The Talking Therapy Run Down

Hi all

Apologies it has been a while.  As my last blog detailed, I have recently moved into my new house and this, along with the usual, has occupied a lot of my time recently.  Apparently it's important to insure your life and buy plates.

There was never a sofa.

Anyway, I thought I'd forego writing about my experience in dealing with anxiety and the aforementioned house move, and how anxiety has fared with recent pressured social events that I have been involved in.  I will say, overall, these have been a success albeit laden with a few sticky patches.  This is progress, though, as said sticky patches would once have been unidentifiable amongst the myriad of total stickiness that I would have had to endure.  

Instead, I thought I would blog about my experiences with talking therapy that has helped me try and keep my anxiety in check, and, ultimately, that has helped me to be able to function more adequately in life than before.  There has been a lot of talk, both virtually and verbally, recently about the effectiveness of therapy so I thought I would contribute, for what it's worth.  I appreciate that there is information on all of this already laced within this website, but hopefully putting all into one blog will be useful.

Therapy No.1: NHS, referred to by GP
Year: 1997
Age: 10
Status: Year 6, final year or primary school

Obviously, so far back, I had no idea what was wrong with me or what the therapy was all about.  My parents went to the doctor's who must have referred me to the NHS therapist.  This came about after I had my first ever panic attack whilst on holiday in Devon.  I also remember fearing death at this time and repeatedly asking God (as someone who isn't religious) that I didn't want to die.  Whether there was anything else to trigger my parent's taking me to this appointment I don't know.  But basically this therapy came about as a result of the first time in my life when it was clear that anxiety was going to dominate my youth (albeit I didn't know that then).

There were only two therapy sessions.  One at the start so that the therapist could make both me and my mum cry in order to try and ascertain what the problem was, and a second one several weeks later to review progress.  I must have had to carry out exercises in between; all I remember about this was drawing circles, the size of which indicated how anxious (whether that was the term he used I don't know) I was feeling.  Given how long ago this was, I can't remember how much success this therapy had; although given I've spent the following 18 years dealing with anxiety, one could make a reasonable assumption.  

Key lesson learnt: I was always destined for an anxiety-filled life to have had therapy at such an early age...

Accessibility: I can't remember how long it took before making the appointment and getting seen.  I don't think it was long, as perhaps children are prioritised?

No. sessions: 2

Cost: Free

Success: 4/10 - may have helped alleviate the immediate issues but no effect long-term.


Therapy No.2: University counselling service, self-referred
Year: 2006
Age: 19
Status: Second year of University

I should mention that refraining from accessing therapy during my entire high school career sounds positive, but I know for a fact that I should have obtained help on more than one occasion during this time.  Call it inexperience, feeling weak, uncertainty or whatever, but for some reason even at my lowest times during high school - and there were many - I never took this option. 

And as it happened, this self-referral in 2006 only occurred out of desperation. At the time, not only was I experiencing well-established panic attacks, but my mind had decided to loop things that I couldn't get out of my head.  I thought, to use a term not conducive to helping remove mental health stigma, that I was going mad.  

Anyway, I won't dwell much on this.  I had only one session, which frankly is all I expected, and my condition was put down to stress.  I knew it wasn't - but you have to remember I was desperate.  At the time I'd have seen a trained chimp.  What I didn't know back in 2006, of course, was that I needed CBT and not a counsellor giving me relaxation techniques.  

Key lesson learnt: Therapists at Universities certainly have their place (especially to deal with issues such as exam stress) but aren't necessarily trained in therapy for advanced conditions.

Accessibility: Outstanding - I went to book an appointment and was seen within 20 minutes!

No. sessions: 1

Cost: Free

Success: 2/10 - chocolate and fireguard springs to mind, but to be fair on them they could only do their best and probably weren't used to someone like me knocking on their door.  


Therapy No.3: NHS, referred to by GP
Year: 2007
Age: 20
Status: Third year of University

At the same time as accessing the above therapy, I booked in to see the GP to obtain another course of therapy on the NHS.  Now, we are in really troubled times at the moment with regards our NHS system, so to have a go at it seems wrong, somehow.  But I can't lie - the service and the therapy I experienced here was nothing short of useless.  For a start, it took 13 months - I'll repeat that - 13 months from being referred from my GP to getting an appointment.  By which time, the reason I had booked into therapy in the first place was less of a concern.  Third year of University was one of the better times for me, so seeing a therapist during this time wasn't as relevant.  OK, so I still had anxiety, but I was in dreamland compared to 6-12 months prior.  

You could argue, therefore, that judging the quality of the therapy in light of this is unfair, but it is the healthcare system's fault that I had to wait that long in the first place. So, here goes.  The therapist was the same person I saw with my parents back in 1997.  I realised after not too long that I didn't really like him as a person; he came across as very unsympathetic and unhelpful, which is not what you need in a therapy session.

Secondly, what I needed was CBT, not counselling.  Now, I couldn't influence this at the time because I still didn't know that's what I needed, but the fact I got counselling shows two things: (1) that the GP didn't properly understand what mental health conditions require what therapy to treat them and (2) that, in my town, there was only one therapist - a counsellor - available to see on the NHS.  Hence the absurd delay.  

I was also limited to a certain number of sessions, again unsurprisingly.  So what I was a victim of here is an over-stretched service and a therapist who, quite frankly, I didn't get on with.  Consequently, the lasting impact was less than negligible.  

Key lesson learnt: The NHS needs / needed (as maybe it has improved in recent years?) a radical overhaul in mental health therapy provision.

Accessibility: Shocking. 13 months from referral to appointment.

No. sessions: 7

Cost: Free

Success: 1/10 - no lasting impact.


Therapy No.4: Private CBT, self-referred
Year: 2010
Age: 22-23
Status: Couple of years into my first main job.

I would argue that this was my biggest wake-up call, therapy wise.  By this time, I had researched into CBT and discovered that it was this that I needed.  I was specifically seeking therapy at this juncture to deal with my problems with eating out, although of course what I didn't know then is that this was just a manifestation of a chronic underlying anxiety condition.  Just because panic attacks were less, I thought my only problem was with eating out.  What I didn't twig was that eating out was the only thing I did at this time that really generated panic disorder.  Something, I would reasonably argue, ought to have been picked up by the so-called CBT therapist that I saw.

