Mental Weather

You may have picked up from previous blogs that I work in the field of environmental sustainability.  I changed jobs back in January and although this new job has its own stresses, I love the area of work I'm involved in and hope I am lucky enough to continue working in this area in the future.  I won't go into exactly what I do but sufficient is it to say that it involves running events and supporting organisations become more sustainable themselves.

Things aren't quite this bad...

A significant part of my job and a big passion of mine is the severe weather side of this, i.e. protecting organisations from being shafted by severe weather.  One of the most fulfilling parts of both of my jobs is/has been working in communities and, more recently, with health professionals in trying to make patients and communities more resilient to the impacts of the weather and to try and alleviate fuel poverty, where possible.  I'm currently, with support, developing a network with health practitioners to try and make severe weather something they think more about on a daily basis.

As such, the research and real-life situations I have seen in developing this is quite striking, in terms of how much of an impact severe weather can have on physical, but also mental health. Physical is more obvious: cold weather and fuel poverty can lead, in the worst, cases to pneumonia for example; heatwaves can cause heatstroke and breathing difficulties; flood water can carry water-borne diseases; you could get struck by lightning or go arse over head on ice.

But the mental health effects are less well understood and, more importantly, less well discussed.  Whether it's less well discussed because of that lack of understanding or because of the stigma that we know still surrounds mental health I'm not sure, but it's certainly the reality.  So how can severe weather affect mental health, exactly?

- One of the direct ways is through Seasonal Affective Disorder.  At a conference I was at yesterday (one of the reasons that spurred me on to write this blog), SAD was mentioned for the first time at any sort of work event I've attended.  But this is a key condition that is affected directly by the weather.  Of course, it's not just about weather; it's also about the darker days.  This must be a horrible condition as it is purely cyclic and you know when it's coming.  I don't have SAD, but if anything I have the opposite!  

- There is also a direct link between physical and mental health.  In snowfall or icy conditions, for example, elderly people in particular are almost homebound.  They can't get out for fear of falling over. A friend of our family fell on some ice whilst walking to a non-gritted bus stop during one of those recent severe winters and were it not for one of our friendly bus drivers coming to the rescue he would have died.  Since then, once he'd fully recovered physically, he has come outside far less for fear of it happening again.  It has restricted his life much more, and when he does venture out he needs someone with him all the time for confidence.  This particular person is very much a positive person too; someone with perhaps even less initial confidence or someone who already had a mental health problem may have really struggled after just this one incident.  Winters now are almost a no-go.

- The knock-on effect of being homebound of course is loneliness.  The gentleman I mention above is still living with his wife, but many people in their 80s are widowers.  Such people rely on going out and about to socialise, and when the weather prevents this with whatever severe conditions it throws up, it can have a debilitating effect on a person's life.  They become lonely and depressed very quickly, which is a sad way to conclude a life.

- Flooding, something we've seen a lot of over the last few years, is something that can have an adverse effect on anyone's mental health.  If someone's home gets flooded it can cause thousands of pounds worth of damage.  It then takes a long time to get back to normal and it also becomes more difficult to sell your home, especially in areas where it floods frequently.  The strain that this can put the residents under can be exceptional and needless to say this can lead to significant mental health problems especially in the longer-term, namely depression and anxiety.  You would always be on edge that it was going to happen again.  This could be especially heightened if you have a family to support.

- Fuel poverty, as mentioned above, isn't directly affected by the weather. Fuel poverty comes about via an accumulation of problems resulting in a lack of money to pay for heating.  But of course, it is exacerbated in cold weather and can cause months of misery - and yes, again, depression and anxiety - for those people worst affected.  In a More Economically Developed Country as were are, no-one should really have to choose between heating and eating, but that is the reality.  And the mental health effects of striving to do this must be telling.

This list isn't exhaustive, and needless to say any physical effects as a result of severe weather impacts can impact negatively on mental health, particularly if it affects you or a carer severely or frequently.  My argument is that, I'm no expert on health at all, and yet even I have identified through my work that there are numerous effects that severe weather can have on mental health, so more should be being done.  Some organisations, such as the Joseph Rowntree Foundation, are doing more on this but the problem is only likely to get worse.  With an ageing population and climate change increasing the amount of severe weather events we get, more research needs to go into the effect that weather events have on mental health, and more importantly more efforts needs to go into helping people in these situations.  It will only become worse otherwise.

Tackling this specific issue is only a small percentage of my role; maybe there needs to be more roles that focus on this fulltime?

Best wishes
Al

Me and My Blog: Two Years On

It is two years to the day since I set up this website.  At the time, I had either just finished or was about to finish my last round CBT therapy for helping with my anxiety.  If I hadn't finished, I must have had no more than a couple of sessions left, which out of 50 isn't many.  I was living in my first shared house and about two and a half months into the experience.  It was an uncertain time and although I was much better than the same time the year before, I was still in a darker place in 2012 than I am now in 2014.  

In case your maths isn't great

As such, in this blog I thought I'd look back at the last two years and try to celebrate progress that I have made since then.  The past few weeks have at times been tough and as a result thoughts have been coming and going about just how much anxiety has affected my life.  So the changes I emphasise below may not seem much, but given the dominance anxiety has had over the years, I think I can genuinely look upon the following points as milestones.  Here follows an appraisal:

1) Moving out, moving back and moving out again

Just moving out of my parents’ home was a huge achievement in itself at the time, because a year before I could barely go outside, let alone move away.  But this first experience of living away came with many issues, not least of all the people I ended up living with.  Aside from a good friend of mine, the others were very difficult to live with when you're someone who has obsessions with cleanliness and who is uncomfortable in situations with 'new' people.  I was hoping to get more social situations from moving out, but this didn't materialise and I ended up wanting to get away from the people I was living with rather than be with them.  Housemates came and went, but none of them were to my taste and apparently cleanliness was something that in their eyes should be reserved to a bygone era. 

