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- Herausgeber: Hammersmith Health Books
- Kategorie: Ratgeber
- Sprache: Englisch
- Veröffentlichungsjahr: 2020
Anxiety is a familiar word, one which seems hard to escape in today's busy world. It affects more than 280 million people worldwide from all walks of life, and can be a completely debilitating and isolating mental illness. In this new book, Lynn Crilly brings her warm, non-judgemental, family-friendly approach to bear on a the rising tide of contemporary anxiety, exacerbated by political and economic uncertainty, climate change, social media and a world that is being transformed ever more rapidly. She looks at how anxiety manifests, how it relates to other mental health problems and what the many options are for treatment and restoring well-being. As ever, she draws on a wide range of health practitioners to explain therapeutic options - both mainstream and alternative - and thereby provide a truly varied toolkit with something for every individual to try. Throughout, case histories support, confirm and illustrate the practical information, always with the emphasis on hope for leading a fulfilled life unconstrained by the effects of anxiety.
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Hope with Anxiety
a self-help guide for those affected and their families, friends and carers
Lynn Crilly
With a foreword by Jeff Brazier
To Kevin, Charlotte and Samantha and To all my friends and family – thank you for loving me!
Contents
About the Author
Lynn Crilly is an award-winning counsellor and mother of twin girls. When one of her twin daughters, Samantha, struggled with OCD and anorexia nervosa, having followed the conventional therapy routes to no avail, Lynn took the decision to follow her gut instincts and rehabilitate Samantha herself. She subsequently developed her unique form of counselling to support sufferers and their families going through similar experiences. Lynn continues to work with families every day, battling mental health issues at her clinic in Surrey, UK. She uses the knowledge and experience she has gained to write self-help books covering an array of mental health issues, with the aim to help combat stigma and destructive myths whilst also providing a positive and constructive way forward for families and carers affected. She is admired for her passion and understanding – something she attributes to the strength and loyalty of her family and friends, with whom she spends as much time as possible. Other books by Lynn Crilly are:
Hope with Eating Disorders, 2nd edition
Hope with OCD
Hope with Depression
Fundamentals: A guide for parents, teachers and carers on mental health and self-esteem, with Natasha Devon
www.lynncrilly.com
Acknowledgements
First and foremost, I would like to say a BIG thank you to my wonderful husband, Kevin, who has always given me his unconditional love and support. His unquestioning belief in me has given me the strength to achieve all I have so far … I love you more with every new day.
To our beautiful twin daughters, Charlotte and Samantha; I am so proud of the gorgeous young ladies you have become and love you both very much!
A big thank you to Callum and Jay for loving our girls unconditionally and making my family complete … love you both loads.
Much love to my mum and dad, who have always been there for me with the kettle on and ready to listen, with their constant love and support.
My brother Steve and sister-in-law Sue, thank you for being there.
A special thank you to Kate, Wendy, Gill, Gerry, Leanne, Hannah, Dionne, Kyra, Michelle, Shauna, Melissa, Mitch, Neil, John, Bobby and all my friends who continue to love me unconditionally, your friendship is a rare valued gift.
A warm thank you to our wonderful GPs, past and present, John Dalzell and Sarah Benney, who over the years have given us as a family and me as a professional their unreserved support.
Thank you to all my clients, both past and present, who have put their trust and belief in me and my work, which has enabled viiime to help and support them to make the positive changes needed in their lives and, in doing so, changing mine.
A huge thank you to Mel Hunter, who has been my writing hand to help create Hope with Anxiety.
A special thank you to my life coach and loyal friend, Jeff Brazier, who, when I was lost, helped me find myself again; for that I will always be grateful. As a father, husband and coach yourself, I could not have anyone more qualified to write the foreword for Hope with Anxiety. Thank You!
I have been incredibly privileged to have been supported by so many wonderful people from all walks of life, who have all trusted and believed in me enough to make a contribution to this book; for that, I thank you all.
Lastly and by no means least, thank you to my lovely publisher Georgina Bentliff (Hammersmith Health Books) for being so supportive, open-minded and a total pleasure to work with.
Once again, a big thank you to all those mentioned above and the many others who have championed, helped and supported me over the years; without each and every one of you, I know I would not be who and where I am today, both personally and professionally; for this, I will always be grateful.
Foreword
Anxiety comes in many guises. It can be obvious or hidden, logical or baffling. Its symptoms can be clear, or they can require some detective work. Often anxiety feels like an unstoppable force, out of our control, and watching someone we care about in the grip of it can be both frightening and frustrating.
Few of us are immune to the impact of anxiety. Even if it does not have a scene-stealing role in our own lives, almost all have watched from the wings as someone we care about struggles with its destructive effects. It is all around us, and yet still quite misunderstood.
In my life-coaching practice, I hear about anxiety on a daily basis, and through the experiences of my clients I have come to recognise it in the many different ways it takes hold in people’s lives. This became particularly evident during the most anxious times we’ve ever experienced as a society, through the Covid-19 pandemic.
This book is therefore more relevant than ever. Lynn ploughed her energies into finishing it during the difficult months at the height of the epidemic, to give hope to the increasing number of people who find themselves in the grip of an anxiety disorder. Through these pages, she gives them both a supportive hand to hold and an invaluable roadmap through their experience of anxiety, whether that is their own illness or that of someone they care for.
Her knowledge of the subject, backed by scientific evidence, xis deep, coming from a place of compassion and care rather than simply from science. The stories from her contributors further bring this accessible and comprehensive book to life. Theirs – the lived experiences of those affected by anxiety in its many and varied forms – show the depths that this illness can take people to. Their stories also demonstrate the light at the end of a long, dark tunnel that they never lose sight of.
