Fight or Flight Response: The Paradox of Anxiety Recovery

Pic: pd breen

My feet tap insubstantial, fleeting, on the narrow city pavement. Past closed stores with quirky displays shrouded by dark; car park entrances emitting the endless chug and smell of vehicles; the plaques of narrow, pretentious galleries; and the sleek miniature lobbies of boutique hotels. The human scale of this laneway is comforting in the early evening but my aloneness beats furious in my chest.

I am small but carry with me a scrambling, sabotaging energy. It’s a boiling liquid that threatens to bubble and spill over the situation I’ve so meticulously set up – an online date.

It is this anticipatory anxiety that I remember so well from my dating days. Those walks to the groovy little cubbyhole city bars were far easier to endure than the nauseous, low-level misery of the tram or train ride into the city, as once on foot my adrenalin had a limited outlet in the forward momentum of my limbs. (Trains were worse for some reason, perhaps the larger scale of the stations compared with the more human streetscape of the tram.)

For years I would fight this anxiety, through breathing exercises and ‘self-talk’. We’ve all heard of the fight or flight syndrome. Once you’ve used your will to deny the urge to run, there seems no choice but to do battle with the remains of that urge, to use every tool at your disposal to calm yourself down.

But I slowly realised that trying to damp down my fear was just increasing it. Fear denied has a way of making itself known. Why not try to harness this energy instead of fighting it? Why not run into the situation instead of away from it?

This is hardly a new idea. Back in 1962, in the quaintly titled Self Help for Your Nerves, Dr Claire Weekes used the terms ‘floating’ and ‘masterly inactivity’ to describe her remedy for anxiety, explaining it this way:

it means to give up the struggle, to stop holding tensely onto yourself trying to control your fear, trying to ‘do something about it’ ... It means to by-pass the struggle, to go around, not over the mountain ...

More recently, experienced sufferers and therapists alike urge a general acceptance of the brute fact of anxiety before we can hope to lessen it. On the HealthyPlace.com site, Tanya Peterson writes:

When we fight against anxiety, we inadvertently promote the belief that we’ll feel better, be better, once we’ve conquered anxiety – but not before. This puts pressure on us, makes us feel worse about ourselves, and it serves to increase anxiety ... Accepting ourselves for who we are, anxiety (or other mental illness) and all, is crucial for well-being.

When we react to anxiety with further anxiety, a vicious cycle is created. If we can stay with the initial anxiety and accept it as part of the totality of experience, it becomes easier to manage.

Or does it? In fact, there’s a very big caveat to this. If the anxiety is so overwhelming that you can’t breathe, speak or walk, the idea of going with it in the way I’ve suggested above is a bit insulting. The anxiety needs to be brought down to a level where it is manageable first. And this is a gradual process, not something that can be done in a few minutes, hours or even days. It’s the stuff of daily work and practice, and often outside help in the form of therapy.

Reducing anxiety is a long-term task

Bringing the anxiety down to a manageable level could require anything from medication and a course of CBT to simple breathing exercises in front of the tele. Mindfulness in the form of meditation or mindfulness exercises is a great way of doing this, because it fosters the very acceptance that anxiety sufferers struggle with.  or And unless you’ve been floating around in orbit for the last twenty years, you’ll know that exercise can also be helpful.

For years I had a very bad problem talking with clients on the phone. It was so severe that the kinds of advice you get on the internet for treating panic attacks were laughably useless. The irrational terror was so extreme I wanted to scream. Anything I could do in the situation itself was impossible, because the raw, visceral fear that eventually even the sound of the phone ringing provoked was just too high. Sometimes the only sensible thing to do was not answer the phone at all.

In the end, drugs were the only thing that helped. They gradually gave me a level of confidence that has remained to some extent even though I’ve now stopped taking them. (Which is not to say it’s fun, or easy – it’s just do-able now, most of the time anyway.)