So on 27 January 2013, I moved back to my parents.  Some would argue that this was a step backwards, but I think me recognising the problems I was facing AND recognising the fact that moving back home WAS a step backwards and doing it anyway a) takes balls and b) shows how down the shared house was making me feel.  

But the great positive about living at this place though was the fact that I got through the ten months relatively unscathed.  Finishing successful therapy not long after I moved there helped as tools that I'd learnt were still fresh in my memory and I could handle situations better.  Yes it was hard and made me feel low, but I got through it, and my anxiety hadn't really increased despite this. But by the end I was staying at home every weekend anyway so moving out was inevitable.  

The biggest test was moving on again.  I stayed at home for another seven months or so, and I spent the last three (at least) months of that looking for a better alternative shared house.  I wasn't getting very far and was losing all hope, until eventually I found somewhere that I felt good about.  I was scared, because I identified this place as a potential to meet new people and improve my social life - scared because of my anxieties around this.  But I was excited and knew I had to go for it.  Fortunately, me and my friend who I lived with before got the rooms and it has been everything I could have hoped for.  I kept saying to myself that if I search for long enough I would find somewhere that would give me what I wanted and I'm pleased to say that persistence paid off.  It may never be as 'homely' or 'comfortable' as living at home, but it's something I need to be doing and I think I have grown as a person since I moved in here, not least because I've made some more good friends out of it.  

The first couple of weeks were very hard - ironically, even harder than the first place, perhaps because of that bad experience and not wanting to experience it again.  Or maybe it was because I put too much pressure on myself to enjoy this place and to be sociable.  But after that difficult first few weeks I stuck at it and I'm so glad I have.  As I said, I feel that I have grown as a person which has only helped my anxiety and confidence.  

2) The New Job

If you'd have said two years ago that'd I now have a new job, I wouldn't have believed you.  I was comfortable in my previous job and although local government has its own frustrations, I worked through this and reflected on the fact I was doing a job I generally enjoyed and that was related to my degree.  So, for the sake of my anxiety, why on earth change?

This new job is, of course, a relatively recently development - January this year, which, to put into perspective, was 4.5 months into living at this new house.

The hardest thing about leaving the previous job was leaving some really great people behind.  Something that I am always reluctant to do when I know that I need people around me.  As I've said before, keeping people close by is fundamental when you have anxiety, whether you feel like having people around you or not.  I'm lucky in that people I work with in this new job seem great too, but there are only four people in the whole organisation so social opportunities are less as a result.  So, early on I was quite concerned that I'd thrown away a good social opportunity; many would argue that this isn't a good reason not to change jobs, but as I've already said, having people you trust around you when you have anxiety is fundamental to recovery and maintaining a status quo.

The other negative is that this job is very busy.  So was the old one, but if anything this one is busier, and deadlines are more prevalent.  And, of course, the wonderful world of commuting is also upon me, which is the one thing I wanted to avoid given what happened in 2011.  Plus it's two hours of each weekday I don't get back and this buggers up my over-obsession with wanting to do things quickly and efficiently - thus providing the potential for more anxiety.  In fact, the combination of all of these factors is quite anxiety producing, and I've had to be careful in the last month or so to not tip myself over the edge.  Let’s just say that I've had to practice my CBT techniques a bit more in the past few weeks than I have in the many months prior.  

So this all sounds quite negative, but not necessarily.  For a start, given that two of the biggest influencers from my previous job have also recently left, and given general circumstances around working for local government at the moment, it is definitely a good move.  It's also a good move for my personal development in terms of improving my knowledge and experience and I am beginning to enjoy the company of my new colleagues more and more.  It's still stressful and challenging, but I know now I have to do my best to monitor this and try and accentuate the positives.  

Plus the main fact is - not long ago there is no way I could have even considered going for an interview for a new job, let alone get it and start quite successfully in it.  This, I hope, can only show strength of character on my part.

3) The Blog and Twitter

I'm still not sure what I think about social media, whether it be blogs, Twitter, Facebook or any of the others.  The likes of Snapchat and Instagram are still alien to me and I don't intend on signing up to them anytime soon.  I feel that social media is a screen behind which to express your emotions for some people, and for others it's a platform for boasting about how great your life is - your new house, new relationship, new job, new diet... whatever.  It's like an all year round round-robin.  So despite what I'm about to say, I'm certainly not totally in favour of social media and sometimes, especially for people with mental health issues, I think it can do more harm than good.

But, here I want to focus on the positives it has given me over the past couple of years. Obviously, this is an easy one to discuss in terms of timescales, as this blog celebrates two years since I set up this website, and I have set the scene above in terms of what I was doing at this time.  At first, I blogged in the knowledge that it wasn't reaching out to too many people.  I did it because it helped me to express thoughts and opinions, important in light of the fact I didn't have too many people around that I felt I could - or wanted to - express such thoughts to.  But despite this, I always had the aim of making this website a tool to help other people.  I knew, with my job eating up time and lack of overall confidence and selling ability, that I'd never make this website the UK's first port of call for someone looking to learn from someone else with anxiety.  Neither would I want to.  But it would be nice to at least obtain a few people who did enjoy reading it, or who found it useful or familiar in terms of experiences shared.  But over the two years, it has taken a while for this to materialise.  Sure people read it - the stats tell me that - but not too often and with no great feedback.  To the point where, especially after even more time was eaten up when I got this new job, I was considering winding up the site.  

