Reverse stigma and inverse SAD... and other tripe

Hi all

Well it's been nearly a year since I moved into my 'new' house.  I can say with confidence that this was one of the best decisions I have made in my life, despite the fact that my job is currently under threat (who's isn't?) I do not regret it one bit.  The current negative is that it has been a fairly difficult week for me, mostly due to the aforementioned job - trying to bring business into the organisation is not something I find very easy and it's something I'm having to do more and more of at the moment.  Lots of meetings, lots of train travel, lots of taking my bike on the train.  

Insert generic, stigma-heightening work place anxiety image here

I had a very awkward moment on the train on Thursday this week where my breathing went to pot and memories of my meltdown over five years ago kicked in.  Thankfully I managed to contain myself.  In fact, cycling when I got off the train from that journey seemed to help, as it released the anxiety adrenaline from inside me into some genuine adrenaline and physical breathlessness - rather than just mental breathlessness.  

I did, however, spend two hours in a meeting on arrival with five of those sort of blokes who think they are important whether they are or not.  I had to informally present about our organisation, which is normally fine for me these days but I don't normally do it after having a near-panic attack on the train and then having cycled forty minutes to the venue.  So that wasn't easy either.  But crucially, I got through it.  My CBT techniques definitely helped - as daft as it sounds, but rationalising things like 'I am allowed to duck out of the meeting for five minutes if I need to' or 'I can ask for water if I need some' etc often helps.  I think generally we spend too much time thinking people will judge us if we do things like this, and this is especially heightened if you have anxiety, but frankly, a) they probably aren't judging us anyway and will just be fine with it, and b) if they aren't fine with it, they probably aren't the sort of people you want to work with or be in a room with anyway.

My anxiety had improved once I was back at the station, albeit I was still on alert.  I contemplated speaking to my boss when I got back to the office to explain that I was feeling like this, but I did not.  Moreover, I have never told her about my anxiety condition more generally.  Okay, so it's less relevant these days, but why not tell her anyway?  Why not be open?  Hell, I write this blog, I speak to my friends about it, I splurdge on Twitter. So why not just talk openly about it with my boss and colleagues?

This is an even more a puzzling question when you consider that I really get on with my colleagues.  They are like friends to me, as much as work colleagues, which I know is a very unusual thing and something I try not to take for granted.  Just to set the scene - there are only three of us! We're only little.  So why not be open about my mental health?

Is it stigma?  Possibly.  I don't fear the reaction of my colleagues at all, but perhaps I stupidly do fear that they may treat me differently, or think that I am unable to cope in certain situations.  This is my problem, not theirs, as there is no evidence to suggest they would think that.  It's almost reverse stigma; I'm the one holding the stigma about my perceived reactions to my own condition!

I think as well, though, something I have always done since working is try and keep my personal life separate from my work life.  One of my two colleagues, for example, tells us about her personal issues which is fine, but that's just not something I would do.  I class my anxious past as a personal issue, rightly or wrongly.  But apart from generic things like what I did at the weekend (which I still get embarrassed about, because what I do is not 'interesting' compared to what I think other people will perceive as 'interesting' - reverse stigma again!) I don't tend to talk about my personal life, such as relationships (or lack of), my family's disabilities, or anxiety.  In fact, I think this thing about appearing 'uninteresting' is the main reason why I don't talk about such things - in that, I can't imagine for one minute why anyone would find my life interesting.  So perhaps that is more the reason why I don't talk to my colleagues about my experiences with anxiety, then - although I think it's a bit of both this and that reverse stigma bollocks I've just made up.

I only told my boss at my old workplace about my anxiety condition when I as good as collapsed on the floor because of it one time - so my hand was forced somewhat.  Apart from on my last day, where in my leaving speech I made reference to it.  It wasn't planned, so go figure why I did that.

Ultimately, though, everyone should feel that they can talk to their boss and colleagues about their mental health conditions freely and openly, without fear of ridicule, bullying or judgement.  From what I have read from many people with experiences of mental health conditions, this is not always the case, and from what I gather people have even been forced out of their jobs because of the lack of support they have received via their workplace, or even, their workplace exacerbating their problems after telling colleagues about them.  This is not acceptable. It's good to see the charities doing their best to raise awareness of course.

So all in all, with a lack of job security somehow making my job busier and more stressful, the combination of both factors makes this next few months probably the hardest I have been through, work-wise.  During my terrible times, work was one of the few fairly positive constants - whereas now it could be the cause of future troubles.  

Not helped by the fact that summer is not my favourite time of year.  I feel more lonely in the summer.  I think this is because you see people and couples outside in the park enjoying themselves in the warm sunny weather* and it's in your face all the time.  I also hate the heat.  So combine the two and you get what I call inverse Seasonal Affective Disorder, a condition normally experienced by those who are negatively affected by winter.  If anything, I'm the opposite.

Oh yes, and my latest on trying to find a partner.  I'm still online.  I've had another date.  Went okay but no further contact was made.  Still trying... 

Over and out and time for another new week to begin.  Positive thoughts...

Best wishes
Al

*It's currently raining.

NHS vs private talking therapy: My experiences

Hi all

There has been a lot of discussion recently in newspapers, mental health magazines and on social media about the quality of NHS therapy versus private therapy.  This has probably come about as a result of the recent junior doctor's strikes taking place and the continuous talk that the NHS is in financial trouble.  Mind has also been conducting some research with their members recently about primary care and their experiences of mental health treatment and their GP.

If only all therapy rooms contained a cushion like this

Ultimately, like everything, one's opinion of NHS therapy against private therapy will be down to individual experience, rather than the whole picture.  There will be exceptional therapists working in the NHS who I'm sure will be as frustrated as the next person about for how many sessions they can see patients for, and so on.  So yes, all I can go on is my experience of therapy, bearing in mind I've had both NHS and private therapy for chronic anxiety and I've also had many discussions with my GP about the subject.  I will attempt to describe these experiences and subsequent "advice," if you can call it that, on the back of this.

1) My GP

I first visited by GP with (what I now know was) anxiety back in 1998 ish, when I was only 11 years old.  I was accompanied by my parents.  All I remember about it was crying profusely and being referred to an NHS counsellor, as they called them generically then.  I can't comment on the quality of the appointment given it was about 17-18 years ago.  

Now this particular GP has been practising at the same surgery in my town for goodness knows how many years, so when I went the second time, on my own probably in around 2006, he at least knew me and would have been able to see that I'd been referred to a counsellor many years ago.  At this point, I was once again referred to an NHS therapist and prescribed beta-blockers.  I didn't have the knowledge to argue against any of this ten years ago.  Then, after my incident of hell that I described in my last blog, I went back to the same GP again - 2011 - but this time with more knowledge in my back pocket.  I told him what I wanted to do, and only went to see him for two reasons; 1) so he knew what was going on for his records and 2) to discuss beta-blockers, which I went onto again having come off them a couple of years before.

