Friday, 16 October 2009

This is Panic 13 – Therapy

Well folks, it’s been a long time coming this one so I wanted to share my experiences that I’ve had with therapy. I should say now that I am throwing counselling and therapy under the same title here, basically any sort of talking related bits to help you get well as it were.

Apparently having therapy sessions regularly appears on those lists of “things to do before you die” which always struck me as odd. Before I’d really thought about it, therapy was a thing people did when they were ill. Now I’ve grown older (though not necessarily wiser) I realise that things like therapy can be very helpful and reflecting on who you are and why you do certain things with an objective observer can be very useful.

I had a smallish bout of therapy back in early 2004. Looking back I was physically not that bad but for a messy break up with someone had left my head a bit of a mess and it spiralled a bit from there to the point where I wasn’t really sure what was going on. I was having infrequent panic attacks as well which obviously wasn’t helping matters.

I got put in touch with a guy called Arthur through the church I go to. Arthur had training as a counsellor which sounded ok to me, he said he didn’t want any money from me because I was a student at the time so thought “well I feel bloody miserable and it’s costing me nothing but my time so why not?”

Arthur was actually a really nice old boy (he was nearly 80 when we met) and was also very good at what he did. Now as it was through church, yes there was a Christian element to what was going on which I know is not everybody’s bag. That said whilst we prayed at the end of every session and he occasionally pulled the odd part of the bible out to explain a point, he knew what to say. It wasn’t “your ill feelings are the work of the devil, repent sinner!” sort of thing, but carefully considered thoughtful words from a guy who shared a belief system with me.

That was a while ago now and since then my anxiety issues have come more to the fore than minor bouts of depression. I should also point out these recent visits to therapy were not through my GP so the waiting times were drastically cut down.

I actually asked to be referred to someone through occupational health at work. Work had been really stressful and I’d suffered burnout after trying to do everything for everyone. When I came back to work, I sat down with my boss and asked if there was scope to see someone. They don’t want me having time off ill, I don’t want me having time off ill and I wanted to take more of a grip on my problems. As I’ve said before, I owe it to myself and my fiancĂ© to be as healthy as I can be. It’s right that I make that effort and so my boss referred me on.

In any one year through my work you can have 7 sessions total. It seems like an odd number but I was told it was one introduction session to get to know a bit about me and my issues and then 6 actual sessions as it were. I was actually pretty grateful for the fact I got someone relatively close to home, round the corner from my other half in fact so I could go and see her afterwards.

A session was about 50 minutes, give or take a bit, which is a good amount of time to delve into stuff and develop ideas without being too long and straining your brain too much. It sounds kind of cheesy but it was always on comfy chairs in nice well lit, pastel coloured rooms, I guess to try and be as relaxing as possible. The one thing that I noticed, probably because I never sit still for more than a few minutes at a time is that the room was set up so I was nearest the door but could never see a clock in my line of sight. To be fair that’s a sensible tactic. The client feels less time pressure if they are not looking at the clock.

We covered a lot of ground actually in a few sessions. A lot of my issues (and this is not going to shock anyone who has even the most basic knowledge of psychology at all) stem from my adolescence and growing up in the home environment that I had. We dug back into some of the decisions made by me and for me, what I liked about them and what I didn’t like and had a look at some of the things that may have triggered me having anxiety issues and panic attacks.

It was actually interesting to sit there and have someone help me do nothing but reflect on my and why I do things for a sustained period of time like that. The whole process threw up a lot of issues surrounding being assertive when I need to be and why I am so passionate about things and get so wound up so easily. We also spent a lot of time looking at how I could perhaps relax better and get rid of the megaton of nervous energy that I seem to have so often. We talked about me doing things to “let things out” like singing more and how the physical act of breathing out or singing could be useful for me as I hold stuff in.

It’s odd to think when you first try some of these techniques that you’ll be using later but I realise that I am using some of them, particularly some of the assertive linguistic techniques. I did learn a decent relaxation technique that I was told to try at work. The only shame of course is I never get 15 minutes to myself to try it.

