Tuesday 20 August 2019

#MindYourself: Learning to live with chronic anxiety - Julia Molony's ten year struggle

If depression is the common cold of mental illness, then anxiety, now epidemic, must be akin to allergies or asthma - if not normal, exactly, then at least a common variation. Here, Julia Molony details her decade-long struggles with persistent negative thoughts, and shares what light there is

Julia Molony struggles with a cascade of catastrophic thoughts, including deadly spiders, sink-holes and locked-in syndrome. Photo: Boris Conte
Julia Molony struggles with a cascade of catastrophic thoughts, including deadly spiders, sink-holes and locked-in syndrome. Photo: Boris Conte

Publicly, I tend to make a joke of my anxiety. It can seem more palatable that way - if I spin it into a ditzy "aren't I so neurotic?" narrative, in a time-honoured distancing-by-humour strategy that countless emotionally wobbly people such as myself have employed since it was first made popular (and acceptable) by Woody Allen.

Laughing at it helps to neutralise, a little bit, the hold it often has over me. And on good days, it is an accurate reflection of how I feel; a worry-wart, a fretful person, sure. But still able to make fun of myself, to laugh at my own expense, to be light and spontaneous and, well, happy. Not necessarily someone entirely defined by fear.

But the reality is that there's also quite a lot about my anxiety that isn't very funny at all.

It's not funny when it takes me over bodily, making my stomach churn and my palms sweat. It's not funny during the times when it overwhelms me, leaving me unable to do much else but shake and sob.

The people close to me very often don't find it very funny, when they've spent hours at a time talking in circles around my obsessive thoughts of illness, death and catastrophe. Or tried to argue and reason with my absolute conviction that I'm about to die or that I've got a terminal disease.

And the many hours of my life I've spent, white-faced and drawn, pacing the room into the small hours of the night because the only reason I can possibly think of to explain why my boyfriend's mobile is going to voicemail is that something terrible must have happened to him? Definitely not very funny at all.

At those times, I'm unlikely to be found making a joke of it. Not least because in the face of white-hot fear, all humour deserts me.

But also because during these interludes of distress, my first instinct is not to wise-crack in pubs, but to hide. To let texts and emails from friends go ignored and unanswered, to cancel social plans. Because I'm so consumed with the simple business of fire-fighting fear that the idea of entering normal life, except for the strictly necessary (work, food, exercise) seems too much.

To live with anxiety is to live inside a locked box. Extreme worry traps you in your own mind and cuts you off from the world. It is both tortuously isolating and, to outsiders, boringly narcissistic. But a big part of the reason that I want to hide, if I'm honest, is the shame.

It's not a version of myself that I like very much - the wan-faced ghost that emerges from time to time, usually during periods of stress or transition. Mostly, I'd rather conceal myself away until, as it invariably does, the storm passes, my mind becomes my own again and I can get through, say, an evening with friends, without feeling like my head is entirely elsewhere or having to figure out an exit strategy in advance in case of a panic attack.

But one of the few lessons that I've learned in the decade or so since I developed anxiety is that hiding is almost always a mistake. The temptation is to try to seek relief, and safety, by retreating to bed. In my experience, this only ever makes things worse. To escape one's own mind, one has to do everything humanly possible to wrench oneself away from the internal and out to the external. And the first rule is that this is always harder when you are lying down.

In any case, hiding from shame about being anxious is, thank God, becoming increasingly unnecessary in today's world. Anxiety disorders are estimated to affect up to a third of all women at some point in their life. If depression is sometimes referred to as the common cold of mental illness, then anxiety, which by some accounts is more prevalent, must be analogous to allergies or asthma - widespread enough to be, if not normal exactly, then certainly a common variation on normal.

I mean, even a member of the British Parliament 'came out' a year or two ago as a sufferer of OCD. Tory minister Charles Walker artfully described his struggle with the "hundred little blackmails a day", the unwanted thoughts that prompt him into irrational safety behaviours, such as washing his hands hundreds of times over.