So overall, there were three times that I went to my GP over the course of about 13 years; I'm sure in total it was more than three times, but three batches if you like.  I know when I went in 2006 I had to go back a few weeks later and get a stronger dose of beta-blockers, for example.

Positives: 
- I've seen the same GP for 20 years.  This means that he knows me and my profile and is familiar with my background.

- His answer wasn't to automatically prescribe anti-depressants.  I've heard of a few cases involving friends when they have been to see their GP about what is clearly an anxiety condition and being prescribed anti-depressants without any other options being laid out before them.  Mind's latest members magazine says that "57 million anti-depressant prescriptions were written in 2014 - a 46% increase since 2012."  This is hugely worrying for me.  My view on anti-depressants is for a separate blog altogether, but to sum it up, they shouldn't be seen as the first or only option for people with anxiety.

- He is generally quite an approachable person and empathetic with what I was going through, taking it seriously.

Negatives:
- He had no real suggestion of what to do other than refer me to the NHS therapist and prescribe beta-blockers, making it sound like there were no other options.

- By his own admission he wasn't an expert in mental health conditions.  You could argue this is a positive, to at least admit it.  But it doesn't bode well.  The third time I went to see him when I told him I'd referred myself privately, he asked me how I'd done that and said 'through the charity Anxiety UK.' Needless to say, he hadn't heard of Anxiety UK or what such charities were able to offer. He did, at least, make a note of it!

Overall, though, compared to many people, this was a relatively positive experience and he at least listened to my issues, took them seriously and did his best.  Ultimately it's not his fault that he wasn't educated adequately about mental health back in the day, and has probably not had the time since to learn more about it given the pressure GPs are under to work all the hours God sends!

2) The NHS therapy

As the above describes, I was referred to an NHS therapist on two separate occasions; the first time in 1998 and the second time in 2006.  The former, I can't remember much about for the same reasons.  It was too long ago.  I remember doing some exercises at home that he gave to me that was something along the lines of drawing negative and positive characters, with the idea of reducing the size of the negative character to banish negative thoughts.  How effective it was is relatively unknown, although given I had a debilitating anxiety condition for 14 years subsequent to that probably speaks for itself.

The second time I was referred was nothing short of a shambles.  I've mentioned this on this website before, but from referral to seeing the therapist took 13 months.  Yes, 13.  Mind's latest magazine states that "50% of people wait more than three months for talking therapies."  Yeah, right.  Three months would have been a delight.  I remember receiving a call about nine months on, just before I was due to have the appointment, saying that it had been cancelled.  Little did I know it would be another four months before it would be rearranged.

This was hopeless, given that a lot can change in a mental health condition in 13 months.  Indeed it had; certain symptoms had changed quite significantly, albeit I was still suffering.  Moreover, had I known what the quality of the experience had been like, I wouldn't have bothered attending the appointments in the first place, as the below describes.

Positives:
- He was based locally.  That sounds like a minor point but as you'll see from the private therapy experience below, an important one.  

- It was free of charge.

Negatives:
- I had to wait 13 months between referral and appointment.

- I was limited to about seven sessions.

- The therapist was not very empathetic or understanding. He was quite brash compared to what you'd expect and I didn't warm to him at all. Maybe 'tough love' was his thing - well, it didn't work for me.  As such, I didn't find the therapy remotely helpful, and I can say with confidence that I was no better after the seven sessions I'd had.  

I have some sympathy with the therapist. It's not his fault that I had to wait 13 months, or that I was limited to so few sessions.  This is the endemic failing in the NHS mental health therapy system; it's creaking at the knees.  Is it any wonder that GPs prescribe anti-depressants so quickly and don't talk about other options enough, given that they know that local therapists are under so much pressure as it is?  Sadly, I suffered a combination of a failing therapy system, which in 2016 looks like it's only getting worse, and a poor quality therapist at that.  Overall, this experience was therefore a total waste of time.  

3) Private therapy via self-referral

In about 2010, I referred myself to a private therapist.  I still had chronic anxiety, although at the time I didn't realise I was as bad as I was.  The main reason I went to the private therapist was to 'resolve' my eating out problems, which were causing me great distress and preventing me from socialising properly.  What I know now, of course, is that eating out problems are just an output of a wider, more chronic anxiety condition overall.  At this time, its main way of manifesting itself was eating out.  However, I didn't find this out through the private therapy.  

In this instance, I didn't speak to my GP first.  I just went straight to the therapist and, having read up about Cognitive Behavioural Therapy (CBT) by this point, my only criteria was to see a CBT specialist and that it was local.  After some web searching, job done... or so I thought.

Positives: 
- She was based locally.

- I was seen less than two weeks after making first contact. Slightly different to 13 months...

- Compared to the private therapist, she was more approachable as a person and generally had a kinder nature about her.

Negatives:
- I was limited to eight sessions (although that was probably a good thing - see below)!

- I had to pay; I think it was £35 a session, but I could be wrong. £35 x 8 = £280 in total (yes I had to use a calculator to do this).  

- I didn't really appreciate this at the time, but the therapy I was getting wasn't actually CBT. I knew at this point that CBT was what I needed, but having never experienced it before, I didn't know what to expect.  What I got was counselling. The sessions were dominated by trying to work out why I was experiencing what I was experiencing, rather than trying to deal with the problem first.  When my Grandad died and how, surprisingly, had nothing to do with why I couldn't go to the local Wetherspoons and eat scampi and chips.  The counsellor was so desperate by the last session that we just spent an hour listening to sounds of the sea.  

So sadly, the negatives by far outweigh the positives again.  The key lesson here is, just because you're going privately, don't assume you won't meet the same restrictions as in NHS therapy and don't assume the quality is automatically going to be better.  

4) Private therapy via charity

When I had my meltdown in 2011, I knew I needed help, but of course I'd already experienced poor NHS and private therapy and didn't quite know what I was going to do.  Thankfully, I stumbled across Anxiety UK and read what they could offer.  Admittedly, I thought it was too good to be true.  Anyway, I chose to go down this route; I went to my GP as described above just to let him know the score and to go back onto beta-blockers and then wait in anticipation (an anxiety-filled mess of anticipation, granted) for my first appointment.

Positives:
- I was seen within two weeks of referral, this despite an admin error which occurred at the start!

- I had access to an unlimited number of sessions. I had fifty in total, which gives you an idea of the sort of help I needed.

- The therapist was excellent. For a start, I was getting CBT not counselling.  Yes we talked about my past (I generalise), but probably not until the 20th session or something like that.  I was given the tools to help with my anxiety condition. I was given the power back in my own hands. And I was given a shed load of homework to do, which is a good thing of course!  (I will emphasise at this point that as a patient you have to put in to therapy what you want out of it, as long as you get the opportunity to do so).