I say 'so-called' CBT therapist, because I didn't actually obtain CBT.  Although I had ascertained CBT was what I thought I needed, I still didn't know exactly what it was about, so at the time I just got in with it, albeit with a bit of confusion.  I know it wasn't CBT now, because this therapy was all about the therapist trying to find out why I had this eating issue and spent the majority of each session talking about my family history and how this could have caused it.  No. No. No.  This is not CBT.  This was counselling in some form or another.  There was also one session dedicated to relaxation techniques.  I'd heard enough dolphin noises by this stage.

The final thing to emphasise is that, although this was private therapy, it was still limited to only a few sessions.  In this sense, it was no different to the NHS and frankly, the quality of the therapy was no better either.  

Key lesson learnt: Private therapy isn't always the answer!

Accessibility: Good; I was seen within a couple of weeks from making first contact.

No. sessions: 8 - limited to this number.  

Cost: £60 first session £30 thereafter; a total of £270

Success: 1/10 - no lasting impact; I still had problems with eating out, the one thing I was hoping to resolve.


Therapy No.5: Private CBT, self-referred via Anxiety UK
Year: 2011-12
Age: 23-25
Status: Well into my first job, moved out of home for first time towards the end of treatment

And so finally, a tale of good news.  This call for help was as a result of that particular event that took place on a train back from Cornwall, when I had a panic attack for 14 hours non-stop.  Subsequently I could barely leave the house and my anxiety levels had hit a new level that I didn't think were possible.  I knew action had to be taken otherwise I was in serious trouble.

Having had no previous success locally, privately or via the NHS, I was in a bit of a quandary about who I should turn to.  Thanks to Google, I stumbled across Anxiety UK, a charity dedicated to providing help for people with anxiety.  I called their helpline to arrange an appointment with a therapist via webcam, because there wasn't a therapist available in my town.  It was impossible for me to travel any distance at this time, so webcam therapy was my only option - but that fact that it was offered in the first place was a revelation.  

Within two weeks I had my first appointment with a therapist who happened to be based 262 miles away.  She was an NHS therapist part-time and a therapist working privately on behalf of Anxiety UK the rest of the time.  She only had a few non-NHS patients at one time, of which I was one.  And lo and behold, ladies and gents, I was getting CBT.  I was obtaining the help I needed, not just to help deal with the current situation but the whole underlying anxiety condition that I'd had for 13 years.  The focus was on how to deal with the situation as it was in the present, not about why I got to that point in the first place.  This did get discussed later on, but only when I was a little more stable and we were able to get more into the meat of the condition as a whole.  

There was also less pressure to improve, because sessions were unlimited; i.e., you got what you could afford to pay for.  And finally, I must say that the therapist was outstanding.  She listened, advised, and shared her own experiences - as she too had experienced mental health conditions over the years.  We got on almost as friends by the end, and I could not speak highly enough of her manner and intelligence on almost all issues that I had to raise.

Key lesson learnt: Try going via the charity route.  Enough said.

Accessibility: Good; I was seen within a couple of weeks from making first contact.

No. sessions: 50; unlimited depending on requirements.    

Cost: £20 per session; £1,000 overall.  The best £1,000 I have ever spent.  

Success: 9/10 - I will always have anxiety, but this extensive therapy has helped me manage the condition so much better than I ever thought I could.  It's more rational, I can keep it under control more and I have tools in place to help me in the more challenging times.  I set up this blog just after the therapy had concluded which says something in itself.


There you have it folks.  My aim here is to share my experiences, raise awareness of these and to suggest things to look out for if you are looking to access talking therapy.  

My final message is this.  It appears from mine - and others - experiences in obtaining the therapy you need to deal with a long-term anxiety problem, that paying for someone's services is the only answer.  What do people who can't afford such therapy do?  The fact that good quality therapy may only be accessible to those who can afford it is absolutely abhorrent and a shocking indictment of mental healthcare provision in this country.  This is a sweeping generalisation of course, but I'm purely going on my experience.  There will be excellent NHS therapists out there - and as I've documented above, poor private ones - but nevertheless, my point still stands.

I will conclude by mentioning that this website was three years old on 15 June. Still going strong. Well, still going anyway.  I hope I can keep it up, if nothing else so I can add my two-penny's worth into the 'trying to help raise awareness of anxiety' sphere.  

Best wishes
Al

Moving on... again

For those of you unfortunate enough to follow me on Twitter, you may have noticed that some of my recent posts have been about me recently buying a house.  It's one of those annoying things that modern day life, i.e. social media, allows you to do.  I don't particularly like the idea, as sharing with people that you've bought a house can be seen as boastful and arrogant - if you didn't want the attention why would you post something like this?

My new house is slightly smaller than this...

After all, I'm sure we all know that reading other people's posts that seem to suggest that their lives are wholesome and ticking along beautifully can cause depression for many people who perhaps are not going through a good time.  However in my case, I've only shared this with Twitter followers (people I don't know with a theme in common - i.e. experiencing mental health issues, tackling stigma and/or professionals in mental health care), as opposed to Facebook (people I do know).  If I was to post it on Facebook, or even tell friends about it, I feel like it becomes a big issue - which of course I don't want it to be, as this will put more pressure on me that it works out.

So why share it at all?  Largely because I'm so amazed that I've actually got to a point in my life that I've actually been able to buy a house that I feel the need to express it.  Amazed, not so much in terms of me being able to actually afford to get onto the property ladder, but more because I'm actually in a mental state conducive enough to making buying a house possible.

I first set up this website nearly three years ago.  Back then, I was on the road to recovery from a serious anxiety incident, and indeed, a lifetime of chronic anxiety.  Not long before the inception of The Anxiety Tracker, I could hardly leave the house - my parents' house, that is - let alone move out.  By the time I set up this site I was living in my first shared house (which I'm still amazed I came through without any major setbacks).  But because it wasn't the best experience of my life I moved back home again.  Then, in September 2013, I moved into another shared house, which has turned out to be a much better experience, overall.

So back in April 2012, what made me go down the shared house route?  My friend, for one, who was moving back to Stafford and wanted to live with someone he knew.  But I knew that he would be away a lot (he's a musician, so goes away touring frequently) and I knew, consequently, that I would be alone quite often if we moved somewhere just the both of us.  Being alone, I knew, was the worst thing for me, because time on my own just gives my mind precious space where it can dominate me with anxious crap.  So I went down the shared house route, with the aim to meet new like minded people.

