Books, Non-Fiction

Book extract – The Anxiety Book by Elisa Black

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The Anxiety Book: A True Story of Phobias, Flashbacks and Freak-Outs and How I Got My Inner Calm Back is journalist Elisa Black’s account of struggling and coping with chronic anxiety. The book is a guide of sorts for other anxiety sufferers to find that there is a way of managing, if not conquering anxiety. The book is published by Hachette Australia.

1

The drowning hole

 

Even in the summer sunlight, the side of our house was a sly bog.

Avoided during games of chasey in favour of the sloping cement that ran around the valley-side of our place, it was only during times of great childhood peril – those bored days when we would unchain our bad-tempered snapping terrier and let him chase us around the garden while we shrieked and tried to leap onto the safety of the bonnet of Mum’s latest clapped-out car before he latched on to an ankle – that we would sometimes find ourselves forced down the bad side. The dark side.

If we weren’t running too fast and the gloom wasn’t too deep, we could place our feet carefully on the jumbled rocks that lay between the house and the weed-ferns that no amount of wet could destroy, and make it safely to the back lawn.

But if we misjudged or slipped in the terror-excitement of the chase, we would glug shin-deep into the sucking black muck.

At night, with the heaviness only a day of sunshine and running-climbing can bring, my eyes would droop towards the soft pull of sleep. Then, night-after-night-after-night, I would see my mum and baby brother walking the path down the dark side of the house, would see the depthless hole open up in front of them, and they were unaware they were already dead, their heads sucked under so suddenly and smoothly that not even a bubble of breath would remain, just the dirty-mud surface of the drowning hole.

Most of my memories are of fear.

I wasn’t born in a war-zone, wasn’t beaten or abused, didn’t witness addiction or terrible disease, can’t even say I was born with a funny-shaped birthmark or teasable speech impediment. Yet I have a terrible fear that plagued me – that plagues me; that sits in my gut like a mouldering toad or crawls into my chest as a swarm of bees.

Only now do I catch glimpses of what it is to live without it.

The first thing I can remember, fogged around the edges and cast with the kind of malevolence only decades of fearful remembering can bring, is the drowning hole.

Today it reads like some kind of crappy schlock-horror. I’m sitting with my mum and my baby brother on the front lawn of neighbours who live just over the hill. The neighbours’ baby toddles in its overalls, fat arms stuck sideways, towards a tiny bridge, while its mum and mine discuss motherly things. And then it topples, face first, into the gaping hole that lies beneath that bridge, and all of a sudden it isn’t there any more and its mum is screaming and stumble-racing towards the hole, and I stand there with my mum, who has gathered my brother to her chest, and watch.

This isn’t one of those historical mental health books where you will learn all about which psychotherapist developed which treatment in whatever year.

I don’t remember the baby being pulled from the hole – which Mum insists was only ever a puddle and a shallow one at that – nor do I remember walking back over the hill to our little house for a snack or nap or whatever two-year-olds do on a sunny afternoon.

In my inchoate mind’s eye, that baby is dead, the drowning hole an evil entirely capable of moving and feeding on my mum and brother and me, and I must always watch my family and make sure and check-and-check-and-check so they don’t die. So I don’t die.

As for many children with a talent for the melodramatic, for me the ordinary world sat side by side with the monstrous. For me, much of the ordinary was monstrous – sucking, slavering, engulfing, destroying.

The illusory became flesh, tearing at my heels the way our dog would if I mistimed my run around the yard. Childhood anxiety is the gothic horror, the haunting presence, the gaping wound.

When you are young, soft around the edges, malleable and open, everything is ‘the most’ and the ordinary morphs into horror in a blink – the shadow is the vampire, the creak a faceless ghoul, the parental telling-off is steps away from a Hansel-and-Gretel-esque abandonment in the woods.

Of course, now I am grown I no longer fear the drowning hole.

Except that, really, in many ways, I still do.

My anxiety is a wild beast.
It has destroyed relationships, clawed at my insides until

I was sick, left me cowering under blankets, plagued me with panic attacks and tipped me into postnatal depression following the birth of my first son.