As the title of the book suggests, hope with anxiety is a truly powerful force that can change lives. With hope, change is possible. With hope, brighter and better times are ahead. With hope, the tremendous effort required to break free from anxiety is worth it. With hope, families can work together rather than be pulled apart.
I have no doubt that this book will become a much-thumbed resource to a huge number of people. Lynn has worked tirelessly to add this to her portfolio of books helping break the stigma around mental illness. Just like Hope with Depression, Hope with Eating Disorders and Hope with OCD, I fully expect Hope with Anxiety to change the way people understand these kinds of condition and to give families real help – and hope – to move forward.
Jeff Brazier
Father/Husband
Life Coach and NLP Practitioner
Television presenter
October 2020
To cut a long story short…
Anyone looking at us 16 years ago would have assumed from the outside that we were a perfectly ‘normal’ family: my husband Kevin and I and our beautiful twin daughters, Charlotte and Samantha, seemed to have everything anyone could possibly wish for and more. We were in a really good place in our lives, glued together by the strong foundations of our marriage and two happy, healthy girls. Of course, we had our ups and downs like most couples and life threw challenges our way, but we always worked together to overcome them and move forward, trying carefully to balance our scaffolding business and family life, just like any other working parents. We were doing okay… or so we thought.
Our picture-perfect little world fell apart when Samantha was diagnosed with the early stages of anorexia nervosa at the start of her teenage years. Her battle with this particular mental illness tested our family to its limits and just when we thought we had come through the worst, she was diagnosed with obsessive compulsive disorder (OCD). We had no knowledge at all of eating disorders or OCD when the girls were young, and tackling these two illnesses, one following the other, was akin to climbing a mountain without a map, a guide or any of the right equipment.
The main thing as a mother I was armed with was love, and empathy as a fellow sufferer of mental illness. I had faced my own struggle in the years before Samantha’s issues became xiiapparent. For me, the diagnosis was depression and for three years I tried to shift the black cloud that permanently overshadowed my life. With the unconditional love of my family and close friends, and a supportive GP who prescribed antidepressants, I was finally able to pull myself free, but I can now see that I too am pre-disposed to mental ill health and I have since had to be alert to and act on the tell-tale signs that those dark and threatening clouds could once again be gathering. I now realise it is something I will probably have to be aware of for the rest of my life.
Along with that personal experience of depression, it was also the battle we faced with Samantha that ultimately led me to where I am now, writing this book … Hope with Anxiety.
Like any parent, I wanted to do the best I could to help my daughter to recover. We tried everything we could to get her the help she so desperately needed, from our local (very supportive) GP to both NHS and private clinics, but sadly nothing appeared to be working for Samantha. I read many books and scoured the internet for as much information and guidance as I could get my hands on, but I could not find anything that I or my family could truly relate to or which gave me any real hope that there was a light at the end of the tunnel for Samantha and for us as a family.
Every website, book or support group I found seemed to focus mainly on the actual person experiencing the illness and not the family, friends or carers whom I felt needed help and support just as much as the sufferer. I desperately needed answers and was keen to reach out to others, anybody with a genuine understanding of what was happening to us, to help us stop Samantha’s condition in its tracks, but there was nothing.
In a moment of desperation, with my family falling apart, I let my intuition guide me and took the decision to rehabilitate her myself. Thankfully, with the full support of our GP, the girls’ school and our family and friends, I was able to dedicate myself completely to Samantha, injecting positive thinking, love and xiiihope, whilst trying to show her a life outside of the eating disorder and later the OCD, never giving up on my belief that she could and would get better, no matter how difficult the situation became.
I slowly encouraged her to start communicating with me. She began sharing her distorted and, at times, highly irrational, views of her world and her innermost thoughts, her head engaged in a constant battle with itself. Patience, love and open-mindedness were paramount, not just with Samantha but for the family as a unit. It was the steepest learning curve I could have ever imagined but, step by step, Samantha slowly found her way back to us.
Despite Samantha’s illnesses and my own experience of depression, Kevin my husband has never really understood mental illness, and has never pretended to. At the height of Samantha’s illness the pressure and enormity of it all took its toll on us briefly, to the point that I once asked him to leave … Thankfully he ignored my request and stayed, continuing to provide his powerful and unconditional love and support, without which we could never have survived. He used to think Samantha was intentionally behaving as she did for attention, but now he readily accepts things for what they are, supporting Samantha unconditionally even though, sometimes, he struggles to get his head around her quirky ways of thinking.
Samantha’s twin sister, Charlotte, has also been pivotal in her recovery and now works alongside me at my practice, with an empathy that can only come from first-hand experience. She has forfeited pieces of her own life so that Samantha could be given the full-on care that she needed and the bond between my two girls is now unbelievably strong. Their mutual respect for one another, as a result of the journey they have shared, is testament to that.
I have learnt through all of this, the importance of constant communication, patience, non-judgement, unconditional love xivand, most of all, HOPE, and that in fact there is no such thing as the ‘perfect’ family. Trying to be perfect is not only unrealistic; it can be dangerous.
