perilously ill. My colleagues called an ambulance out, and here is where I should have seen the first clue as to what was going on. The paramedics were relaxed from the moment they arrived. They never seemed worried and they didn't even take me in.
A more rational me would have seen this as a sign that nothing serious was wrong. Sadly, I was unable to shake off the trauma of the situation. I barely even acknowledged the fact the paramedics left me behind as a sign of anything. I sunk deeper and deeper into my own head, convinced I must be chronically or terminally ill.
It sounds like a huge leap, right? Well, things got worse from there. To try my best to cut a long story short, I still didn't know what was wrong. I certainly didn't have a clue it was anything psychological. Over the next few days, I thought about nothing else but that "collapse", as I call it. My thoughts sped up and I fell into a spiral where I convinced myself I was seriously ill, which triggered the same symptoms to keep repeating themselves. Looking back, I'd actually had a few symptoms in the weeks leading up to all this. I'd been having palpitations without worrying about them too much. Clearly, something hadn't been right, and some sort of big moment was inevitable. But anyway, over the next few days, I mostly retreated to my bedroom. I was given two weeks off work and I just stayed in the house, trembling, waiting for the moment whatever I had would take me.
I went A&E a couple of times, but was sent home confidently by doctors that told me there was nothing wrong. I was even given a blood test. I should have listened, but I just felt like the extent to which I felt ill wasn't coming across. I felt like the doctors were missing what was wrong, and that part of the reason was that I wasn't being clear enough. It was almost as if I was trying to make myself worse in order to get taken more seriously, although I didn't see it at the time.
So, what was actually wrong? And why did it get so bad?
I've mentioned this before, so I won't say too much about it, but about a week later, I got to the point where I was so scared, I decided I wanted to just end it all. I always knew that serious mental illness can lead to suicidal ideation, but I never knew that you could be driven to it through fear as opposed to depression or something like psychosis. In any case, if I'd have gone through with what I planned to do, I can tell you that I would have come out of it very much alive and looking very silly. I almost laugh at it now.
I pulled back from the bring, though, and called 999 instead. I'd called them a few times over the past few days and was told I wasn't an emergency, but yet again, this didn't sink in in the slightest. Things changed with the mention of suicide, though. Six hours later, an ambulance came and took me to hospital. I stayed in overnight, had more blood tests done, gave a urine sample, had a chest x-ray, and a CT scan and had a holter monitor hooked up to my chest. Pretty exhaustive tests. I had some really frightening moments lying in bed where I felt like life was slipping away, and the doctors seemed genuinely perplexed as to why I was in such a state.
The big shock came the next morning when they told me I was going to be discharged. I was expecting to be moved to another ward for further tests to get to the root of it. I definitely did not think I would be told to go home. But my tests came back all clear. Physically, I was in quite good shape. You wouldn't have known that to look at my at this point, though. I could barely stand up. It's the most ill I've ever felt (never doubt the extremes anxiety can take your body to physically).
The big problem was that, although I was being told I was fine, nobody was even attempting to explain what was wrong with me. Even after being discharged, nobody told me what they thought the problem was. At this point, I was still in the dark. I had no idea what was wrong, but all my mind could do was race and race and dwell on that incident at work.
The seed of an answer finally came in the hospital entrance area while I waited for a taxi. I had my discharge sheets, so I was looking through them while trying to stay conscious and upright, and although most of it didn't mean anything to me, there was a small section where the doctor states what they believe the issue was. In my case, it was something along the lines of "altered state of consciousness caused by hyperventilation triggered by anxiety." I started looking up the subject of anxiety on my phone and found my way to the subject of panic attacks, and suddenly it made sense! I knew surprisingly little about anxiety and panic attacks, but I couldn't really argue with it. Naturally, that wasn't the end of it all, but it was a nudge in the right direction.
What were your next steps?
I was living in London at the time and hadn't been there that long, so I registered with a GP and made an appointment. By this point, the symptoms had taken hold too deeply that one document, albeit an authoritative and reliable one, was going to make everything better. I was struggling badly. I knew what was wrong now, but I feared it immensely. And there was always a niggling doubt in the back of my mind that it might be something else.