Then, about five months ago, I decided to give Twitter another go.  I had a Twitter account before, which I closed down, as I had about four followers who may have added me thinking I was the comedian.  This time, I set up an account in honour of this site, @AnxietyTracker, and have sort of self-learnt over the past five months how Twitter works.  I still don't have a huge amount of time to spend on it, and there are some days when thinking about anxiety even with the aim of helping others is, frankly, the last thing I feel like doing.  But in five months I have heard from many more like-minded people, people who understand and appreciate my blog and what I'm saying and people to whom I can reciprocate such understanding.  By focusing my Twitter account exclusively on people I don't know (and non-celebrities, who don't interest me in the slightest), it can be used purely as a tool that emphasises my desire to improve anxiety awareness, albeit in a much smaller way than those people who put all of their time into this and professionals in the field.  

So now, it doesn't just allow me to express feelings and opinions, it allows me to share them with people who understand, who want to read and allows me to learn a heck of a lot from a group of people I don't know.  Mutual stability, you could call it.  I like to think, therefore, that I have used social media as a benefit, rather than as a hindrance to myself or an annoyance to other people. I'll let my small group of followers be the judge of that...

4) Greater Acceptance

When I say a 'greater acceptance,' I mean a greater acceptance from other people in terms of understanding and appreciating my condition, as well as having a greater self-acceptance of anxiety and how it affects me.  In terms of the latter, saying that I have 'accepted' anxiety as a problem may sound unhealthy; what I mean is that I am now more comfortable about it and happy to talk about it than I was a couple of years ago.  This, of course, may be symptomatic of both getting older and being in a better place than I was, but I remember even in the 'better' spells of my school and University life, I was as shy and embarrassed as ever of to talk openly about my anxiety.  Now, I don't necessarily instigate talking about it, but I am happy and open to if someone asks me about it.  

And, as it happens, more people have asked me about it in the past few months, especially since I have shared more things from charities on Facebook (back to social media again) - so friends pick up on things.  I have had a few frank and honest conversations in the past few months about my experiences with some friends, and this has been rewarding.  I think on all occasions, their reactions have been both inquisitive and empathetic to an extent, and certainly not negative.  Even though all of the people in question I've known for at least a while, you can never be sure what people's reaction is going to be, but overall they have been positive.

And this is the point.  Stigma does still exist, but I think the biggest thing I have learnt since starting this website two years ago is that there are a heck of a lot of people who are doing their little bit to try and combat it.  Collectively, I think this is one of the most positive movements in recent history, a movement that actually makes a positive difference, led at the front by charities whose whole task it is to rid society of mental health stigma.  I'm contributing a miniscule amount towards this movement, but everyone's equivalent amount is starting to get heard and make a difference, and I for one aim to continue doing my little bit until real change has been felt across all walks of life.  Let's see where we are on our journey in another two years.

Best wishes
Al

Life Defining Anxiety

My experience was never like this...

I've always been told by professionals that blaming my anxiety for certain aspects of my life is not helpful.  If anything, one could argue that it would fuel anxious feelings by almost giving anxiety as an excuse and as such attributing it to everything that is wrong with your life.  I know that anxiety hasn't been the cause of all of my regrets in life, nor are there many cases where anxiety is the sole cause of any.  But the condition that I have put up with for nigh on 17 years has more than just been an inconvenience to my life and my achievements, or lack of them.

Before I start reeling off the examples where anxiety has hindered me, I appreciate that I am still a very lucky person, when put into the perspective of not just a global population but even a UK one.  I don't live in poverty, I have great friends and a supportive family and my physical health is as good as one could hope.  I can't pretend to imagine what it must be like for a person who cannot say that they have one or more of these factors; living with anxiety in these cases must be incredibly hard and I'm sure, in many cases, insurmountable.  With the recession in particular, more and more people in this country have had to suffer with the consequences of job cuts and difficulty keeping their heads above water, itself a cause of anxiety.  People with long term health problems need incredible strength to keep themselves together, but again anxiety - and other mental health problems - can occur if you're stuck with a particular condition for so long. And I will not patronise any further by pretending what this must be like, and honestly, hope I never have to find out.
 
I have grown up in a world where most people I know have also been lucky, in the same respect I have.  Materialism is quite high on most people's agenda, something I personally hate, possibly because I've had the experience to enable me to cherish the less material things in life.  But this isn't to say it would have been nice to do certain things that other people I know and have grown up around have (mostly all) done.  Or if they haven't done it, it's because they have chosen not to.  A few example follow:

