Friday, 20 November 2009

This is Panic 15 - Robert Enke

This one folks, will be a different format to TIP and also there'll not be a massive amount of humour involved. I am sorry for that. I try and make these entertaining to read but the subject for this one hit a bit close to home for me for a variety of reasons. However, as ever, I'm going to talk about it because that's the best thing to do.

Many of you who know me personally know that I speak German fluently and follow German football. After a couple of problematic years away from Germany, Robert Enke returned to the German Bundesliga at the time I was just moving there.
Enke had started his career in his home town of Jena before moving to Mönchengladbach and then overseas. After an unspectacular career in Europe during which he played little and was bottled by his own fans while playing for Fenerbahce, Enke moved back to Germany to join the club he would later captain, Hannover 96.

The details of Enke's last few years and death are tragic to say the least. He became depressed and had regular panic attacks, crippled by the fear that he would be overtaken by a younger, better player. However football remained his release but he never felt like he could be open about his illness.
In 2006, his daughter died aged 2 from a heart infection which is said to have really affected Enke and plunged him back into a downward turn.
8 months before his death, Enke and his wife adopted a little girl but the German international was so worried that he believed if people found out he was depressed, they'd take the child away.

We all know how Enke died and I will not re-hash that again but it spoke to the real issue and one of the reasons why I started this blog in the first place.

I sat with my laptop and watched Enke's memorial service in front of 45,000 people inside Hannover's AWD Arena and thousands more outside. These people were friends, family, colleagues, supporters and admirers of this one man and yet he felt that he couldn't be open about what was wrong.

The stigma around anxiety and depression can cripple us as much as anything else and we can spiral downwards into an emotional black hole. Believe me, it's happened to me and I know it's happened to at least one other person reading this. We can change attitudes towards anxiety conditions and other mental health problems and we can hold out our hand and help each other through this.

I beg of you, if you are feeling really low and depressed about any condition you have, please talk to your GP. There are also great groups like Depression Alliance who can help and if you really need to talk to someone right away, call the Samaritans who also do excellent work.

As a fan of German football, Robert Enke to me was Mr Hannover 96. He was the man I saw leading Germany into the World Cup and beyond and was one player who I respected greatly. Even as a hardend Hansa Rostock fan, I will admit to having wished we got to see him play more.

Please folks, never ever think you are alone with this. Together we will all make it through.

For Robert Enke; that which we do not see on this Earth will live forever in the stars. Schlaf gut.

Monday, 9 November 2009

This is Panic 14 - Finances

Hi folks, after a bit of a brief break due to the hectic nature of life, we're back and this one's been brewing for a bit.

This is another attempt by me to be slightly topical. You can't escape it on the telly or in newspapers or articles online, this financial recesion is everywhere and we keep hearing about it...constantly. With money getting tighter and things like loans and the like becoming harder to come by it can start stressing us out and that can't be good.

Think tank The Young Foundation published a report in January of this year called Receding Tide: Understanding unmet needs in a harsher economic climate. The conclusions coming out of it were that the recession will have an impact on the mental health of the nation. The report comes to the conclusions that as finances get tighter, we start trying more and more to satisfy our material needs and this means that our psychological needs suffer as a result.

It's actually something a lot of us tend to do. I certainly do; we get so wrapped up in all the other little things in life like paying the bills and doing this and that with friends and keeping up with the Jones' that we forget that we need to look after ourselves. I have done this at work from time. I try to make sure everything is done at work and run myself into the ground and make myself ill both physically and mentally.

That report points out that our system is geared much more towards the material than the psychological and I'm inclined to agree. Without getting to much into my own personal political philosophy, there never seems to be much of a focus on how or why we do things but simply that we do them and do them at the expense of everything else, including ourselves it seems.

I know I am lucky. I got laid off about a year ago, was out of work for 2 months and then got a job paying a significant amount more than what I was earning while I was employed but I still have a lot of empathy and sympathy for those out of work. It is really worrying as we sit there thinking of how far we can make things stretch or last that little bit longer. Coming up to Christmas as well and all the expectations on people regarding presents and decorations and the like.
Last year I managed to do ok. My money I got from my old work was enough for me to live and be able to do ok at Christmas along with the fact I could go shopping whenever I wanted to but what I was spending on Christmas presents could not be spent on other things.

I made a really concious choice when I had no real income that I was going to use the money wisely. I cut out anything that could be cut out. I cut back on foods that I could do without and planned more clearly what I was going to make for meals during the week so I could plan expenditure.
Budgeting if money is tight is time consuming but it is a really sensible idea. If you are worrying about stuff then you need to do what you can to minimise that worry. If you know how much you have then it makes it easier to plan it all out. Sure it doesn't improve the cash flow or get more money in but if you know what to work with, it's one less thing to worry about.

