you do have my sympathy). No, these intrusive thoughts ‘stick’ in your head. One ordinary Tuesday afternoon you might suddenly imagine killing your child, or jumping in front of a train, but instead of chalking that odd idea up to a funny mind tic, you fixate on it. You are filled with panic and revulsion that you could think such a terrible thing – are you a murderer? Do you want to kill your baby? The terror consumes you, and the thought takes hold ever more firmly. In some instances, you ruminate, falling into ever more tangled thought patterns to try and ‘neutralise’ the thought. Try arguing with your exhausted and panicked brain about whether or not you might be a paedophile for twelve hours straight and then tell me if you think your need to line up shoes neatly is a bit OCD.
In Mad Girl, her memoir about mental illness, the writer Bryony Gordon describes how these obsessions took hold in painful detail. A fear of germs meant that ‘I was so scared of blood on my hands that I began to wash my hands as much as possible, the irony being that they soon began to crack and bleed.’[26] Later, she began to think she might have murdered someone. That’s how far the brain can travel with OCD. I once drove around a roundabout several times thinking I’d run someone over. There was nobody there. My brain still wasn’t convinced.
If you’re not falling down a mental rabbit hole to try and stop the horrible thoughts, then you might be acting out compulsions. This pattern might go something like this: you imagine your family dying in a horrible accident. You panic about this horrible thought, and desperately need to figure out a way to stop it. So your mind makes bargains with itself. Just turn that light switch on and off twenty-five times when you enter the room and they won’t die. But don’t forget! Oh you think you missed a go? Well, do it five extra times to be completely sure. And maybe add in a back-up – just to be sure. Wash your hands until they are raw and bleeding and cracked. Something still not feeling right? Do it again – if you fuck it up, your family might die. Aged nine, I worried that my mum might die while she was out if I didn’t turn off the light switch correctly. And I didn’t really know what correctly looked like, only that I’d ‘feel’ it when it was. That meant turning the light on and off for hours. Yes, it sounds stupid, but I was nine and thought my mum would die. That’s not something you can argue with rationally when you have OCD. That’s the illness. That’s the impossible mind maze that you find yourself in. There’s a good reason it’s called the doubting disease.
On a lighter note, I do appreciate a well-hung towel too.
For people who have OCD without physical compulsions, there is just a cycle of irrational thoughts which whirr around the brain. Maz (not his real name) is divorced, and his ex-wife has primary custody of their children. Maz told me that he’s engulfed by relentless thoughts that his kids have come to serious harm. ‘I have images of accidents, my kids crying, of close calls with cars or balconies or whatever the fuck.’ He imagines that they have died if he can’t get hold of his ex. He will start to physically panic, which just leads to more intrusive thoughts. Sometimes Maz will convince himself that the thoughts are premonitions, or have come true, and he’ll rush over to check on the children. Relief is always fleeting, as reassurance can only go so far (I used to spend hours googling OCD to try and calm myself down, but it worked briefly, if at all, and would actually prompt new fears, because I was giving them credence). Even without compulsions, you are always trying to counterbalance the terrible thoughts, and this can cause exhaustion and immense distress. Maz feels like he becomes a shell of himself when he’s in the grip of obsessive thoughts: ‘I can barely express myself or breathe, the morning light and air hurts, and I become convinced nothing will end well.’
I know this distress. Sometimes the ruminations get so bad that your mind starts skipping – like an old vinyl player getting stuck. You’re so mentally exhausted that you start repeating words, phrases and sayings in your mind. You can’t work your way out of the loop, and you feel hopeless. This, in turn, provokes fear, and then physical symptoms, and then back to obsessive thoughts. Do I sound overdramatic? I assure you, if anything, I’m downplaying it slightly for space reasons.
Panic disorder
This is characterised by panic attacks – an extreme distortion of the fight-or-flight response. What’s that? The fight-or-flight response is a basic human reaction triggered when we feel a negative emotion like fear. Obviously, it’s very normal to feel fear when you’re in danger. This response evolved to let us react quickly in a threatening situation: to fight, or to run away. The adrenaline released in such a situation allows us to move faster, gives us strength and makes our reactions sharper – some think it’s what allows amazing examples of strength in a crisis – e.g. a mother managing to lift a car off her trapped son. That phenomenon has a great name – ‘hysterical strength’.
But panic attacks can happen when there is no actual danger near. They seem to be triggered by false alarms, and the adrenaline and cortisol produced then work against us, making us hyperventilate, feel dizzy and shake after the fear has passed. But the danger seems so real, it’s hard to believe there’s nothing to be afraid of. Cue more attacks.
Before I explain the wide-ranging symptoms of such horrible attacks, it might first be helpful to describe what it feels like to actually have one. The worst panic attack I ever had took place in Finchley, North London. I suppose it was as good a place as any. I was eighteen, driving my car across a main road in a terrible storm. The cars were queuing up and slowing down, and the torrential rain meant driving through what looked like a lake in the middle of the road. My heart was beating fast, and my skin suddenly felt freezing cold, but I was pouring sweat. As I inched towards the ‘lake’, my ears roared with white noise and I started to lose my vision. Spots and flashes flew before my eyes and I couldn’t breathe. I mean it. I could not catch a breath. I was heaving and gasping but no air seemed to be getting into my lungs. Every part of my body was shaking and nothing felt real anymore. My legs and arms felt detached from my body, and I believed I would die, right there in that car, crossing that stormy road. I didn’t, of course. I got across. I pulled over. I shook uncontrollably for about twenty minutes, cried a lot and went home. You can bet I avoided that crossing for years.
Eleanor Morgan, the writer of Anxiety for Beginners, describes the first time she ever had a panic attack even more viscerally. Because it’s the first one which is the most terrifying. The one where you feel you’re dying for real. Later on you might know you’re not, even though your body insists you’re wrong. But that first one. Hoo boy. Morgan was at school, and ran to the loo, thinking she was going to vomit. But instead the cubicle started to move around her, and the walls felt ‘like putty’.
‘Nothing made sense to any one of my senses … what else, if not death, could be the end point of such physical and mental free fall?’[27]
Like Eleanor’s, Beth’s panic attacks started as a teenager. She told me that the symptoms terrified her, because they felt like a physical illness, as they do for so many initially. ‘For a long time people definitely didn’t believe what I was saying when I tried to explain how I felt. When it first started all the symptoms matched up with those of a stroke, my arms would become ridiculously heavy, I’d get numbness and tingles over my body, my eyesight would go, my body just felt like it was shutting down and it was terrifying. My legs turn to jelly, I shake, I get very cold, my stomach drops, I get dizzy. It can genuinely knock me out for a day after, which is great fun. I tense up so badly when it starts, [that] I just cause more issues for myself when it calms down. I hate not being in control, so trying to repress it is how I deal with it. It’s never worked.’
Catherine’s panic attacks also started at school – more particularly, at a stressful point in life – her GCSE exams. As is common, they were initially intensely physical. ‘When I was sixteen and didn’t understand that I had anxiety or that I was experiencing panic attacks, my symptoms were very physical – pounding chest, weak legs, blurry vision, knotted stomach, hyperventilating etc.,’ Catherine told me. ‘As