For actors, writers, sports people and musicians to publicly discuss their mental-health betes noirs has become commonplace, but for a politician to do so represents a watershed. It means that to be prone to disordered thinking doesn't have to define you as dysfunctional. There is an army of us out there - holding down jobs, operating well in our families, getting on with life, despite periodically feeling like we are crumbling inside.

In my case, I guess the tendency towards anxiety has always been with me. Or at least, certainly I've always struggled to distinguish well between imagined threats and real ones.

Once, in secondary school, while walking down the street, I heard a car pull up behind me and responded by leaping comically over a garden fence in fright, so sure was I that I was being chased by axe-wielding murderers.

Despite the fact that I hadn't looked to check first. Which was slightly embarrassing when, having landed arse-first, I turned to see a friend and her mother, peering over at me and holding my school-bag. I'd left it on the bus, so they'd followed behind me to return it.

There is probably a genetic element to anxiety in my case - like most maladies, both nature and nurture play their respective roles. Quite possibly, in my early life, a base-level sense of security, a belief that mostly, things will turn out okay, wasn't laid down.

But it wasn't until about a decade ago that it all really kicked off. My propensity to worry began to detach from what could be thought of as appropriate and proportionate to a given set of circumstances, and take on a whole life of its own. It stopped being something that would kick into gear over a deadline or an unanswered phone and then resolve immediately, becoming a pattern of thinking and rumination that might go on for days or even weeks - in a destabilising sequence of terrifying escalations and (occasional) short reprieves. Anxiety, I began to notice, is often cumulative. Worry breeds more worry.

Part of my problem is a dysfunction of the imagination. Catastrophisation is what the experts call it. Or in layman's terms, always thinking the worst. But for some reason, when faced with a number of different possible outcomes of a given situation - a medical test, say, or a loved one failing to show up at an expected place at an expected time - there's often only one possible narrative that seems real or plausible to me, and that is the most frightening one I can think of.

The ability to feel balanced and well in day-to-day life depends on making a leap of faith - a conviction that though terrible loss, abandonment, trauma, life-changing injury and death are all a part of life, they probably won't happen today.

For me, making that leap of faith doesn't necessarily come naturally or automatically. Some days it comes, but with a considerable amount of effort. Others, it doesn't come at all.

A cognitive-behavioural therapist once explained to me that by living imaginatively, repeatedly in your own personal worst-case-scenario, you do not, despite what you might think, better prepare yourself for a negative event. All you do is traumatise yourself over and over again, thereby exacerbating a feeling that should disaster actually strike, you wouldn't be able to cope. It exaggerates and amplifies a pre-existing sense that the world is essentially a perilous and threatening place - that dangers lurk all around us.

Which is, in itself, a world view that sometimes becomes so overwhelming to me that I have been known to fantasise about being temporarily placed into a medically induced coma - just, you know, for a bit of a break from all of the things that I am afraid will go wrong.

Every generation tends to think itself more anxious than the last. But given the epidemic levels of anxiety around the place these days, I think it's fair to say that this state of affairs is being compounded by how we live now.

The internet has a lot to answer for on this front. I'm pretty convinced I would be at the very least 50pc less anxious if I didn't have 24-hour, non-stop access to a tool that harvests news of traumas, death, terrible accidents and everyday heartbreak from across the globe and delivers them directly into my brain.

The worst thing about the internet is that anyone who engages with it will be kept up to date, not only with news of negative occurrences that represent everyday, common risks - road traffic accidents, for example, muggings and murders, that sort of thing - but also has access to an encyclopaedia of obscure terrors in life that you'd never even think of, were they not plastered all over Twitter.

This category includes things such as deadly spiders turning up in bunches of bananas, sink-holes, locked-in-syndrome, a rare and deadly bacterial infection that the Mail Online seems to be particularly enchanted by, called necrotising fasciitis. If I could un-know about any of the above things (and plenty more besides), I'm quite sure my quality of life would be significantly improved.

The wash of disaster that floods over us the moment we turn on our computers in the morning gives us an elevated sense of the risk of daily life.