Some basic CBT has also helped. I understand better now how sensitised anxious people become to our reactions. We become hyperaware of every bodily reaction and thought, and frantically try to interpret them. We react as if every sign of anxiety is inherently dangerous. This happens so quickly at the neuronal level it’s impossible to stop, but just being aware of the process has helped me become a bit more detached.

There’s another reason why riding with the anxiety isn’t as easy as it sounds. Often part of the anxiety itself is a fear of what others think, and the imperative to hide our discomfort sometimes seems to be a matter of life and death. I get annoyed at how scared I still get, in social situations, of looking scared, and the high standard I demand for my level of confidence. But at least I don’t respond to these expectations like I used to – in the past, I would either put on a show of extroversion which was painfully transparent anyway, or withdraw further into myself, horrified, if I could not hide my fear.

All this is to say that the very basis of recovery for me is that it is always provisional, always incomplete. (I don’t want to suggest that I’ve conquered my anxiety – there are plenty of situations that I still avoid, although I have made progress.) Recovery involves a major contradiction – a fundamental acceptance of the impost of anxiety, and a willingness to harness its energy, along with a long-term plan for reducing it. Embracing this contradiction is a daily challenge.

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Heatwave Hell in Melbourne - And Afterwards

Pic: Koshy Koshy

Last week, Melbourne endured four days of temperatures over 40 degrees Celsius, including three days over 42, and two days at virtually 44 degrees.

Adelaide fared even worse: 42.1 on Monday, 45.1 on Tuesday, 43.7 on Wednesday and 44.2 on the Thursday. On that day Roseworthy, north of Adelaide, was the hottest place in South Australia, with the maximum temperature reaching 46.4.

I wasn’t expecting to write a blog entry primly entitled ‘How I felt after the heat wave’, especially as I’ve just had a whinge about the difficulties of being green and anxious. But then a couple of friends talked about being depressed and tired once the weather had changed so I decided to make a few speculations about it.

It was a week when things got a bit too sci-fi for my liking. The level of heat was something I felt I hadn’t experienced before, but apparently things got this bad back in February 2009, culminating in Black Saturday, when the temperature reached 46.4 in Melbourne. (As you can see these extremes are turning me into a climate nerd!)

It seems there is something we lack when we think and talk about temperature. We don’t have the words to describe the spiritual and emotional effects of extended heat. We know that the very young and the elderly die in heatwaves, as do numerous small animals – bats, possums, birds – and in the worst hours we fancy we experience something of what they must have gone through, but we can’t possibly.

Nor are we able, as a society, to communally memorialise the heat. We commemorate the bushfires of course, and the terrible loss of life and home, as we should. But somehow the communal bruising of extended extreme weather doesn’t get memorialised.

Perhaps we should have some kind of public art work that can be added to over the years, recording the highest temperatures for each summer with accompanying statistics and stories. Some of those stories would be funny but some of them would be tragic – losing grandparents and young babies to heat stroke for example. More than double the number of people died of the heat in the week before Black Saturday (374) than died in the fires (173).

Maybe the lack of a vocabulary for this type of stress is why some people try to go on as if nothing has changed – there were still joggers on my street early in the the mornings of the hottest days. Routines are comforting touchstones in uncertain times, but it's important to adapt and bend. A friend of mine rode his bike to the local shopping centre for breakfast, but he rode slowly, and found it less tiring than walking would have been.  

Suffering the heat

With extreme heat and cold, it’s not, in a first world country, just about the temperature. It’s what battling the temperature, and the practical effects of the extreme weather, takes out of you physically and emotionally.

If your body is overheated for a long period of time, it’s a low-key, extended suffering. It’s exhausting in a way that is difficult to describe. I imagine that battling with extreme cold has similarly debilitating effects.

But why the mental effects, the lingering ennui and depression? Although there is a robust public discussion about the heat, with plenty of warnings and advice about how to cope with it, there is no advice on how to cope with the fears it engenders. Perhaps being very hot for a long period provokes ancient, preverbal terrors. There’s also the strange sense of anticlimax that we experience when the temperature drops suddenly, and we are expected to go back to normal straight away.