- She was also excellent because she made you feel like her friend. Between sessions, she must have seen scores of other people, and yet remembered everything we'd spoken about the week before. And, because of the 50 sessions, she got to know me as a person.  She was also warm and welcoming on each occasion.  What was clear was that she enjoyed her job.

- Webcam therapy was offered (see below).

Negatives:
- Anxiety UK didn't have a therapist based in my town, which at the time was hopeless because I could barely leave the house, let alone travel any distance. The person I saw was based in Glasgow, which is about 260 miles away from me... because they were able to offer webcam therapy. This didn't really matter in the end, as the therapy I obtained was almost as good as the therapy I would have got if it had been face to face. 

- It cost £20 a session, x 50 sessions = £1,000.  I didn't need a calculator for this one.  I was also lucky; the pricing structure was based on household income; at the time I was living with my parents who were both retired so I was able to obtain the cheapest bracket.  It was also £5 a session cheaper via webcam.  It was £35 for the next band up, which would have been £1,750, so a significant difference.  That said, it was worth £10,750 if I'm being honest, given the effect it had on me, as many of these blogs have described.  

What's the key message here though?  The lady I saw privately practised with a few patients at a time - the rest of the time, she was an NHS therapist in Scotland.  This proves that excellent NHS therapists do exist, although no doubt she may have been constrained to the same restrictions all NHS therapists suffer from.  In fact I recall her talking to me about this one time, saying that she dabbles in private therapy just so she can offer a less restrictive service at least to some patients.  

To say my therapy experiences have been mixed would be an understatement.  Based on my experiences, whether NHS therapy is any poorer or not in terms of quality is debatable, although in terms of logistics, such as waiting times, it is certainly much worse. The most frustrating thing is that I had to pay £1,000 to find good quality therapy.  WHETHER YOU CAN GAIN ACCESS TO GOOD QUALITY THERAPY SHOULD NOT BE BASED ON HOW MUCH MONEY YOU ARE ABLE TO SPEND, and this is the main problem with mental health therapy in this country, in my opinion.   

Ultimately, though, I strongly believe it is down to the individual therapist that you happen to be paired with, whether it be NHS or private.  My overarching advice would be, therefore, not to give up if your first experience of therapy is poor; keep striving for better until you get what you need.  If you can't afford to pay £1,000 of course, then you might be restricted.  See capital-letter bold font rant above.

Best wishes
Al

Five years ago today...

I am writing this at 22:30 on Friday 25 March 2011.*

I woke up, having of course only slept for around two hours despite being exhausted.  I had travelled for six and a half hours on the train the day before and as always, it's this sort of travelling that exhausts me.  So why did I sleep so little? Unfamiliar surroundings - I was in a Bed & Breakfast in Falmouth, Cornwall.  Today was the day that I had arranged a meeting with a course tutor at the Falmouth campus of Exeter University, to discuss potentially starting a Master degree in September.  I was determined, and convinced by this determination, that I was ready for this challenge.  My job had stagnated and anxiety had effectively ruined my chance of enjoying my University degree like the ones most people get - hard work, but fun and rewarding.  For the most part, mine had been an anxious mess, filled with panic and social angst.  

Falmouth - I'm sure it's a lovely place

So I feel that I need a clean break, and this course in Falmouth looked like the ideal opportunity to start anew.  However, the meeting with the course tutor wasn't at the forefront of my mind at this time in the morning; it was negotiating my way through breakfast.  Eating out isn't my strong point, and just the thought of going downstairs to eat anything was making my stomach turn.  The main concern, of course, was having to converse with the breakfast makers to tell them that I didn't want any of their apparently delicious breakfast.  The extent of deliciousness is irrelevant - I couldn't eat anything because I wasn't at home.  Simple as.  I used the "I'm nervous about meeting the course tutor" excuse, and made the whole thing into a bigger deal than it really was.  You see, I'd not actually even decided for certain that I was going to do this Masters - hence the meeting - so it wasn't a make or break trip. 

So I spent as little time as possible in the breakfast lounge, being glared at by people who wanted to make me breakfast but who couldn't for my refusal, went back upstairs to pack and then scarpered.  My meeting was at 9am and I had a bus journey to take.

I had prepared for the meeting yesterday by visiting the campus so I knew where to go, which bus to catch and where to visit, so this helped.  I was anxious, of course, but in control.  I had the meeting, which went well - it was just a fact-finding mission really, to see whether I felt that I could fit in.  As I write this, whether I fit in is now irrelevant. 

I made my way off campus but still had about an hour and a half to kill before the train home.  I went for a walk around Falmouth, a lovely seaside town, just to gauge the sites and get some exercise.  It was unusually hot for late March, and I foolishly wore my winter coat whilst having to carry my luggage with me, so by the time I got to the station for my train I was hot and even more exhausted than when I started.  And then for the seven hour journey back.  

I got on the first leg, Falmouth to Truro, sat down and attempted to chill.  What happened next was unimaginable.

The first thing I noticed was my hands and feet starting tingling.  This was getting worse by the minute and I was getting hotter.  I then knew what was happening.  This was the onset of a panic attack.  It then dawned on me that there was no escape; I was on a train, in unfamiliar surroundings, seven hours before I was due home.  All alone, with no-one but hundreds of prying eyes for company.  This exacerbated the panic.  My head started racing, heart started thumping, the tingling turned to numbness and it was at this point that I realised that I had lost control.  The panic was all encompassing.  I quickly looked to the floor as my eyes started blurring. 

All of this must have happened over the course of about 20 minutes - it felt like two - because we'd arrived at Truro station.  I somehow had to stand up and then get off the train.  I stood up, made my way to the door, and dropped my mobile phone in a trembling panic; fortunately it landed just ahead of the gap between the train and the platform.  I girl picked it up for me.  I couldn't really look up because I knew if I did I'd collapse.  I edged very slowly towards a chair.  There were no chairs!! Where are all the seats?? This is a railway station! 

Instead I saw a member of staff and told him I was panicking.  I don't know why.  I wasn't thinking straight.  He found a chair - I remember it because it was one of those chairs you get in schools. It was brown, relevant for no reason.  I sat near to the ticket barriers at Truro station, head permanently down knowing that lifting it wasn't an option.  I remember shaking and thinking "there must be a hospital in Truro, if it comes to that."  Then another staff member approached me.

He had obviously been called by the original staff member I spoke to and to be fair on him, he took empathy with me.  He asked me what was wrong, I was honest.  I remember repeating that "unless you can bring Stafford to Falmouth I'm not going to get better anytime soon."  He stayed with me for a while but then had to leave.  I sat there for a while longer, but knew I had to soon go over the bridge to the platform where my train was due.  I asked the original staff member if the other guy who was more understanding was around to escort me.  He wasn't.  I felt hatred towards this guy for not helping me. How ridiculous, did I think he had a degree in psychology? 