Yes, for those of you who have been down this route yourself, you'll know that I was rather naive to think this would happen.  It didn't.  The people there were, at best, weird and unclean and that is why I only ended up staying for 10 months.  I'm amazed I stuck it out for that long.  I think the fact that I came to the end of my 50 sessions of CBT about 3-4 months into this experience helped me get through it, as me and my therapist were able to talk about this and tailor coping techniques to the living situation.  That said, I jumped for joy when I moved back to my parents - but I knew it could only be temporary.

I was determined to let this fantasy of meeting new people and getting a good shared house experience be a reality.  I looked at seven different houses in my home town, most of which were similar to the one I had already moved from.  S**tholes, in summary.  But alas, just as I was giving up hope, I found a place where the landlords seemed to care about house dynamics.  When I went round to view it, I was with two other prospective tenants, almost in competition, and met the existing housemates in the communal area.  It was daunting - as I have social anxiety - but I knew that it was an opportunity I had to take.

So I did, and I'm still here today - for another two hours anyway.  I'm moving out today, into my parent's house for a week before moving into my new house hopefully next Friday.  

So what have been the positives of the shared house?

- I have met two great new people.  One sadly moved out a few months ago, but both of them have been great to live with and, although it took a while for me to open up, I became / have become very comfortable with them.  It did enrich my waning social life.

- I believe this experience - and even the first bad experience - has strengthened me mentally, in some ways.  Simple things, like fending for myself, I found difficult before.  Becoming more assertive if people do things to annoy me (this is still hard, but better).  I think the experiences have strengthened me as a person and prepared me for my next venture.

Negatives?

- I'm not sure the experience has improved my social anxiety condition.  I thought, again maybe naively, that greater exposure to forced social situation (and by 'social' in this case I mean simply cooking at the same time as someone or being in the communal area with them) would instill confidence in my social ability and improve my social skills.  Not so.  If anything, they have declined in recent months as I find opening up about certain things or meeting new people increasingly difficult.

- Little things, like messiness and people using facilities when I want to, has always got to me more than it should - and again, if anything this is worse now than ever!

- Recent times.  Two new tenants have moved in relatively recently and they dominate the house a bit.  Things are noisier, busier and I find it difficult to get space... which leads me onto...

- A change in me.  By this, I mean I feel now that I want my own space a lot more.  I want the peace and quiet, I want to be alone more, I think having now lived in a shared house for over 30 months in total, I've 'been there and done that.'

So that is why, along with practical reasons, I felt it was as good a time as any to buy.  My friend, who I have lived with for the whole of those 30 months, is renting a room from me, so he will still be around half the time.  The other half will be a test, and for me the next venture will be a balancing act between making the most of and embracing this new peace and quiet, to making sure it doesn't consume me and trigger idle, anxious thoughts.  I hope I am more prepared for this now.

So yes, it is a daunting step - I'm not quite sure what I'm feeling at the moment - but the next stage, I feel, in my chronology of trying to smash through my anxiety condition.

However, there is one thing that genuinely scares me.  At the inception of both new living experiences, and one time when I stayed at a friend's house for two weeks to look after their cat, I suffered with really bad, short-term depression.  I have never had depression for a long period of time, I'm grateful to say.  But the one thing that has triggered it is moving to a new place.  Unfamiliarity and the daunting-ness of such a big move is probably the reason, coupled of course with a vulnerability that having an anxiety condition for over 17 years can generate.  So that is what scares me about this move - I don't want to experience this again,  I hope that almost expecting it will help me manage it better; conversely, expecting it could make it more likely to happen.  I just hope the perceived magnitude of the move will not affect me too negatively.  

So I write this a week before I move into my new house.  A couple of hours before I move out of my shared house.  Another chapter is about to begin.  Sadly for you lot, I have no doubt you'll here about it here or @AnxietyTracker first...

Best wishes
Al

Election 2015: My mental health perspective

I have never cast a political vote before.  Yes I'm 27, and I've never voted before.  Does that make me ignorant to the issues of the planet?  Wrapped in my own self-centred  little world?  Stupid?  Or I just don't care?  I hope that it's none of these things.  I've only been old enough to vote in one previous general election (I was just a month shy of 18 in 2005) and a few local/council elections, but this is the first time where I feel I deserve a say in who should run our country.  I didn't know enough about the parties in 2010 to know what I was voting for (OK, so stupid then?).  And in the last local election, where I'm registered, I could sneakily cast 100,000 votes for any other party and the Tories would still get in.  So what's the point?

Please don't consider the quality of the logos when voting

However, this time, I have made a conscious effort to pay attention, to listen to what the politicians have to say, to align myself one way or the other, left or right, red or blue, or yellow, or purple, or green.  I read what I believe to be the only newspaper that is as unbiased as they come, so this has helped me form my own opinion.  I have also, following their publication last week, read key parts of each of the five party manifesto's.  Just for context, I'm based in England so can't vote SNP, Sinn Fein or Plaid Cymru etc.

Also for context, my parents live in the aforementioned Tory heartland of rural Staffordshire, which has been in Tory rule since the Dinosaur party.  My parents, as far as I know, have always voted Tory.  The only recent revelation is that Ukip are closing in a little bit on the Tory rule there, and I wouldn't be very surprised if my parents went this way too.  They think there is too much pressure on services in the UK and HS2 is proposed to crash through the golf course my dad plays at.  So make of that what you will (and you'll be right).

I'm still registered there, but where I live in central Stafford, it is more even between Tory and Labour.  It changed in 2010 to Tory, and it's touch and go whether it will go back or remain.

So why I do feel compelled to vote this time?  I suppose I just want my say, and as I say I'm more knowledgeable about what I'm voting for now.  I didn't read the full manifestos of course; three more Government's will have been and gone by the time I did that.  So I researched what issues were important to me.  These included the environment and climate change (my job and my passion), the considerations of young people who I have visibly seen have been shafted in recent years, public transport and then the big issues such as immigration, housing and the NHS.  And the other main factor I specifically researched?  What each party intends to do about providing better mental health support and tackling stigma.

Now at this point I must mention this.  Another reason I didn't vote in 2010 or in local elections was because I don't believe a word politicians say.  Moreover, I worked for local Government for over five years and during this time, the majority of councillors I came across were rude and rather up themselves.  So I lacked belief that they would stick to their word and didn't particularly like the way in which they governed.  Not too much has changed my belief in recent years; but my attitude has.  Sadly, it's one of acceptance, that politicians will always break promises, fail to deliver in certain areas and often come across as up themselves.  There isn't much I can do about that, so I have to accept my cynicism and doubt and vote in the pretence that each party will do what they say.  I don't believe for one minute that they will - but if I let this get in the way I'll never vote, as, I'm guessing, won't anyone else.