- Learning to drive.  I did actually have many driving lessons back in 2004-5.  I must admit it felt like I was frogmarched by my father to the post office to collect my provisional licence; it was literally on my 17th birthday.  My mum doesn't drive, so I think my dad was keen for me to as he has seen the minor hindrances that not being able to drive has given to my mum.  However, I didn't feel ready but back then I had little confidence or power to argue.  Goodness knows how many lessons I had, but each one was a living hell.  The last year of sixth form was the best year of my entire school career, but this driving lark spoilt it.  The lessons were all that was in my mind.  As one lesson ended, my mind starting thinking of the next one.  I would basically have a panic attack before, during and after each lesson, everytime without fail.  My mum even bought me some weird tablet things (can't remember what they were - not beta blockers!) that were supposed to calm me down at the peak of distress - they had no effect.  My instructor was horrific as well; very blunt and not very patient or encouraging.  Why on earth I persisted with this for so long - and indeed why my parents let me persist with it - is still beyond me, but I got so far as to take a test.  Now, I knew I wasn't competent enough to pass a test, but even if I was, the anxiety and panic I was experiencing rendered driving adequately impossible anyway.  The world's best driver wouldn't have been able to pass a test in the state I was in.  It was after this test, in June 2005, that I knew I had to stop and perhaps unsurprisingly I have never stepped foot inside the drivers seat of a car again.  Even to this day, ten years later, the very thought isn't one I wish to contemplate.  So far, not being able to drive has been an inconvenience at worst, and I actually enjoy catching buses.  I'd catch the train to work even if I could drive, and because my line of work is environmental sustainability, I kind of have a handy ready-made excuse for why I don't drive.  But this isn't to say it won't be more of an issue in future and even now I'm not sure I could face it again.

- Holidays. I've been on many holidays with my parents in the past, but because of an incident back in 1996, this kind of lay the foundations for holidays to generally be difficult in years to come.  From 1999, one of my best mates came on holiday with me and my parents to try and alleviate the problems I'd previously faced, which largely worked.  I could relax more and my mate offered the appropriate amount of distraction.  However, discounting Guernsey and Ireland, my only venture abroad has been to Barcelona, and this was for my final year undergrad Geography fieldtrip in 2008.  I'm not sure how, but I managed to survive the majority of this trip panic-free, possibly due to the amount of work and sheer number of people we were with.  My main issues with holidays are 1) like driving, bad experiences linger.  2) the fear of being in isolation and away from safety; if something went wrong e.g. a panic attack, having no-one 'safe' there to help me feels like a very daunting prospect.  3) Food - sounds daft, but my various issues with food in the past, which has been exacerbated by trips away before, is something I need to take seriously.  Only in the past year has eating out with friends become more comfortable again, and I still feel that a holiday could reverse this trend, as it has in the past.  Unusual food and pressure to eat, I suppose.  These days, I usually go away for a few days with another good friend of mine; we usually rent a caravan or cheap self-catering property.  This is fine; it's with a good friend, within this country and we control what we eat and when.  I can look forward to these trips, by and large.  But the thought of 'going travelling' or going on holiday abroad, as all my other friends have done, doesn't fill me with anything other than nervousness.  I'd love to travel to certain places and I do think that going somewhere for a week in the next few years is more likely than me getting in the driver's seat of a car.  Holidaying may be easier if...

- Relationships.  I don't want to dwell on this for too long and it would be wrong of me to say that anxiety is the only reason that relationships for me have been - to say the least - hard to come by.  But my confidence in certain situations has been slaughtered by having had anxiety for so long.  I have social anxiety although this has improved in the last couple of years, the aforementioned ability to eat out being one reason for this.  But I still struggle in certain social situation (e.g. with people I don't know or who are quite confident) and struggle even more to break the ice with someone I like.  In fact, change 'struggle even more' to 'almost impossible.'  There is a mental block in me that refuses to budge, despite being more anxiety free now than I was a couple of years ago.  There have been many periods in my life where I couldn't have even considered a relationship because I was in no fit state to look after myself, let alone be with somebody else.  But now I am, making that step has become no easier, and I do, at least in part, put this down to a crippled confidence as a result of anxiety.  Unfortunately, it also feels to me like we're also living in an ever increasing confident society.  As it happens, some of my friends haven't had too many successful relationships either, but some have, and in the days of social media, every other day it seems like people I know are getting married or engaged, which does nothing to improve my hope or self-esteem around this issue.

So there are three of the biggest examples (there are others too) I can give to you where I feel that anxiety has been a real problem.  Going through the pain of panic and intrusions is enough in itself, but the longer-term hindrances that it has also, at best, contributed to is another thing entirely.  This is the shape of my whole life we're talking about, things that people who went to the same school as me and grew up in similar backgrounds take for granted. I appreciate I generalise - I won't be the only one - but being surrounded in general by a society who are happy with their relationships, go on holiday and who's only driving concern is how much their insurance is, does not make these things any easier - quite the opposite, in fact. 

I can't predict where I'll be in five years.  If you'd have said to me this time last year that I'd be back living in shared accommodation which was actually going very well, and that I'd have a different job, I wouldn't have believed you. So who knows what is round the next corner.  But the reality is, years of anxiety has rendered many life-defining things extremely difficult that many other people I know don't even have to work at.

Best wishes
Al

Seven Steps to Stability - Step 7: Raising Awareness

MHAW 2014

The final Step to Stability that I think is very important to include is how I have sought solace and compassion in talking to other people about anxiety and other mental health problems.  Previous to the last couple of years, I'd never spoken to anyone about such issues apart from close friends (see MHAW blog 4) and therapists, not least because I'd never have had the ability; just the thought of talking to a stranger, even if it isn't face to face, would have been too much to bear.  I suppose this is for two reasons: 1) the fear of what they would think of me and me caring too much about this, and 2) talking about it would probably trigger off unwanted thoughts that in turn would lead me to have a panic attack.

But since the therapy I've received, I have wanted to do my little bit to spread the word about mental health, both for myself to try and improve my confidence around talking to other people about the issue and secondly to help or provide comfort to a fellow sufferer, who may be in the depths of anxiety.