I staggered across the bridge and onto the next train - leg two, Truro to Taunton.  I sat down and barely moved.  I was next to someone.  Not even sure what gender they were. There was a small TV screen on the back of the seat in front.  The physical feelings were still there.  I was going mad.  I still am.

Oh for goodness sake, we're in Taunton.  I knew that this was edging closer to home, but at least sitting on the train I was able to just sit and not interact or move.  Luckily this time, the changeover of trains was only ten minutes and on the same platform, so I didn't have long to wait before leg three, Taunton - Birmingham.  This was the longest trip and where I made a fundamental mistake. I tried eating something.  It was a chicken sandwich.  Silly boy.  I was barely able to drink water, let alone eat a chicken sandwich.  I was panicking.  I was also concerned that by not eating anything I would make the situation worse.  Ultimately the good news was that I wasn't getting worse.  But I wasn't getting better. I was feeling sick. Hot, Sweating. Panicking. Unable to breathe.

I arrived at Birmingham.  It was dark by this point.  About a 30 minute wait.  I sat on the ground at the platform.  The last leg, from Birmingham to Stafford.  There was a delay, which didn't help.  Am I ever going to get home?  I sat at a table on the train back to Stafford, on my own, with a person on the table adjacent, looking at me. I looked at myself in my phone. I was pale. We arrived into Stafford, I was still feeling the same. My dad picked me up.  We didn't talk about my anxiety, ever. But I told him what had happened. He didn't say much.  What could he say? 

I got back home and I attempted to force beans on toast down me. This was about an hour ago.  I ate half. Wished I hadn't eaten any. I phoned my best friend. What was he supposed to do?  He tried saying the right things. They didn't help. It wasn't his fault, I was a mess.

Who am I kidding, I am a mess. I am still panicking.  It started at about noon and now it's 10:30. That's a ten and a half hour panic attack.  What am I supposed to do now? My chances of ever going to Falmouth are ruined. My chances of ever going to University again I ruined. My anxiety isn't any better at all.  I'm still a mess. I have had hundreds, literally hundreds, of panic attacks in the past and this is my worst.  I'm back to square one. No, square zero.  I can't see what I'm typing any more, my tears are filling up my eyes.  I need to try and sleep, how am I going to do that?

25 March 2016

For months after this incident, I could barely leave the house. I couldn't socialise, catch the train and even work was being affected. But it also prompted me to get the help I really needed, rather than the shoddy excuses for help I'd had previously.  This was ultimately CBT through Anxiety UK, which lasted for 13 months and a total of 50 sessions.

In those five years, I had gone from the wreck portrayed above to someone who has their anxiety condition largely under control. I still have my moments of course, I always will. But I have achieved some good things, all of which seemed impossible five years ago.  I cannot advocate therapy enough. I was in crisis and hope I never get there again. I now realise my destiny is in my own hands.  I will never forget the help my therapist gave me.  But now I truly feel what happens in my life is down to me. 

Anxiety will always be a part of my life. But I'm determined never to let that happen to me ever again. Life is too short.

*To clarify, this was actually written today, I wrote it as if I had been writing it five years ago.

I present to you... varying degrees of confidence

Hi all

I had an interesting conversation with a friend the other day about confidence.  He was talking about another friend he knows and how he was surprised that he was comfortable and confident in certain situations (e.g. lecturing) and not in others (e.g. clubbing).  His argument was that if you're confident at delivering a lecture in front of say 50 to 100 people that you're more likely to be confident in a social situation too.  

Apparently a cheesy grin and a beard also helps

I disputed this strongly as I have experience to back this up.  I have to deliver quite a lot of presentations for work; these are usually in front of around 20-30 people but occasionally up to around 100.  As long as I know what I am talking about, which I normally do otherwise I wouldn't have been asked to present in the first place, then I am totally fine with this these days, probably because I have been tasked with delivering several presentations in career so far.  My university degree was also quite presentation-heavy, which at the time I hated, but now I'm grateful for it.  

It's actually got to the point where I enjoy presenting on most occasions.  I feel it's one of my strong points and feedback from various people has backed this up.  I enjoy feeling like I am telling people something useful, I enjoy being a bit less bland than some presenters you get and know ultimately I understand that delivering a strong presentation could improve my own reputation if I ever needed/wanted to get another job. 

It's not always been like this though.  It may not surprise regular visitors to my blog that once upon I time I hated presentations.  I used to ruminate about them for weeks, even months, prior to their occurrence.  I then started to improve and feel less nervous about them (although I certainly couldn't say I enjoyed them), especially when I started my first main job.  However, all of this then changed when I had my breakdown in 2011.  I could barely leave the house let alone get up in front of several people and present.  I vividly remember a presentation I was doing in front of about 70 people on a topic I was confident about - but it was only few months after my mother of all panic attacks, so it was absolute hell.  I didn't sleep for days previously, and on the day itself I was shaking and in deep distress.  I'm amazed I got through it; at one point I felt like I was going to pass out.  So I can fully appreciate how daunting presenting can be, especially for someone with anxiety.  It's the idea of hell.  Therapy, medication or whatever route one chooses that hopefully helps to alleviate ones anxiety as a whole, will also hopefully in time make presentations easier - but trying to do presentations with an anxiety condition is like trying to knit a jumper wearing steel gloves.

That said, once the severest part of my anxiety condition had passed, for the last couple of years or so I've started to enjoy presenting and today I barely even get nervous on most occasions.  I've provided some pointers that I have used that have helped me get to this point at the end of this blog - although ultimately, without my 50 sessions of therapy, this apparent confidence I have with presenting would not be possible.

So if presenting is okay, why are social situations not?  I would say I am better at social situations now than I was in 2011-13 (when I could barely interact with anyone), but I'm certainly not as confident in social situations, especially those with people I'm less familiar with, and I'm still at best very awkward.  This is why I disputed my friend's argument that if you're confident at one thing you're likely to be confident at the other situations too.  Not the case.  Whether his theory could be applied to people without an anxiety condition I'm not sure, but I know people who have had similar experiences who have never told me that they've had anxiety.  

Even worse, of course, is the 'asking a girl out' conundrum which lags me about 15 years behind everyone else my age.  The thoughts of going up to a girl I hardly know (or vaguely know, or know quite well, or know very well - you get the idea) and asking her out makes me want to run for the hills.  Why this is the case would require an entirely separate blog (and indeed I don't really know the answer) but I think this proves that for me, at least, being confident in one situation requires totally different skills to being confident in another.  And of course, what do most girls like in a guy?  Confidence.  I really don't stand a chance, do I?