Some time into Samantha’s recovery, I was contacted by the mother of a 17-year-old girl who was suffering from an eating disorder. She asked me if I could help them as they were finding, as we had, that none of the conventional routes were making any difference. Encouraged by my husband, I approached their situation just as I had Samantha’s, looking beyond her illness to the person within and giving her the unconditional and non-judgemental support that I realised from our experience had been so beneficial. Having been able to help her and her family successfully, I made the decision to build my own counselling practice based on everything I had read, learnt and experienced from our own journey with Samantha. I then went on to do some studying of my own, including training as a Master of NLP (Neuro-linguistic Programming – see page 105) and as a PsyTaP practitioner (see page 115). I was keen to work with other sufferers and their families, giving them the unreserved support and complete lack of judgement that my own experience had taught me was both vital and necessary. I tentatively opened my doors to people from all walks of life, struggling to deal with mental illness, be it the sufferer or a supportive loved one. My little successes were never shouted from the rooftops but from then on people seemed to find me through recommendation and word of mouth. I am now contacted on a daily basis by frantic and frightened parents, carers and siblings from all over the world, all of whom have concerns about loved ones, some as young as eight years old, most just wanting to talk to me, desperate for a glimmer of hope. I now help people suffering from anxiety, OCD, eating disorders, depression, self-harm and low self-esteem. The way I interact with my clients may seem a little unorthodox to some; however, I feel it is important to get to know the person as a whole rather than just seeing them through the lens of their xvillness, and working alongside the family rather than just the sufferer helps to build a united front against the illness.
No two people who enter my office are ever the same and they all experience the issues in a way that is unique to them; hence, the way I approach their treatment is similarly unique to each client. I am learning about each individual case as it naturally unfolds so I can give as much time and attention as we need, both in and outside our sessions, to build a mutual trust within our relationship which enables me to be one step ahead of the illness, in turn facilitating a quicker and more effective recovery for all concerned; we may do puzzles together while we chat, make jewellery or do other arts and craft projects. The atmosphere tends to be much less intense than the traditional image of the patient-therapist relationship and can at times even be fun! I have certainly learnt a lot from working with people in this way and I focus on maintaining a positive environment, so from the minute they walk in they feel comfortable and at ease and from the very start they know they can get better and that they are in control of their own recovery. I also respond on an emotional level rather than a clinical one to the things they tell me.
I do not always get it right and I do not pretend to; on the odd occasion there may be the need for additional assistance and input from other avenues. However, my practical and down-to-earth approach has earned me the endearing handle of ‘Fairy Godmother’!
So here I am, many years later. If you had told me over 10 years ago that I would be doing what I am doing today I would not have believed you. Nor could I have foreseen that our future as a family would be so much healthier and happier, our dynamics have changed in a way I did not think possible. During these rewarding years I have had the privilege of working with some wonderful people and their families, each and every one of them unique. Whilst I have been able to support and guide them through their journeys, I too have learnt from them. My xviclients have said that they find my practical and down-to-earth approach really refreshing and have even compared me to the therapist in the film The King’s Speech on more than one occasion! His methods were unconventional and unorthodox – but they got results. I never expected my practice to expand to the scale it has, but through this I have been able to share my ever-growing knowledge of all kinds of mental illness and help clients to find the best route towards recovery, not just for the sufferer but for those close to them as well.
My ever-increasing client list highlighted just how little emotional support or real empathy there was available for the carers, friends and families of those suffering from mental illness and, having had first-hand experience of the destruction it can cause within the family unit, I felt compelled to write my first book (Hope with Eating Disorders, published in 2012). I was keen to share what I had learnt from our journey with Samantha in the hope that it would bring some guidance, comfort, strength and hope to others. Outwardly it was impossible to identify families who were going through similar experiences, yet when I spoke openly about what we had experienced within our family, I learnt that most people I knew were struggling with something behind closed doors. They had been too afraid to talk about it for fear of the stigma or judgement, which sadly still surround mental health issues, even in today’s society when a staggering one in four of us will experience or suffer from some form of mental illness at any one time. It was then I realised how widespread issues like self-harm, anxiety, depression, OCD and eating disorders were and how confusing the wealth of information available on these subjects can be to the reader. Despite many high-profile initiatives by the Government and various celebrities, making mental health awareness a target, there are still countless people of all ages suffering in silence, in need of help and support, and many loved ones, friends and carers confused and unsure of how to help them. These resources have become even harder to xviiaccess during the Covid-19 pandemic and I fear waiting times for mental health services will have lengthened significantly.
Looking back, although Samantha had left most of her issues behind, she never truly felt comfortable in her own skin until recently, when she reignited her love for drama and the arts and completed a BA Hons in Drama and performing arts. Consequently, we have watched her grow into a beautiful, confident and vibrant young lady, pursuing a passion that allows her to express herself. Her passion and desire for life have been strengthened by the encouragement of her supportive and loving fiancé, Jay. Charlotte also has a wonderful, understanding husband, Callum, who has been on this journey with us since the beginning, so I am hugely relieved – being happy and healthy is all I have ever wanted for both of my girls.
As for me…
Which brings us to Hope with Anxiety…
Having experienced first-hand some of what you are probably going through, my main aim in writing this book is to help you understand anxiety disorders and identify the symptoms of this destructive mental illness as early as you possibly can, allowing you to intervene swiftly and with more insight into the different treatments available, which are paramount for a quicker and more effective long-term recovery.
After the first edition of Hope with Eating Disorders was published in 2012 and was, I am very proud to say, very well received by sufferers, carers and those who work in the eating disorder world, I went on to write more books: in 2015 John Blake Books published Fundamentals, A Guide For Parents, Teachers and Carers on Mental Health and Self-Esteem, with co-author Natasha Devon; in 2018 Hope with OCD, was published by Hammersmith Health Books; then I wrote the second edition of Hope with Eating Disorders, followed by Hope with Depression, both again published xviiiby Hammersmith Health Books, in 2019 and 2020 respectively.
