We live in an anxious world right now. In a previous article we outlined the difference between being anxious and anxiety disorder, but what does it feel like to have anxiety disorder and what does it feel like to have an anxiety attack? MQ Copywriter Juliette Burton shares her experience.
I was diagnosed with anxiety disorder when I was a teenager. I was also diagnosed around that time with many other conditions which I later learned were ways my mind had found to cope with that overwhelming anxiety – eating disorders, obsessive compulsive disorder, agoraphobia, body dysmorphia and others.
While some of those other conditions I’ve learned to manage and make a full recovery from, when it comes to anxiety disorder it still rises and surprises me. And recently, since the pandemic, my anxiety seems to have gained a super strength it didn’t have before.
Pre-pandemic my anxiety disorder could sometimes get in the way of my daily activity. I would sometimes spend a fortune on taxis because I was overwhelmed by public transport. I’d avoid places or people as I’d feel like I was unsafe. Those thoughts, feelings and visceral responses were all my anxiety disorder talking, it wasn’t indicative of my actual level of safety in the present moment, usually.
Recently, my anxiety symptoms have escalated and begun to affect my life. In fact, earlier this month I had a very strong anxiety attack on my way into the MQ offices. Rather than allow it to turn into shame, guilt, and isolation, I made some notes in the hope that explaining what I was experiencing might help others to better understand anxiety disorder and anxiety attacks.
Noticing the attack begin
I was heading into London on the train after a long period away from the capital. I’d been on sick leave due to physical illness which, looking back, usually causes my depression and anxiety disorder to ‘wake up’ internally. Crucially though, due to the pandemic, the familiarity of the journey had faded along with my confidence in managing my anxiety levels.
Feeling relatively stable in my thoughts and feelings, I boarded the train, managing the intrusive thoughts about whether I’d locked my house (this used to be an obsessive compulsive symptom for me. But nowadays when I notice those thoughts I pause and challenge the thinking cycles behind it, I know how fast it can escalate into debilitating patterns of thoughts and behaviours).
As we drew closer to London, I felt my heartrate suddenly increase. I was struggling to breathe.
I hadn’t been aware of what the thoughts were that began this physical response and by the time it occurred to me that this was an anxiety attack, the physiological effects were so great they had become my new focus, not the thoughts that caused them.
I now know, looking back and having spoken with my therapist about it, that there had been thoughts about going back into London, where I’d spent the pandemic. There had also been thoughts about my life choices, illness, successes, loneliness, isolation and a lot of grief. The station I was pulling into I’d not been to since before the pandemic. My life had been very different back then. Huge changes to my life involving big transitions have occurred since I’d last been in these surroundings. Shadows of deep loss hung over me: loss of relationships, life, a way of life of a certain type of hope.
However, at the time I’d not been even aware of those layers of thoughts. All I knew at the time was that I couldn’t breathe. Next came a fixation on intrusive thoughts about my body image, a common experience for someone with body dysmorphia. For me it quickly escalates into the habitual thoughts of “I shouldn’t be seen by anyone”. This debilitating belief is linked, for me, to my eating disorders too which again can have dangerous consequences in behaviour.
Nowadays I understand where these core beliefs come from and I can better understand the origins therefore better communicate with myself internally to manage them. However it’s taken years of therapy and deep work to get to this point. And even then, the anxiety attacks still come.
By the time I got off the train my breathing was still a problem, I was experiencing pains in my shoulders and neck and even my vision was becoming blurry. I couldn’t focus on anything. This is when a crowded area then makes things worse – unpredictable movements of strangers, unfamiliar noises all adding to the feeling of fear.
What helps an anxiety attack?
There are many treatments for anxiety disorder and panic attacks. I’d already used some CBT methods I’d learned in therapy in the past in this instance. And new research is being done to discover more effective treatments.
In this instance, and in the immediacy of the anxiety attack, I also tried using the following techniques I knew had previously helped in similar circumstances:
Breathing exercises and Breathing GIFs (a moving image that helps you focus on breathing in and out).
Messaging friends (for emotional support and practical reminders of how to manage the physical symptoms. Once the symptoms calm down, the same friends can help me talk through the thoughts that caused the attack).
Music (noise cancelling headphones can help me focus on soothing tones, breathing regulation and can help manage the unpredictability of my surroundings. Research has shown music can help us manage stress.)
My outfit choice (sometimes not always a great option, but often selecting the armour I wear, metaphorically speaking, helps me cope with anxiety provoking situations. It can give me a forcefield bubble within which I can visualise myself managing my anxiety levels a bit like a superhero costume).
Using sense-based exercises to help me ground myself (eg, finding all the colours of the rainbow around me, focusing on sensations I can feel, wearing perfume I can smell to engage with other senses in my body)
Grounding stones (stroking a stone in my pocket can help me to ground myself in the present)
Reminding myself what I am experiencing is a panic attack and not a real life or death situation.