The summary is that having a chronic anxiety condition can have a hugely negative effect on someone's confidence full stop.  My concern is that in the areas where I'm least confident, this lack of confidence is terminal and irreversible.  Regarding presentations, I'm just grateful that I generally do feel good about doing them and am trying not to take this for granted!

So to finish, here is my guide to delivering a good, confident presentation.  I'm not saying it's right - it's just my guide! (Appropriately caveated, I feel). 

1) Take the opportunity to do as many as possible, even if you hate the thoughts of it.  They can provide you with exceptional anxiety-managing skills as well as the added bonus of projecting yourself; very useful for work.  Practice may or may not make perfect but it can certainly help.

2) Know what you're talking about. If it's a less comfortable subject, do your research.

3) Ditch the notes.  This follows on from point 2.  There is nothing worse than reading from pages of notes, not least because it restricts your expressionism but people can also notice the paper shaking if you're nervous.  Reading off notes can also make your style naturally more monotonous.  

4) Be clever with PowerPoint.  It's vital not to put too much text on a slideshow, but I tend to use succinct textual bullet points on the actual slides as my notes / prompts (see point 3).

5) Move around, if it helps. I'm quite expressive when I'm presenting - I tend to move around a lot and I'd recommend this.  This helps to achieve point 4 (e.g. you can point at the screen if you want to emphasise something and it doesn't look awkward) and also helps to release that nervous energy a bit, whilst masking any nervous shakes you might have.

6) Don't worry about the audience.  I used to play off people's reactions - yawning, looking away, fiddling with their phones.  Why aren't they writing any of this down??  Don't worry about any of that.  Think about what you might do during someone else's presentation.  It doesn't mean what you're saying isn't interesting, it might just be that they have had a long day!

7) Be honest with your incompetence.  What I mean is, if you make a mistake, e.g. stumble over a word because you're nervous, let people know you've noticed and make a joke or light hearted comment about it.  One of my best errors was saying 'depravity' instead of 'deprived' - I then made a joke about how all deprived people are evil.  It works, you get out of it with class (well, maybe not in this case!) and confidence.

8) Practice before you are due to do the talk, both on your own with a timer and in front of someone you trust if possible.  The former is always important regardless of how confident you feel.  The latter might not be so relevant if you're getting better at presenting, but still useful to consider.

9) Don't forget the other stuff.  I used to spend so much time worrying about the presentation that on the day I'd forget to consider the logistics, e.g. where do I need to be, when, etc.  This will reduce your stress on the day and allow you to focus.

10) Take a bottle of water.  Naturally, when you're combining nervousness and talking your mouth becomes dry.  If you have health anxiety like me, I'd always notice this and start worrying about it.  I now always make sure I take some water so I can pause if needs be to take a swig - don't be frightened to do this!

Any other ideas duly welcome!

Best wishes
Al

Trying to be positive

Hi all

As you will no doubt have picked up on this site via previous blogs, I have undertaken various rounds of therapy over the years for my chronic anxiety condition.  The only successful round was the fifty sessions of Cognitive Behavioural Therapy I had most recently, when I paid £1,000 in total (£20 per session) via Anxiety UK to obtain private therapy, as is the sad reality of the difficulties of accessing mental health support in this country.  

Not quite, but you get the idea

Anyway, before I get political, one of the many things I grasped whilst undertaking these therapy sessions was trying to be positive.  CBT is all about re-wiring of thought processes, something that takes years to master - and actually, I would argue, something you can never master completely.  One example of this is turning a seemingly negative situation into something positive, and trying not to let the little things that don't really matter get you down.  I was naturally a very negative person; I would say CBT and years of hindsight has turned me from a negative person into a slightly more positive but still very sceptical person, but still I count this as an improvement.

One of the CBT techniques that I commenced in 2011 was writing what I call a 'Positive Journal' (PJ).  This is a notebook that I keep in the drawer at the side of my bed that is there to capture all the positive things that happened during the day, effectively in the form of a detailed list.  

Now this didn't faze me, because I used to keep a journal from 2003 to 2007 ish.  The key difference, though, is that these older journals recounted everything that had happened on every given day, whether it be positive or negative.  And, it perhaps won't surprise you to know, most of it was negative because for the majority of the time I was suffering from severe anxiety.  I remember one post that just said "why is this happening to me?" The rest of the articles were of much the same ilk, coupled with re-telling the embarrassing cavorting that one did as a lanky, unpopular schoolchild (and early University student).  I swear to this day that routinely filling in my journal day in day out did me more harm than good, because it captured the horrible feelings and emotions that I went through on any given day, when really I should have tried to forget about them!  

So whilst, at first, I was sceptical (surprise surprise) about starting a new journal in 2011, I realised soon that by only documenting the good things that happened on any given day gave me some warm memories and thoughts to look back on, rather than all the other bilge that goes with it.  And, of course, this is coupled with the fact that I have been much better in terms if controlling my anxiety since around 2013 anyway, so really bad days became less.

So what exactly do I record?  Mostly things to do with other people, so whether it be having a laugh down the pub with a friend, some chats and banter with work colleagues, or anything where I've had a chat with someone else.  It could also include things I do alone, such as enjoying a walk (which as you know I do) or watching my football team win. It could be a compliment someone gave to me or a personal achievement.  Or it could be even more simple, like feeling chilled out or even having a good dream.  I also carry a small jotter with me in my bag, so that if I'm out an about and something happens that I must record, rather than forget when I get home to write in my PJ, I capture it there and then (if feasible!).  It can also include personal winning battles against anxiety, like going out for a meal where I can actually eat everything - the sort of thing most people take for granted.

So why bother?  Mainly, because it makes you appreciate things in life.  Just the other day, I had a couple of really good meetings with people at work, one because I was able to impart my experience on someone else which obviously felt rewarding, the other because I liked the person's company.  Might not sound a lot, but whilst writing these entries into my PJ, it made me realise how many good people are in my life and how many things can make you feel good, warm or hopeful.  It also gives you that ability to turn something bad into something good.  An example of this would be when I was campaigning to bring the local bus service back.  At the time, the campaigning wasn't going well, and yet people kept thanking me for trying.  So I captured the thanking bit into my PJ and ignored the rest.  It just makes you realise that things aren't all that bad and that there are often more people who positively influence your life than you think.

It also makes you appreciate things more.  I'm sure that by writing certain things - take walking again as an example - into my PJ it has made me appreciate them more when I'm doing them again, because I think "this will be one for the PJ later!"  It almost gives you your own competition, to make everything better than before.  To increase the positive things in your life.  And it can also increase your compassion, by realising that many of the positive things that happen are as a result of other people.  This can make you want these things to happen more often, therefore by being more compassionate, you get these feelings again and more people want to be part of your life.