My series of sessions have ended now and I need to decide where to go from here. I either go back into the primary care route and talk to my GP again and possibly go down the route of the improved access to psychological therapies, or look for other free therapies or pay.

I think the best thing for me to do right now is ironically what I’ve been doing; sit, contemplate and think about where to go from here. I don’t need to instantly rush back into another kind of therapy or constantly need to analyse who I am or why I do things.

It was a useful process though and for us anxiety sufferers, I actually recommend it. I talked in part 9 about wondering why an individual attack happened and this is just an extension of that. This is me looking at the bigger picture of why I have all my panic attacks and it can only do good I feel.

Now…time to chill out on that couch.

Wednesday, 7 October 2009

Make it write - This is Panic in Anxious Times

As I've mentioned before, This is Panic was recently featured in the magazine Anxious Times, the quarterly magazine of national charity Anxiety UK.
A bit of backstory; I emailed Anxiety UK asking to be put on their blogroll if they had one, they asked me to write about the blog. It covers a bit of ground that's been covered before here but it serves as a good introduction to me and the idea of the blog. I hope you enjoy it


Originally published in Anxious Times issue 71, September 2009

I always start with the gory details.

I’m 25 and had my first panic attack at 17. I was in the car with my dad and my sister and I saw my face in the rear view mirror of my dad’s Vauxhall Astra and thought I was about to die. The pins and needles caused by my hyperventilating were so strong that my thumbs locked into my palms and my eyes clamped half shut. Since then I have had up times and down times. During my time living in Germany, I started having stomach issues that were linked into my anxiety and to this day when I am having an anxiety attack, I will continually burp. My triggers are health related and I am continually scared of having a heart attack, a stroke or catching meningitis to the point where I will stare at my arms to see if I have a rash.

We all find ways to cope with our anxiety conditions. Some people go for runs, some play video games, I write.

Writing was a hobby that I fell into at 15 and, now that I have this chance to examine it, it’s one of the few true solaces that I had growing up and one I still have today. No matter what I do or how hectic the day has been, there is always time to jot something down. My great uncle wrote poems in the jungles of Papua New Guinea, my fiancĂ© writes on TV for a popular mens magazine, I do This is Panic.

This is Panic started out as a post on Facebook. One Friday in May of this year, I was off work due to a viral illness and stress and the anxiety that plagues me was fully in control of me. Out of nowhere I found myself writing a really long rambling mess as to how I was feeling and what it was that affected me. I actually felt a lot better for having done it, like I’d screamed every ounce of air from my lungs. I’d always told people that I had panic attacks but I’d never gone into so much detail.

I got a response from a variety of people in a variety of ways, many of them reminding me that whilst anxiety affects me, it doesn’t define who I am. I wanted to answer people whilst continuing to talk about the problems I was having. Work was stressing me out so I talked about work, my work ethic, how I don’t know when to stop and the effect that it all has on my anxiety. It helped me examine everything in a different light.

One thing people talk about with the internet is the chance of anonymity. You can divulge as much or as little about yourself as you want. You can even make it all up should you so choose. Not me, I wanted people to see what this was, who I was and how I felt so brutal honesty isn’t an editorial choice I make as a writer but a necessity. Honesty is the best way of being able to accept that you have a problem and helps others to understand it. It was from there that more ideas came for posts and more and more response came. I decided that I didn’t want it to just be me writing but This is Panic to be a sounding board for sufferers or friends of sufferers or professionals with a bit of handy advice to impart whilst at the same time continuing on with my writing/anything else I decide to do with the blog (I am experimenting with the idea of video posts).

I don’t expect This is Panic to be a cure all for anyone, least of all me but I know that the blog has helped me take on an objective and rational examination of myself and my condition. It’s not a replacement for professional help (and hopefully by the time this is published I will have started mine) but it’s me taking as much of a personal hand in my own care as I can.

Anything I write for This is Panic is all my own garbled thoughts and I use examples from my own life to illustrate my point. Somethings won’t work for everyone just like they don’t all work for me. If they do or don’t, I will say. I’m not trying to play at doctor or therapist but as a lot of us are in the same boat, I just want people to know that we’re not crazy and there’s tuff we can do to minimize the impact this has on us.

