vestiges. But maybe I’m not blunt enough, because often I’ve told people and had a nod, a gesture of understanding, or sometimes just no reaction at all. It always amazes me, because I think if most people sat in my brain for a bit, they’d be shocked at how weird and intolerable it can get. The real release is talking to other people affected by it. A friend once called me to tell me that she’d decided that her neighbours might be out to get her. The anxiety behind this vague and weird thought was complex and impressive, but I got it. Because we both have weird and scary thoughts, we were able to fully spill all our irrational obsessions without the fear of being judged.
I guess what I’m saying is that anxiety is complex, messy and dark. It’s not just panic attacks or a fear of crowded places – horrible things which are easy to understand by a general audience – but relentless obsessions, terrible thoughts, exhausting compulsions, physical malaise and deep sadness as a result. I think it’s important, as we make strides to talk about mental illness, that we also make sure we know how grim and plain weird it can be. Progress and acceptance are not only achieved by being able to talk in general terms about mental health, or by highlighting stories of recovery – true understanding means bluntly talking about the hopelessness, the fear and the ugliness of it all too. The writer Hannah Jane Parkinson has written about her life with bipolar disorder so honestly that it helps you to see the reality of her illness. She does this without any hushed tones, or half-measures. ‘There was the time I was sectioned and spent 22 hours in a “mental health suite” (read: a small, airless room with two chairs in it) waiting for a bed on an inpatient psychiatric ward (one was eventually found out of borough). There was being released from hospital after sectioning, therapy abruptly stopped, and having no continuing mental healthcare in place.’[20]
Anxiety doesn’t go away, it controls your life. It stays with you at parties, at work, when you’re with your loved ones on holiday, when you’re safe in your bed. It affects your day-to-day life in a way that normal worries don’t. If you’re worrying about a job interview, those nerves tend to go away after the meeting is over. An anxious person will have worries that will likely mushroom. The interview could go perfectly well but the worries will remain, expand, mutate. They’ve got a hold of you and the grip is vice-like. Mixed anxiety and depression are the most common mental disorders in the UK – as many as 7.8 per cent of people meet the criteria for diagnosis.[21]
People worried about a specific issue might well experience deep distress, but people with anxiety will likely feel a vague sense of fear and nervousness all the time. Imagine they are successful in the job interview: while people without anxiety might have reasonable worries about how their first day in a new role might go – getting on with their new colleagues, or whether they will be up to the challenges a new job brings people with anxiety will worry about a whole host of things that might not seem proportionate or rational. How will they cope travelling to work? How they will handle a new routine? Will they fall over in front of their new colleagues? Could they get fired on their first day? What if they have a panic attack in the office? What if there’s a fire and no clear exits? What if their dog dies while they’re out? (I’ve had that fear before many times.)
When I started secondary school, I remember having the usual worries about the first day – making friends, finding the lessons too hard, fitting in. But within days of starting, I felt overwhelmed by them. I’d lie in bed worrying about the journey to school, being late, not knowing anyone, and whether I’d see my parents again (I told you anxiety can mushroom). I cried every single day that year, desperate not to go to the place which made me feel so scared and sad. I could not shake it off, and it didn’t get better as time passed. Instead, my worries just mutated, latched onto new things, spread their roots through my mind. That was my first long period of anxiety, and it was the most distressing, because I was just eleven, and I didn’t know what the hell was happening to me. A dear friend I made when I was thirteen told me that she used to tell her mum about ‘the sad girl’ in her year. That was me. What a nickname to have …
There are important physical differences too. While worry might make your stomach churn or give you sweaty palms, these symptoms will likely go away when a stressful situation passes. For a person with anxiety, the physical symptoms are legion. I mean it. There are hundreds of ways anxiety can impact on your body – chest pain, dizziness, headaches – and stranger ones. For me, I get a twitch in one eye, jumpy legs, ringing ears and a boiling-hot face. That’s also a great description for a dating profile; feel free to use it.
At school, I often felt nauseated beyond belief. I’d get headaches, and feel dizzy, and I’d find it harder and harder to breathe. I constantly thought I had a problem that the GP could sort out, I begged for days off school. With the number of physical symptoms anxiety can bring on, it’s no wonder people often worry that they are seriously ill. I said earlier that anxiety is a slippery thing. Sneaky, you might say. It can mimic other illnesses incredibly well. Health fears can become all-consuming – the first time people experience panic attacks, the most common assumption is that they are having a heart attack or a stroke. Later it can be a worry about brain tumours, MS, Parkinson’s disease. The list goes on. And health anxiety isn’t merely harmless worry. One study in Norway showed that people with such fears had a 73 per cent higher chance of developing heart disease over ten years than people who didn’t have anxiety.[22] Lucky us, huh?
Anxiety and worry are different beasts. It’s important to stress this, because if we want to understand mental health better while also reducing stigma, we must also understand how serious anxiety is. Just as depression is not just ‘feeling sad’, and postnatal depression is not simply the ‘baby blues’, anxiety is not just nerves. It’s also really, really common. While the mental health stat most commonly heard is that one in four of us will suffer with mental-health problems in our life, those problems can sound pretty vague – many people probably don’t know that anxiety and depression are the most common mental illnesses experienced.
So while there are other reasons a person might experience all-consuming worries, anxiety is the main factor in several mental health conditions. Before I bang on about what these are, let’s state the obvious. I am not a mental-health expert and if you are worried that you might suffer from any of these disorders GO TO YOUR DOCTOR. Also the charity Mind is brilliant for advice and education – visit their website immediately. As the actress Carrie Fisher said of her bipolar: ‘The only lesson for me, or for anybody, is that you have to get help. It’s not a neat illness. It doesn’t go away.’[23]
So without further ado, here are some of the most common anxiety disorders[24] (world’s bleakest drumroll, please):
Obsessive-compulsive disorder (OCD)
Panic disorder
Phobias – such as agoraphobia or claustrophobia
Social anxiety disorder (social phobia)
Post-traumatic stress disorder (PTSD)
Generalised anxiety disorder (GAD)
Gather round while we talk a bit about them!
OCD
It’s important for me to start by saying that OCD is NOT ABOUT TIDYING YOUR CUPBOARDS. If I have to hear one more person airily tell me that they are really OCD about which direction their towels line up in, I will personally go over to their house and fold all their towels into horribly elaborate swan sculptures like they do in fancy hotels.
Despite the common misuse, OCD is a thoroughly nasty affliction, from which 1.2 people out of every 100 in the UK are thought to suffer.[25] It presents itself mainly in two ways: obsessions and compulsions. Both involve intrusive, unwelcome and terrifying thoughts. These are not simply the weird ideas