The above all usually help but, on this day, none of these were calming the symptoms. My heartbeat continued to rise and my hands were shaking. I kept reminding myself this was a panic attack. There is no threat. But my intrusive thoughts were getting stronger and the physical symptoms getting worse. At this point, where the thoughts begin, and the physical symptoms end started getting harder to recognise.
It was at this point I began to feel lightheaded. ‘I haven’t fainted due to anxiety for a long time. I’d rather not today’ I thought to myself. ‘My work laptop is in my backpack, and if my body suddenly met the floor, I’d really like the MQ equipment to not break.’
Other things I’ve found that help in general include:
Mental Health Chaperones
Safe spaces and kindness
“Safe space” is a term thrown about a lot nowadays. But this is a term I use to mean “a space in which I feel safe. A place that has familiarity where I can calm my nervous system”. In London, having been a freelancer for many years before working for MQ, I’ve found a great many. Having worked in many cities across the country and internationally, finding a safe space helps me manage my anxiety hugely. It’s usually easy to recognise when you walk in and there was one I knew of near the station at which I’d just arrived. It has calming lighting, soft furnishings, friendly staff, plug sockets, wifi, corners I can hide quietly in, natural materials like wood, natural light, it’s warm. Interior design can help calm our nervous system a lot.
One thing that invariably helps me in a mental health distress moment is Kindness. People can make the world of difference. One kind act, a kindly face, can help reach into the isolation of an experience like this and pull my humanity and fortitude, my resilience out from the shadows. The kindness of the staff in this particular place that day might not have saved my life but they changed my world. It was there that I could calm my breathing down enough to regain my vision, regulate my breathing, my thoughts cleared and even do work while I was gradually accessing these tools.
Mental Health Chaperones
On this particular day, as I sat in this safe space working away, work colleague reached out and offered to meet me to walk me to the office. Another offered to have a meeting when I arrived. These offers all helped me manage my anxiety. I’ve coined the term “mental health chaperone” meaning a friend or person who chaperones me to get to a place or execute an activity that on difficult mental health days is more challenging than usual.
Another friend offered to be my “mental health chaperone” from the office to the station, and when I asked a close friend whether they could pick me up from the station at the other end to drive me home, I was extremely lucky that they said yes. I’ve been known to use taxis and Ubers on days when anxiety has hit this hard.
With support, kindness and creativity as well as therapy-informed tools and strategies, I can get through these attacks, and they do not prevent me from living life like they have done in the past. I’m not going to lie, since the pandemic, these attacks and my mental health conditions have proved more challenging than they were for many years. But perhaps that means there’s more to learn.
Longer term solutions
Just like with physical health, there are habits I can keep up consistently to give myself a better chance of having better mental health. For example, eating well, sleeping well, talking with friends regularly, socialising, seeing new places, learning new things and being of service to those around me all help. I now realise these things tune into the Five Ways of Wellbeing, a recommended way of framing habits that can help our mental well-being in a bigger picture.
One big thing that helps me is physical activity. Research has shown that physical exercise can help our mental well-being. I know from experience that regular exercise can help keep my mental health in better shape as well as my physical health. But since having Covid at the start of 2022, my immunity does seem to be less strong and repeatedly getting infections of various kinds means physical exercise has been harder to keep up consistently. I’m aware the effect this has had on my anxiety levels too.
Managing my anxiety disorder is a life-enhancing effort, and it does take effort even now after over 20 years of living with it. I’ve lived with it long enough to know they do always pass however horrific they might feel at the time. I’ve also learned that avoiding situations that cause anxiety attacks isn’t always the best plan.
My habits inform my resilience. Mental well-being is like a muscle I need to strengthen. Something like going into London on the train is an exercise I can do again and again to improve my confidence and learn to manage the intrusive thoughts.
The Mental Health Snowball Analogy
In some ways, I see anxiety as a snowball. The positive experiences that take effort is like rolling the snowball up a hill, the effort means the positive effects gather and build into a bigger and stronger ball of confidence. Unfortunately the same can be said for negative, isolating experiences – if I don’t expand my world with those little positive efforts the snowball of low self esteem and isolation and withdrawal can build even faster, like a snowball rolling down the other side of a hill gathering power over my far quicker as it picks up the pace and rolls away from me.
The thoughts that come with anxiety attacks can be extremely difficult to manage. There’s a lot of shame I still hear internally thanks to internalised stigma. Writing this I hope will empower others (and myself) to remember this stigma is outdated, unhelpful, keeps me stuck and in fear and yes in a way safe from taking further risks, but with that then my world shrinks. And my lust for life is insatiable enough to give me the empowerment necessary to break from these shackles of anxiety that binds me from expanding my horizons.
Having anxiety disorder and anxiety related disorders need not prevent me from living life, being productive, taking risks. With flexibility, understanding, support from my friends and work colleagues I can ride these waves as brutal as the tossing and turning riding them might be.
Researchers are doing vital work to understand why certain people, like me, develop these conditions and what can be done to prevent and treat them.
Support MQ Mental Health Research to help researchers do more to help people like Juliette.