This is where things start to get hazy. I don't remember everything exactly in sequence, and nor do I care to. But what I do know is that things took another turn for the worse when, out of the blue, I developed a sense of derealisation. Again, I didn't know what it was, so it became my new problem that triggered a whole new wave of anxiety and panic. I actually believed I might be developing schizophrenia. I look back and chuckle now. Schizophrenia doesn't present this way, and it certainly doesn't start with a random collapse at work! But that's what had happened to my mind. I'm convinced I was beginning to develop agoraphobia by this point. My legs would turn to jelly at the thought of leaving the house. If I did make it outside, it felt dangerous, as if I was on the verge of another collapse.
I went to the doctor, though, and explained everything and she saw my notes. She told me to refer for counselling, which I did, and offered to give me antidepressants. At the time, I was wary of psychoactive medication (uninformed, basically) and said I just wanted something to kill the physical symptoms. My mind was in a place where the physical symptoms were the problem as far as I was concerned, and it was that that needed to be addressed. She prescribed me some propranolol (beta blockers) and said I should come back if things don't improve.
In the early stages, the beta blockers didn't really help. Part of the problem was that I was now in such a thick state of depersonalisation and derealisation that all my attention had latched onto that and I was convinced I was seriously mentally ill. Things continued to spiral downwards and, to try once again to cut this long story as short as possible, I agreed to go on sertraline. I also got some diazepam. I was lucky in that my therapy appointment came through very quickly, as well.
So things started to get better from there?
At first, no. The therapy was good in that it made me feel safe and looked after, but I didn't have a good start-up experience on the sertraline. It worsened my depersonalisation/derealisation even further, and before I knew it, I couldn't feel emotions anymore. Except for fear, if that's an emotion. It was like a wall had been built in my mind and my emotions were stuck on the wrong side of it - still present, but inaccessible. I didn't know, or even suspect at the time, that the sertraline was the cause, but I'm adamant it was now. It just fits together. This was really serious, because I was now more anxious and scared than ever, still concerned that I was becoming schizophrenic. I presented to A&E on three occasions, turned up at my GP surgery with no appointment and even tried to get myself admitted to a private psychiatric hospital! Yeah, it was desperate.
And then something changed. One morning, I got up, and I was fed up of chasing around for something or someone to save me. I was fed up of being scared and waiting to die. My diagnosis from several psychiatrists was Generalised Anxiety Disorder. In essence, something had to give, and that something would have to be. So instead of going back to the doctor or to hospital or just lying quivering in my room, I went for breakfast at a local café. And then I went for a walk in the rain. I felt it. Just a semblance of normal feeling. It was like the old me was trying to poke through.
It was fleeting at first. I still relied on the beta blockers and I had quite a decent supply of diazepam, both of which were doing something by this point. Over the next few days and weeks, I also noticed the sertraline starting to do its job. I'd had to come through a hell of a start-up, but I was bouncing back. I also had an amazing therapist, for which I feel very lucky, as CBT on the NHS is incredibly hit-and-miss. I learned some useful techniques for challenging my thought processes, but the most useful aspect for me was simply feeling looked after. My therapist was also superb at helping me learn to relax again. I also found a handful of books that really resonated with me and helped point me in the right direction towards recovery (Claire Weekes, Paul David, Matt Haig).
How are you now?
I'd be lying if I said I'm 100% symptom-free. But I can tell you that, when it comes to the symptoms of anxiety, I'm 100% fear-free. I still get the odd bout of palpitation, but I don't care. I still have mini-attacks of derealisation which are basically attempted panic attacks, but I don't care. None of it escalates anymore, because I no longer feed it that secondary dose of fear. I also listen to my mind and its irrational nonsense a hell of a lot less. I also manage my mental health better. I run a lot. I eat better. I sleep... okay-ish, but better than I used to. And I don't worry anywhere near so much. If I find myself expecting the worst, I challenge it. I live in the moment more, which takes so much pressure off your shoulders when you really get good at it. In other words, I'm progressing and I think I'm growing into a better person precisely because of what I went through. I'm genuinely excited about the future and I believe in my ability to make something of it. I never used to feel that way about myself. I'm going to Bratislava for a few days with my best friend from my university days next month and could not be more excited. Not bad for a guy who, only a few months ago, was creeping towards agoraphobia.