The ways I have done this have mostly been via the means of various forms of media and communication.  I have rarely spoken to someone face to face about anxiety other than the aforementioned friends and therapists, but in this day and age where everyone can know everyone else's business, it's not difficult to raise awareness via other means.  People who are experiencing severe anxiety may also prefer to talk via the web than face to face at first anyway, simply because it is easier.  The very step of talking to someone verbally can be anxiety inducing in itself.

The main channels that I have used to try to awareness are as follows:

1) Anxiety UK's pen pals booklet.  This is a little booklet included every six months (I believe) In Anxiety UK's magazine, that simply provides brief details about where a person lives, a little bit about them and their anxiety condition.  By signing up, you are basically obliged to respond to anyone who contacts you.  I have been emailed by a couple of people via these means and written to by someone too.  It's really interesting to hear their stories and each one I have admired, because I could tell that they were going through difficult spells at the time they wrote their email/letter.  If I have helped just a tiny little bit or given them any ounce of comfort then I deem this a success.

2) Research and blogging for Mind.  I wrote a blog for Mind quite a while ago now and regrettably time appears to have condemned it into the web's ether, but I had a fair few positive comments on the website and a couple of emails about this. I also posted it to my Facebook account, following which I got some unexpected comments from a couple of people who had no idea I had anxiety and who showed some real support whilst sharing their experiences.  This was really nice and to be honest not the reason I originally blogged for Mind!  I have also done a telephone interview with Mind about the effect that mental health had on me as a young person and the help (or lack of it) that was available to me at the time.

3) This website.  This is obviously my main tool through which I use to raise awareness or ask questions about myself and mental health.  I have been blogging for nearly two years now and even though writing a blog can sometimes (but not often) be a chore rather than something to enjoy, I'm glad that I've managed to keep it relatively regularly updated.  I admit that this week, given the amount of work I've had and tiredness etc, it's been a mini challenge writing a blog each day but I feel it's been worth it.  Doing this for Mental Health Awareness Week won't raise any money or change anyone's life, but I hope at least that it will do what the Week says on the tin - raise awareness of mental health. 

I'm also on Twitter now too, something which I should have done a while ago but have only got round to in the last couple of months, but love it or hate it, this is a very good way of raising awareness and already I have connected with some very insightful and interesting people regarding the mental health agenda.  If you're stumbling across this blog not via Twitter, I'm @AnxietyTracker incidentally.

Obviously, one of the main things I've got from doing this awareness raising is a positive feeling of helping other people.  My therapist talked a lot about compassion and how the feelings associated with this are, in themselves, very good at alleviating anxiety and panic.

Another reason for doing this blog and the rest of my contribution is to help others, not in a therapy way (I'll leave that to the professionals, contrary to MHAW blog 2's topic!) but in a 'you're not alone' type way.  I thought I was well and truly alone with anxiety when I first started doing all this, and it's only in the last year or so have I really learnt how many people have had experience of anxiety and other mental health problems, both people that I know and that I don't.  If I can provide some wisdom and experience to someone's chaos then I count that as an achievement.

And the third thing I've already touched on - people have also helped me, and this is the primary reason why I have included this as a key step in the seven towards my stability.  The comments, tweets and emails that I've seen, either in response to something I've written or just generally, have been fascinating and it's great that so many other people are out there doing their bit to raise awareness as well.  I've learnt so much from so many 'real life' people!  It's almost like there's a community of us who just want to do our little bit and even though few of us know one another, there is an increasing togetherness in the overall drive to make society more aware and accepting of mental health issues.

Of course, none of the stuff I do would have been possible without the help of the therapy, which of course I received by going via Anxiety UK, the charity that kicked off all this in the first place.  So in terms of my Seven Steps to Stability, we've kind of gone full circle.  From finding the charity, to helping them myself either directly or indirectly.  In just over three years, that's not bad going.  That said, we all think that the contribution we make is bigger than it probably is and I know that I don't do much else beyond the virtual world, such as skydiving or running a marathon to raise money for mental health charities.  Just the thought of either of them would give me a nosebleed.  But within my bounds of comfort, I hope that this blog and other work that I will endeavour to continue to do will at least make a little difference, both to me and to others. 

Finally, kudos to the Mental Health Foundation for running MHAW in the first place.

Mental Health Awareness Week may be concluding, but our mental health problems will keep going.  In writing these daily blogs, it has brought some anxious feelings to the surface for me, which perhaps has been the main negative in doing this for MHAW.  Perhaps if I was more comfortable from the beginning about talking about anxiety, writing about it quite intensely like this wouldn't have this affect.  Which leads me onto my final message: The fight continues - the fight to get better ourselves and the fight to challenge the stigma that still exists in some parts of society. 

Thank you to everyone who has read my MHAW blogs and please do keep coming back for (semi) regular updates.

Best wishes
Al

Seven Steps to Stability - Step 6: Exercise

MHAW 2014

This is an interesting one, and actually exercise wasn't something I was initially going to include in my Seven Steps to Stability.  Reason being, putting it simply, that I don't play competitive sport at all or go to the gym.  It's just not for me and never has been, despite my school trying to force me to play rugby for five years.

The only thing I've ever really done consistently exercise-wise is walking, but even this became difficult after the 2011 incident.  I remember once walking on my own around in the rural area around where my parents live (and where I lived at the time) and because I was on my own and a fair while from home, given I only had my feet to take me places, I started panicking that I wasn't able to get out of the situation.  I had a mini panic attack on my walk back and as such it was difficult to differentiate between the feelings of this and the physical effects of the gentle incline back to home.