In the eight years since the first edition of Hope with Eating Disorders was published, many things have moved on and changed in the way mental illness is portrayed and understood. The wider public’s understanding of these complex conditions has in many ways grown, but at the same time the pressures that society faces are evolving at such a pace that it can be difficult to keep up. The media landscape has altered, with the internet and social media exerting a stronger influence than ever before – and this is something we do our best to influence positively with our Hope with Mental Health YouTube channel.
Furthermore, my own understanding and experience have also grown, thanks to my clients who continue to teach me so much. No two people who walk through my door are the same, and every single one of their experiences has allowed me to grow and expand my knowledge of mental illnesses and how these affect individuals and the people caring for them.
In the chapters that follow, I will try to answer some of the questions that I am asked frequently and my objective is to give you, the reader, the hope and belief that you have the strength and courage not only to support and guide your child/friend/loved-one through these turbulent waters, but also to be able to see them safely to the other side, where they and indeed everyone closely involved with them will be able to move forward with their lives. I would like this book to act as a road map not only for those who simply do not know where to turn for help, but also for those who would like to have a clearer understanding of anxiety disorder in general.
I hope to relieve you of some of the burden, confusion and pain you may be feeling, as you enter the unknown and to arm you with as much knowledge, guidance and strength as I can, to enable you to continue your journey with courage, trusting in your own personal skills and instinct, just as I did. Remember always that communication is the key, along with unconditional xixlove, perseverance, non-judgement, patience and hope.
This book emphasises that there is no ‘right’ or ‘wrong’ path to recovery. My own experience demonstrates that each family or support network must take whatever action is right for them; if one option proves ineffective, try another – never buy into the myth that people with an anxiety disorder cannot recover. Never give up hope and never give up trying.
With hope, perseverance, love and a lot of effort from us all, my family has reached a very positive place. Samantha graduated in 2018 with a 2:1 in performing arts, and has written her own book Hope Through Poetry (some poems from which are in this book) to be published by Hammersmith Health Books in October 2020. She has become engaged to Jay, who I know will continue to love and support her through any difficult times that may lie ahead. Above all, she is happy and healthy – bubbly, funny and waking with a smile on her face. Her sister, Charlotte, is forging her own path with her loving husband, Callum, and has a bright future ahead; my husband and I can look forward to the next phase in our lives, finally content that our girls are happy and surrounded by love. Our experiences of mental illness have brought us to where we are now: wiser, more appreciative of each other, and with more understanding of others. I never stopped hoping we would one day reach this point, and now I am able to hand that hope on to you. Anything is possible… my family is living proof of that.
Please note
Over the pages that follow you will share the experiences of other carers and sufferers and realise that some of the emotions you may be experiencing are natural and normal. You will be given an insight into how your loved one is thinking and feeling, with the aim of providing you with a genuine understanding of their condition. I have also included an unbiased guide to some xxdifferent types of treatment available, both mainstream and alternative. All the contributing individuals and therapists are real people, but some have changed their names to protect their identity.
xxi
Monster on my back
by Samantha Crilly
It sat on my back quite comfortably most days,
Merrily playing along, singing my praise.
The taste of misery always kept it near
As it wined and dined lavishly on fear.
I fed it for years, very generously so
It never had any motive to get up and go.
Only when I gradually stopped feeding it
Did it then grow weaker and weaker, the less I needed it.
Soon, having nothing to stay for
That’s when it began to walk out of my door.
The stronger I grew, the weaker it became
As it starved profusely on the lack of my pain.
Light as a feather it soon blew away …
It can fly by my window from day to day
But I will always tell it to be on its way.xxii
Chapter 1
What is anxiety?
‘Anxiety’ is a familiar word, one which can seem hard to escape from in today’s busy world. We may hear that anxiety is ‘on the rise’, that we are raising a generation of ‘anxious’ children or that our constantly ‘switched on’ way of life is leading to a more anxious state of mind. But what does that really mean? What does anxiety actually feel like, and what effect is it having on the way we live our lives? Is it a by-product of modern life that some people are inevitably saddled with or is it a severe mental health condition which can be overcome?
So, what is anxiety?
Anxiety, in its clinical sense, is defined as a feeling of unease, worry or nervousness. However, in reality it is much more than that. It is a deep-rooted, debilitating and destructive mental illness that affects both the sufferer and their carers alike. Once well established, the severity of this dreadful illness and the tormented misery it rains down on the sufferer can destroy relationships and ruin the lives of not only the person suffering but also everyone around them.
The word ‘anxious’ is actually derived from the Latin word ‘angere’, meaning to strangle or to choke. This feeling of physical distress is a common symptom felt by those suffering 2from anxiety. Some may describe anxiety as ‘being trapped in quicksand; the more you struggle to free yourself of the thoughts, the worse they get’, others as ‘an inner scream they want to let out, but feel as though they are paralysed’, or even as ‘a swarm of bees constantly buzzing around in your head, leaving you unable to think clearly and rationally’.
Anxiety can change a person’s way of thinking, their feelings and/or their behaviour. This can cause the person high levels of distress and difficulty in being able to function mentally, and sometimes physically too. Individuals who have an anxiety disorder may not always look as though they are ill, particularly if their symptoms are mild. However, some sufferers may show more obvious and explicit physical signs (see page 32).