This cynicism stretches to mental health.  In the nearly three years that I've been writing blogs on this site I've mentioned on numerous occasions my experiences with therapy.  I have learnt so much about other people's experiences too; from friends, from magazines such as Anxiety UK's Anxious Times or Mind's magazine and via social media.  Many have had negative experiences at the hands of the NHS, whether it be too few sessions, lack of compassion, lack of understanding, ridiculously long waiting times, or whatever.  I must emphasise that private therapy can also be like this as well.  So in my opinion, mental health provision needs a total overhaul, with easier access to quicker therapy that you can access for as long as you need.  Do I believe any Government could achieve this whether they say they can or not?  No, of course not.  But again, I have to ignore this cynicism and move on.

So, in summary, what is each party  (in alphabetical order) saying about mental health:


Conservative:

Provide significant new support for mental health, benefiting thousands of people claiming out-of-work benefits or being supported by Fit for Work.

Provide therapists in every part of the country providing treatment for those who need it.

Enforce the new access and waiting time standards for people experiencing mental ill-health, including children and young people.

Ensure that women have access to mental health support during and after pregnancy.

Proper provision of health and community based places of safety for people suffering mental health crises to stop vulnerable people being detained in police custody.


Green:

Ensure no-one waits longer than 28 days for talking therapy and those in crises have 24-hour access to help.

Eliminate places of safety for children with mental health issues by 2016.

Ensure everyone has access to a 'mental health bed' in times of need.

Implement a campaign to end mental health stigma and discrimination and support the Time to Change initiative.

Pay particular attention to mother's, ethnic minorities, ex-servicemen and children in the treatment of mental health problems.

Give priority to the physical healthcare of those with mental health problems.


Labour:

Bring together services for physical health, mental health and social care into a single system built around the individual.

All NHS staff will be trained in mental health issues.

Ensure that teachers have training so they can identify problems early and link children up with support.

Use of mindfulness to build resilience, especially for children.

Ensure that the great majority of patients can access talking therapies within 28 days,


Lib Dems:

Invest £500m to transform mental health care with waiting time standards to match those in physical health care.

Inclusion of a waiting time standard from referral of no more than six weeks for therapy for depression or anxiety and a two-week wait standard for all young people experiencing a first episode of psychosis.

Increase access to clinically and cost-effective talking therapies.

Revolutionise children’s mental health services.

End the use of police cells for people facing a mental health crisis.

Set stretching standards to improve the physical health of people with mental health problems.

Develop a campaign promoting the steps people can take to improve their own mental resilience – the wellbeing equivalent of the ‘Five a Day’ campaign.

Establish a world-leading £50m mental health research fund.

Continue to support the Time to Change programme to tackle stigma against mental health.

Ensure better training in mental health so people can identify if someone has a problem.


Ukip:

Develop a 'whole person’ approach to health and that means giving mental health parity with physical health.

Recognising there is often a link between addiction and mental illness and offering appropriate treatment where this is the case.

Provide access to specialist mental health treatment for pregnant women and mothers of children under 12 months of age.

Fighting the stigma around mental illness and supporting those seeking to get back into work.

End the postcode lottery for psychiatric liaison services in acute hospitals and A&E departments.

Provide a single point of contact for veterans experiencing mental health problem.


So there you have it.  Like with most things politically, what this summary will probably do is confuse you more rather than less, as it did for me.    

If you go by quantity alone, the Lib Dems seem committed to investing in and tackling mental health problems the most, but is this enough to get them the vote on mental health alone?  The good thing is, the issue appears in all of the party manifestos, which is progress.  It is seen as important whether you're right or left wing, which again is strong.  It would be fascinating to undertake a study (if it's not already been done) that shows what party the people who do stigmatise mental health generally vote for, or whether it's fairly random.  Similarly, who do those people that work in the mental health profession vote for?  And, most importantly, who do people who have experienced serious mental health problems vote for?  

What this blog aims to do is just get you thinking about what the parties are considering.  I'm not going to say that you should or shouldn't vote - to say the former would be hypocritical.  I believe we have a right to choose whether we vote or not, on the assumption that one doesn't normally vote if they are ignorant about what the parties stand for, as I was - and always will be, to some extent.

As for who I vote for, I genuinely haven't decided.  It will factor in the mental health policies but also other important issues of mine, as outlined earlier.  By main concern is this: it is often Government policies that cause heightened mental health issues in the first place... meaning that when we're voting, we must consider the whole package.

Best wishes
Al

8: Anxiety@ The Pub

The final of my eight part 'Anxiety @' series (blimey, this has been going on for a while eh?!*) focuses on what it is like to have social anxiety.  I refer to the pub specifically, although this could include any type of social activity involving other people. As I understand it, a social activity is not 'social' if it doesn't involve other people, so by it's very nature, this is the sort of anxiety that occurs in the presence of others.

Photo from Anxiety UK website - Google's were all crap

What a great blog this is so far.

The way I would define social anxiety is having a chronic lack of confidence when in a social situation; a fear of looking foolish; a fear of appearing uninteresting; and of course a fear of all of this resulting in a panic attack.  It's often the case that social anxiety and panic disorder collide.  In fact, panic disorder pretty much collides with everything.

The other factor to throw into the mix which is more specific to me as an individual, is the fear of eating, which, as number 4 in the 'Anxiety @' series demonstrates, has been particularly difficult for me over the years.  Often, struggling to eat can lead to social embarrassment, as various previous blogs have described. 

So for now I'm going to cut out the panic disorder and eating elements, which cloud the social anxiety problem as a whole.  I don't have social anxiety just because of the panic disorder and eating problems.  These are simply other factors that make it worse.  This is proven by the fact that even today, when both my panic disorder and eating out issues are much improved, I still experience social anxiety.  So the two questions are how and why?

This is best demonstrated via the medium of case studies.  Sorry - I appear to have gone back to work.  But in all seriousness, examples of where social anxiety has occurred where eating out hasn't been involved, and recently enough so that panic disorder was less of an issue, is the best way for me to explain what it's like.

