21 September 2016

Going pro

Image courtesy of cbenjasuwan/
FreeDigitalPhotos.net
A couple of weeks ago, I did something that I haven't done in decades: I sought professional help for my mental health issues - specifically, my generalised anxiety.

Those of you who regularly read my blog will know two things about me. The first is that, every now and again, I experience a period of exceptionally high anxiety, more often than not over some anticipated problem, rather than an actual crisis.

The second is that I've got by with little professional help - just one short course of treatment from an occupational therapist more than 20 years ago, when my OCD first took hold.

Although I've read a lot of books and online resources, I've never properly tackled my anxiety. My default approach is to grit my teeth and drag myself through difficult times hour by hour, managing to hang on only because I know I've survived them before.

The reason I'm seeking help now is that there's no end in sight to my current stress, as the cause is my parents' declining health and corresponding difficulty in managing on their own. 

My sister lives half an hour's drive away from them, so does what she can on the ground, while I - being 100+ miles away - have tried to make myself useful with research on care options, funding, Power of Attorney and so on. It's a steep learning curve, but being proactive and getting informed creates an illusion of control amidst all the worry, sadness and frustration.

Tearfully telling a friend about it all, I said 'I feel such a wuss. I mean, everybody goes through this, don't they?' 'Yes,' she said, 'but everybody goes through it with tears and anxiety.' A friend once again being kinder to me than I am to myself. 

She's right, of course, just because everybody goes through it, doesn't make it any easier at an individual level. In the same way, everybody experiences bereavement, but that doesn't make your own losses any more bearable. 

Having closely followed this year's Paralympics, it occurs to me that, likewise, you wouldn't expect somebody who had lost an arm in an accident to take it in their stride just because millions of other people are amputees!

When I found myself wailing to another friend 'I can't imagine ever feeling happy or relaxed again', I realised that I needed to do something; I had to arm myself with some proper tools to cope.

After my GP had listened to my woes and my response to them - or, at least, what she could hear of it all through the sniffing and the crying - she said, 'I had another patient in almost exactly the same position and cognitive behavioural therapy [CBT] really helped'. I left the surgery with a self-referral form for the Mind Matters Barnet service.

The form is largely taken up by an Anxiety and Depression Questionnaire, which asks how often you feel, for example, 'Little interest or pleasure in doing things' and 'Down, depressed, or hopeless'. I scored a lot of 3s, ie 'Nearly every day'. 

A telephone assessment quickly followed, once again accompanied, on my part, by sniffing and crying that rendered me almost incoherent at times. A few days later, I was told that I had been approved for CBT...but that there was a four month waiting list.

So, in the meantime, it's back to the teeth-gritting and getting through life hour by hour - with just the tiniest of lights visible at the end of the tunnel.

17 August 2016

Anxiety on wheels

Driving is one of those apparently straightforward day-to-day activities that causes me anxiety for a whole host of reasons.

My biggest fear is the perhaps rather obvious one of being involved in a crash, though this generally only rears its head when I'm on roads where high speeds are permitted. 

The main issue is my lack of control over the vehicles around me - I'm worried not only about other drivers' competence (or lack thereof), but also the risk of mechanical failure that might send tonnes of metal hurtling into my path.

It doesn't help that my car - a striking copper-coloured Micra - is nearly 19-years-old and only has a 1 litre engine. I can't even overtake speedily, let alone nip out of the way of trouble.

Up until the beginning of this month, I hadn't driven on a motorway in more than 18 months, although I had often been on busy - sometimes 3-lane - A roads. This was due to circumstance, rather than avoidance, but I was starting to worry that I would lose my nerve completely, if I didn't get in some practice.

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As it happened, I had to travel to the Midlands a couple of weeks ago and I was nervous as I set off on my journey of 100 miles or so up the M1.

Once in the flow of fast-moving traffic, I was plagued by visions of doom. I imagined every high-sided lorry that passed toppling onto my car and crushing me. I expected a tyre to blow out, or my engine to fail, at any moment. And every time the traffic slowed and began to bunch up, I envisioned a multi-vehicle pile-up.

Also, I couldn't help thinking of the neighbour whose car was written off, when a wheel came off a lorry on the opposite carriageway and bounced across the barrier onto her car bonnet. She and her passengers escaped with minor injuries, but it could have been a different story, had the wheel landed a split second later, on the roof.