Yet it’s fundamentally wrong for the body to be this overheated and it feels that way. It took me three days to get over the physical effects of the heat. In those days I paced myself well and got everything done that I needed to. And there were small breaks, too, during the ordeal, like the Wednesday morning at quarter to six when I opened the front door and the morning air was cool and welcoming so I walked a couple of blocks and it was the most beautiful reprieve. To feel alive in the world and able to move freely without being overheated.

But by the last day I’d had it. I escaped the house at about 3, drove myself to Camberwell library, picturing the waiting beanbags, which no one usually uses – imagining myself on one of them. And when I got there, sure enough there were a couple of empty beanbags. On one side of me, a young man had fallen asleep. On the other, a young couple sat close and chatting quietly. An almost full bottle of spring water on the ground beside them. Forgot. The. Water. Damn. At Ashburton library two days earlier, the staff had put out a jug of water and plastic cups – a great idea. Camberwell library hadn’t done that so the utter joy of the beanbag was marred a bit by thirst, but it was manageable.

Anyway, the end of the ordeal was in sight, and came earlier than expected. On the way home from the library the temperature started to drop – by about 10 degrees Celsius in an hour. That was enough to provide immediate relief and then the full cooling came a few hours later.

It was a sobering glimpse into a future dominated by catastrophic climate change. When I was growing up, it was a big deal (and kind of exciting) for the temperature to reach 100 degreees Fahrenheit, which is ‘only’ 37.7 degrees Celsius. A few months ago the Bureau of Meteorology made an announcement – that the climate of Australia had changed, and that there was no point in looking at climate records to forecast the future. I try to imagine what would have happened if those four days had stretched to five, or six, or more.

In the future, will there be a number of days every year when certain places will be simply uninhabitable? I imagine there could be evacuations. Or instead will there be public places set aside with airconditioning for people to huddle in?

When it came to bushfires – which usually get worse when the cold change hits because the winds fan the flames – my state got off lightly. There was no repeat of Black Saturday. This was a huge relief, although in Victoria alone, the Grampians blaze burned for 52,000 hectares, one person was killed, about 4000 sheep lost their lives, and 27 houses and about 60 other buildings were lost. Terrible, but it could have been so much worse.

So – a huge impost on the body and spirit that probably translates into a huge dive in productivity across the state. I feel as if I’ve gone through some ritual ordeal. And yet in twenty years' time I won’t be boasting to my great-nieces and nephews about how I lived through the Great Heatwave of 2014 – what they will have to put up with in future heatwaves will make last week look like a pleasant spring interlude!

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Eco-Anxiety: The Challenge of Being Green and Anxious

Pic: Shehal Joseph

It’s going to be 43 degrees Celsius in Melbourne today – a ‘scorcher’. I’m at my PC, noticing how rapidly my hair is drying and trying to figure out how soon I can dash off to the shops for supplies before the air starts to bake. The milky blue of the morning sky is threatening somehow. It seems like a good time to complete my blog entry on the challenges of having anxiety, or any sort of mental illness, and being eco-friendly or simply aware of the issues, ie climate change.

There is a vague menace in heat waves for me that makes the difficulty in sleeping, especially early on in the heatwave, almost certainly psychological.

It’s not just the magic figure of 43 that is stressing me out today, but the fact that it’s the second day of what will be a five-day heat marathon, with four days of temperatures 39 and above. I picture myself by the end of it a frazzled, dried up twig, mentally scarred for life by my ordeal.

For the fact is once my double brick house starts to cook, if I don’t take adequate cooling measures I quickly go into an odd dissociated state of mind that makes me incapable of taking positive action. The trouble is that this state creeps up on me before I have time to prepare, so I have planned for it this time, and will probably end up in the local library by early afternoon. Later in the week, once the sun has started to set, you might find me wading into the dirty water of Elwood Beach, oblivious to the frenzied chirping and splashing of the crowds who actually think it is FUN to cool down on a hot day and not just grim necessity.