Example 1: This was about 18 months ago, not long before I left my previous job.  There was a fairly generic work do taking place.  Work do's are generally a fuel for social anxiety, because 1) I never feel as comfortable with work colleagues anyway for obvious reasons, and 2) because no-one at work has ever known about my anxiety conditions.

Ah - and this is really interesting actually as I'm kind of finding out things about my condition as I write this.  Because of health anxiety, I have a fear of the effects of stimulants on the body.  Alcohol is included in this, and consequently I tended to only drink a little and then go soft, so to speak.  In the past, whenever I drank too much, I woke up at about 4am with my heart racing and feeling terrible, which then led to a panic attack.  So I stopped drinking.  But of course, when you're out with work colleagues, and they ask you 'why aren't you drinking much,' my reply generally won't be 'because I have an anxiety condition and it causes me to have a panic attack if I drink too much.'  Call it stigma, call it a conversation killer, what you will, but I never gave a legitimate reason.  Well OK, so I may have said 'for health reasons,' which technically is true, but you get the point.

Anyway all this drivel shows how significant the influence of alcohol has on a social situation.  Sadly, in modern society, you're often automatically seen as uninteresting if you're not drinking for no reason that is deemed acceptable by those who are drinking.  So I often go into social situations, especially with people who don't know about my condition, knowing that talks of alcohol are going to dominate the night.  And you may have noticed (or maybe not, if you too are pissed), that when people start drinking, one of the main things they talk about is around stories of other times when they have been so off their face that they had intimate relations with their friend's grandmother, or something equally as worrying.

So what this example - and many others - shows is that alcohol has a huge influence on social anxiety.  I either drink and suffer the consequences, or don't drink and get badgered all evening as to why I'm not drinking.  Call me a tiresome bore, but I generally go for the latter.  

Example 2: A house party, probably about five years ago now, at my friend's house.  This particular friend generally sits in other 'friendship circles' to me, which means apart from her and my mate who effectively came with me, the other people at the party weren't people I knew well.  Put me in a situation with new or unfamiliar people and I'm petrified.  I feel bullied by others in conversational terms - I feel I need to have seen that film or heard that band or visited that country that they are talking about.  The reality is, I rarely watch films, my music taste is so specific I have no idea what is happening in the mainstream, and my only venture outside the UK and Ireland was on a university fieldtrip.  Sadly, the materialistic fabric that makes up modern life dominates social conversations, especially with people you don't know well, and as such I'm automatically perceived as 'unusual' as someone who doesn't really treasure the same things most others do (ironically - some of these 'unusual' character traits that I have are often as a result of anxiety!)

Now this would be fine if I had confidence.  You could argue that being 'different' could provide a real social opportunity, a tonic amongst the generic nature of most social conversations.  But sadly, what social anxiety makes you do is cower under the discomfort of being 'different' rather than allowing you to express yourself.  You become wildly uninteresting rather than the most interesting.  And even if people don't see you as uninteresting, you feel uninteresting - because you have no confidence.  The reality is this:

I don't feel I have anything interesting to say.  Or rather;

I don't feel I have anything to say that other people would find interesting.

Example 3: I mentioned in my last blog about living in a shared house that social anxiety has been an issue here too.  I've been fortunate, in that this has forced them to find out more about me and in so doing make me feel more comfortable with them over time.  But it's not been without it's difficulties.  There have been other people there during my time at the shared house who have always made me uncomfortable, the sort who assume that you're uninteresting if you don't share their views or find the things they are interested in interesting yourself.  I began to appreciate that's not so much my fault, but it doesn't help my own confidence either.

But even the people I have got on with well, I still find it difficult to answer a question such as 'what have you got planned for the weekend?'  If my answer is 'watching football, chilling, walking' for example, then those feelings of uninterest come back.  I feel like the social eyes of the world are watching me, expecting me to say I'm going hang gliding or parachuting, or at least going out with 'the lads' on the piss until the early hours.  Which takes us back to example 1.

Incidentally, none of my friends, nor myself, could be classed as 'the lads' in any way, shape or form.  And that is one element of my social personality that I'm quite proud of.

Now to factor back in the aforementioned eating problem: could it be that this has caused the social anxiety to be worse, or could it be that it's the social anxiety that's caused the eating problem?  As with trying to identify the cause and effect of many anxiety problems, especially those that interrelate, it's very much a chicken and egg situation. Does health anxiety cause panic disorder?  Or the other way round?  In truth, I don't think even the most highly qualified psychologists know the answer to that.  That said, I think I'd still have social anxiety if I didn't have an eating problem, as the confidence thing can occur whether eating is involved or not.

The final question is, what has caused this social anxiety.  Is it other forms of anxiety and the effect it has had on my personality?  Is it my upbringing?  The eating problem as mentioned above?  Is it purely genetic?  Where does the lack of confidence come from?  Years of being unhappy and, for a while, bullied at school?  Years of being single?  

I would suggest all of the above have had an impact.  I don't think, after so long, it really matters now.  It's more about appreciating the people I do feel comfortable with, of which there a few - but this core group of friends has really kept me together over the years.  It's more about welcoming those few new people into my life who do accept me and value me for who I am, not who society wants me to be.  And it's about managing those occasions when I am thrusted into uncomfortable circumstances and managing them in the best way I know how - if anyone can tell me what this is, by the way, please let me know.

----------------------------------------

* As I said at the start of this post, this is the final blog in the 'Anxiety @' series.  I also said it's been going on for a while, which it has.  Eight blog posts all around different themes in terms of how anxiety has affected and still affects me, and several sub-themes within each one.  What does this show?  Just how much anxiety and mental health conditions as a whole can affect someone's life.

I would never say that I've had a severe mental health condition.  I say that because I'm here today in a position to write this blog, and I've never been hospitalised as a result of my condition.  And yet despite this, anxiety has still affected my life, its outcomes and my future in a multitude of ways.  So how about those people who can class their condition as severe?

Which is why all the talk about cuts to mental health budgets, the stigma that still exists and the lack of awareness that is still abound in certain pockets of today's society frightens me.  This needs to change.  The time to act is now.

That's all I hope to achieve by writing these blogs.  A microscopic needle in a land full of haystacks.  But I hope, occasionally, that the right person with the right microscope picks the right haystack, and finds something amongst my ramblings that they find helpful.