It's this kind of unpredictability that those of us with OCD find hard to deal with. We seek comfort in compulsions that give a sense of control and seem to establish a degree of certainty over our environment and our lives. Certainty is an unachievable target, however, and trying to carry out compulsions while driving is likely to be counterproductive!

Other anxieties also come into play when I'm driving. Every time I smell smoke or burning, I assume it's a problem with my car. The same goes for any unusual noise. A couple of days ago, as I parked up, I noticed that my engine was 'roaring' - only to get out of the car and realise the sound was coming from a motorbike further up the road.

As an anxiety sufferer, my senses are on permanent high alert for problems, whatever the situation, but I've become even more nervous about my car, now that it's so old. My recent journey 'up north' has, at least, helped me to regain some degree of confidence on motorways. 

And I very much appreciate the convenience and freedom that driving affords me. Those benefits more than make up for all the associated anxieties: as is so often the case, facing your fears definitely has its rewards.

20 July 2016

Brexiety

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While I wouldn't wish OCD on anybody, if I see someone experiencing similar anxieties and responses in a non-OCD context, I welcome this as an opportunity to raise awareness of the condition by drawing parallels to 'normal' life.

Take, for instance, reaction to the recent EU referendum. 

I live in London, where the vote was in favour of 'Remain', and everybody I know was devastated by the result. The ensuing uncertainty about this nation's future was - and still is - the cause of most people's distress. And uncertainty is something that those with OCD find difficult, if not impossible, to tolerate. 

It's that inability to tolerate the unknown that leads to compulsions such as excessive hand-washing, to avoid contamination and illness, or repeatedly checking the front door is locked, to prevent a burglary. 

The disorder causes a myriad of other less well-known behaviours, many of which appear utterly illogical, having no basis in common sense or practicality. We all wash for sanitary reasons and lock up for security, but most of us don't, for example, feel compelled to perform actions a set number of times.

So how does all of this translate to the EU referendum result? 

In the immediate aftermath, the government's silence as to the way forward fuelled anxieties. One colleague repeatedly said - almost wailed - 'What's the plan? Why hasn't anybody told us what they're going to do?' 

A week or so after the result, she circulated an email with a link to a petition to 'Prosecute Nigel Farage* under the Racial and Religious Hatred Act 2006'. Now clearly this petition wasn't going to provide clarity as to our future, but as she said 'I know there are so many [petitions] at the moment. I think signing them might be helping my feelings of helplessness.'

She wasn't the only one. People across the country have been driven to take action - any kind of action - to regain some sense of control. The uncertainty is just too great to sit idly by waiting for something to happen.

There's a very clear parallel between how all of these people are feeling and reacting in the wake of the referendum and how those with OCD feel and react on a day to day basis.

And so how was I faring in all of this? - surprisingly well, as it turned out.

My ordering compulsions are often triggered by distressing events on the world stage and I was certainly upset by the result. However, within a few days, I had resigned myself to it, concluding that there was little I could do to change things. 

I admit, I was quite surprised by this response, as I frequently worry about things I can't change. When I reflected on it, though, I realised that those anxieties are generally about situations where I can, at least, imagine the possible outcomes and consequences, such as, say, my car passing or failing its MOT.

In relation to 'Brexit', I don't know what all of the repercussions will be and, as a result, there's no clear focus for my anxiety. The uncertainty is just so huge that it's beyond comprehension and so - perhaps strangely - I've been able to stop worrying about it.

If you also now feel helpless and anxious in the face of an uncertain future, I'd ask you to spare a thought for those of us who live with that constant tyranny. It's really no fun at all, is it?

* * *

*Former leader of the United Kingdom Independence Party, who fought for the country to leave the EU for years.

16 June 2016

Madam Speaker

Public speaking is an activity that fills many people with dread, not just those of an anxious nature. My own fear has its origins in an incident that took place when I was 17-years-old. 

At my secondary school, the upper sixth-form pupils had to take it in turns to read a bible passage at the lower school assembly. This meant joining the head teacher up on the stage, in front of hundreds of 11 to 14-year-olds. As a teenager, I was an introvert and the last thing I wanted was to be centre of attention. 