If asked what my plans are for the site, I’d say that I want to keep writing it and think of new ways to try and give a real person’s perspective on panic and anxiety whilst hopefully being able to publish articles from other people who want to do the same thing.

The dream is people reading it and feeling they’re not alone. For a very long time I felt very isolated with this problem. I was even once told by a doctor to “pull myself together”. I was lucky that people took the time to understand what was with me and by nature I am so social that I went looking for help. Some people are not so lucky or so social. My biggest hope is that This is Panic makes one person feel less alone and more like a human being. If that happens, it’ll be worth it.

When I am writing a blog post I try and sign off in a semi humorous way that is appropriate to what I’ve been talking about. Now whilst I inject humour into my writing, this subject isn’t a joke to me. I do not know when and if my anxiety problems will stop as I can’t see the future. I still gave minor episodes and the odd full blown attack where I am convinced that I am about to die. I am a massive dentalphobe and don’t like water on my face as I nearly drowned twice at age 4. I am scared that my children will be susceptible to this because I do.

I just want to react in the best way I can with every skill I have and I want to help end some of the preconceptions surrounding something that a lot of British people suffer from. I may not make it better but I want to make it right.


Monday, 14 September 2009

This is Panic 12 – Hospitals and Doctors and Needles, oh my!

The above title came to me as more of a joke than anything else. The writing process for this blog is always a bit of a mish mash of ideas mixed in with trying to provide some sort of commentary on regular events. Having written last time out about having a dental phobia, initially I was a bit wary of going for another health topic so soon but once this title came to me, I knew it was worth trying to have a chat about all this.

Unless you have been living in a black hole (insert Bracknell/Guildford/name of your local hovel here) you won’t have missed the insane array of news on the virus called H1N1, known to us in the Joe Bloggs Brigade as Swine Flu. There’s more and more talk at the moment about the upcoming vaccine that is being produced, how it’s going to be administered, who is first in the cue and will it even work. My initial worry wasn’t any of that; it was more “uh oh, needles”.

I’ve been nervy of needles for ages, as long as I can remember. Going through school every so often you needed those all too crucial immunisations against those variety of diseases like polio and the ever dreaded BCG injection for tuberculosis and I would always go a bit funny looking at needles. I always gone for the tried and tested classic of not looking at it but of course you still know what’s coming and thus I still get really angsty just waiting for the needle to go in. I suppose the issue for me is, and this sounds so daft but it’s true, I don’t like pain. Some people don’t mind it but I hate pain and injections have always hurt me and unnerved me so my natural reaction when faced with one is to panic. Now I know full well that if I go to certain places I may need them and I will suck it up and do it but I will be warning the nurse/healthcare assistant that I am likely to get very agitated.

It got me into thinking about doctors and hospital appointments in general because sometimes they can be really scary places to go. It creates a bit of a crazy cycle where you’re ill and need to be seen but you’re scared of going to the appointment so you don’t get seen so you get more ill meaning the need to be seen increases.

Aside from what opponents of healthcare reform in the USA say, the NHS is there to help us when we are ill and that doesn’t just mean plastering your leg if you break it but with stuff like anxiety, panic, OCD and anything else you care to name.
Doctors, nurses and other healthcare practitioners are incredibly well trained professionals who want to do the best they can to help you with whatever’s wrong. We have a right to be scared but we need to relay that fear to whoever we’re dealing with. Psychic powers don’t come with a medical diploma so if you’re worried about something, tell your GP. If you’re worried about seeing your GP, tell someone and they may go with you.

I was a lot more worried about seeing the doctor when I was little than now. Little me thought that you only went to the doctor if something was really seriously wrong with you. This isn’t the case now of course and the only thing that bothers me at the moment is just having to wait. My GP’s good but he barely ever runs to time bless his cotton socks. Now we’re not always so lucky with our GPs I know but you are within your rights at your surgery to ask to see another doctor or to register elsewhere as long as you’re in the catchment area of that surgery. Don’t shop around though just because you don’t like what you hear! Doctors have a duty to tell you their opinion of the best treatment for you, in my opinion that’s what a good doctor will always do. I’ve disagreed with my doctor before but we reached a compromise on a few things.

