Mental Health Week 1: Anxiety

Posted on my work intranet site on Monday 12th May

Today is the start of Mental Health awareness week and I have decided to support the campaign by blogging every day about my personal experience and views about mental health. I feel very vulnerable in doing this; there is still a stigma attached to mental health, but I think it is important to ‘lean in’ and ‘step up’ and ‘speak out.’ I have felt inauthentic in not being brave enough to comment in the past – and I know that one of the only reasons I am doing so now is because, like the gay footballer who only comes out at the end of his career, I am leaving the company at the end of the month. But [redacted] has been a very good home to me for the last 4+ years and if my speaking out can help others or make a positive impact on the culture with regard to mental health just a little bit, then it’s worth my feeling a little uncomfortable.

Today’s theme is Anxiety. The focus of this will be around being aware of what causes anxiousness, how to handle it, manage it, cope. My experience of anxiety has been intense: I have Post Traumatic Stress Disorder (PTSD) as well as depression. My PTSD is thankfully no longer the severe diagnosis that it was a year ago (I am only two points above mild in moderate now, whoop!), but it is still a daily feature of my life.

The Mental Health Foundation defines anxiety as “a type of fear. It is usually associated with the thought of a threat or something going wrong in the future, rather than something happening right now”. Whilst PTSD is much more about being stuck in a traumatic event in the past which feels like it’s happening in the now, I have also suffered from anxiety as a side-effect of PTSD: a lack of trust that something won’t go wrong again, anxiousness that I’ll experience a triggering episode, fear of going to sleep just in case I get night terrors. Over the years I’ve learned to distinguish between when I’m feeling ‘anxious’ or ‘overwhelmed’ and when I’m panicked. For me, an anxiety attack is very different to a panic attack (which will transport me to the trauma in the present) but fear of which can take over life in a very similar way.

[It helps I think to distinguish between stressors and triggers. A trigger is something which will have the effect of transporting you to a place of extreme fear where your ability to respond rationally is incredibly limited. Stressors can be controlled, triggers cannot].

Anxiety is like low-level noise, like a constant buzzing in the ear, it exhausts and feels like you are being physically pulled down – but you’re still (vaguely) in control: it’s possible to talk yourself out of it, or into it (and whilst no-one consciously wants to inflict an anxiety attack on themselves, internal self-dialogue can be very powerful, in a negative way). The age-old platitudes that if you can ‘think positively’ or ‘do some exercise’ *can* help with anxiety – assuming that the anxiety hasn’t debilitated you to the extent you also suffer from its close cousin, depression. To be quite honest, when people ‘helpfully’ suggest exercise as a solution, it makes me want to cry or kill, usually in equal measure. 

My mental health experience has made me very cynical of people or organisations that suggest that ‘thinking positively’ or ‘moving more’ might help. Putting on a brave face almost meant my death, and I’m not being melodramatic. If you try to ignore something for too long, the pressure will one day explode, like the air in a pressure cooker has to get out somehow. I didn’t even think I had been ignoring it – I’d done counselling, I was coping, this was just my life. Apart from the first year or so after the event, when I arrived here in February 2010, I felt to all intents & purposes absolutely fine. And my work record seemed to reflect that, with Fandom directorate awards two years running. 

But then there was a period where I was working 12-14 hour days, 6-7 days a week, over a 3 month period…. There were very practical business reasons for these hours – the timelines were set by Europe, I was the only one in the team, my immediate line manager hadn’t been appointed to lean on, and the supporting teams for the work either didn’t yet exist in the structure (there wasn’t for example a competitor intelligence team) or were also overworked. The work needed doing, so I attempted to do it. For anyone, this could have spelled disaster from lack of breaks, lack of sleep, no self-care. For me, it meant a breakdown and the re-emergence of my PTSD, which I’d been keeping a lid on, but which was now spilling over. When I look back, I just hadn’t faced the truth that anxiety attacks at the thought of leaving the flat were part of something that meant I wasn’t better, that moving house 6 or 7 times in 3 years meant I just didn’t feel safe anywhere, that cutting off ties with my family because I couldn’t bear them knowing meant I wasn’t at ease with my own truth and didn’t want to confront it in those I loved.  Looking back, now, I think that breakdown two years ago and the help I’ve got since then as a result was possibly actually a life saver.  Although at the time, it almost meant the end of my life. 

That breakdown meant I was forced to confront my mental health head on. I had to share what was happening with my bosses (& my new boss, less than a week into the role when I broke the news has been continuously awesome) and it meant I had to get help; initially more counselling, latterly psychiatric help. My psychiatrist has helped me to understand the symptoms of PTSD which made so much sense to me as soon as they were explained. 

When you have PTSD your ‘window of tolerance’ is much narrower than the normal person’s.  If a normal (forgive the use of the word please) person is under stress they will usually be at the peak of their window of tolerance – this is what people might call the ‘stretch zone.’  Sometimes, if someone jumps out behind them they might jump and feel unsettled.  When a normal person is at their bottom of their window of tolerance, they’ll feel exhausted, wiped out, they’ll probably plomp themselves down on the sofa, maybe have a duvet day.  The thing is, with PTSD the window of tolerance is much smaller, and there literally isn’t a stretch zone – so what seems like a ‘normal’ amount of stress can be debilitating.  The constant feeling of panic, the actual panic – these states are part of hyper-arousal and outside the ‘normal’ window.  What I hadn’t understood before I saw my psych was hypo-arousal – but when she explained it to me, it made so much sense.  I’d thought my chronic tiredness was just a feature of my depression, but it’s actually also an integral part of PTSD.  It’s the embodiment of the freeze response, hiding from the world, not partaking, not being.  And generally, following a period of hyper-arousal you will drop suddenly into hypo.  Reclaiming your space in the narrow window of tolerance isn’t easy.

The work I have been doing with my psychiatrist for the past 14 months has been about grounding, setting boundaries, lifeline integration – and re-wiring my brain through EMDR therapy. It’s hell and it’s working. I feel strong enough now to flap my wings and fly, to leave this home that has been so good to me, to go my own way and create my own future how I want to live it. It’s a long way from where I was not long ago when I couldn’t envisage any future, and didn’t want to. 

If you’re feeling anxiety, look after yourself. Self-care is really important. No powerpoint presentation is worth your mental health. Once you’ve lost it, it’s easy to lose it again, just like an ankle once sprained is that much more likely to get sprained again. For very real business reasons we’re all being asked to work harder, to do more, to be more. But remember you can’t be anything, let alone ‘more’, if you ignore the warning signs and break down. Don’t let the pressure build up to explosion levels. Set your own boundaries and say “no”, or “not now”, at least sometimes.