We were given no guidance as to how to deal with this challenge and by the time I stood up to deliver my reading, my heart was racing; my voice trembled so much that I was almost unintelligible. That experience was a poor foundation for handling similar situations in the future.

So intense is my dislike of speaking in public that I even avoid asking questions in group settings, unless I absolutely have to. Then I become so dizzy with nerves that I barely register the answer anyway.

I'm not much better in social environments. While I love to chat and to make people laugh, I can only cope with an audience of up to three. If a lull in surrounding conversations means more than that tune in to mine, I'm instantly uncomfortable. I'd be a great stand-up comedian, if only I could hold all my gigs in a wardrobe.

However, as a writer, giving talks is a great way to raise your profile and promote your work, so it was something I had to face. Not least because I also wanted to share my experience of living with obsessive-compulsive disorder, in order to raise awareness and to help address the ongoing stigma around mental health.

Image courtesy of North Finchley Library
The first couple of talks, at local libraries, were as nerve-wracking as I'd expected. I had to put my glass of water on a shelf behind me, so that nobody could see my hand shaking when I took a sip. However, they seemed to go well and I received a good reception at both.

Last month, I gave three presentations for staff at my local council, to mark Mental Health Awareness Week, and was surprised to find that my anticipatory nerves had gone. By the time it came to the second, I was actively looking forward to the event.

All the usual speakers' tips had failed to calm me previously, so what had changed? My increasing familiarity with my material probably helped, but I think the key factor was the positive response to my earlier talks. Now, at least, I was going in with the confidence that my audience wouldn't be bored rigid.

At every event, I've ended up chatting to people who either have a mental health problem themselves or know somebody who does. It's rewarding to be able to steer them in the direction of appropriate resources, or just to reassure them that they're not alone.

And I'm grateful that overcoming one of my anxiety demons means I can now do more to help others tackle their issues.

19 May 2016

Solitary confinement

When my last temporary assignment finished a week before Christmas, I resolved to give myself a month off before looking for permanent work. Fortunately, I received a job offer two months later and took up a new role three weeks after that.

Altogether, then, I was at home for just under four months - and the experience nearly sent me over the edge mentally.

The downslide began soon after I signed on. In the past, I've been short-listed for almost every job I've applied for and haven't been rejected for any that I really wanted, ie post interview. Now the only response to most of my applications was resounding silence.

Understandably, my stress levels rose, in spite of the fact that I had sufficient funds to tide me over for several months. My main concern was that my age might have catapulted me onto the employment shelf. And so long as I was out of work, I felt in limbo and unable to move on with the next phase of my life, which was immensely frustrating.

As the weeks passed, all sorts of old anxieties resurfaced - and were joined by new ones on a daily basis. I ricocheted from one obsessive thought to another with no let-up. People talk about losing their minds and that was exactly how it felt. It seemed as if mine had become a separate entity, with my thoughts running amok like a bunch of crazed Gremlins.

This period coincided with a sudden growth in my boyfriend's pet-sitting and dog-walking business, which meant he was working seven days a week. We live in different parts of London, so our time together dwindled almost to vanishing point.

Not only had I lost my work routine, but also my weekend one, and, as a result, all the associated people contact. I didn't see much of my friends, either, as I felt unable to relax and socialise when I didn't have a job. Often days went by when my only face-to-face human contact was with supermarket cashiers - and with Aldi's high-speed service, even that was fleeting.

I became aware that being home alone so much was contributing to my mental decline; I simply had too much time to think. Although I've always been happy in my own company, and never short of projects to occupy me (even when not job-hunting), I began to feel very isolated.

I'm now in the sixth week of my new part-time position, which means I'm out of the house for at least three days a week, which has definitely improved my mental state. In addition, learning new processes has occupied my brain to the extent that there's no room for my usual anxieties - at least, not while I'm at work.

Isolation is often a feature of mental health conditions and my recent experience has shown me how that isolation can actually make such conditions worse.

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Of course, it takes great effort and courage to break out of that situation, especially if you suffer from, say, depression or social anxiety. 

However, whether that break-out means securing a job, taking up a volunteering role, or just arranging to see a friend for coffee, the pay-off is definitely worth it.