There is of course that one step up from the GPs surgery that makes people feel even worse, the hospital.

It’s easy to associate hospitals with bad things. The media seems to leap on any story surrounding a hospital doing something wrong or a management failure of some description and it does little to calm the fears of people let alone people suffering from something like an anxiety condition!

Having worked in a hospital (and not out of choice, due to building works) for about 4 months, I feel somewhat desensitised to it all, apart from the room where they take blood for blood tests which never ceases to creep me out. Hospitals are just a place where people come to get better to me now but I know that I didn’t always feel that way and loads of us don’t.

You go to hospitals for the big things that need sorting. You go to Halfords if you need to buy a bulb for the headlight but you wouldn’t go to them for a new front axel would you? If you’re seeing a consultant then they will have spent years and years training for this. 5 years to be a doctor, then 2-3 years doing general bits then however many years it is to specialise in something, these people will know their stuff. They can’t make the procedures easier to bare physically but they can be honest and let you know the details you need to know and setting your mind at ease as to what might be coming is half the battle.

Being scared is alright, it’s perfectly natural and I’m not saying you should feel no fear because that’s just impossible. If fear however is stopping you from getting seen and more importantly getting better then something needs to be done about it. Whether it be dentist or doctor, we can be sure that the people we’re seeing are the best for the job. If you help them, they will help you.

The title of this blog is obviously a play off of the line in the ever popular film, Wizard of Oz and to an extent some of our fears about things over the last two posts are akin to when Dorothy finally meets The Wizard. What lies behind the curtain is unexpected and scary until we look at what it is we’re faced with which is ultimately less than we thought it was. The truth, sometimes, may be hard to take but it allows us to move on. For me, my anxiety is that curtain. It obscures the things that I know to be true and distorts reality and makes me afraid of things.

We have a bit of the cowardly lion in us all but for those of you who don’t remember the story, he had the courage all along. We all do. It’s that courage that will help us get well as much as anything else.

Wednesday, 2 September 2009

This is Panic 11 - The Dentist

Now this one is not going to be fun to talk about because this is something that almost gives me attacks just thinking about it but it bares talking about.

According to Dentalphobia.co.uk somewhere in the region of 7-13% of the Western world suffers from some form of a fear of the dentist which means if you apply those numbers to here, somewhere in the region of 4.5 - 7.9 million people in the UK are afraid of the dentist and I am one of those people.

As ever with TIP, we revert back to a story from my past. My fear of the dentist stems from when I was 4 years old. I was with my mum getting a check up as you do when you're little. Being a small boy I didn't want to do as I was told. After a while the dentist decided she was fed up of me not playing along so she grabbed me by the nose and forced my jaw open so she could look inside. I have been a wreck ever since.

I wouldn't pull out any teeth growing up so the dentist needed to do it for me, normally by doping me sideways up to the eyeballs and doing a load in one go. I had too many teeth in my jaw so I had a couple of goes on that one. At one point I had a tooth get infected and collapse so I needed a root canal but no way in blue hell were they doing that while I was awake. It was decided they would knock me out, do the root canal AND pull out 7 remaining baby teeth. It was originally meant to be done over 2 appointments but someone "luckily" cancelled and they did it in one job lot. I had a panic as they put that plastic thing in your hand so they can attach syringes. The only upside was I got to have corned beef hash when I woke up.

I have only ever been to the dentist alone once when I was in Germany. Once...I haven't been for a while now because I can't bring myself to physically sit through it if I don't have to. If I need to be seen then yes I will go but I need to take someone with me. I have a really low gag reflex when anything is in my mouth like a dentist's tool and that's if they can even get me to lie back in the chair. I sit straight backed as long as I can, I really almost cannot sit back in one of those things without nearly hyperventilating.