Best wishes
Al

7: Anxiety@ The Shared House

The latest in my 'Anxiety@' series continues with focusing on what it has been like living in a shared house.  I didn't move out of my parents' home at all until April 2012 - nearly three years ago.  I lived at home and commuted during University and simply didn't have the mental strength to move out.  The thought of it scared me.  After the incident in 2011 (see last blog) any likelihood of this seemed even less likely, but thanks to my therapy that I started a year before I moved out, it gave me the belief that, if the right circumstances came up, I could do it.

It never quite got like this

Not that I specifically looked for it.  It just so happened that my friend, who I met at the start of GCSE years (2001) was moving back to my home town in 2012 after spending four University years and two subsequent years up north.  Needless to say he didn't want to move back with his parents, so he asked me if we wanted to share.

Now the nature of his job means that he's away quite a lot (he's a musician).  He is usually gigging at weekends, which is of course the time when I'm not at work.  I knew back then that living what would effectively be on my own was not an option.  Being alone causes the anxious thoughts to prevail, to rise to the surface and stay there, to be more profound.  If the mind has nothing to focus on, it focuses on physical pains or things to generate anxiety.  Mind clutter, if you will.  So living alone was never an option for me.  

But I also knew that living with my parents was difficult enough.  I'm an only child, and invariably I'd spend many evenings coming home from work and sitting away from them, either because I needed space from them or simply because they weren't watching the same TV programmes as me.  So home, despite being a comfort blanket in many ways, was also becoming quite lonely.

So, with the help of my friend and my therapist, I took the plunge, and we moved into a shared house with, at the time, three other people we had never met.  And to say the first few months were hard would be an understatement.

Lesson 1: Always try and meet the people you'll be living with before moving in. 

Lesson 2: Try and live with an existing friend, if you can.  Someone you're comfortable with.

For a start, my room was, environmentally, a health hazard, and not just for someone with chronic anxiety.  It contained the hot water boiler and the kitchen was below, meaning it was like the surface of the sun most of the time.  It was April when we moved in, so of course it kept getting warmer then too.  Due to the aforementioned factors and single glazing, it was also very noisy.  It was also absurdly light, due to pointless beige curtains and the sun for most of the day.  The main impact of all this was lack of sleep.  I think I must have got about no more than five hours sleep every night for about two months - and five hours would be an achievement.  It was becoming a serious problem.  

This was partially overcome by moving rooms. One of the downstairs rooms was vacant because it took the landlord so long to redecorate it after previous troublesome tenant(!), but once it became available I moved into it.  It was darker (had shutters on the window), cooler (downstairs) and generally less noisy, so this was a significant improvement.  It was a sizeable bedroom as well, so all in all this wasn't a problem (apart from a fairly frequent appearance of cat-sized house spiders, which I'm not very good with either).  

Lesson 3: Don't be scared to move rooms if the opportunity arises, if you'd like to. On a similar point, don't be scared to ask the landlord if you need something; that's what they are there for.  I went in with too much of a 'I need to wholly fend for myself' attitude.

However, this room ended up being my house, basically.  To say the other tenants, bar my friend of course, were not the sort I had in mind would be an understatement.  My mate and I laugh about it now, but at the time it was hell.  They were all messy and unclean for a start off and none of them really pulled their weight in this respect.  The bathroom wasn't much better.  The floor was carpeted for a start.  For someone who verges on obsessive when it comes to cleanliness, this was very difficult to live with.  I expanded the hand sanitiser market by 40%.  Their personalities made me very uncomfortable as well.  As with shared houses, people came and went, but they were all male (which probably stereotypically explains the mess), and all either rather uncommunicative or a lads lad, if you know what I mean.  They made me that uncomfortable that I tended to avoid making contact with them at all in the end; e.g. if one of them was in the kitchen, I'd wait until they were finished.  I was walking on egg shells all the time.  And in the last couple of months, I went back to my parents every weekend; my friend wasn't there at weekends anyway and I couldn't face two days of dealing with this.  

Generally it was a really difficult situation, with only my friend and the change of rooms early doors making me stick it out for ten months.  I finished the therapy I mentioned about a month or so after I moved into this house, which was also difficult.  That said, had I not had all the things I'd learnt from this therapy fresh in my head during this time, I'm not sure I could have coped for ten weeks, let alone ten months.  I knew it was time to leave when someone said I was looking thinner (as a six foot four inch tall slim build male who is in fear of any physical changes, this was hard to hear!), which was induced by avoiding cooking anything healthy or substantial on the hob or in the oven due to their rancid state.  

So in late January 2013, I moved back to my folks.  I needed to get out - and I remember vividly feeling so happy and relieved for the first few days back.  I left my friend at the hovel, unfortunately for him, but he understood that I had to leave.  

Of course, it didn't take too long to slip back into the lonely, isolated world of living with my parents.  I knew I could only let this be temporary.  So me and my friend looked for other shared houses, as before.  I still didn't want to live alone or just with him, due to the same reasons, but, being armed with the first experience, I was adamant I wanted to find a place with some nice people in it, people who not only I could tolerate living with, but who, if I was lucky, I'd even make some friends with.  

However, by the seventh viewing, I was becoming sceptical.  Some were hovels like the place I'd moved from; and at most, the landlords didn't make the effort to allow you meet the other housemates.  Until house number eight.

Lesson 4: Spend time looking for houses you're most comfortable with.  I found spareroom.co.uk most useful.

I was viewing the house alone because my friend was away, and I arrived at the viewing to be greeted by a middle aged woman with bright pink hair.  I thought 'hello, what have I got myself into here?'  Only to find out she was the landlord's wife.  I was then introduced to two other people who it quickly transpired were also there to view the three rooms available.  Along with the fact that I was viewing the house for me and my mate, and there was also one other person interested, there were five of us effectively competing for three rooms.  The best bit: the current housemates were all there, in the lounge, waiting for us and effectively judging us on who they wanted to live there / replace them. 

The good news - great news, in fact - here is that this meant that the landlords genuinely cared about who lived with who, and cared that the newbies were able to meet the housemates.  The bad news - I have social anxiety.

So during this whole charade, I kept trying to come across as confident, and wondering the whole time 'how am I coming across compared to the others? How am I coming across to the people I want to live with?' The most difficult were the questions they asked; I kept over-analysing my answers - too short? Too long? Too weird?  Did I look anxious?  This is a vomit of information and a lot to think about in about 20 minutes, whilst trying to secure a room. 