Anyway, overall, walking and trying to increase the amount I do has been a really good way of helping my anxiety.  It allows you to process thoughts, which sometimes is the last thing you need, but other times it allows you to gather them and in fact make them more rational.  In the meantime, you're getting good exercise. 

The other problem I had around this time was, linked to health anxiety, the fear of what more vigorous exercise may do to the heart rate, especially when you factor in the medication.  Although I was reassured that doing exercise wasn't affected by the medication, believing this is easier said than achieved when you have health anxiety.  So, walking was good exercise, but not particularly anxiety inducing.  And, needless to say, it got easier over time, so I was able to go walking and enjoy it.

I'm fortunate that one of my friends I mention in blog 4 also likes walking, so we often go on significant hikes in our nearby rural area.

The other thing I started just after this incident was swimming. I hated swimming at school for two reasons; 1) the pool was full of slime and 2) the competitive element again.  I hated all PE at school, but I'd heard from various sources that swimming was quite a good way of alleviating anxiety.  Again, you could control the amount of severity you put into it and how far you did with no pressure, as well as it being good exercise and different exercise to walking.  So I reluctantly started and haven't looked back.  It was hard, both physically and mentally at first, but I knew I had to increase my exercise levels. 

Since then, I have got more out of swimming than I had anticipated.  I have met some really great people whilst doing this, most of whom I see every time I go.  I go early in the mornings before work, twice a week if I can.  Now I commute a reasonable distance it would have been easy to stop, but these people have kept me going and I now look forward to going as a result.  Such is the nature of swimming at similar times each week, you will see the same people and chances are some of them will be like minded.  But this social element has done as much for my recovery as the exercise I get from swimming itself, and I would wager others would get the same experience, if they let it happen.

Walking and swimming are great.  They give you good exercise, improve your social life and help you to forget about the anxieties in your life.  I would definitely recommend it.  The worst thing you can do when you have anxiety is to sit around and dwell on your thoughts that's experience talking.  It takes you away from the modern era of screens too; social networking, which in some cases can do more harm than good. 

Let's just hope, as I mentioned in another blog recently, in the case of walking, we still have plenty of places to walk in years to come.

Last blog of MHAW to come: the theme is helping others.

Best wishes

Al

Seven Steps to Stability - Step 5: Trains

MHAW 2014

The next blog to arrive on this website will be the 17th May Anxiety Tracker service to... wherever you like.

The reason for this blog, perhaps unsurprisingly, is because the severe incident of March 2011 happened on a train. It was a bizarre situation in many ways; I'd been visiting Cornwall overnight, but on the train down and during my visit there, I was okay.  I didn't have any major anxiety, other than struggling to eat which at the time was my main problem anyway, so that came as no surprise. 

And I think one of the main reasons the panic attack I had on the train back was because it came as a surprise.  It was so out of the blue that I didn't have time to react, and of course back in those days I didn't have the CBT techniques to help me out or the beta blockers to keep a lid on things.  In hindsight, it was actually not too surprising, because I know now that at the time I did have quite a few issues, to say the least.  But anyway, that's beside the point.

The incident did occur on a train and it was the worst few hours of my life.  I remember dropping my phone onto the floor just before I stepped off the train just before my first of four changes and not noticing, and someone picking it up for me.  I must have been partially crying because they asked me if I was okay.  I think I said thanks and turned away.  I also tried to seek the help of a platform assistant at this first stop, one of whom was useless but one who made the effort to try and talk to me and calm me down. He went away and then I asked for him again, so he could warn the train manager at my next connection to keep an eye on me - this is how serious I deemed it to be.  I remember thinking when I was sitting at the station 'I've never been hospitalised for anxiety before, but this could be the first time.'

Anyway, I asked for him again but he'd finished his shift, so just as I managed to find someone who seemed to understand, he'd gone and I had to stagger, quite literally, to the correct platform.  I couldn't stand up for long so this was difficult in itself.  The rest of the journey didn't get much better.  The two images I have in my mind was 1) sitting next to quite an attractive girl on one of the journeys and wondering what on earth she must have been thinking of the gibbering wreck and 2) at the last station I had to change at, sitting on the platform floor shivering, made worse by the fact that the train was delayed. 

It's difficult to emphasise how bad this few hours was, although I'm sensing you're beginning to get it.

As I mentioned, it took months to make even leaving the house remotely comfortable. But catching a train took far longer than that to become easier again.  The first time I caught a train after that was a few months later and it was very hard.  I hadn't had much therapy at this point so again I didn't have the full suite of techniques at my disposal, let alone had time to digest them. So I spent the whole journey there and back very anxious, only saved by the fact that it was quite a short journey and so was over before it could get very bad.  I did, however, cancel a trip up north at this time because I just couldn't face it.

Through therapy - and this is another technique I could have mentioned in blog 2 - I learnt that, again unsurprisingly, the best way to make catching the train easier... was to catch the train.  I didn't have any train journeys scheduled around this time, so I had to spend money on going somewhere that was a reasonable distance, but not so far that it was too dangerous to consider.  And what did I go for?  To come back again.  I took a one hour train journey - this must have been around four or five months after the March event - to a main station... waited about half an hour, and then took the trip back again.  Knowing I didn't have the pressure of having to do something or meet someone when I got to my destination may have helped too.  I then did it again about a month later and went a slightly longer distance. 

