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 your mind entertains at 2 a.m. on a Sunday night where you suddenly think about your parents doing it and hate your brain for traumatising you (though 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