Most of the stories I read about mental illness portray it as this hellish, horrendous thing that you must wait out. While in the darkest throes of mine, I have found it difficult to read these stories. If my experience was entirely a waste, how could I find the motivation to keep going?
I have found that the prevalent feeling during my illness has indeed been of time wasted. However, I think there are significant benefits if remission is found through medical treatment. I realised that the strategies I learned in order to stay alive, whilst should not be needed as medical intervention should be accessible and a first port of call, may be truly useful to others.
In retrospect, starting a PhD while still burnt-out from my final year of undergraduate probably wasn’t the greatest of ideas. Nevertheless, having three separate supervisors each asking me to do three separate workloads didn’t exactly help. A two-week long episode of severe depression prompted me to take my very first antidepressant. Fortuna, the roman god of luck, must have been doing some gardening or something that week: I then suffered a severe but extremely rare reaction to the drug (most likely serotonin syndrome). From now on, I will refer to the reaction as “The Event”. For some reason The Event semi-permanently changed the functioning of my brain. Overnight I went from someone who never had experienced a clinical anxiety symptom, to someone who was now experiencing almost all of them in their most severe form. It was anxiety Christmas. Ho ho ho aaaaargh!
Having sudden onset anxiety was as though the metaphorical volume knob that controlled the level of fear in my brain was turned up to around 30 times what I thought was my maximum. This, however, was not the most debilitating symptom.
It became apparent that my brain used to have a set of filters that I never knew existed. They were always working in the background, only allowing through stimuli deemed scary enough to be worthy of my attention. The filter would stop me from worrying intensely about everyday risks, based on probability. For example, giving little thought to cycling on a road with high-speed metal boxes whizzing past only a few feet away or a fleeting muscle twinge in my chest. In the “before” times, I thought nothing of these occurrences. The possibility of something bad happening was just a philosophical afterthought.
Suddenly, the precious logic I had relied on for my entire life was no longer effective. Within my mind, twitches and twinges assumed the significance of life-threatening events like a stroke or a heart attack. Any rationalisation would not make the fear, nor the thoughts accompanying the fear, go away. There was always a very small chance that this seemingly innocuous sensation could be serious. Without the internal filters in my brain removing these infinitesimally small chances from existence, the intense fear I was experiencing always had something to grab onto. It always had an uncertainty to leverage.
It felt like the universe had been flipped on its head. It was as if some of the internal circuits in my brain were cut and now flailing around chaotically.
Needless to say, it wasn’t exactly feasible to continue working on my PhD with a severe anxiety condition. I moved back to my mum’s house to try and recover. The most prevalent problem initially was the ten or so panic attacks I was having per day. Their random nature was causing my brain to associate nearly everything I encountered in my house with intense fear. I eventually became restricted to the couch, where I daren’t move.
In a panic attack, my brain seemed to trick itself into believing death was imminent in a situation where a paper cut wasn’t even possible. A panic attack designated every system within my brain as “out of order” so that I could survive the oncoming and perilous threat of absolutely nothing at all. As an overwhelming sensation of doom built, my brain would go into an erratic search pattern. Sensations and sounds that were normally filtered out, such as my heartbeat, would suddenly increase dramatically. My heart rate would quicken to get all the lovely oxygen in my blood to the muscles ready to stay pretty much stationary. “Aha!” my panic attack would go, “the heartbeat is quick and loud so we must be having a heart attack!”. The ridiculous cycle would continue like this.
My mum helped me find a private counsellor to help me recover. The therapist and I spent a long time talking and strategizing on how to deal with the panic. I learned calming techniques (e.g., deep breathing) that helped, but they were only part of the solution.
Reaching Peake Anxiety
The tables started to turn after a particularly severe panic attack in a grocery store. I remember a claustrophobic feeling as I was queuing to pay. A burst of what I can only describe as “doom energy” then filled my brain. There was a powerful sensation, like an invisible force (mental illness has a lot of these) pulling me towards the floor. It took almost all my resolve to keep myself standing upright. From the outside it probably looked like I was daydreaming. I was experiencing the forgotten sibling of fight and flight: freeze. I was rooted in place for what felt like minutes, but was probably only 10 seconds. The attack subsided as the queue moved slowly forward. When I finally reached the till, the attendant asked cheerily, “Hello! How are you today?”.
A deep association had now burned into my brain. I couldn’t even turn the corner of the road to the grocery store before my brain started to ramp up the feelings of panic.
It is here that I started to learn how to be courageous. In order to get back into the grocery store I had to put myself in the situation where I knew a panic attack was likely to happen. My first realisation was that courage, like anxiety in general, is measured in inches. I wanted to get it over with and run mindlessly towards the grocery store. But I was pretty sure this would only result in a panic attack more severe than the first one, making the problem even more difficult to solve.
I inched my way towards that grocery store, each time choosing a point to turn back from and travelling no further. It took weeks to walk around 100 metres down a road, but I had yet to have a panic attack.
Inspiration for the final 200 metres came from an unlikely source. I was watching coverage of the rocket launch taking the British astronaut Tim Peake to the international space station. I couldn’t help but draw the contrast of a man preparing to propel himself upwards using a prolonged explosion and my inability to get to the grocery store. It felt overwhelmingly frustrating.