It all sounds like flowers and roses in the sky doesn't it... but it's not without it's flaws, of course.  If something bad happens on a particular day, of course you don't write it in the PJ.  However, you might still write a couple of other things that occurred that were of a more positive nature that happened on that day.  The issue is, when you read back through, you can often still remember what day the negative thing happened based on the positive things that happened on the same day, which of course then triggers the negative memory.  So over time you have to learn to write things in such a way where this is minimised, which is not easy.

However overall, I've found this to be a very simple way of trying to stay positive, which of course is good for helping to improve the state of your mental health.  I'm not for a minute suggesting that if someone with chronic depression or anxiety suddenly started doing this it would transform their lives, but I would certainly advocate it as a small part of a recovery process.  I'd even suggest it to people who perhaps don't have a mental health condition, as I'm sure it would still make them that bit happier when they read through their entries again.  Try it and see how you get on.

Best wishes
Al

Dates

So I can officially announce that I have been on an online dating site since July. 

AAAARRRRRGGGGHHHHHH!!....

....says someone online dating with an 18 year history of anxiety.

So why have I done it?  Many factors, both demographically, logistically, and anxietally... (there's a new word for you):

1) The town where I live contains 116 men for every 100 women and is in the top ten in terms of towns in the UK with the highest ratio of men to women.  So that doesn't bode well for starters.

It's Christmas, don't you know

2) I know how 35 different couples met.  Of these, 31 met through either work, school or university.  The latter two have long since gone, and whilst, for me, meeting someone through work is a possibility, the nature of my job renders it very unlikely.  I work in a team of only three other people (two from January!) and they are all married (and older, and one is male... you get the idea).  I run a lot of events which attract many people but I'm too busy running round like a tit in a trance to consider who might take my fancy in the audience!  So meeting someone via these seemingly usual channels for me seems unlikely or impossible.  Of the four couples I know who didn't meet in one of these ways, two met online.

3) My confidence has been shot thanks to years of anxiety.  On the rare occasion I grow to like someone, I don't have the ability to ask them out anyway.  At least online you can hide behind the mask of this and appear fairly confident, as much as emails can do this anyway!  Anxiety has also made me look at myself as a boring, uninteresting person with a lack of self-esteem - again resulting in talking to someone I like very hard.

4) I want to find someone.  I've blogged many times recently about loneliness and how this is already starting to creep in, and more importantly how I feel isolation for me will only get more severe the older I get.  Reasons 1-3 render finding someone unlikely so to try and eradicate these feelings of loneliness I considered online dating to be my only option (rightly or wrongly).

5) To test myself.  Whichever way you look at it, meeting someone for the first time after only relatively brief conversation online is a rather daunting experience.  Having gone through my 50 sessions of CBT for my anxiety condition in 2011-12 and since then having moved into two shared houses, bought my own house, moved jobs and improved vastly in other smaller ways, such as the ability to eat out with friends, I knew the one key thing I'd yet to crack - or get anywhere near to doing so - was meeting a partner.  So I felt the only way to be able to test my ability to do this in the face of my anxiety condition, and to experience 'adult' dating, was to force the issue.  I'll come back to this shortly.

Despite it being nearly six months since I first signed up online, I have only been out on three dates in that time, all with the same person.  I had spent four months of total frustration, emailing several women who I felt I'd like to converse with further (none from my male dominated town) and with the few who did respond initially the conversations still seemed to wither.  On the only two occasions prior to my actual date that I got round to asking to meet the girl, they politely didn't respond.  This, of course, is not a good feeling for someone with already a fragile confidence on such issues.  So of course, when I finally arranged to meet with a girl who I seemed to have a connection with, my confidence improved a little.  Especially given that she had 'favourited' me in the first place.

Incidentally, I'm not going to go into the politics of online dating - this is a separate blog on its own.  Sufficient is it to say that I don't really understand it.  What do women think of 'winking' (please read this carefully)? What to put in your profile? In an email? When to arrange to meet? When to give out your phone number? I can safely say I haven't learnt the answers to any of these. Ladies, feel free to help me out.

Anyway back to the story.  So I arranged to meet this girl, and overall the date was successful.  Granted, I'd deem 'successful' as being able to get on the bus (remember, I don't drive thanks to years of anxiety) and actually arrive at the destination, let alone go through with the date.  But despite the expected anticipatory anxious feelings - which I handled pretty well!! - the date was good.  We chatted about a lot of things and we were quite relaxed, despite me being thrown light years outside of my comfort zone.  Remember, this is not dating someone I've already begun to know or who was a friend first.  This is someone I've seen a few photos of with some trivial textual based information, meeting her in a town 20+ miles away from my own.  Me with anxiety.  So I deem this experience as a successful one.

Even more so because we arranged to meet again a week later, this time over lunch and a mooch around a local-ish tourist attraction.  Lunch would have been impossible a few years ago, so the fact I managed to eat something with no major hitch is the first tick in the box.  I wasn't sure after this second date whether we would continue seeing each other because at this early stage I couldn't tell whether there was a proper potential relationship brewing between us.  But alas, we agreed to meet again, and this time she was to come to my home town and we would go to a traditional pub first for a meal and then to watch a gig by one of my best friends (also my tenant) at said pub.  It was something I would have gone to anyway, so it offered me the opportunity to provide her with more of an insight into my life whilst hopefully discovering more about her.

The start was more of the same - a little uneasy between us but overall okay and chatting, followed by another successful meal.  What followed, however, was not expected.  She got totally annihilated by alcohol.  Perhaps this shouldn't have come as a shock, given that she had talked a significant amount about alcohol since we first met; I just assumed it was to make her come across as interesting, because that's the only reason I ever talk about 'alcohol related incidents' (of which there a few involving me, and if they do involve me it's usually someone else that was drunk).  But this was our third date, and by the end she was barely coherent.  Other things happened too, which I won't go into.  I had to almost literally drag her back to my house and put her into bed.  The worrying thing is that we didn't know each other that well - for all she knew, I could have been planning this all along and many guys would have grasped at the chance to be with a girl who, lets say, was offering them anything they wanted.  

But the main concern for me was that this is normal behaviour for her.  I knew this, one because of the amount of time she referred to past alcohol-fuelled nights, as previously mentioned.  Two, because she basically admitted to me that this was actually a fairly quiet night for her and should I not have dragged her home, she would have carried on drinking somewhere else. Three, she wasn't hungover the morning after - suggesting her body is used to this extent of binge.

I, however, am not used to this, nor would I want to be.  I spent much of my life unable to drink anything (due to the physical effects of anxiety, surprise surprise) so I've learnt to enjoy social occasions without the need to drink.  I do drink sometimes now, but in moderation. It's not even the getting drunk I'm bothered about, it's all the factors that went with it.  Again, I won't go into the details.  And as I said, the main concern was the fact she considered this to be normal behaviour, and my other concern is how many other people of both sexes consider this behaviour to be normal?  My naivety knows no bounds, clearly.