Together, anxiety and depression are two of the most common mental illnesses and are thought to affect around one in five of the British population at some point in their lifetime.1 Like all mental illnesses, an anxiety disorder does not discriminate and can affect anyone, regardless of age, gender, sexuality, ethnicity and/or social background.
An anxiety disorder is a serious mental illness deserving of the same attention and respect as any physical illness, yet sadly, it is often still woefully misunderstood, feared and even trivialised. If we were to break an arm or leg, not only would a doctor know how to fix it, but we would probably receive a lot of sympathy and support from the people around us. This is not the case with an anxiety disorder.
Dave Davies, manager of Frank Bruno, who himself has suffered from anxiety and many of whose family members and clients have suffered from depression, talks about how anxiety and most mental illnesses have been misunderstood for many years:3
My mother worried about everything. I thought at first she was just a concerned parent but anxiety along with depression was ultimately what it was. In the 1960s, if someone was not ‘right’ it was either ignored or explained that the person was having ‘a bad day’.
With anxiety, there is no such obvious cure, and people around the sufferer tend to fear what they cannot see, so they can be inclined to draw away and/or worry that they will say or do the wrong thing. This can be frustrating for someone experiencing anxiety, as they may feel that their condition has not yet been acknowledged or taken seriously, or that the people close to them do not care.
Everyone’s experience of and journey with anxiety are unique to them; anxiety can present itself in many different guises and can be an illness of extremes. For some it may produce an overwhelming force of adrenaline, causing insomnia and lack of sleep, while others may find themselves struggling to stay awake and keep their eyes open due to the constant worry and angst exhausting their body.
For someone suffering in silence it can take an act of great courage and strength to admit to a loved one or a medical professional that there could potentially be something wrong. Once it is all out in the open, it can be such a relief for that person to know they are not going mad and that what they are experiencing is, in fact, a very common mental health issue suffered by millions of people across the globe. The duration for which someone can suffer from an anxiety disorder differs from person to person: in some cases, it can take root and manifest itself for months or even years at a time; in other cases it can pass through like a succession of rainstorms.
An anxiety disorder is rarely a response to a real threat. Rather it is the expectation of a danger which may or may not actually occur. Sometimes that feeling is appropriate to the situation, but 4it becomes problematic when it happens so frequently or disproportionately that it begins to impinge on someone’s life and limits their experiences as a result.
Amy, who went through a period of regular panic attacks and severe anxiety, says:
I would feel worried about absolutely everything, and always something that would seem totally irrational (something I have worried about would be that the earth would fall from beneath my feet).
Anxiety is not simply a 21st-century malady. It has not been born out of stressful commuting, juggling childcare or being constantly switched-on to social media, although all these things can exacerbate it. In fact, its roots go back to our caveman days. Back then, when humans sensed danger, their body would be flooded by a surge of adrenaline that would boost their heart rate sending oxygen shooting to their limbs so they were better equipped to fight their foe or flee from danger – the well-known ‘fight or flight’ response.
What, however, is different today is that the churning stomach or tingling fingers we may feel, or the head-rush of inappropriate panic, is often a disproportionate reaction to a situation which should not hold any extreme danger.
When, in some people, it happens over and over again, the stress acts like a tap dripping into a cup of water. Drip by drip the pressure and worry build up until one day the cup overflows. That is when someone’s anxiety may reach tipping point, their mind and body overloaded by these constant surges of adrenaline, and what started as a few worrying niggles can become a full-blown anxiety disorder.
Garry shares his thoughts on how his anxiety developed:5
I think it’s been a drip, drip rather than a specific incident or set of circumstances.
At its most destructive, anxiety invades the tightest corners of a person’s mind, invisibly and insidiously feeding on their every thought, transforming all the potential joy in life into possible disaster, leaving them unable to achieve peace of mind, and having a huge effect on those around them, from parents to partners, employers to friends.
You may turn to the internet hoping it may help you to understand a bit more, or you may scour articles in the press on the condition; this could find you ending up even more confused and frustrated. As there is so much varied information available through various channels, it is difficult to know what applies to you and your own situation.
Throughout the course of this book, you will discover that as a parent, carer, friend, teacher or work colleague you are not alone. I hope you will learn that some of the mixed thoughts and feelings you and your family may be experiencing, inevitably including concern, worry, sadness, frustration, even resentment and anger at times, are normal and natural; most importantly, I hope that you will arm yourself with a real understanding of your loved one’s illness and discover some of the most effective ways to help them and the rest of the family towards recovery.
From my own experience, one of the most important things I have learnt and would like to share with you at this point in the book, is that, you cannot apply logic to something illogical the same way you cannot apply reason to something unreasonable, and you cannot make sense out of something nonsensical. In other words, ‘you have to accept what is, to enable you to understand’.
My mum, Samantha’s grandma, echoes the above with her feelings throughout our journey:6
In the beginning, I was frightened and useless – after all, it’s a mental illness, an illness that cannot be seen. As a little understanding came about, I felt unsure as to the best way to help. As time went by, with more understanding and acceptance through talking with Sam, ease and more self-assurance and confidence crept in. We have become closer during this long journey, the reason being we can talk as equals and listen and accept. She tells me her thoughts; I tell her mine. We laugh when we say or hear something funny and we hug when it is sad.
Within this book I aim to provide you with the information that I think really matters, with no agenda other than helping you, the reader, to understand some of the different types of anxiety disorder, the signs to look for, and some of the treatment and support options that are available to both sufferers and their carers.
What does anxiety feel like?
