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Riding home from work one evening this week, something suddenly came to me. A moment of clarity, a rare thing these days! Triggers! What are they, and starts my anxious mind spinning. 

Whilst having a late night Netflix binge at the start of the week, I got watching "Your Mind, Explained". A series of shorts I have to recommend, especially for anyone trying to get to grips with any mental health issues.  One episode in particular resonated with me, surprise, surprise it was the one about Anxiety. In a couple of minutes, with a couple of simple diagrams, the process which causes anxiety to be an issue is explained brilliantly.

To recap, anxiety is a natural feeling, which is why everyone at some point refers to moments of anxiety. From remembering to doing things before leaving home, to triggers which help up make decisions in the blink of an eye (cross or don't cross the road etc), identifying danger, using our past experiences, or things we have learned growing up. Anxiety is a necessary process to keep us safe and functioning. 

The problem arises when that process is used irrationally, albeit unintentionally. There is a time and place for genuine anxiety. Most will know the unwanted kind which tends to pop up when you are in a new environment, or in a situation which could change things for you, exams etc. This is usually a short lived thing, but it triggers all sorts of physical actions. Upset stomach, dry mouth, you know, all those things which you really don't need right there and then. 

For others, these moments are all too frequent, and triggered by what most would deem the most insignificant of events. Getting on a crowded train or bus for example. For me, this can be complete hell, for most it is just an unwanted situation, but one you will get through with little more than a little reluctance. 

As I was taught by Netflix, this is Social Anxiety, and quite simply, it is the feeling of being judged and watched by everyone around you. Fearing that you are not worthy, not wanted, or just don't fit in. Simple eye contact can turn into a fast spinning whirlwind of panic. Of course, eye contact is something 95% of people avoid in confined spaces anyway, which is demonstrated by our love of phones, games consoles, and newspapers when using public transport. Not to mention my two favourites, headphones and sunglasses. 

Then there is the sort of anxiety I noticed on the ride home, and a far more common one for me. Situational anxiety. Have you ever had a confrontation with someone, and found yourself replaying it in your head? The confrontation lasted 30 seconds, a quick exchange of words, and it's over. But for you, in your mind, the next 20-30 mins are spent dwelling on it. Replaying it, rethinking what you could have, or should have said or done? I am guessing at that time period, as for me, it can last a few hours or a few days. I kid you not. Revisiting the situation, going through the whole thing from start to finish, examining what was said by the other party, exploring what could have been meant by every word. Wondering what that person is thinking or saying about you, how could you have handled it differently. Wondering if they are even bothered about it, or simply moved on. 

An exchange on social media last week is a great example of that. And for the few words that were said, their meaning was chewed over for a couple of days at least. With the intentions towards me,  of the person saying them mulled over too. 

Anyway, back to the ride... 

Riding along a quiet road, decent pace, I noticed a few young lads by the side of the road throwing conkers at each other. From about 50-100 metres away I could see what they were doing. Playful, laughing, no aggression.  However as I got closer I started thinking they might throw something at me as I passed. A lone cyclist, quiet road, I mean, why not, that's what kids do, right. 

Now I KNOW this isn't what all kids do, and I know it is completely irrational to assume something would happen, but that is how this mind works. So now I am getting tense. Remember this is all happening within 50-100 metres at about 20mph! Getting closer I can feel my grip on the bars increasing, shoulders tensing, waiting, preparing for something to be thrown my way. 

Will it hit me, will something bounce on the ground near me, will it make me fall off or wobble. Just the one or multiple, if they do, should I stop, should I just shout, maybe just ride on. If I stop or shout, what do I say, do I swear and become immediately aggressive, laugh it off, turn around and confront them. 

If I say something, what if they reply, would it turn physical, 3 onto 1, confronting is a bad idea, but why should they get away with it... And so on.
10 seconds later, I have passed them, stiff as a board, stressed as I can possibly be. Breathing out for the first time since seeing them.... NOTHING! They are still messing about, play fighting among each other, probably didn't even see me pass by. A few deep breaths, the cycle of anxiety broken this time around, and I carry on on my way home. 

