How to cope with anxiety

Author Kate Riordan had two miscarriages which then brought on severe health anxiety. She describes how she got through the storm

This time last year she was keeping a diary, the writing small and meticulously neat. In it, she recorded everything that happened each day. Not in the outside world but to her, inside her own body.It was the only thing that seemed important enough to her to set down.“Lots of muscle spasms today,” she wrote on 20 February, pen pressed hard to the page. “Aches and twinges on my right side, getting more acute in the evening. Left leg still weak.” At the back of the diary were lists: girls’ names, US states, English counties – all written out alphabetically. While her days were spent obsessively monitoring her physical symptoms, the lists were getting her through the silent winter nights. Putting her brain to work on “Alabama, Alaska, Arizona, Arkansas…” was a diversion tactic to stave off the worst of the panic.

It was two miscarriages and their medical investigations that turned her mind inward until she could do nothing but mentally scan her body, looking for trouble. She was told she had endometriosis and an underactive thyroid, and this completely wrong-footed her. “If my body had kept this from me, what else was it harbouring in its darkest corners? OK, I’d been watching a lot of Game of Thrones, but I felt like an unpopular queen in a court of traitors. My body had become a thing apart from me, capable of keeping secrets,” she writes.

‘I just want to get back to myself,’ I wailed to my husband. ‘But what if I can’t?’

Adding to her paranoia was the fact that she’d written about miscarriage and madness in a novel before she got pregnant. “Had I brought this on myself, or were the gods punishing me? (“You wanted some good material, love? Try this.”) I’d been afraid before – mainly in airports, waiting to board – but that was a price I was occasionally willing to pay for some sun”, she said.

She couldn’t read, couldn’t write, couldn’t sit still, couldn’t be on her own. One evening, the room around her shifted like a glitch in the matrix and she wondered if any of it was real. “I just want to get back to myself,” I wailed to my husband, who wasn’t much less frightened than me. “But what if I can’t?”

Danger stalked her everywhere. Every time she turned on the TV, shewas besieged by hospital documentaries. Characters in books were struck down with horrible diseases. Shecouldn’t even go for a nice walk – once a reliable cure-all – because she was so frightened she had multiple sclerosis that she dreaded every step.

There was a really bad day when she put on some music and danced on the spot, to prove to herself that her brain was still talking to her limbs. She sobbed with fear as she did it, the dogs looking on with concerned bemusement, and told herself that this would be funny one day. And it is funny. And it isn’t, because she can still remember how much nerve it took to do it, even as she offers it up as a cheap anecdote.

Health anxiety is an epidemic estimated to cost the NHS £420m every year. While hypochondria is an age-old affliction (Charles Darwin and Marcel Proust had it).She had hoped “Dr Google” would throw up some irrefutable proof that she didn’t have whichever disease she was petrified of that day. Instead, she discovered a raft of new symptoms that her body cunningly reproduced within 24 hours. The single best thing she did in the quest to feel normal again was to keep a promise to her mum to “stop looking at those bloody websites”.

Her real flesh-and-blood GP, when she went to see her, was great – sensible and kind. She hate to think of anxious people going to those Hollywood-style doctors who dish out medication like sweets, because she wanted all the drugs she could get her hands on then – to soothe her fractious body and feel as little as possible. And there was a lot to numb: bone aches, pins and needles, shooting pains, dizziness, palpitations, muscle spasms, body jolts… Her shoulder muscles were so rock-hard with tension that shecouldn’t lie on either side.

Her GP agreed to prescribe a week’s worth of sleeping pills because not sleeping when she was used to nine hours was making her feel even more mad: wired, disordered and utterly wrung-out from all the adrenaline that was burning around her system like battery acid. That night, she took a single pill and dropped fathoms-deep into a dark, blissful slumber that went some way to calming her hair-trigger nervous system.

The deal with the sleeping pills and antidepressants she’d argued for and got, was that she also signed up for some cognitive behavioural therapy. Face-to-face sessions on the NHS came with a waiting list of four to six months, but if she was willing to try phone CBT, then she only had to wait a few weeks.

She’d been out in the storm and now she was watching it through the window

It was her counsellor, Sam, who gently suggested she give up the diary. “I think it might be making you obsess more,” she said. Another piece of “homework” was to try to stop asking for reassurance. It turned out to be just like any other craving: if she held off for a few minutes, the urge ebbed away. When she managed a whole day without asking her husband if she was walking oddly, she felt as though a fragment of her old, equable self had been restored to her. Mindfulnesswas helpful to her, too.

Her epiphany was understanding that anxiety wasn’t her, it was something happening to her. Instead of being consumed by it, she managed to hollow out a crucial inch of space between it and her. She’d been out in the storm and now she was watching it through the window. Instead of fighting the fear tooth and nail, shepractised a rueful roll of the eyes: “Oh, here’s that old devil anxiety again, up to his usual tricks.” And slowly, slowly, that’s what it became: a series of threadbare illusions she could see right through.

A year ago, she couldn’t wait for 2018. If she got there in one piece, it meant she’d been wrong about being ill. But she sees now that a bigger fear lurked beneath the hypochondria. What if her old sleep-loving, fast-walking self had abandoned her forever?What if she could no longer be a writer because her imagination had become a dangerous place to be?And yet, here sheis, writing about it in the past tense. She still occasionally feels the anxiety sidle up, clammy fingers fumbling for a way in, but she is wise to it now. Or wiser, anyway. she knows it’s time to go out in the fresh air, arrange to see people, turn off her laptop.

How to cope with anxiety?

Kate Riordan givessome practical pieces of advice.

Remember that anxiety itself can create a myriad of frightening physical symptoms. They’re horrible but they won’t hurt you.

If your GP tells you to pull yourself together, go to a different one.

Try not to feel guilty for being a nuisance or because other people really do have the illnesses you’re worried about. You can’t help it and you’re doing your best to put yourself back together.

Turn sabotaging thoughts into hard evidence by writing down everything that supports your self-diagnosis and everything that doesn’t. The second column forces you to apply some objective logic.

Avoid alcohol and caffeine. The jittery effects of too much coffee should make it an obvious no-no, but alcohol is tempting for its ability to loosen tense muscles. The hungover paranoia the next day is just not worth it, though.

Get out in the world. If you work from home, go to a co-working space at least once a week, just to be among other people.

Talk to the people you trust. It’s nothing to be ashamed of and they will want to be there for you. My family and friends were brilliant even when they didn’t know what to say.

Stay off the internet. Stay off the internet. Stay off the internet. Instead, buy Brian Dillon’s Tormented Hope: Nine Hypochondriac Lives.The introduction is like a balm for troubled nerves.