Again, financially this was nonsense given that I was spending train fare on a journey to nowhere effectively, but actually it was an extremely useful exercise.  I was able to test out my other techniques like those mentioned in blog 2 and both journeys, albeit with nerves, were difficult but went fairly well.

The first proper journey after this was slightly harder, again exacerbated perhaps by me actually going for a purpose (work), which of course put pressure on me when I arrived at the destination - I had to do something!  But the two aforementioned journeys gave me some practice that I much needed.  Had I gone straight in at the deep end and taken a journey - after so long - that actually meant something, I could have set myself up for a fall.

The message here is twofold: 1) practice makes perfect, or more accurately, practice makes things that bit easier later.  It would be the same is someone's worst incident of their life occurred in a pub.  Go into a pub briefly at first, then more regularly.  The most difficult thing would be to go into the SAME pub again - and I have to say I have yet, even to this day, gone on the same train journey as the March 2011 one, or even one as long as that to somewhere else.

2) There's something obvious here that says 'just because an irrational panic attack happened in this situation, the only reason it would happen in the same situation again is because your mind makes it happen.'  True, but trying to control this is not easy.  Therapists and probably even friends will say 'don't associate the two events,' but trust me, this is not easy.  And that's why I would advocate practicing a similar situation first, if possible.

Apologies for the delay to this blog. This is due to my inability to access a computer last night, rendering the post impossible. 

I suppose the fact that I delayed this blog is fitting, given the topic.

Later today: Exercise

Best wishes
Al

Seven Steps to Stability - Step 4: Friends

MHAW 2014

Blog number four this week focuses on the power that friends have had on my recovery.  The first thing I should explain is that some of my friends know quite a lot about my anxiety issues and some don't.  Those that do know I've kind of generally told over a long period of time; it's been very rare to tell someone everything in the space of a few hours.

One of the most difficult things to do when you are going through severe anxiety is speak to other people.  In my experience, it doesn't matter whether you know them well or not, whether there is a group of you or someone on their own. Talking to other people when you're feeling like you're going to break is almost impossible.  But what I have learnt is that it is fundamentally important to try and break through these feelings and, as severe is this may sound, forcing yourself to speak to people usually helps in the long run.

But I appreciate who you talk to is important.  The whole point of this blog, of the various mental health charities, of people on Twitter trying to raise awareness of mental health, of this week's MHAW initiative, is to try and break the stigma around mental health, because sadly there are still people out there who do not know how to handle it when people tell them they have a mental health problem.  So telling the wrong person could do more harm than good.

So talking to people you can trust is very important.  You can talk to them about anything aside from your mental health problems at first, which in itself will help you to take your mind off them.  I remember talking to a good friend of mine for ages about music; nothing abnormal about this you might think, but because we share a similar interest in music style, we talked for ages about old song and new, bad songs and great songs and then ended up playing some of them very loudly.  It was just an hour or so of laughter and taking your mind off the darker stuff.

But in terms of talking to someone about your problems, this of course is not easy.  It is likely to be harder to talk to someone you know well rather than a complete stranger in these circumstances - perhaps part of the reason why we choose to talk to counsellors.  You don't know how anyone will react, and if a close friend reacts in a negative way, the impact is worse than if it's a stranger.  But in my experience, the closest friends will just want to support you and help you through it in their own way.  A profile of some of my closest friends follows, all of whom know a lot about my anxiety issues:

No.1: One of my very best friends doesn't ever tend to ask me how I am from an anxiety perspective.  They leave me to talk about it if I know I need to, and in a way this takes the pressure off.  But if I do talk to them about it, they listen intently and then ask questions to find out more if needed.  They are understanding, but we can quickly move on to talking about something else, totally unrelated.  Their tactic, overall, is to not talk about it and to take my mind off it with other conversations.  They enjoy it when I laugh - as daft as that sounds - because they know that my mind is clear for the time being of anxiety.

No.2: By contrast, one of my other closest friends does often ask me how my anxiety is.  Now before, I said that by not doing this, my previous friend doesn't put pressure on me.  But by this person asking me, they make it clear that they care and this person also understands some of my issues having experienced it themselves.  When we meet they always ask me how I am and how I'm doing and I'm happy to tell them.  They always reason with me and let me know how they are doing too.  I sometimes ask first.  It's a different tactic but one that works well in a different way. 

No.3: This third example comes from a friend who I now hardly ever see.  We had a heart to heart many years ago about mental health issues as at the time I was going through a really difficult patch.  And although we hardly see each other today, we occasionally have a deep and meaningful via the means of social media.  It tends to happen out the blue and always seems to come at a mutually convenient time.  But it's great and it means that if and when we do meet properly, we can talk about things quite openly.

The point of all this is to explain how important friends are in helping you through your condition.  Whether it is to share experiences, vent, cry or laugh, USE them.  Don't be scared of USING them.  Perhaps this is a bit idealistic, but the way I view it is that if a friend doesn't want to understand or cannot empathise with your problems, they are best not talking to about these issues and you can move on to another friend.  You'll get success with at least one. 

The first step is the hardest. Opening up to someone can be painfully difficult.  But in doing so and getting a good reaction is one of the best feelings you can get and for me is one of the most effective ways of getting yourself through a low patch.  I can only imagine that this is amplified even more if the first time you open up the person reacts badly... because if it goes well the second, third or fourth time, you will suddenly find real elation and it'll seem like a real success.

As the initiative goes, it's #TimetoTalk.

Tomorrow: Exposure on trains... no, not in that sense.
 