The thing with me and the dentist is that I am a LOT better than I was. I know if it was just a check up where they can 100% say they won't do anything and just pull out the little mirror thing then yes, I can manage, just. I know it's another part of my anxiety that I need to battle but it's been pushed behind the other parts of the anxiety that I have to deal with normally.

As with anything, planning helps combat it.

If you don't want to go alone, don't! I won't go alone now to the dentist and it's a case of finding someone to go with you. Not everyone can be available all the time but don't be afraid to cancel an appointment if you can't find people to go with. I know dentist appointments are hard to come by but you decide how you want to be seen and treated.

The other thing to do is be honest off the bat. Dentists are people too and they are trained professionals so if you tell them all the facts, they can do the best job possible. Tell the receptionist when you book an appointment for the first time and mention it to the dentist as well. It doesn't make the treatment itself easier to take but the dentist will make more of an effort to help you out. At least that's the hope ha ha

Dental hygiene can't be avoided and is something we all need to do unless we want to all be on Fixadent adverts so that means the dentist. It's annoying and scary for a lot of us but you can chew-se (ouch that one really hurt) how you live your life and what you do with your teeth.

I realise that I am not the greatest of role models for this one but in keeping with the creed of honesty on here, I like to think that if I can make people realise how not to do it, that'll be helpful too.

I am also slowly going to build up to going again once work has settled a bit. Watch this space folks, more on this story to gum. (Wow where do I get these from?)

Tuesday, 1 September 2009

Update 01/09/2009

Hey all, apologies for the radio silence. I have been a very busy boy recently away from the blog with trips to various corners of the country to see friends/relations/cats so that's why we've been lacking in posts recently but there is news on the horizon:

More of the wonder of the interwebs:
As a fair few of you will be aware, This is Panic now has a page on Facebook so you can become a "fan" of the blog on there. Remember to invite your friends along as the more people, the better a discussion we can all have about everything. Searching This is Panic on Facebook should give you the page. A big thanks to those of you who have already joined the party.

Everyone loves posts:
The next part of the series is in the works at the moment. As ever if there's anything that you want to see written about. Also don't forget that this is your space too! If you want to contribute anything to the blog itself then let me know either through the site itself or Facebook.

New series:
A new series of posts is in the works as well. It'll be called "Panic Buys" where I and you lovely lot will review some of the products on hand marketed to help us cope with anxiety conditions. I don't mean medications but things like books, herbal remedies, self help guides, anything we can get our grubby little hands on. Part 1 of that is in the pipeline to come out soon but as ever input people! Your reviews are welcome.

This is Panic in print:
I mentioned a while back that the blog was going to be featured in a national publication and as it's now September and the magazine is coming out soon, I think we can let the cat out of the bag.

A while back I sent an email to the national charity Anxiety UK (formally The National Phobics Society) asking them if they had a blog roll and if so could we be put on it. The response was essentially "sorry, no blog roll but we like the blog and would you mind writing something for it?"
Naturally I jumped at the chance.
Anxious Times is the quarterly magazine of Anxiety UK which has articles covering the gambit of conditions from GAD to OCD to Post Traumatic Stress Disorder. It's got regular articles from professionals and is a good publication for anyone who either suffers or works in the field of mental health. For you environmentally minded lot, you can even subscribe and get the magazine sent to you as a pdf!
The article I've written is called "Make it Write" and will feature in the September issue of the magazine, out this week. The article will come out in Anxious Times first and I will publish it at a later stage on here but it'd be great if some of you would go get the magazine and show some love.

That's all for now folks, stay happy and if you can't stay happy at least stay safe.

Anthony

Thursday, 13 August 2009

This is Panic 10 - General Health

As I don't have much in the way of an order for how posts come along, I am heavily influenced by the insane amount of news that I take in via papers, tv and the internet. The talk in America about their health reform and all the insanity with swine flu at the moment, I got to thinking a lot this week about health in general.

They say that sometimes you don't see something till it smacks you in the face. A large chunk of my thinking about all this came when I got...well...smacked in the face. I was moving some stuff about at work and as I bent over to put something away, I managed to take an upturned chair leg just above my eye. Luckily there was no concussion, just a large bruise that hurts badly but it set off a familiar chain of events for me.