All in all the finances story is one that acts as a good similie for us in general. We need to ignore the bits and pieces around the outside and focus on the middle, ourselves that little bit more. There is no shame in putting ourselves first at all if we're low on funds or if we're not well.

In these trying times we need to orangise our priorities and making sure we are well and can live properly is one of them. To some, money makes the world go round but decent mental health cannot be bought.

Wednesday, 28 October 2009

This is Panic 13.1 - Therapy in the news

Well folks this is a bit of an update from the last post. Whilst on BBC News earlier I stumbled across this@

Link to "'Talk therapy for the depressed"

The National Institute for Health and Clinical Excellence (aka NICE) have come out saying that antidepressants shouldn't be used to treat depression in adults with chronic health problems but rather they should be directed towards structured physical acitvity and Cognitive Behavoiral Therapy for help.

MIND, the mental health focussed charity have responded saying that shifting too much of a focus towards CBT and computerised CBT and away from counselling could be seen as an excuse by some health providers to cut funding to other talk based therapies.

Reading the advice from NICE, I can see where they come from to an extent but it seems very much like they are trying to pick one therapy that "works" best and then tar all people with the same brush somewhat.

Depression (and anxiety as they are linked) relating to chronic health problems or even chronic health anxiety is very much a different thing for different people and to push one form of talk therapy over other kinds seems irresponsible to me. It's not scientific to assume that all people will benefit from one kind of therapy to a mental illness.

Take the drugs from the statin family, used for blood pressure conditions. There are a variety of different statins used for different people and you tailor to the patient. Essentially what this advice from NICE seems to be is totally disregarding that individual patients and thrust one kind of therapy upon people which doesn't sit well with me.

I'd hope that NICE will listen to constructive criticisms from the mental health professional community and be prepared to alter that advice in the future.

As ever, this is just the ramblings of myself so please do read the article and the advice from NICE at their website; click here for that.

Saturday, 24 October 2009

Panic Buys - Understanding Anxiety and Panic Attacks

Title: Understanding Anxiety and Panic Attacks
Author: Dr Kwame McKenzie
Publisher: Family Doctor Books in association with the British Medical Association
Click here for the publisher's website
Click here for the book on Amazon.co.uk

The back of this book proudly trumpets that over 4 million books have been sold in the Family Doctor series which makes sense if they follow a similar pattern to this one.

I bought this book a while ago and it's very good if you deal with your anxiety condition and life's problems in a similar way to myself which is to bone up on a subject, read around it and use the appropriate tactics gleamed from what you've read.

The book's format has the various chapters broken up into sections making it easy to stop and start without feeling like you particularly need to race to the end of the chapters which is useful as you don't want to rush through reading anything to better inform you about your condition.

As the book covers a range of subjects within the broader field of anxiety, the book is also useful in that to get to information you may find useful you don't have to read the whole book. The break up of the chapters helps the reader to jump about as needed to and the information is never presented in massively long lumps of text. That said, if like me you are keen on reading around the subject then knowing about other kinds of anxiety disorders can be interesting reading. If that's not your bag and you want it for additional help rather than for interesting reading, the book itself normally retails for about £3-£5 so it's usefulness is not negated by the cost

The book's author Dr Kwame McKenzie is a lecturer in psychiatry at University College London and the book obviously benefits from his expertise. The issue of course with some books written by clinicians and aimed at the lay person is that the way information is presented in certain parts can come across as a bit patronising but the book doesn't bamboozle the reader with overly technical terms and any longer terms are explained.

As well as explaining the conditions and drugs used, the book also covers the different kinds of treatments and provides a chapter on self help techniques that could be useful.

Don't be mistaken, this book is a basic overview of everything rather than an in depth study. It will give you bare bones help and good signposting towards other treatments and ideas that may be useful. I liken it to an appointment with your GP; decent and to the point but short and a bit overly clinical and sterile in parts.

If you're wanting something to hold your hand a bit or help you through a hard time or provide you with effective techniques for dealing with attacks, this is not the book for you. If your problem is a new thing and you want something to read before delving deeper or you want to give something to others to help them understand a bit better than this book will certainly do the job.

With such a low price it's certainly a handy book to have around but it's a bit like taking an aspirin for a broken arm. It'll help short term but it certainly won't cure anything.

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 fiancé 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 fiancé 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.