Not only that, but more and more of us live in increasing isolation and in an increasingly abstract, virtual way, cut off from the things that root us firmly in what is real. Social media often turns us all into voyeurs, more observers of our society than participants in it. As we move away from the material in favour of the virtual, we lose a vital connection to the substance of things, old-fashioned concepts like real, living, breathing communities, and having a connection to the land. These are the things that encourage humans to feel as if they exist on solid ground.

I'd love to be able to say that I've recovered, that I've discovered a miracle cure and am now anxiety-free, but the reality, predictably, is more complicated than that. After a decade spent in hope that I would one day spontaneously snap back to the rather more carefree person that I was before, I've come gradually to accept that, no matter how much I might wish for it, it's unlikely to happen.

The mid-life years are supposed to be among the most difficult, and happiness, as the sociologists hold, follows a U-shape pattern on a graph - tending to be highest in early and later life, while sagging in the middle. So I can hold out some hope that I will at least mellow a bit with age. But I'm pretty sure that anxiety will always be with me. I'm pretty sure that there will be periods in my life when I'm relatively free from it and periods when it will come hammering back to haunt me at full force.

Experience has taught me, at least, that it will pass. And that in the meantime, there are certain things that I can do to get me through.

Such is the demand for a remedy for anxiety that a whole scientific discipline, not to mention an industry, has grown up around the search for solutions.

Among those on offer, I have tried quite a few.

When in real difficulty, medication in the form of a selective serotonin re-uptake inhibitor is for me, a swift and efficient palliative. I'm not afraid to resort to it when I absolutely need to, and for the rest of the time, knowing that the option is there, that there is a simple, straightforward way out of that locked box, if necessary, is sometimes comfort enough to get me through.

I have tried cognitive behavioural therapy, which helped in the short-term quite a bit, and Jungian therapy, which didn't. Though based on my own survey of one, that is perhaps not a fair comparison. Maybe the Jungian approach would have been more effective in the long run had I stuck with it over a period of years, but Jungian therapy is expensive and I didn't hang around long enough to find out.

Meditation, in my case, has proved to be of limited benefit. I acknowledge that it does at certain times help me feel more relaxed, but you have to have a certain degree of composure to be able to meditate in the first place. Trying to do it when acute anxiety strikes is, in my experience, a waste of time.

It's a conventional wisdom repeated so much as to almost sound trite, but it remains true that exercise can do wonders. For me, it can sometimes be the next best thing to medication. I'm as lazy as the next person and, when faced with the decision of whether or not to get off my arse, will defer and prevaricate and postpone. But I will usually pay the price. During a rough patch, the difference in my world view before and after 60 or so laps in the pool can be dramatic and startling.

I walk out the door, convinced that everything is hopeless and the world is black, and come home feeling that I can cope, that it might all be okay. The only downside about exercise, though, other than the fact that it's a pain to do, is that the benefits are gallingly temporary. In my experience, the lift lasts, at an absolute maximum, 48 hours. If I really want to stay on top of it, I have to do it every day without fail, which just isn't always practical.

And then, the final weapon I keep in my anti-anxiety arsenal is Desert Island Discs. The experts in cognitive behavioural therapy counsel distraction as the first principle as a way of breaking a negative-thinking loop. They offer suggestions like counting backwards or singing. But for me, I find that a download from the BBC Radio 4 archive often offers a handy 45 minutes' reprieve from tormented thoughts.

Every episode of the show ever broadcast - 70 years of castaways - is downloadable from the BBC website. I load them up on my iPod, block out the rest of the world with my headphones, go for a walk and escape from my own life (and brain) into someone else's. The ones I like best are the salty storytellers who've been through a few struggles and hard knocks themselves. I like the rich life stories of people who have overcome alcoholism, prejudice, troubled early lives, illness or even nervous breakdowns (and many of them have) and gone on to lead full, fascinating lives.

Desert Island Discs is soothing, life-affirming and inspiring, all at the same time.

It's not enough to stop anxiety, but it can help put it in perspective.

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