A lot of my triggers for panic attacks are health related and have been since they began. It was a blemish on my chest that sparked off the first ever panic attack that I had. Now obviously in hindsight there were a lot of other contributing factors but it was seeing that blemish that did it and off I went.

It's always little things like that or little twinges that set me off in some way. If I can rationalise out the issue then it makes it easier to calm myself down. Part of the process for me has become to try and sort out my health and be healthier. If, in the unlikely event that something ever was wrong with me, if I am healthy then I'd know about it right?

I realise now a bit further down the road that the above is not a great attitude to have. I see that now and I have modified my approach somewhat. Being healthy is a good thing full stop. Now I am not at the peak of physical condition but I am in decent condition. I walk 30 minutes a day (thanks to work), I cook with fresh veg and little oil and I try to keep stuff low fat. It doesn't sound like much I know but keeping myself in decent condition has helped somewhat with my anxiety.

From experience of casually meeting other sufferers of anxiety problems, certain lifestyle choices can exacerbate the issue rather than help it. Now I made a lot of changes after I went on to my tablets (see TIP part 5) so these are all since about December 2007 but they were useful to me:

1. Cutting down on alcohol: Admittedly this one was a direct result of my medication but I've kept this one up somewhat since I came off of medication. Those of us with a passing knowledge know that alcohol can be a depressant if you have loads and also (and this is definitely the case for my meds) you can't drink whilst taking them. If you're not on meds then a drink won't kill you but don't go overboard.

2. Cutting down on caffeine: This one was a personal choice. Now we've all had too much caffeine now and then and we know what it does to us; we get twitchy, we get jumpy and your brain rushes a mile a minute. Now personally I find none of these helpful for battling anxiety when I am having a moment. Whilst I know some people and books advise totally removing caffeine, I like the taste of tea and coffee too much. I limit myself to 4 caffeinated drinks a day in total which is normally 1 coffee and 3 teas a day. I spread them over the course of the day and I never have anything like that after about 7or 8pm. After that, hot milky decaff drinks like low fat hot choc or caffeine free herbal teas are your friend and will have a better effect and help

3. Cut down junk food: Sugar like caffeine has the twitchy high energy thing if you have too much of it. I like stuff like chocolate and the odd take away but I always feel slightly sluggish after one for some reason. I always try to use at least some veg in every meal I cook, even if it's tinned. Again, moderation and the world won't end if you have a kebab on a Friday night or a chocolate bar but eating loads of junk food will increase your weight, make you feel sluggish loads and I find it lowers my mood if I have too much of it in too short a space of time.

The other part to all of this as well is trying not to over react if you ever do feel unwell. Now this is the bit I struggle with. That twinge you worry about is an instant worry to me that I am about to drop dead but I am getting better at not going off the deep end.

When I took that whack to the head, I went and got seen by a nurse at work. I made a point of saying "I've done this to myself and also I suffer from an anxiety condition and I'd like some reassurance that I am ok please." The nurse did a good job of giving me a full examination needed for a head injury and took the time to clearly explain what was wrong, what wasn't and what to do when I went home.

Now we all get ill, we all get injured but we need to not instantly associate every injury with instant death. Now a shot to the head is different and do make sure to get yourself checked if you take a half way decent blow to the noggin but you will take a few knocks and they will do next to nothing to you in the long run. If you're worried, get them checked out but rest assured, unlike in the USA at the moment, the only bill you'll get is a clean bill of health.

Monday, 3 August 2009

This is Panic 9 - relapsing

I am aware that the word relapse has certain connotations attached to it that are not pleasant. It speaks more of drug or alcohol addicts falling off the wagon rather than the context I mean it in here. I mean relapse as in having another attack after a period of relative stability. I wanted to use this post to have a look at how people deal with having a large attack out of the blue and how to get back on track.

I suppose to an extent I look at myself as a functioning anxiety sufferer. I have moments of high anxiety but they do not interrupt my sleep or my daily life so this past weekend was a real downer for me.