Things aren't perfect. I had to give up work and move home with my parents, and I'm still out of work. At 32, it doesn't feel great. But then again, I no longer look at it through the judgemental eyes of others. This is part of my recovery process. I'm also in a bit of a financial mess, but even that is looking up now, and my reaction to the situation is so much calmer and more measured than it would have been were I still the old me. I don't consider myself an anxiety sufferer anymore, because I don't suffer.
One thing I used to say was that health anxiety was not a main aspect of my condition. I always saw it as a sort of overarching fear of life - of work expectations, of social situations and just anything that required anything of me. I was right insofar as that's how I grew up and how I've always operated and how I've always lived. It led to major depressive episodes in the past that I shouldn't have kept to myself. At the age of 22, while studying for my Masters, I had a really bad bout of prolonged depression that sucked all the enjoyment out of that year. I should have gone to a doctor. I didn't tell a soul, and look how things eventually transpired. But when I look at this specific breakdown, it's clear that health anxiety and existential angst were actually at the heart of it. It was the next stage of my anxiety, if you like, and it really took me down.
Nevertheless, I'm slowly learning techniques and ways to manage those thoughts and feelings. It's been a really challenging year, but I've climbed out of hell and I don't intend to go back.
Any advice
A few short bits of advice to share with you. Bear in mind, I'm not a doctor, a scientist or a mental health expert. I'm just a sufferer who found his way out. This is what helped me and some combination of these things should, I believe, help you too:
1) Get help. Anxiety disorders are eminently treatable, but they often become chronic, and one of the main reasons is that people don't seek help quickly enough. Take your mental health seriously. Be prepared to push for a better therapist if you're not happy with the one you have. It may take energy you feel you don't have, but it's very important. It's your health.
2) Consider medication. They don't work for everyone, side effects, start-up problems, yadda yadda yadda. I'm aware of the downsides (very aware). That's why I don't say "take medication". And you can recover without it. But do consider it. Think carefully about it, and if you do take the plunge, be prepared to stick with it. It does get better eventually.
3) Stop trying to figure it all out. Assuming you've been checked out and your diagnosis is some form of anxiety, don't treat the symptoms like separate issues in their own right, to be fretted over individually. Shove it all under the anxiety umbrella. When you have a cold, you don't individually worry about the stuffiness, the muscle aches, the runny nose, the sore throat etc. You just accept it as part of your cold and move on. Do the same with anxiety. Those palpitations, sweats, stomach issues, shakes, tingles and whatever else you have, it all goes under your anxiety umbrella, and it all requires the same response.
4) Remember - you can do anything. I'm not saying you should take your agoraphobia or OCD or GAD and drag it, kicking and screaming up Mt. Kilimanjaro (at least not right away). But what I am saying is that, despite how awful anxiety makes you feel, it can't stop you doing anything. And nor can panic attacks. You won't come to any harm. Furthermore, your brain retains the ability to actually create new neural pathways, so by getting on with your life, you actually give yourself a chance to physically eliminate your anxiety disorder from your brain. You don't have to be strong to do this. You just have to be accepting of the way you feel in the now, because it's temporary, and it will pass, no matter how long or how severely you've suffered.
5) Find some books and other literature that resonate with you and help you and make you feel that you're being pointed in the right direction. And then stop. By this I mean, don't fill your bookshelves with anxiety literature. All you'll do is make the subject a massive part of your life. When you find what feels right, that's where you stop the search. You don't need anything else.
6) Look after yourself as best you can. This is really hard when you're mentally ill, especially if depression is thrown into the mix. But it makes a difference. Surround yourself with the right people. Discard people who contribute to your illness. They aren't worth it. Get some exercise. I know it's a bit of a cliché, but there is solid data to show that exercise is good for mental health. I was even offered a running course on the NHS. But you don't have to run. Just get out into the world, get your heart beating (yes, you are meant to be able to feel it!), and get a bit of a sweat on. Eat right. I'm as guilty as anyone of not doing so. To some extent, I think I believed I was having a heart attack that day because I'd been so badly for so long. You'll be amazed how much better you feel just by eating a little better. You can still have whatever enjoy (did you know you get a release of dopamine just by thinking about food you like?), but try to factor in more of the good stuff.
I think I'll stop here before this turns into my memoirs. It's a long read, I know, but I had a lot to say! I hope something in here helps somebody find their way back. Anxiety does not have to be forever. It's up to you whether it will be or not.