During an attack I tend to walk in tight circles, or back and forth over a certain spot, dragging the base of my palms down either side of my head, over and over. Sometimes it feels like there is a swarm of bees in my chest. Or my blood has been replaced by cold water. A slew of negative emotions and thoughts ascend through the gut, the chest – swinging off my ribs like monkey bars – up through the esophagus and into my head.
Once it has taken up residence in my mind – no longer a vague rise and fall unsettlement, like bars on a stereo – it can be hard to concentrate and difficult to form memories. I have a very bad memory.
Of the various neurological conditions and disorders that make guest appearances in my family, anxiety is the only regular cast member. Severe anxiety can be difficult to describe. It is a form of worrying, mounting to panic, which possesses its own energy. It is often illogical. Anxiety picks through the rubbish of bad thoughts like an Ibis; it selects the most rotten, and does away with it. There is an inability to nurture oneself, often rooted in an active dislike for oneself. From experience and in conversation with others I’ve found the body responds to panic in idiosyncratic ways.
A scientist was on the radio last month. He talked about how the ability to identify patterns has been central to the evolution of our species. Pattern recognition and processing, he said, is the basis of our communication, reasoning and abstract thought. It makes us human. It’s what sets us apart from other animals. I thought about this in the waiting room at the doctors. Patterns – identifying and creating them – has underpinned much of my treatment.
In the early sessions with the mental health nurse I was asked to identify things that are common to each bout of panic: the way I respond to negative thoughts; the way negative thoughts perpetuate more negative thoughts; the way those negative thoughts dislodge from the first person point of view and morph into second person, so that suddenly a voice other than my own starts whispering “you don’t deserve to be happy.” It’s a dangerous carousel.
From there I was asked to try and recognise these intrusive thoughts and label them as such. This process reminds me of the surveillance of metadata: you may monitor the sender, the receiver, the time and date of the email or phone call, its duration, but not the content, not the message. Likewise, one of the strategies taught in Cognitive Behavioural Therapy (CBT) is to identify the architecture of anxiety, its patterns of behaviour, separate to what the sufferer is anxious about.
The nurse told me to visualise intrusive thoughts as clouds that drift across the mind. She asked me to visualise the distance between me and the moving clouds. Something cinematic opened up: thoughts like clouds, clouds like rocks above, or the undersides of ships. And me: sometimes on the ground, sometimes underwater. Those clouds, I found, formed patterns, became kaleidoscopic. Some days they are even beautiful.
Patterns are based on repetition, a consistent arrangement of elements. I call the bad days my Paisley Days. They take on amorphous shapes. The good days are Argyle, or Diaper. And the good days are good because they’re built upon routine. There are certain activities I do, or tasks I perform, that lend a gentle rhythm to the hours.
Perhaps it is thirty minutes of reading, or walking up and down the hill five times, or writing five hundred words, on anything. Anchoring the task to a number (thirty minutes; five times; five hundred words) propels me forward. Scheduling is another method, saying this block of time will be spent doing that. Tasks like punctuation marks – commas to rest in, full stops to breathe in – are the scaffolding of my good days.
Routine can be a ladder leading out of the well of loneliness, to borrow from Radclyffe Hall. Because living with severe anxiety can be a very lonely experience. Loneliness is a whole other cluster of realities, yet there are things these states have in common. Olivia Liang’s book The Lonely City mediates on loneliness in the mind, body, in history and art, and is a worthwhile read for anyone in need of words to articulate the way they feel, whether sometimes or always.
Routine is calming, I’ve found, it pacifies the anxious mind. And it is only in the country of clear thinking that we can experience happiness, or at least a sense of peace.
There is a danger in this. I know it. The danger is getting too comfortable in routine’s embrace. To be limited by fear. I recently ventured beyond the boundaries I’d erected – broke the day’s 4/4 time signature – and it ended badly. Or at least, it didn’t end how I’d hoped. But I’ll keep trying. I know routines can be altered by degrees; entirely new routines can be established. The task is to teach that to the anxiety, that illogical animal.