Anxiety may be recognised as a state of mind, but its effects can be physical as well as emotional. Think of the word ‘anxiety’ as something of an umbrella term made up of a whole host of symptoms, from which each individual will have a set of feelings that characterise their own anxiety.
For some people ‘anxiety’ means a constantly whirring and worried mind, for others it may mean not being able to leave the house. Some will make others very aware of how they are feeling, while others will keep their difficult feelings to themselves. A number of people may not even realise that anxiety is the underlying cause of their physical symptoms, such as stomach upsets or insomnia.
As the following examples show, anxiety affects people in myriad of ways.
Eve describes how her anxiety makes her feel:7
Anxiety makes me feel like I’m trapped constantly trying to fight off a monster chasing me.
Jo tells us how anxiety makes her feel:
It feels like a sudden overwhelming heat in my body. My chest starts to tighten and then it’s like my body goes cold. I feel ill and like everything is taking over and is out of my control.
Pete says of his anxiety:
It feels as though I am in extreme fight or flight mode at all times, even when there is no reason at all to feel this way. It’s terrifying and deeply upsetting.
Everyday stress versus an anxiety disorder
One of the most common misconceptions surrounding anxiety is that it is the same as being stressed. In today’s demanding world, it is virtually impossible to find someone who would not describe themselves as stressed, at least some of the time. As a result, many people may sometimes, or even quite often, feel anxious. That is not to say though that everyone has a problematic anxiety disorder. Some stress or anxiety throughout life is natural. It can even be helpful, keeping us on our toes and helping us face and overcome some of the daily challenges that life brings. However, too much anxiety – and the unpleasant symptoms it can cause – can have the opposite effect, paralysing us and stopping us from living our lives and moving forward.
As Lottie explains how her anxiety makes her feel:
I find it hard to think rationally and can get extreme thoughts with it. Anxiety makes me feel annoyed as I can’t do simple 8things and can make you feel like a failure. I would find it hard to breathe and focus so I could never do the things I wanted.
In today’s society, particularly on social media, there does seem to be a tendency by some people to use the word ‘anxiety’ glibly, almost as a badge of honour, without any in-depth understanding of what it really means, and doing so can do a disservice to the legions of people who are truly suffering with an anxiety disorder.
It is vital for all of us to understand the distinction between feeling stressed and actual anxiety. The examples in Table 1 successfully highlight the difference. Again, it is worth noting that someone with debilitating anxiety will have individual symptoms that are unique to them and may not identify with all these examples.
Table 1: The differences between stress/everyday anxiety and anxiety disorder
Everyday anxietyAnxiety disorderFeeling self-conscious, embarrassment and awkwardness in social situations.Avoidance of social situations and of being around other people for fear of being judged or humiliated.Realistic fear of a dangerous object, place or situation.Irrational fear causing avoidance of a place, object or situation that does not pose a significant threat.Being nervous when preparing for an exam, job interview, performance or other big event.Constant, agonising worry about everyday events, possibly accompanied by unexpected panic attacks.Worrying about paying the bills, getting a new job, relationships and other major life events.Constant and distressing worry that causes significant misery and interferes with daily life.9Feeling sad or anxious and not being able to sleep after a traumatic incident.Suffering from repetitive nightmares and flashbacks of the event. Extreme insomnia.Feeling nervous about flying or travelling to a new or unknown place.Feeling physically unable to travel, even if it is for work and could put their job in jeopardy.How common is an anxiety disorder and who does it affect?
An anxiety disorder is very common, yet it can be quite hard to accurately measure how many people are affected. We all feel anxious from time to time, but it is the frequency and depth of the feelings that accompany it that determine how problematic the anxiety actually is. If the anxiety is impacting on someone’s life, affecting them in the long term, or stopping them doing things they once enjoyed, then it may fall into one of the recognised anxiety disorders. Furthermore, anxiety can accompany or be a by-product of another mental health issue, making it even harder to identify.
Paige shares her experience of suffering from multiple mental illnesses:
Since I was suffering with anorexia and bulimia, I only became aware of the anxiety after I started having counselling and I started to realise that when I was in situations where I was around food, that my thoughts would race and I would start to get panicked.
Despite these difficulties in pin-pointing and ring-fencing anxiety, the statistics paint a stark and concerning picture: According to the Mental Health Foundation’s Fundamental Facts About Mental Health 2016, there were 8.2 million cases of anxiety in the UK in that year.2 When it comes to generalised anxiety disorder (see page 34), it is thought that around one in 20 of the population are affected.310
Anxiety disorders cut across age, gender, race and social class – many of the most successful people battle with its effects – yet evidence also shows that certain groups in society are more vulnerable.
Both men and women can suffer from anxiety; however, being a woman can put you at a higher risk of developing this illness. In adulthood women are thought to be twice as likely to have an anxiety disorder as men,4 with this acceleration between the sexes happening in the mid-teens. It is fair to interpret the Mental Health Foundation’s 2014 statistic that 22% of women feel anxious ‘a lot’ or ‘all of’ the time (compared with 15% of men) as strong evidence that up to a fifth of women may be suffering from, or be at risk of, some kind of anxiety disorder.5
This statistic may be slightly skewed by men’s continuing reticence to recognise and talk about their mental health, but nevertheless the statistic does suggest that women may be more susceptible to the effects of anxiety. The reasons for this are complex, and may relate to their hormonal cycles, the stressful caring roles women can be more likely to take on, the pressure of ‘having it all’, along with the feeling of judgement by society if they get it ‘wrong’.