So, I completely abandoned my plan of slow progression down the seemingly never-ending road, and ran mindlessly towards the grocery store (well, on reflection, more like someone walking briskly, late for a bus). I found myself getting further along than I thought I would before the panicky feelings started. They eventually arrived as the shop sign came into view. To my surprise, the feelings seemed to halt at the “potential crisis” level. As I entered the store, I braced myself for the full onslaught of a panic attack, but it did not happen. I found myself pausing briefly just inside the store doors, perplexed at my current upright stature, before realising that the less time I was in the store the more likely I could maintain my bipedalism.
I had but one item on my list: sub rolls. I quickly made my way over to the shelf where I had always picked them up in the past. Croissants. Packets of croissants were sitting directly where the sub rolls should be. The space-time continuum must have ruptured. “Oh no” I thought, or something along those lines. I hurriedly scanned the entire bread section. Hot dog buns, baguettes and burger buns lined the shelf adjacent to me in abundance. Pitta bread was squished in right at the end. I hustled around to the other side to find to my disappointment Brioche and ciabatta occupying my full gaze. There were bagels and focaccia in my peripherals. But nothing approaching sub rolls.
A person in a calm state of mind would come to the logical conclusion to simply get the next closest type of bread. But I was neither calm nor thinking logically. The only thought that occupied my otherwards chaotic mind was “Get the sub rolls and get out of there”. And I had yet to acquire sub rolls. So, a task that should have taken a minute was now pushing ten. My aimless wandering finally came to a conclusion at the drinks section when, finally, a rational thought fought its way to the front of my awareness “Why don’t you just get a baguette?”.
Despite the disaster of the missing sub rolls, my brain had not eclipsed into panic. Nevertheless, I wanted to get the heck out of there. I found myself in a shorter, but still significant queue. The panicky feeling ramped ever up so slightly. I kept my focus on the till, determined to get my disappointment of a baguette paid for. This time the till clerk only uttered a rather disgruntled “Hello” while I was beaming ear to ear. I walked outside and called my mum. “Tim Peake went into space and I went grocery shopping, those two achievements are about equal, right?” I rhetorically asked her.
Before this point, I thought courage was the act of overcoming a fear; you know, like skydiving or something. But, in reality I think all that’s really doing is overcoming common sense. Jumping out of a plane without the proper training is not exactly clever. These types of “facing your fear” experiences do not even approach the amount of learning that is required to be courageous.
I learnt that bravery and courage mean different things. I believe that bravery is something inherent. Bravery requires automatic filters, the ones I lost, to work in the background to allow the individual to function. The filters allow us to go outside, drive cars, get on aeroplanes as if these were the easiest things in the world. I think most of us don’t even realise we are being brave.
Courage, on the other hand, is learned. In situations where our automatic filters do not protect us, it requires learning to navigate the monumental emotions as they arrive. There was no overcoming my panic attacks. I could not face up to them as if it was some sort of cavalry charge. It wasn’t a fight for control. Instead, I had to learn how to exist in the torrent of fire that a panic attack causes.
Learning courage had benefits far beyond tackling my panic disorder. I learnt how to step into everyday fearful situations like public speaking and important meetings. It meant I gave talks on counselling and meditation in an academic environment, right out in the open. In fact, I frequently talked openly, honestly and challenged people’s perceptions.
In all honesty, a severe anxiety condition should not have been the way I learned courage. The vulnerability I have experienced during mental illness has been, at the very least, a semi-permanent fixture in my everyday life. It often feels like everyone is attacking me, due to the preconceptions and expectations the vast majority of the population have. Any emotional conflict I have, for example a heated argument, has had an exponentially greater impact after “The Event”. It feels like my emotions are persistently on the edge of being over-activated resulting in my brain collapsing in a heap.
What I really needed, all those years ago, was not courage: it was medical treatment. After my severe reaction, I needed a scan of my brain to determine what on earth went wrong. If we had a scientifically oriented mental health system, I would have been prescribed the two medications which are now dragging me towards remission seven years too late.
Instead, I suffered through a PhD with an untreated severe mental illness, collapsing in exhaustion at the end. As I gripped on to the last remaining threads of my life, I cursed the clinicians, counsellors and psychiatrists who had told me that I could “manage” my symptoms. Like Hannah Jane Parkinson of the Guardian, I despaired at all the blog posts and articles which conflated the effects of everyday stressors like grief and change on mental health with serious mental illness. I couldn’t understand why those with physical illness are praised for scouring the earth for medical treatments (or research into them) while my efforts to find alternatives to the “one-size-fits-all” mental health treatments were disparaged as non-compliance.
Out of all the nightmares I have suffered, only one continues to keep me up at night: I am terrified that the knowledge and understanding that my fellow sufferers and I have learned will be ignored. The final twist of the knife in society’s impalement of our lives.
So, if you want to learn courage, don’t listen to an idiot who risked their life and terrified their loved ones by climbing a mountain for the benefit of no one but themselves; listen to those of us with a mental illness, who are just trying to get through the day.
Dr Alex Mendelsohn (a quantum superposition of all gender pronouns) is not real. Dr Alex Mendelsohn is also not an artist. Well, technically they are real but using a pen name to protect their identity while they recover from a severe mental illness. Alex completed a physics PhD on a topic at some time in the past somewhere in the UK. They have started a blog: “The Anxious Physicist” and set up a twitter page: @AlexJMendelsohn