Heatwaves are made more likely by climate change, which leads me to the original topic of this blog entry – it’s not easy being green, and it’s especially not easy if you have any type of mental illness.

I need to acknowledge from the get-go that poor people – and many of us with mental illness are poor – produce very low carbon emissions anyway.

One thing that annoys me about this is that we don’t get social credit for our small carbon footprint. No-one congratulates me on not having replaced my 1997 Starlet with a new car in the last few years but they would probably pat me on the back if I bought a new Prius. Yet I am saving more emissions by not buying a new car, because the emissions involved in producing the Prius would probably be higher than the extra emissions from continuing to drive my little four-cylinder. Similarly, I get no kudos for not having an air conditioner to help me through the heatwave (although I do get plenty of sympathy!) I know someone on disability who doesn’t heat his house in winter, and he’s not earning any awards for Best Green Citizen of the Year. Of course, many of us don’t have cars (that may also be a conscious choice).

But what about voluntary green actions? These often involve extra effort, such as shopping at an organic grocery store that may be further away than the local supermarket. They also require additional planning, eg having enough plastic bags in stock, and remembering to take them with you when you go out. And often (but not always) buying green products is more expensive than the conventional option. As well, with automated checkouts, the anonymity of supermarket shopping can seem so much easier.

If you do have a car, it’s tempting to drive to a social event rather than taking public transport because you don’t have the stress of waiting for the train or tram, or battling your paranoia about the other passengers and any other worries common to anxiety sufferers; then there’s the quick get-away that a car makes possible if the socialising gets too much.

The irony is that people with mental illness can struggle just doing normal things, while conscious green actions require a kind of super-normality.

But being green is also important for many people, whether or not they have mental illness. This is because meaning and purpose are vital to wellbeing, and making an effort to be eco-friendly can provide some relief from the feelings of guilt, fear and anger that the ecological state of the world can ignite.

However, I have no illusions about the limits of said greenness in the scheme of things. In a free market economy where both major parties in Australia are centre right, the idea of doing the right thing – and being viewed by various industries as a niche market for your trouble – can be demoralising rather than empowering. The sense of helplessness this situation engenders can lead to depression, so it’s tempting to ignore the whole issue.

It’s true that nothing I do personally, in my day-to-day practical life, is going to affect climate change significantly. That idea is itself a form of greenwash, brought to you courtesy of the fossil fuel industry and big finance, which between them are investing in enough coal mining and exporting to send the planet to buggery in a few hundred years.

It is also a depressing fact that wholefood stores are generally just as profit focused as the evil supermarkets. It is highly likely that your local organic store is not using green power, for instance, and if it the company is growing, its carbon emissions may actually be increasing.

And buying a green product from a large company that mostly manufactures non-eco-friendly products is tokenistic at best. I bought a diary this year that was carbon neutral, but the company as a whole is anything but, and produces plenty of products that aren’t carbon friendly at all. If you’re going to buy green products, I’d suggest buying them from a company that is trying to do the right thing with all its products, not just one or two that have been created for marketing purposes. The book Greenwash by Guy Pearse has enlightened me on this distinction; it has all the dirt on who’s really doing the right thing in the corporate world, and who’s not.

Yet I don’t see my tokenistic green actions as a complete waste of time, money and energy. I see them as contributing to a more eco-friendly culture – one that will hopefully grow stronger in the long term, and is waiting in the wings for when climate change has become such an emergency that even the most cynical powerbrokers are forced to act.

Also, when I buy from wholefood stores I am at least protecting diversity (Australia has one of the most concentrated supermarket markets in the world, dominated by the duopoly of Woolworths and Coles) and supporting small suppliers. I’m also planning to put my money where my mouth is, by moving my term deposits entirely away from the big banks at the end of the month. This will not only increase my support for local credit unions but it will give me a lovely, revenge-y feeling – I can’t wait to tell the NAB that my money’s no longer going to support their dirty investments.