Margo says of how making her life simple has helped her in recovery from anxiety and overload:
Looking back, for many years I was constantly trying to be the perfect wife, mother and daughter, all while holding down a high-pressured job, probably not doing any of it very well! It wasn’t until I hit the menopause that I fell apart, everything caught up with me and I was forced to take the time to reevaluate myself and my life. Thankfully life is less complicated now, I left my job and spend more time at home doing simple things while spending ‘quality’ time with the family. I feel like a different person.11
Causes of anxiety
It is clear that anxiety disorders can have a range of complex factors at their root, including biological and psychological causes, as well as factors linked to society and the knocks and challenges that life can throw at us. Although there are various theories surrounding its development, it is thought to be a combination of biological, genetic, cognitive and environmental factors acting together or individually as a trigger.
The common factors that can play a part in the onset of an anxiety disorder include:
Imbalance of chemicalsGenetics and family historyHistorical experiencesStressful life eventsThe impact of stressful world eventsLong-term physical and psychological health conditionsHormonal imbalancesHistory of drug or alcohol misuseSide-effects of medicationDietPersonality typeCaring for someone else.Imbalance of chemicals
One of the possible causes underlying an anxiety disorder may be an imbalance of the brain chemicals (‘neurotransmitters’), particularly serotonin and noradrenaline, that are involved in the control and regulation of mood. This is a simple explanation of a very complex process, involving the way that nerves connect and communicate with each other. If they are out of balance, it could contribute to someone developing anxiety, depression and/or another mental illness. It is a complex area, which is still 12not fully understood and requires more research, but it is widely accepted that these neurotransmitters do have a part to play in making someone susceptible to anxiety, although other factors from the list below are also likely to have a role.
Genetics and family history
While anxiety is often linked to someone’s experiences in life, it is also now known that genetics can play a part and if you have a close family member with anxiety, you are more likely to develop it yourself.6 While there may be a genetic link – research is ongoing – it is also worth bearing in mind that the link may also be due to the fact that we learn behaviour from those closest to us as we are growing up.
Myrtle, who has suffered from generalised anxiety disorder since she was a young child, shares her thoughts below:
Both of my parents are very anxious and do not acknowledge that or talk about it. Growing up, my parents worried a lot and would make the world feel stressful and they continue to do so.
It is also important to note that having a parent or close relative who has experienced an anxiety disorder, or another mental illness, does not necessarily mean that someone will develop it themselves.
Tom shares his thoughts on his family and anxiety:
My mum is a worrier and it’s far too simplistic to blame her as my brother is fine and we had the same upbringing, though I do think her worry gave me the idea there was something to be worried about.
Historical experiences
It is now thought that going through difficult experiences when 13you are a child, or early in your adult life, may leave you more susceptible to an anxiety disorder later on. Abuse, neglect, an unstable family life and/or another traumatic event can have an impact that can last a lifetime.
Anabelle shares her experience with post-traumatic stress disorder (PTSD) from past traumatic events:
The trauma built up over a number of years, possibly up to 10 years before it got to the point where I just couldn’t ignore it any more. It was a gradual increase – slowly – relying on alcohol more and more, slowly developing phobias, then panic attacks settling in a number of years later. So by the time I realised I was in trouble, I hadn’t even immediately linked it to something that had started to happen when I was 7 or 8 years old.
Battling through painful emotions and situations as a child can lead to low self-esteem, leaving that person less able to cope with life’s knocks, and this could impact someone’s chances of developing a more anxious mind-set.
Stressful life events
Often a stressful event or long-term stress can be the precursor to an anxiety disorder developing. This may be because self-esteem, which when strong can be an important defence against mental illness, is compromised. It is understandable that difficult experiences can leave people feeling uncertain or apprehensive, with trust issues towards others or a shaken belief in their own ability to handle challenging situations. Without support to help someone cope with the emotional fallout caused by stressful chapters in their lives, it is all too easy for an anxiety disorder to develop. People who have experienced a relationship breaking down, redundancy, bereavement or even a stressful ‘positive’ event, such as moving to a new house, having a baby or getting married, may also experience anxiety.14
Rachel tells us of her stressful life event:
After losing my beloved daddy I was so fearful of my mum and brother leaving me. I was so young I didn’t understand death and just thought my dad didn’t want me but as I got older and watched my mum become ill I started to understand and the fear grew and grew around health and death and when she did die when I was in my teens my anxiety was that bad I was terrified to leave my house, talk to people etc in the fear they would die too. Due to my anxiety and other mental health issues I started to believe I was cursed as everyone I got close to died or left.
The impact of stressful world events
In recent years, the rolling 24-hour news agenda, book-ended by the constant interruption of social media posts, has made it hard to escape the impact of world events. The reams of headlines, reports, analyses and campaigns can feel overwhelming and induce feelings of anxiety in even those who have never suffered from mental illness before.
There are some obvious global issues that have particularly impacted people’s mental health; the destruction of the planet and the impact of climate change are an ever-present worry, so much so that this has been dubbed ‘eco-anxiety’. The associated changing weather patterns, causing droughts, floods or freak meteorological events, only add to the pressure.
Wendy gives us her thoughts on ‘eco-anxiety’, since her young daughter has started excessively worrying about the planet and climate change:
Since climate change has come to the forefront of people’s minds and the news, my daughter, who is only 8, has been worrying herself to the point of not sleeping; she is scared that the world is going to end imminently. It is a concern, as she is young, and I would like her to enjoy being young and without anxieties.15
The coronavirus pandemic of 2020 has sent stress levels soaring to possibly unprecedented levels (the mental cost will still be counted for many years to come), exacerbated by the need for many to self-isolate, robbing them of the opportunity to share the mental burden with others.