But I was so adamant that I needed to get that into that house.  Why?  Because it offered the biggest opportunity of my lifetime.  A chance to grow, a chance to make friends, a chance to really test myself, with the therapy armed within me.  A chance to strengthen.

Fortunately, two of the other viewers didn't come across particularly well - one barely said anything (even compared to me, which is a challenge) and the other wanted to draw up things like cleaning rotas.  Even I knew this wasn't going to go down favourably.  The landlords also saw me as favourable, because I was able to fill two rooms at once - with my mate in the other room.  So in September 2013, I embarked on my biggest social challenge ever - I (was allowed to) move(d) into this house.  

The first three-ish weeks were a living hell.  All that hard work for not just nothing, but for pain.  It was one of the few times I've ever actually suffered from depression.  I was in despair the whole time.  I was in tears just cooking dinner, which I then struggled to eat.  Sleeping had ceased again.  My dad came round a few days in for a reason I can't remember, and for an hour after he left I was crying manically.  I was close to leaving before I'd even settled in.  

The first question is, why did this happen?  Well, I always expected it to be fairly hard at first, because I have chronic anxiety and a big change like this will take it's toll, initially, just like the previous place.  But I think the key thing here is that I had put pressure on myself to make this experience go well and for it to improve my life.  Perhaps, in a way, similar to why I had my biggest ever panic attack on a train (see previous blog) after I went to visit a University about doing a masters that would 'change my life for the better.'  Combine that with pressure not to eat and do things solely in my room and to go into the communal areas and socialise.  The exact reason I moved in here was causing me utter hell.  

And, as I've said before on this website, I don't suffer from depression, but I have had short bursts of it in the past.  I cannot begin to imagine how people go through chronic depression because it is just absolutely unbearable.  

The second question is, how did I get out of it?  A trip to Wales with another good mate helped; this occurred about three-four weeks in.  I came back more relaxed and refreshed and stronger - able to hit the problems where they hurt.  I focused on my therapy techniques, which had gone out the window during this first period.  My good friend that I lived with was also around for longer than usual after I came back from Wales too, so his familiarity and advice helped.  And I'm still here to this day.

Lesson 5: Don't be scared to take some time out of the situation to freshen your mind up.  Inadvertently it worked for me.  

It took a while, but I actually started to enjoy it.  The other people we were living with were all great people, we had a laugh, and have since even socialised from time to time.  I think I've made a lifetime friend in at least one of them.  The phrase short-term pain for long-term gain was certainly applicable in this case.  I become comfortable, I felt more popular and the only things I had to concern me were the little things you'd get at any shared house.  

But these little things are now starting to get to me more and more.  One of the good housemates has already moved away, the other is doing so in the summer.  For the last six months or so, I've become happier to be on my own, and less tolerant to not being able to cook or shower when I want.  I still have social anxiety, too, and an improved social life as a result of moving here hasn't actually changed this, so I still feel uncomfortable from time to time, a feeling I'm fed up with now and want to minimise.  This combination of reasons means I feel it's time to move on again.

And alas, I've recently been successful (subject to contract) in buying my first house.  Fortunately, my good friend who has been with me throughout both of these shared housing experiences, will join me as my tenant, so I'll still have the company, but with more space than before and hopefully less discomfort.  I will reserve my thoughts and feelings about buying a house for a later blog, when I've actually moved in, but to say I'm experiencing a myriad of both positive and nervous feelings about it would be an understatement.  

But despite going through some really tough times during my shared house experience, ultimately I achieved my goals of (a) having the balls to move out of my parents' in the first place, (b) having the balls to move back temporarily when the first house didn't work out, (c) meeting some great new people and improving my social interactivity and (d) making me mentally tougher and stronger, which I believe it has done.  I think my shared house experience, both the bad and the good times, has helped me manage, test and allow me to learn more about my anxiety second only to the therapy itself.

But now it's time to move on again, to another new chapter in my life.  That will involve me being a lot poorer than before.

Best wishes
Al

6: Anxiety@ The Road and Railway

This is where calling the series 'Anxiety @' falls down again, on the basis that the title of this blog doesn't make a great deal of sense, but what I'm basically referring to is how public transport has affected my anxiety condition over the years.  

To set context, below is a timeline of the most significant transport related events that have happened in my life, non-anxiety related:

2004: Started taking driving lessons.
2005: Failed a driving test.
2005: Started commuting about 40 miles most weekdays on the train for University.
2008: Finished university, then worked in the same town I lived in until 2014, so the maximum I needed was a 20 minute bus journey twice daily.  Occasionally had to take the train for meetings / conferences.
2014-: Started new job; 50 mile total daily commute.  Have to take train sometimes for meetings / conferences.

The 09:41 to Anxietyland

To start with, I will say that I actually enjoy catching the bus.  My mum has never driven and consequently she always used to take me on the bus from when I was a baby.  Because my parents always lived in the same village when I was growing up (and still do now), we saw the same people whenever I catch the bus and consequently got to know quite a lot of nice (and annoying) people.  To this day, whenever I go up to my folks' to stay, I usually end up catching the bus to town just to see some old faces.  It's like a comfort blanket in a bizarre way.  Some good friends of our family have been made by me or my mum meeting them, initially, on the bus.  

Lesson 1: Appreciate these 'comfort blankets,' even if they may seem odd to others...

However, when I turned 17, my dad marched me down to the post office to file my application for a driving licence.  Within a couple of months, the summer between my penultimate and last year of sixth form, I was starting to take lessons.  

Sadly, the last year of sixth form was probably the best year of my schooling life.  I say sadly, because driving lessons, which persisted during most of this period (August 2004 - June 2005) were making my life a living hell.  The day before my first lesson I had a panic attack about them, and was in one of those panic-states directly prior to that lesson taking place.  I remained in this panic during the lesson and I remember afterwards feeling so emotionally drained I just broke down and cried.  Unfortunately, little did I know that I was going to go through this before every single lesson I ever undertook - if not worse.  I was even given some tablets (can't even remember what they were) that I took just before each lesson to 'calm me down,' which unsurprisingly made no difference.  The whole experience was an absolute nightmare.

So, as you can see from the timeframe above, why did I persist with it for so long?  Well, as with so many things, the first reason was because I was determined that I wouldn't let the anxiety beat me, which of course it already had, arguably even before my first lesson.  Secondly, I felt real pressure from my dad - he saw the inconvenience it put on my mum not being able to drive and thought it was a key milestone in my development as a human being.  So I would have had to encounter his wrath if I gave up (he never really got the anxiety thing - another blog in itself, I feel).  But of course, this pressure all added to the anxiety.  What didn't help either was that the instructor wasn't a nice man and it wasn't just me who said this.  Several others didn't like him, but got through it because, of course, they didn't have a chronic anxiety condition.  