I spent the night (in a separate bed) barely able to sleep, my heart thumping.  Anxiety-wise, it was one of the most difficult nights I've experienced for a long time (although nothing compared to my panic attack dominated days years ago, I must emphasise).  My mind was racing - what happens now?  Fortunately, I had the guts to at least speak to her the morning after and rather than blame her I just said that I didn't think I could make her happy from a social perspective.  And that's true, as I'm sure some guys (most guys?) would be more than happy to get smashed with her and do whatever they want with her (which in my book equals disrespecting her). What I actually wanted to say to her was that I am deeply concerned that she is going to ruin her life by depending so much on alcohol and drinking that heavily (and 'socially smoking' when she has been drinking, something else I can't tolerate - although that's just my bugbear I appreciate).  Fortunately, my friend who was gigging at the venue backed me up.  You'd expect this given he's a friend anyway, but he's also honest and would have told me if I was over-reacting.  

And it is a real shame, for she was a very nice person - interesting and ambitious. She's currently in the process of setting up her own business, which is admirable.  But had you been me, with my history, in my position that night, all of this would have paled into insignificance. It's difficult to write about this experience without sounding like I am blaming her, or disrespecting her - who knows what circumstances she has had to go through in life up to now.  And I'm also not trying to say that the relationship would have worked anyway, as getting close to someone like me with anxiety can't be easy either.  I suppose I am just shocked at how different social lifestyles can have such a significant impact on people's overall livelihoods.  And again, my naivety in terms of what people enjoy doing socially knows no bounds.

It did allow me to learn from the experience though, and despite what happened, I now feel more confident about what to look for, how dating should feel, and what I want.

And, despite the lack of success with the general online dating experience so far, it has also given me a little more overall confidence.  Confidence that to some women I might be vaguely interesting.  Confident to feel a little more proud of who I am and confident that I can potentially find someone if I persist.  

However, it has also made me realise what a hard task this is - and it still feels like I'm forcing the issue.  The experience with my date didn't help with this - the whole thing always seemed forced and I wonder, still, how 'natural' a relationship can feel when you're ultimately forced together online.  My six month subscription has just ended and I haven't renewed, but this isn't necessarily the end.  And now I've opened up about this on here, I will keep you updated.  Deep joy, I hear you cry.

I'd like to conclude by wishing all readers a fantastic Christmas and a prosperous New Year.  I know this can be a difficult time of year for many people and my thoughts are with you.  Lets hope 2016 is a better one for all of us.

Best wishes
Al

Everything I value is being battered

Hi all

I've been a bit down lately.  I think this coincides with a slow social spell, shall we say, in terms of not doing a lot out of work hours, that doesn't involve being on my own.  I am so much better these days at enjoying and appreciating my own company; one of the big positives about buying my house back in June was that I get more of this now and less uncomfortable-ness or stress sharing with other people.  But it doesn't alter the fact that it becomes increasingly distressing when I see most of my friends and those closest to me, whether by choice or design, in seemingly happy relationships, with their future all set out in front of them.  I have, rightly or wrongly, resigned myself to the fact that I am one of the few people seemingly not destined to find my 'special someone' who I ultimately settle down with.  I don't believe there is someone for everyone, I believe there is someone for everyone else. 

Battered fish... what do you mean 'the pics are getting less relevant?'

So, without a partner to share my life with and without any family locally apart from my parents (and with no brothers, sisters or cool aunties), I am, and always have been, reliant on my friends to provide me with a social life and interaction.  For you see, whilst being on my own is something I'm these days better at tolerating, and even enjoying, I still need interaction, especially in the dark evenings, to keep my mind from wandering to anxious thoughts.  And, without using the word carelessly, to stop thinking depressing thoughts about my future - being alone.  Plus the fact I do enjoy times with my friends!

Having had anxiety throughout the majority of school and University life, my confidence in many social situations has been battered.  It's also meant that making friends back in those days wasn't easy.  So I only have a few friends I can call upon.  Yes, they are truly fantastic people, a core of true, 'real' friends whom I wouldn't change for the world.  And, although quality not quantity generally stands, in this case it would be nice just to have a few more friends in the local area that I can call upon to fulfil my social palate.  It can be a challenge just to get someone out for a drink on a Saturday evening, particularly these days when all of these people are too busy enjoying their seemingly richer, fuller lives.

What all of this means is that I have learnt to value 'other' things in life.  I may have only done this in the past couple of years, when I should have done it a lot sooner, and not have been ashamed of doing it, but still - better late than never.  By 'other' things, I mean those things that don't include relationships, something that I don't have, and social occurrences, something which happen infrequently for me. I have blogged about these things a few times before, and how I must value them more and more.  The problem is, quite literally all of these things - and more - are being battered in some form or another. 

1) Buses.  I've been moaning for a while now that the council and the bus company - kind of a combined effort - that provided a bus to my parents' village has, as of 5 Sept this year, been cut.  This has caused now nearly three months of distress to many vulnerable people and no-one, to put it simply, has given a shit.  From a selfish point of view, I have mentioned before how I actually enjoyed catching this bus, because I knew so many of the people and the bus drivers who used to drive the route.  It was like a warm, friendly community which I enjoyed being a part of whenever I stayed at my parents place.  This has, quite literally, been ripped apart by this rash and poorly considered decision.  

2) Swimming. One of the best decisions I have made in the last five or so years was to take up swimming, for both the exercise (physical and mental I hasten to add) and because I have met some really great people here.  We're going for our third consecutive Christmas meal in a month's time which says it all (notwithstanding a Christmas 'meal' isn't something I could have done anyway much longer ago than that - see previous blogs!)  However, swimming is fast become a farce.  It is getting busier and busier and is filled with a huge number of inconsiderate people who swim wherever they bloody well like and sod the rest.  I have to slalom my six feet four frame through this splurdge of disrespectful folk - at best.  Sometimes it's impossible to pass at all.  To the point where, to swim properly and without getting angry at how so many people can have so little compassion, I am considering going to swim somewhere nearer to my workplace just to get away from it.  But in doing so, I leave behind my friends.  It's really disappointing that it has got to this.

3) University.  Although I finished University 7.5 years ago, I still go back to the campus quite often to help out with, for example, providing talks to students on my career since Uni and judging graduate dissertation presentations.  Through whoever I've been working for, I also host a student placement each year from the department.  As such, I get on very well with the lecturers and have a very good laugh with a few of them, one in particular who was my dissertation tutor in final year.  Guess what.  The department's staff is being cut by 20% - he might be one who leaves - and there is even the threat it's closed completely.  