I have taken medication – Aropax, Cipramil, Effexor, Zoloft, to name but a few – tried psychotherapy, hypnosis, exposure therapy, visited psychologists and psychiatrists and naturopaths and herbalists and more.

I’ve doggedly practised yoga, meditated morning and night, exercised feverishly to try to rid myself of the adrenaline throbbing through my veins.

I’ve sought solace in alcohol and avoided anxiety-inducing situations to the point of agoraphobia.

Some things have helped for a while, others not at all, and always anxiety was there in some way, lurking around the corner.

For twenty years I have sought a cure and for much of that I haven’t even known what I was fighting, haven’t understood why I felt the way I did, why I couldn’t cope with things others found everyday-normal.

What have I learned?

What wisdom about a life with anxiety – after almost four decades of it – can I impart? Do I know enough to shield my sons, to save the one already feeling the sharp stab of fear in his gut?

Maybe.

This isn’t one of those historical mental health books where you will learn all about which psychotherapist developed which treatment in whatever year. When I am in the throes of a panic attack and feel like my heart is about to explode out of my chest, or when anxiety is sending the same thoughts through my head over-and-over-and-over until I feel like I might go insane, I don’t actually give a crap when cognitive behavioural therapy was invented or when Zoloft first entered the market.

What I really want to know is that I am not the only one who feels like this, like some strange circus freak who would be laughed at if she ever confessed to the turmoil in her gut. I want to know what might work, how it might work, what else to try if it does nothing at all.

And I want to know what others feel. I want to know about your darkness, your fear, what widens your eyes in the still of the night, or sends you rushing for the toilet in the middle of the day.

For all our differences, the unique reasons why you are you and I am me, there are still universal truths to our terror, a shared knowledge: when you catch a glimpse of your reflec- tion in the story of another and, if even for a moment, you feel less alone.

I want to know that I am not alone, and I want to know the things that might help me get through the next minute, hour, day, the rest of my life. The things that might help you.

My anxiety is that tightness in my chest, the wild scrabbling of whatever is masquerading as my heart.

My anxiety is the constant worry, the fixating, the obsessing over things I cannot control: sickness, death, oblivion.

My anxiety is my upset stomach, my inability to focus or sit still or do anything other than lie curled in a ball because the fear is so great I can’t even face standing up.

My anxiety says I can’t do this, any of it.

My anxiety says life is scary and dangerous and fraught and unpleasant. Even when I am having the most beautiful of days – when I am at the beach with my healthy children, or they are tucked safely in bed and I have a great book and an excellent glass of wine, or I am horse riding or travelling or laughing with my husband, or reminiscing with old friends – my anxiety is sitting in the corner of my heart, reminding me that this could be the last time I am this happy, that even being happy is dangerous because it is daring the universe to show me how bad things can be, that only by being ever vigilant do I have even the smallest hope of preventing any of those terrible things happening to me or my family.

I am very good at hiding my anxiety. As a kid you learn that being vulnerable is the very best way to make sure other kids know you are weak and easy prey. Never show fear. Never show the bullies that they have made you sad or scared. Develop the perfect poker face. And definitely don’t tell others what you are scared of.

Anxious people crave control, perfection, hate being unsure, hate the lack of certainty inherent in life.

The problem with all of this is that accepting vulnerabilities, letting go of control, showing your less-than-perfect face to the world, is part of shedding anxiety like a wrinkled snake’s skin.

Treatment of anxiety is a movable feast. What works for one person may not work for another, may not work for you or me. And what works for you at one point in your life may stop working and something else may take its place.

And it’s important to make it clear – right here at the beginning – that it may be very, very hard to challenge your anxiety. To face your fears. And while it can be hard to see a doctor for the first time, to try a new treatment in the hope that it will be the right one for you, you must persevere. Don’t give up if it takes time to find what helps. Don’t give up.

People are complex and your anxiety is probably caused by more than one thing. In the same way, you’ll probably need to consider more than one thing when it comes to trying to quash it.