Best wishes
Al

Seven Steps to Stability - Step 3: The Meds

MHAW 2014

The third blog outlining my Seven Steps to Stability focuses on medication.  Now, any regular readers of my blog may be surprised with this given my general viewpoint of medication for mental health issues.  As yesterday's blog suggested, I always favour therapy ahead of medication, unless it's a particularly severe circumstance.

There have been times in my life when I've been close to needing medication just to numb the pain there and then; but I've managed to keep rational enough to realise that, if nothing else, the effects on your physical health that medication may have may do nothing but exacerbate health anxiety.  Plus I don't like the general concept of relying on medication, if I'm honest, as below will convey.

But, I have been taking one form of medication for a long time now.  I used to be on them for a good couple of years between what must be about 2006-9 or something like that.  I then came off them, but not surprisingly, after the March 2011 panic attack from hell and the subsequent decline in my mental state, I went back on them again.  Beta blockers, as I understand it, are generally used for people who have had or are prone to heart attacks to control blood thickness and heart rate.  Writing this is difficult by the way; analysing the heart rate and talking about blood often makes me feel faint, so I'll move on and accept that if you want to know more, look it up...

But they are, according to my doctor, often taken by people with anxiety.  They are often taken, for example, just before someone who hates standing in front of an audience is about the deliver a presentation.  I was basically told to have one when I felt I needed one in addition to taking a regular one per day.  I never did this and instead stuck to a regular routine, for fear that there would be other unwanted side-effects that I may notice if I took one just before, for example, a presentation - back to health anxiety again. 

At the outset, I was on 50mg strength, which is quite a significant amount considering I hadn't had a heart attack.  When I went on these again in 2011, I knew what they were about.  However, I made a fundamental error.  I took my first one at lunchtime whilst at work (I have a thing that I should always take them just after I've eaten, even now) and I nearly collapsed within minutes of doing so.  The reason?  The over-analysis of the effects it was having on my blood and heart, which I had massively exaggerated and which made me feel... well, faint, as explained above.  This was the only time that I was ever driven home from work early as a result of my anxiety condition, and it's all because my brain was playing tricks on me.

My tactic was to switch to having them at home - a safer environment at the time - and after a main meal.  I suppose you could argue that this worked, because I never had the near-fainting experience again.

So I started back on the meds probably in April 2011 and now, over three years on, I am still on them, albeit with a reduced dose from 50mg to 12.5mg.  Yes, the lowest they produce is 25mg so here I go cutting them delicately in half with a tablet cutter. 

So two questions remain: 1) What effect have they had on me, and 2) Why don't I come off them now when I'm, in comparison to 2011, a million times better?

To answer 1).  I think they have helped.  One of my big preoccupations - a cross health anxiety and panic disorder thing - was with my heart rate.  I over analysed it way too much and, of course, in doing so the likelihood of a panic attack increased.  One of my other CBT techniques (see yesterday) which I've purposely saved until today is to NOT CHECK yourself and for me, particularly the heart rate.  I learnt that checking got me nowhere and in fact dramatically increased my anxiety (this would also go with checking other body parts too).  But of course, this took a long time to get right (I still slip back sometimes), but to score it on the same scale as yesterday, not checking would get:

Implementation: 7
Time: A long time
Success: 9

Very successful, then.  But the beta blockers did make this easier; they effectively prevented my heart from beating as fast in unnatural situations, which meant my preoccupation gradually eased anyway.  So overall in this respect it has helped over time.

Where I think they have been more of a hindrance is twofold; one, regarding health anxiety. The so-called small side-effects have been large for me, such is the nature of the condition.  The second, similarly, is around what it actually does to you - back to the original reason I nearly fainted again.  I remember when I first started taking them when I was still having frequent panic attacks; my body felt like it needed a panic attack and the beta blockers were stopping them from going full blown.  I count this is a negative at first, because this was a really screwed up feeling, which then triggered - again - my health anxiety and made the panic attack last longer, albeit slightly less severe.  It was an odd feeling and one I know other people have felt too.

But overall I would say it has had a positive effect in just calming me down a bit and making it so the 'not checking' technique described above became easier.

To answer 2), why am I still on them after over three years - and now probably something like seven years in total.  The real reason - fear of coming off them.  Worryingly, they are like a comfort blanket.  I'm not even convinced I'd notice the difference if I stopped taking them - 12.5mg is minimal after all - but I have in my mind that the psychology of not taking something will tip me over the edge.  I've always looked for excuses for not testing coming off them completely, like 'oh I've got a lot of work on at the moment,' and I fear that if I do it will unnecessarily raise my anxiety again.  Why come off them when they aren't doing me any harm (if they might be doing me harm, please don't tell me, otherwise my health anxiety will kick in again).

The doctor is happy to keep prescribing them and, although I don't for one minute claim that they are mental health experts, at the same time they can't be too concerned that it is having an effect on my physical health, otherwise they'd try and talk me off them - I'd hope at least. 

But this is another reason why I'm not keen on perhaps stronger 'mental health meds.'  One could argue that I have become reliant on beta blockers just to keep me ticking over, to keep the lid on any boiling over, metaphorically speaking.  I would not want to become equally as reliant on a mental health medication and the easiest thing to prevent that is not to take anything in the first place.

My message would be this.  Medication has its place, there's no doubt about that.  But seriously think about whether any medication is right for you, and if so, which medication is best.  It might help in the short-term, but could end up becoming a dangerous burden in the long term.

My next Step to Stability: Friends

Best wishes
Al