Within a minute of this happening, my mind is busy, writing this blog entry in my head. It's a breakthrough! Finally I have a perfect example of how the anxious mind works, and how quickly normality can become hell for some people. Similar cycles pop up repeatedly for the remainder of the ride home, and every ride which has any kind of interaction or even just potential interaction with people along the way.

Now imagine that thought process, almost ever present, ready to leap out at you and start spinning. Any situation is a potential trigger, it just takes the wrong word, look, or environment for it all to start spinning. Shopping, travelling, driving, the list is endless. And the list is very different for different people. 

So finally after almost a week, here I am writing this, hoping that it once again strikes a chord with one or two people out there, and makes some sense of what they are feeling. Or in some cases, makes it easier for others to understand how some peoples minds works. 

Anxiety and avoidance go hand in hand for this exact reason. It is not the fear of the activity or event, not the lack of will to participate. But instead the fear of the unknown, unplanned, unforseen. Being unprepared for a situation which might arise, and the subsequent spiral of thoughts it will induce. 

Meeting a stranger for the first time. I can outwardly appear fine about it. My natural defences will help me fight through the situation with some dark humour, a little laughter and finding a way to speed my way through the encounter. Like a duck in water, on the surface, all seems calm, I am gliding along through the conversation or situation. But below the surface, all hell is breaking loose. Legs kicking like crazy, struggling to stay afloat and present.

While I may glide through a situation with apparent ease. By the end of it I am absolutely exhausted and drained. Needing some me time to recharge, regroup, before I can even contemplate being in a similar situation. The natural ability to fight through a situation can become a serious drain on the mind, and if put in a situation too many times, in too short a period of time, can lead to a complete shutdown. 

This is something I try and avoid putting myself through. So if ever you see me being quiet, doing my own thing, not being too chatty or getting into big conversations, that is more than likely all that is going on with me. The same I would guess would apply to some others too. 

To put it into context, when the average person has a physically exhausting day, it is nice to put your feet up in the evening. When the same person has a long week, it is nice for them to take the weekend to themselves to get their energy back. When you do that for too long without a good enough rest, you become weak, exhausted, and unable to function correctly..

Welcome to my mind.... It is exactly the same, you just can't see the soreness, or massage it away. It just takes time. 

Phew, speaking of exhaustion... For once, it is physical for me, and that is a nice feeling. Doesn't mean I will sleep any better, but it is nice to physically feel recovery once in a while.

Speaking of sleeping, before I go... YOGA!

I blogged about relaxation the other day, with James and his reflexology being one way to recharge. At the moment yoga is my thing. Spending time with yourself, relaxing the mind while working the body hard, all in the privacy of my home, and not moving an inch. The best part being, with no risk of encountering anyone in the process. 30 minutes of a near state of meditation is an amazing thing, and something I am really benefiting from. So if you get a chance, relax, be at one with yourself, and take some time out to relax your mind. 

A few deep breaths here, and I am done.... 

Namaste 

2

You may recall last year I did a few sessions with the Royal College of General Practitioners in Central London. Working as an "expert patient", I assist with role play scenarios, giving the students the chance to interview, assess and mock treat me.  For anyone not in the know, I have a long history of anxiety and depression, and was asked by my local GP if I would be interested in helping with teach the future generation of GP's better understand the conditions by doing these sessions. 

So, after last year, I thought it was all over with, and heard that there would be no more session. However to my delight and surprise I received an invite a couple of months back, to do a session in September 2019. Needless to say, I booked the time off work, and last Friday I went along. 

I should say before I go on, that these days in the past have proven to be quite mentally exhausting. With the travelling at peak times, to Central London, then doing 8-10 sittings with students, re-enacting the presentation of the condition, it all starts to become a little too real by the end of it all. So facing rush-hour on the way back home, can sometimes be almost a step too far. 