And if someone, however well intentioned, tells you to just stop worrying, to choose to be happy – and sooner or later someone will – ignore them, because they have no idea what they are talking about. Anxiety is not something anyone would choose.

But you can choose to try. Try different techniques. Choose, in your calmer moments, to see the funny side of the ludicrous tricks your mind plays on you. Try to accept that, along with all of the truly horrible parts of anxiety, you may also be sensitive, creative, imaginative, funny, caring and all of the other beautiful things that come as the panacea to anxiety. And, more than anything, there is always hope.

Anxiety tries to tell you that the very worst thing could happen at any point, that you need to be always aware, to always keep yourself safe.

Hope tells us that the very best could happen at any time. It tells us that today could be the day you find your answer.

2.

What is anxiety?

 

Anxiety is the nameless dread that grips your gut and turns your insides to water.

Anxiety is the pain in your chest, the tight ball of gristle squeezing your heart.

Anxiety is the fear that you are dying or going mad, and that everyone will see it happen.

Anxiety is disgust, contamination, dread.

Anxiety is eyes-wide in the small hours of the night, flushing hot beneath the sheets with the terror of the coming day.

Anxiety is sitting in a group of friends and smiling and laughing without hearing a word, so focused are you on just getting through this moment, and the one after, and the one after that.

Anxiety is head-spins, snapping at those you love, the shits, the shakes, tears and tears and tears.

Anxiety is guilt. Guilt for the ruined holidays, the worried parents, the scared children, the frustrated partner ignored or burdened, the opportunities lost, the wonderful marred.

Anxiety is wondering how many more days your body can possibly keep going, feeling as it does.

Anxiety is anger because you can see that life is beautiful but feel powerless to live it without the cloak of fear.

Anxiety is not a worry from time to time, a niggle over something forgotten or mislaid, or a personal slight regretted. It is full-body, overwhelming, life-wrecking, mind-jacking anguish.

Anxiety is too small a word.

Everyone feels anxiety sometimes.
The anticipatory nerves you feel before an exam. The edginess that sets you on your toes before a performance. The dread that gnaws at your gut when you are waiting for the doctor to call. Anxiety keeps you safe, helps you perform well, makes you aware, vigilant, ready to react. This is the good anxiety. Well, if not good, then at least helpful.

But when anxiety seeps into every corner of your life, when it colours the days red and fills the dark hours with waking nightmares, when the dread becomes so pervasive that you can’t go to the supermarket or see friends or get out of bed – when you fear life itself – anxiety is a problem. More than a problem.

I can’t remember a time when I wasn’t nervous. Mum called me ‘highly strung’ and I thought the pressure in my chest must have been caused by strings pulled tight across my body, thrumming and ready to snap.

I wasn’t, nor am I now, perpetually panic-stricken; the anxiety ebbs and flows, and often without rhyme or reason. Real-life stress might elicit an appropriate reaction, something everyday might tip me into full-blown panic. Anxiety feeds on itself like a snowball careering down a mountain. The niggles become nudges, the worry becomes anxiety, the nervousness becomes panic and, if you can’t find a way to calm yourself, it feels like it might destroy you.

So, what is anxiety and how the hell can we stop it?

You probably already know what I’m going to say next but, sadly, there is no one solution, no therapy or pill guaranteed to cure anxiety in everyone. Anxiety is complex, both in its genesis and its expression.

For every researcher or scientist empirically testing different theories or treatments, examining methods and medications appropriately and thoroughly, there are a dozen shonksters promising a cure if you just follow their seven-step program to develop calm, or sniff this homeopathic remedy made of the distilled tears of anxious virgins.

The worst part is that most of us are so desperate to feel normal, to rid ourselves of anxiety, that we will try just about anything.

The anxiety of women seems to be lumped in with the general ‘stuff that makes women women’ or as us just being hysterical or on our periods.