Matty says of how the pandemic has affected his drug and alcohol misuse and mental health issues:
As for the coronavirus, I know that I will probably survive the illness. I’m not scared of the illness taking my life but myself taking my life through extreme loneliness being isolated alone.
Isolation is fine for someone who lives with their whole family and has support around them. My being alone has taken a huge toll on my mental health.
Garry shares his wise words during the coronavirus epidemic despite suffering from multiple mental illnesses:
I keep telling myself not to worry over things I can’t control and, somewhat surprisingly, it helps with the virus anxiety.
For decades now, the ongoing threat of terrorism has been buzzing constantly around, punctuated by acts of violence that create spikes of real fear for millions of people. Alongside all those huge issues, there will be smaller news events that nevertheless have a massive impact on individuals, taking an often-unseen toll on their mental health until a dangerous or distressing tipping point is reached.
Whatever the news agenda at the time, the effect is the same, creating a climate of fear that leaves people struggling to cope, perhaps trapped in a cycle of rumination or wakefulness that can turn the dripping tap I have talked about into a gushing torrent. Panic attacks, obsessive compulsive behaviours, eating disorders or substance abuse may be among the multitude of unwelcome 16knock-on effects. This anxiety can all too easily spiral into depression, sending sufferers plummeting into the depths of despair.
While it is important to be well informed, and often to act on the advice or information we are given, it is also vital not to become so caught up in global events that we do not leave time and space to rationalise and recover, giving our minds a rest from the ‘doom and gloom’ that can so easily become overwhelming. With the news now available 24 hours a day on TV, radio and social media, it is all too easy to become almost addicted to the constant adrenaline-fuelled ‘fight or flight’ response, not leaving our minds any time or space to clear, enabling us to see things in a different light.
Long-term physical and psychological health conditions
Having a long-term illness, whether it be physical or mental, can raise a person’s risk of experiencing anxiety. This may be a symptom of the illness itself – for example, the signs of an overactive thyroid may mirror those of anxiety or the anxiety may be a by-product of coping with another condition reflecting the restrictions, fears and worries that the primary illness brings.
Suzie, whose daughter suffers from social anxiety disorder, shares their experience:
It became apparent through talking to the psychiatrist that, as a young child, she would never make friends easily; if we were out as a family, she would rely on her younger sister to join small groups of children and make friends and then would join in once the friendship was secure. From a very young age, she suffered with perennial rhinitis but, despite my early efforts, this was not diagnosed until she was about 6. As a result of this chronic condition, she was bullied at primary school from a very early age through to junior school, which in part led her to suffer with anxiety in her adult life.17
It is very common for an anxiety disorder to overlap and co-exist with other psychological illnesses. The link between depression and anxiety, for example, is very well documented, while others – such as eating disorders or self-harm – may also have a strong crossover.
Jo shares her thoughts on how her anxiety and borderline personality disorder are interlinked:
Having borderline personality disorder means anxiety becomes an extreme emotion. Anxiety can start to come on with no apparent cause and escalate quickly towards panic attacks. But just as quickly it can dissipate too.
People who live with conditions such as ADHD (attention-deficit hyperactivity disorder) or dyslexia are more prone to anxiety, not least because of the low self-esteem that so often affects those with one of these diagnoses. When you struggle with reading, writing, concentrating, paying attention or sticking to the ‘rules’ it can be difficult to feel good about yourself and this can in turn lead to many worries about different areas of your life. People with ADHD and/or dyslexia may be upset at how others perceive them, and worry about the future. Their anxiety may be particularly tied to their ADHD or dyslexia, or it may be about a broader range of issues.
Phil, whose son suffers from ADHD and anxiety, shares their experience:
My son was diagnosed with ADHD at the age of 6. He found it difficult to concentrate and sit still, with his mind and anxiety all over the place. School was a challenge for him, being seen as unruly and troublesome. Eventually we managed to get him seen and he was prescribed drugs to help him control the ADHD and the anxiety that seemed to co-exist alongside it; this helped immensely. Now aged 14 he still takes the medicine, but has managed to control the ADHD; he does have some 18lapses at school, but fortunately his school has a special unit to help, advise and guide him through everyday situations. He finds it hard to make and maintain friends of his own age, as his interests tend to be more of someone younger, which can upset him and cause him to be anxious. He does seem to thrive best with a structured environment where he knows what is required from him but we do need to keep him on track every now and then. He is a lovely boy, well liked with a unique personality.
Anxiety is almost always embedded in autism, a condition where people may struggle to understand the unwritten social rules that are part and parcel of everyday life and where senses can be heightened, making the world a bewildering, noisy, confusing place. Understanding and relating to other people can be a real challenge, and people with autism can take things very literally, struggling to understand things like jokes or sarcasm. This can make them very anxious about doing or saying the right thing. Worrying about the world and their place in it can lead to autistic people questioning why they are ‘different’, which can also give rise to a huge amount of anxiety, which they and their loved ones have to find ways to manage throughout their lifetime.
For people with autism, routine and familiarity are absolutely key and so the arrival of the coronavirus pandemic was for many a massive extra challenge. It took away all certainty, upended routines, kept loved ones away, messed up weekly schedules, and took away the normality of school, college or work. All these things that are essential for keeping an autistic person’s stress and anxiety in check were suddenly taken away, without warning, and the impact for those on the autistic spectrum was huge.