With this in mind, for this session I decided to switch things up a bit. Rather than presenting with anxiety, which is quite a high energy feeling, I decided to go with depression this time. Strange as it sounds, and in no way saying it is easier to cope with, the energy needed to present as depressed is far lower, so far less taxing on the mind. With 10 sessions to do on this day, it was the right decision. It probably worked out better for the students too, as this was their first few weeks as Year 3 students, and many have not even touched on mental health. Win win you might call it. 

Seeing the difference in reactions between the groups of students, presented with something that has no physical manifestation to examine was quite interesting, and secretly a little amusing. Their faces as the presentation started showed a fresh thought process was  underway. Each time I presented I would switch up the language used, the prompts given, and the assistance with the flow of the situation. I was delighted to see that none of the students felt they were entirely comfortable or confident in running through the whole scenario without the assistance of their colleagues and tutor who were all in the room. Not to proud to ask for a time out and see what others thought, very refreshing. 

To help matters along, my own state of mind was good this time. In the past I have wound myself up about the whole event, and started the day on a downward spiral, and finishing the day a lot lower than I started. On this day, due to good self management, finding my own time and space, and a smooth running session, all was well. For the first time, I didn't stay in for lunch, but instead opted for the fresh air and scenery of Tottenham Court Road. Not wanting to get caught out with a low battery on the phone, I had taken a portable power bank with me. Complete with the WRONG USB lead! £15 for a USB type C lead was somewhat upsetting, but needs must, and it kept me sane, so money well spent... I guess!

By the end of the day, I was fresh as a daisy, and ready to do battle with the commuters on the way home. Luckily for me, we were out a little before the main event of Friday rush hour in London begun, so by the time I got to Highbury and Islington for my train home, a seat awaited me. It was nice to be on a train at the start of a journey for once, and get a seat, while seeing others stand as they got on later into the journey, boarding at stations I have joined at in the past while commuting.

While at the RCGP, I connected with a few new people, one of which who co-ordinates other similar role play days for students etc, so I am hoping to hear back from her, and see if I can offer any help on other matters in due course.  I have been quite slack in my drive to help others fighting mental health issues, for numerous reasons, none of which are particularly astounding or worthy, so it feels good to have done another one of these sessions, to at least do a little bit to help. 

Til next time... Take care all. 

 

The clock is ticking down on my next session at the Royal College of General Practitioners on Friday, and I have to say the suspense and stress is building. It will be my second rush-hour trip to Central London in the week, which never bodes well with me even at the best of times.

The first session I did was a real eye opener, and while it was fun, it was quite draining too. That was starting from a nice high spot in my mental cycle. This time around I am somewhat lower than I was before, so it will be interesting to see what impact that has. Whatever the cost to me, the important thing is being able to help the students understand the presentation of anxiety and depression.

On the plus side, the whole day is a known thing now, it is not full of surprises and uncertainty, so that will help enormously I am sure. I will just get there nice and early again, missing the majority of the morning rush, and have a little wind down walk before getting started.

I will have to put some thought into the scenario for this time too. I am quite happy with the original, but it is good to mix things up a bit. As much for my sanity as theirs. Really is quite draining mentally, recalling events from your life, and playing them out in a scenario over and over for a day. By the end of the day you are mentally exhausted. I kind of envy the actors who also participate in these events. Surely it is much easier to pretend to suffer with something you don't already struggle with. Maybe I am wrong, who knows.

Either way, as I say, the main thing is the students come away from it all with a better understanding. I really do want to have more time to answer questions, and help in any way I can. With so much work being done to raise awareness of mental health issues, it is only right to make sure it can be identified and caught nice and early, so help can be given before the issue worsens for the patient.

Which reminds me actually, I have got to read back through my emails, and do a submission to the BMJ as suggested by Niki. It may come to nothing, it may be the beginnings of being able to do something more positive, time will tell. Not like I don't like writing now is it!

Right, better get my head in gear and thinking cap on, ready for the (next) big day.

Thanks for reading.

PS, students, you can now find all my MH writings on my new website www.snazy.co.uk (if you are not already reading this entry there)