It’s also the case that being slightly greener can sometimes save money, for example buying from op shops or thrift stores. This retail model is flawed too, I know, because it relies on a certain amount of consumers to buy new products to donate. Yet there is so much good in op shops – the volunteers and what they gain and give, the programs that the profits go to support, and the idea of re-using someone’s discarded junk instead of having it consigned to landfill. A few op shops have been set up to include an element of repair and restoration, and it would be great if this model was adopted more broadly.

Then there’s the wider recycling movement, which is literally redesigning the culture of consumption – fix or repurpose things if possible; if you do create something new, build it to last; and borrow, share and rent rather than buy.

Well, my hair is now dry so I am dashing off to the shops – sadly, it must be admitted, in my car. The irony is that it’s even harder being green during a climate-induced heatwave, especially if you’re heat-phobic. Which leads to my conclusion, that I now take small green actions when I can, while voting for the Greens, the party that wants to take big action. And when I can’t be green because of mental issues or finances, there’s no point in bashing myself up about it.

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Silver Linings Not All They're Cracked Up to Be

I finally got around to watching the comedy-drama Silver Linings Playbook the other night. The film’s hero, Patrick Solitano, is a sufferer of bipolar whose problems stem from his initial refusal to take medication. I’m not exactly the first person to watch it through the lens of mental illness, and to be judging it poorly on its portrayal. Yet it’s been critically acclaimed and has received a huge number of accolades, won Jennifer Lawrence an Oscar for Best Actress and and has a 92 per cent critics rating on Rotten Tomatoes.

Actually, the parts of the film that did deal with mental illness weren’t uniformly terrible. If the humour is done in the right way (ie laughing with, not laughing at) the travails of trying different drugs and putting up with the side effects until the right drug is found can have a funny side. The ability to laugh at difficulties is an essential tool for getting through any chronic illness, and also a way of educating non-sufferers.

However, while Patrick and his potential romantic partner, Tiffany, initially toss drug names and their side effects at each other in a humorous way, once Patrick is resigned to taking his meds the film as a whole simply forgets that both of them are on drugs. There are no more side effects, no having to get off one drug and try another, just two people trying to be human. Which is fair enough, but the loss of drugs from the narrative, which implied that both characters were on stable regimes that enabled them to enjoy complete sanity, made me wonder whether the film had been funded by a drug company.

But I don’t want to give the impression that this was the sole thing wrong with Silver Linings. I wish. No, it was the script and the characters. There is a certain kind of Hollywood humour that consists of people starting off on a high register of emotional conflict, and staying there. Part of the humour in these films consists of people being rude and abusive to each other. This is the style of Judd Apatow, who directed and cowrote films like The 40-Year-Old Virgin and Knocked Up. It has been hugely successful, so much so that other writers have adopted it (traces of this style can also be found in The United States of Tara).

This, sadly, is the style that dominates Silver Linings Playbook, courtesy of writer-director David O. Russell. Robbie Collin of the Daily Telegraph said there was ‘a tiring fruitlessness to the mayhem’ of the film, and I couldn’t agree more.

I didn’t entirely dislike the characters – there is something brooding and interesting behind Jennifer Lawrence’s Tiffany and she’s such a good actress she gives every character resonance – but the script makes her a lonely bad girl in a way that is cliched and boring.

But no movie experience is a complete waste of time. It was actually quite timely – well, spookily timely – sitting there and watching the hero deny his need for meds. I have just been going through the same thing – coming off Luvox because it had stopped working, trying to exercise to compensate. Then my back gave in on me and my mean sister told me that she had noticed I wouldn’t look at her.

So I did some googling and found an SSRI called Lexapro that seems to have fewer side effects than other SSRIs. I am seeing my doctor and hopefully getting a prescription when the surgery gets back from holidays next week. (Art imitates life, or is it the other way around?) I wish I could be confident of ending up as functional as Patrick is by the end of the film, but I fear that my experience with Luvox will be repeated with Lexapro and I’ll have to switch again. Watch this space ...

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