4) Work.  Sadly, the Government don't care remotely about environmental sustainability.  As such, my job is currently under moderate threat.  Not only is one of my biggest passions in life, protecting the environment, at risk of being neglected, but I may not have a job fairly soon unless I change tack completely.  Apart from the obvious stress (anxiety?) unemployment would bring, it would also mean removing myself from my work colleagues, who are all brilliant people.  I have become part of real team over the past couple of years in this new (ish) job and this is very important to me given my circumstances.  Yes, of course there is always a chance I will get this again in a new job, but being realistic, it would be hard to replicate.

5) Walking. This is more long term, but given various issues, walking in the incredibly beautiful surrounding areas of where I live may become a rarer and less enjoyable thing if various things conspire against our environment - because as I mention above, people don't care about it.  See this blog for my fairly recent rant about this.

My real worry is that, if all of the above experiences either decline or disappear, coupled with my lack of a relationship and friends who ultimately, eventually, will probably move away and become less available to socialise, I am going to be left scrabbling for very rare glimpses of enjoyment.  What really makes me sad is that, when I was surrounded by plentiful opportunities for socialising, especially at University, I couldn't take advantage of them because of crippling anxiety.  Moreover, this probably prevented me from sparking up that relationship with that 'special someone' and puts me in the position I find myself in now.  Now I'm in a place where I could enjoy more social activity, sustain a relationship and appreciate the above list more, the ultimate irony is that everything that does exist is crumbling to the ground around me and things that don't are looking less likely than ever to start up.

Sometimes it really is hard not to blame anxiety for how life pans out.  This is one of those times.

Best wishes
Al

Commuting Chaos

Hi all

Commuting is something we all do.  Technically, if we walk downstairs from the bedroom to the kitchen, we're commuting, in a sense of leaving A and getting to B.  The only time I would argue against this theory is if you're out for a walk with no destination in mind - but even then, I imagine you'd like to end up back at home at some point.

Normal day at my railway station.

But of course, walking downstairs from the bedroom to the kitchen, sometimes calling via the lounge, is not something that generally stresses one out.  Commuting in the form that we understand it, i.e. leaving the house to go to work, on the other hand, can be a nightmare.  For someone with anxiety, going to wherever you're going to isn't what is frightening you - it's what happens on the way that you are concerned with.  

I've been commuting by train for work now for what will be two years this coming January.  The train journey is between 32 and 45 minutes (depending on whether I take the local or faster service) one way, so I spent at least an hour and five minutes per weekday on a train.  And that's when it runs when it should.  

And it's not just the act of getting on the train; it's also the bits either end.  I work in Birmingham, and my commute takes me to New Street station.  You may have heard in the news that it has recently been revamped.  In essence, it now has a glass roof and ticket barriers.  The trains still get delayed.

Anyway, it is a very busy station, especially at rush hour and being in a huge, dark place with hundreds of people dashing about can be very daunting and nerve-racking for someone with anxiety.  It is chaos.  You have people running past you and towards you, in all different directions.  People with suitcases that trip you up. General noise and confusing announcements.  And 25 platforms (12 platforms with a's and b's, and platform 4c is which is halfway to Smethwick).  Where do you start?  Stations of this size are not friendly places and can make the whole experience a splurge of utter nonsense.  I like to go into the station, walk absurdly fast through it, and come out onto the platform (fortunately my trains back usually leave from one of two platforms, so it's not too difficult) without spending any more time than I have to there.  I've yet to see the new glass roof.

Then there are the trains themselves.  Crammed.  Absolutely crammed.  The luggage rack or the toilet is often the best you can get by way of a seat.  The only way you can get a seat is by being rude and getting on the train first, otherwise you've had your chips.  You can try and stand where you think the doors are going to stop but you never get it right.  So you get on the train and have to stand pushed up against other people, many of whom are being ridiculously loud by talking on their phones or having bought their screaming children on board (it was half term last week...)  It is a horrible experience for anyone.  But for someone with anxiety, it's a real test.  It's a panic inducing environment and not a pleasant one.  

Being on a quiet train can be difficult enough - the inability to escape, the pressure of being 'ok' in front of total strangers.  I know this after my panic attack from hell in 2011 which ultimately sparked off the creation of this website.  But when you throw in far too many people, all of whom are in their own worlds pretending that there is no chaos going on around them, and you get total ridiculousness.

The public transport system in our country is absolutely abhorrent.  Anyone that commutes regularly will know this.  And for anxiety sufferers, it has more than just a negative effect on getting somewhere on time.  Just working out which train to get and at what cost can require a PhD.  And thanks to the current austerity culture, it isn't likely to get better anytime soon.  No money to spend on more carriages, more trains and something I would introduce if I was in charge of the rail network - "SILENT ZONES" - which would prevent anyone from making a single sound, let alone 'quiet zones' which are about as effective as using candy floss in an advertisement trying to persuade you to reduce your sugar intake.  Anyone who made a noise faced a £10,000,000 fine.  Which would then be used to fund MORE TRAINS.

MORE TRAINS would also mean fewer cars.  Hows that for stating the obvious?  The town in which I live is quite small, but the road system is notoriously terrible.  It is usually stationary at rush hour (and not at rush hour).  I don't drive (although I did try and learn but had to stop lessons back in 2005 due to multiple panic attacks at the wheel - ohh, anxiety) but having to commute at rush hour by road cannot be any more fun than being on a train.  At least on a train you can read a book or newspaper, play snake (I'm not one for overly modern technology) on your phone etc.  But you have to negotiate your way through thousands of other irate and stressed drivers when driving and keep in control.  At least if you were on a train and lost the plot you wouldn't endanger the lives of others and yourself in quite the same way.  

Our local buses are also being cut, as I've recently been blogging about.  These services provide a lifeline to many people, especially the elderly, who are now facing isolation and loneliness and, of course, the direct impact this will have on their mental health.  It's horrible to think that we live in a world where saving a little bit of money takes priority over the mental wellbeing of hundreds of pensioners.  So in this sense, a stressful commute is better than no commute at all.

Cycling isn't much better, given how poor the quality of our cycle paths are and how inconsiderate some drivers can be to cyclists.  Walking is probably the best option, but working any more than a few miles away from home renders this an unviable option.  

Commuting has a huge impact on our mental health, and not usually for the positive.  As difficult as this is, I would strongly recommend working as close to your house - or better still actually at home - as possible.  I enjoy my job, and what usually spoils my day is the commute there or back, rather than the job itself.

It can have a serious detrimental effect on anxiety sufferers.  It blocks recovery.  It can trigger panic attacks.  This can then have knock-on effects, both at the time (e.g. if you're driving a car) and in the future (i.e. attributing a panic attack to being on a train and then finding it hard to catch another train again).  This is what happened to me.  Thankfully I have overcome the worst of my commuting fear now, but it still mars my day all too often and one can only imagine what someone with anxiety experiences if they walk out into this world of commuting for the first time.  We look upon the powers that be to invest in commuting infrastructure (etc) to improve our experience.

Don't expect this anytime soon.

Best wishes
Al