Looking back I’d probably indulged a bit too much on the Saturday evening. It was nice though, Chinese take away which I ate too much of, a couple of bottles of Perroni and watched Charlie Wilson’s War (good film) and repeats of Mock the Week before bed. Nothing new there, pretty average Saturday night for some I’d venture.

I woke up about 2:15am Sunday morning and I was burning up. The room felt like a furnace and it felt like the world was chattering in my head. I managed to get downstairs and into the dining room/kitchen and took a few good long deep breaths. I started having one of my moments where I thought a skin blemish was a sign of me getting septicaemia. I was awake for about an hour where I managed to talk myself off the ledge with a mixture of deep breathing, autogenic relaxation and a cup of chamomile and limeflower tea. I took a glass of water with me and headed back to bed. I am claiming a small victory as I managed to have all that and not wake anyone up.

I woke up feeling drained and a bit antsy still but felt ok after a bowl of Lidl own brand malt crunchies and a cup of tea. Having packed up all my stuff (I was on holiday last week), I hopped in the car. Now with 6 of us in there I was in a seat right at the back over the wheel arch in what in normal circumstances is the boot. Trust me, never a great place to be. I thought my stomach was ok but I felt nauseous very quickly which make me anxious and made me burp a lot. I tried to counter the panic by listening to an audiobook and taking deep breaths of air from the window. I got worse and worse as the journey went on, feeling more and more nauseous until I started properly hyperventilating. For some reason I was trying to fight the attack until I couldn’t get the words out, we stopped the car in a country lay by and I dived out onto the grass with my paper bag. Only when I got out did the pins and needles rush up my arms and face. I was breathing out of the bag with people gathered round me as I sat on the grass.

Now as ever, I am now feeling a lot better. Hyperventilation to end the whole attack lasted about 8 minutes if asked to hazard a guess. I got to my destination and sat down with a decent lunch and a cup of lemon and ginger tea which seemed to help. The annoying thing for me was that having done relatively well and not having had a full blown attack for about 3 months and if I am honest I feel a bit down about it.

Now those of us who suffer from an anxiety condition where attacks are (sadly) the norm, learn how to recover and move on from it. The issue here is how do we deal with the set back when we’ve come a long way? The idea is that we never want to have an attack again so what do we do now we’ve had one and feel like we have to start from square one all over again?

I personally try and have a loose attitude to timing when it comes to attacks. I obviously remember roughly when I have had one but I do not remember the exact date unless something else specific happened. I try not to have a mentality of an accident clock, “x days since last attack” and then resetting it when I have one. I can understand why people do that but personally I find the idea a bit restrictive. You end up in this cycle being obsessed with time and how many days and weeks and months you’ve not had an attack rather than just getting on with things.

The big thing for me is trying to reason out why I may have had an attack. Understanding the issue helps defeat it I feel. Allow a bit of hindsight (a day or so) and then think about the reasons why you had one. For me the attacks yesterday could be attributed to things like the argument I had with someone, the increased levels of alcohol in my system over the last week, the excess of food I ate Saturday night combining with being very over heated in bed. I don’t want to go too far into the ins and outs as to what was the primary cause because 1, there may not be one and 2, it’s possibly too complicated a process to try discussing inside 10,000 words here on TIP.

That said I feel it’s crucial to try and understand what may have caused the attack. Whilst on a superficial level “just because” may seem like an answer, it’s kind of glossing over the answer to me because there is a reason for most things. Now I admit that there’s no known reasons for many things (Why are the worst things for us those that taste the nicest? Which came first, the chicken or the egg? Why do people watch Strictly Come Dancing?) but when it comes to human behaviour, there is generally an answer for most things. Now I am not saying that people need to go into pain staking detail and peel back all the emotional scabs for every minor incident but self examination helps me so I generally suggest it to people.

The only real advice I can give is what I have heard from so many people, “don’t beat yourself up!” Attacks happen. They happen for a reason. The best way to counter them is to not agonise about the fact that you had one and balling yourself up to try not to have one again but to work at changing the factors that caused you to have one. It is all merely a stumble, nothing more.