Lesson 2: Being open with your parents in fundamental, even if you don't like their reaction.  I wouldn't have gone through months of pain if I'd have been!

My free periods in the last year of sixth form were on Thursday mornings, which is when I usually had lessons.  I dreaded them.  It was only the remainder of Thursday after the lessons that I could temporarily forget about them.  So I went through ten months of this, about 38 lessons I think it was, until for some reason I was booked in for a test.  I knew that I wasn't anywhere near good enough to pass a test, and even if I was, I knew that my anxiety would be so high that I couldn't function adequately in a test situation anyway.  Yet stupidly, with a lack of ability or power to stand up for myself back then, I went through with it.  I failed within the first five minutes (I think it was when I put the car into third instead of fifth gear... or it could have been when I accelerated instead of braked... take your pick) which in a way took the pressure off a bit because I knew I had failed anyway.  But the whole experience was traumatic.  

By which point I'd had enough.  I found the courage to say that I wasn't doing this any more.  I still don't think my dad truly understood how bad things were for me then or how much pain I was going through.  I think now, ten years on, he probably regrets rushing me into it, because since I took that test in June 2005, I have never stepped foot inside the driver's seat of a car again.  And frankly, I have no intention to.  If people ask why I don't drive, I have a trump excuse, which is 'I work in sustainability so it's good practice not to drive.'  Other excuses include 'cost' and 'haven't needed to,' all of which are true to varying degrees.  But they aren't the real reasons.

So not being able to drive is another reason why I still catch the local bus from time to time but also why I have been wedded to trains, especially during the periods I set out at the start.  The train experience during University was generally fine, as often I commuted with one of my Uni friends who did the same trip and it was only a 20 minute journey.  Things went wrong, I complained, but I don't recall me being particularly stressed about it, and overcrowding wasn't much of an issue back in those days (that makes me sound very old).

As I mentioned, when I finished University back in 2008 I did a job that occasionally took me to London, Birmingham or other local stations, but on these odd occasions, nothing went badly wrong from what I remember.  

That was, until 2011.  I've blogged about this numerous times before, but just to summarise, this trip - one from Cornwall (including four changes) - ended up being the worst experience of my life, led me to have what I call an 'anxiety breakdown' and was probably the biggest turning point in my entire life, anxiety related or otherwise.  The whole eight hour journey back was the worst eight hours of my life, worse than the rest of the 17 years of anxiety I've had put together.  Frightened, isolated, confused and just scared of what my future would hold.  

But as with traumatic events like this, subsequent events where there are similarities can trigger off the same feelings.  So, lo and behold, catching the train the next time after this caused a panic attack.  I cancelled a trip to see a friend up north, a trip I'd done before, simply because I was petrified of going through the same experience again.  It got so bad that even catching my comfort blanket, the local bus, became difficult and then so did leaving the house.  It was a downward spiral towards agoraphobia.  Everything was falling apart and it all started on a train.  It was around this time - summer/autumn 2011 - that I knew action had to be taken, and that's when I contacted Anxiety UK to get help, and 50 therapy sessions later... well, scroll through this website to find out the rest.

Lesson 3: Although this was the worst incident I'd ever experienced, I'd already been living with anxiety for years before. So my advice is to get help as soon as you know that things aren't right.  Don't wait for years like I did - otherwise this incident may not have happened at all.

Why was it a train journey that caused this?

Well, the trip itself was to visit a University in Cornwall because back then I was convinced that I was fed up with my job and I felt my anxiety was in check enough that I could go and do a masters degree.  In hindsight, the mother of all panic attacks that I had may have been for the best in that respect too, given that in hindsight I knew I couldn't have done a masters back then.  Anyway, I think I'd put loads of pressure on myself and combined with environmental factors (such as it being very warm for March but me wearing a winter coat) I just found it difficult to face eight hours of no company, isolation and prying eyes.  The panicky feeling started, I then became hyper-sensitive to others around me and so it spiralled out of control.  I had no mechanisms back then to stop it. 

Lesson 4: Don't put pressure on yourself, or listen to pressure from others, about doing certain things at certain times in your life - like a masters degree!

Whether it would have happened if I'd stayed in Cornwall another night, I don't know.  That said, if it hadn't have happened, maybe I wouldn't have ever got the help I really needed for my anxiety condition.  Short term pain for long term gain - albeit this pain was brutal.

Anyway, part of my therapy was to catch the train to somewhere for no reason.  Rather costly I grant you, but it helped and over time the fear became a bit easier. I still felt nervous before a train journey, but less so each time and by about 2013 I began to apply the tools I'd learnt to travelling situations and they were making a difference.  It was about winter 2013/14 when I caught the train to somewhere (don't remember where), and recalling when I had nearly completed the journey that 'I didn't even worry about this.'  So it took about two and a half years to recover.

And now I commute daily on the train.  What I get now is stress, not anxiety.  Overcrowded trains, delays, being overly-obsessed about small things annoying me, noisy people, people booting me out of a reserved seat, the extortionate costs - but these are normal stresses.  OK, maybe I'm slightly more stressed about this than your average person, but I never thought this would have been possible to achieve at all a few years ago.  

Longer journeys for social or work trips are a bit more challenging still.  What if this happens, what if that happens.  I do have to apply contingency for these sort of trips, even today.  But at least I have the contingencies to apply and can usually get through them with no more than minor discomfort.  London is my least favourite, especially where the underground is involved, but I tend these days to stand on the tube with my eyes closed and big headphones on, and try and block everything out.  Whilst trying to remain security conscious. 

Lesson 5: Prepare for train (or equivalent) journeys by taking anything with you that may help you get through it, such as music, books, newspapers, food, drink, directions... etc.

All in all, me and transport have had a rollercoaster of a relationship.  I don't intend on driving anytime soon - I can see this being something I never do.  But it doesn't really bother me at the moment.  I've had a love-hate-love-hate relationship with trains, but at the moment I'm out on the right side.  

But the reality is this: my lowest ever point happened on a train.  But it led to my biggest ever achievement in my life - being better at managing my anxiety condition.

Best wishes
Al