When I was twenty-five I went to see a ‘doctor’ who had a clinic tucked in behind an insurance broker. In his office he attached sensors to my thumbs and had me pick little bottles out of a machine that told him I had contracted glandular fever as a teen (no), had a parasite in my gut (no), and if I went back to see him for at least eight weeks he would be able to cure the panic that was threatening to tip me over the edge. I thought it was bullshit and I went back anyway, so desperate was I to be better.

But solace, relief, might be found – can be found – if you are willing to think laterally, employ multiple techniques, make peace with setbacks and avoid dodgy practitioners who practice BS instead of medicine.

Despite the plethora of books written by anxious men, it is actually women who are more likely to be diagnosed with an anxiety disorder.

Perhaps men writing about their anxiety are seen as more interesting, or associated with cooler stuff like attractive vulnerability (as opposed to female neediness) or Woody Allen- esque quirks. The anxiety of women seems to be lumped in with the general ‘stuff that makes women women’ or as us just being hysterical or on our periods.

There are a few possible reasons why women are diagnosed with anxiety more frequently than men. It could be that we are more susceptible because of our hormonal make-up, that we are just more likely to see a doctor with our symptoms, that the lion’s share of childcare falls to us, or that women are more likely to experience gender-based violence, socioeconomic disadvantage, and lesser social status and rank.

The ancient Greeks, although a little confused in their ideas about anxiety (and female anatomy in general – they thought anxiety, mostly observed in young women, was caused by the uterus wandering around the body blocking passages and causing disease), were onto something with the maxim know thyself.

A little self-exploration (minus the generally associated wankfest that comes with much self-help) if done with honesty, and a willingness to accept some uncomfortable truths, can reveal where the root, or roots, of your anxiety lies.

Anxiety, in all its clinical manifestations – generalised anxiety disorder, phobias, obsessive-compulsive disorder, post- traumatic stress disorder, panic disorder, among others – is one of the most common groups of psychiatric disorders, seen in around 14 per cent of adult Australians every year.

There is no single trigger, but certain factors may mean you are more at risk: a family history of mental health problems, drug abuse, long-term stress, health issues, even having certain personality traits like perfectionism or low self-esteem.

New research is even exploring whether or not the types of bacteria in your gut could be responsible, and if the poo of an unaffected individual might make you feel better; others are investigating the possibility that postural complaints could lead to panic attacks. Others hypothesise that certain anxious people will benefit greatly from a simple vitamin regimen – but more of that later.

If I dwell for too long on the things I fear, if I can’t find a distraction or can’t reason myself out, my anxiety picks up speed. In many ways it feels like a demonic centrifuge in reverse. As my attention focuses more and more on the ‘what- ifs’, as I feel more and more overstimulated, inside I feel like everything is spinning faster and faster, the spinning mass’s centre getting smaller and smaller and hotter and tighter until it feels like it might either burst from my chest or crush me.

Anxiety, to me, feels selfish. By its very nature it is intro- spective. No matter the source – social anxiety, panic, fear a giant spider will lay human-sized eggs in your shed – the fear is ultimately about what that will mean for you.

I worry desperately about my children – that they will get sick and suffer and die. But the base of that fear, its dark and sordid heart, is the fear of what that would mean for me – what would happen to me if the worst happened to them? I do not think I could go on if they died or were horribly maimed. I do not think I am strong enough.

I don’t choose to feel this way. I look at the people around me and wish I could be as unconcerned, as relaxed, as they seem to be. And I understand why anxiety can be frustrating to the people in my life.

I want to comprehend how anxiety seems to others, to those without it. If you haven’t been floored by panic attacks or kept awake night-after-long-night with obsessive worry, for weeks and months and years, if you haven’t obsessed about your health until you were convinced you were dying and begun to experience the same grief you would if it were actually true, how can you possibly be expected to understand its impact?

Anxiety disorder is just that: a disorder, an illness – and we didn’t choose it any more than the person with cancer chooses theirs.

But I get why sometimes others must wonder why we just don’t stop.

Everything feels huge and important and slightly unreal when you are small. It’s why so many of our demons are formed when we are too young to realise that there really isn’t anything to fear in the shadows.

The Anxiety Book is published by Hachette Australia

You can buy the book here 

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