JOG ON JOURNAL

A Practical Guide to Getting Up and Running

Bella Mackie

Copyright

William Collins

An imprint of HarperCollinsPublishers

1 London Bridge Street

London SE1 9GF

www.WilliamCollinsBooks.com

This eBook first published in Great Britain by William Collins in 2019

Copyright © Isabella Mackie 2019

Illustrations by Anna Morrison

Isabella Mackie asserts the moral right to be identified as the author of this work

A catalogue record for this book is available from the British Library

Information on previously published material appears here.

All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, down-loaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins

Source ISBN: 9780008370039

Ebook Edition © November 2019 ISBN: 9780008370046

Version: 2021-01-21

Dedication

For everyone who got in contact with me after Jog On came out and trusted me with their mental health stories – this journal is for you

A NOTE FOR EBOOK READERS:

You will need a blank notebook and a pen to get the most out of the Jog On Journal.

CONTENTS

COVER

TITLE PAGE

COPYRIGHT

DEDICATION

A NOTE FOR EBOOK READERS

INTRODUCTION

SECTION ONE: MENTAL HEALTH

1 GETTING HELP

2 THE ANXIETY UMBRELLA

3 FIGHT-OR-FLIGHT

4 PANIC ATTACKS

5 PHYSICAL SYMPTOMS

6 INTRUSIVE THOUGHTS

7 BAD COPING SKILLS

8 GOOD COPING SKILLS

SECTION TWO: RUNNNNNNINNGGGGG!

1 GETTING STARTED

2 GOALS

3 CONFIDENCE

4 ANXIETY AND EXERTION

5 PREPPING

6 LET’S GO RUNNING

7 YOU DID IT!

8 PANIC VS. PUFF

9 GETTING TO KNOW YOUR BODY

10 HABIT

11 NOW WHAT?

12 THE DIFFICULT SECOND WEEK

13 DIFFERENT WAYS OF RUNNING

14 WHAT TO LISTEN TO

15 ON THE WAY TO 5K

16 BOREDOM

17 LONGER-TERM MOTIVATION

18 WHAT COMES NEXT

19 SCARING YOURSELF ON PURPOSE

20 PITFALLS

21 BEING PROUD

FOOTNOTE

END NOTES

RESOURCES

ACKNOWLEDGEMENTS

ABOUT THE AUTHOR

ALSO BY BELLA MACKIE

ABOUT THE PUBLISHER

INTRODUCTION

Hello. Welcome to my diary – where I’ll be writing down my innermost secrets and talking about boys I fancy.

Oh no, wait, this isn’t that kind of journal. This is a journal for YOU. And while you’re welcome to write about boys (or girls) as much as you want in it, I’ll be focusing more on mental health and how running might be able to help you. Some of you will know that I wrote a book called Jog On – some of you might have read it. It’s OK if you haven’t (but, y’know, feel free to pick up a copy, my dog needs to be kept in bones) because this journal will hopefully be a space for those who read the book AND for those who didn’t but still would like to know more about the link between mental health and going for a jog.

Jog On is a book I wrote about my experience with anxiety – a horrible condition which makes life feel incredibly scary and can leave you feeling unable to cope with the everyday. I wrote it to show other sufferers that they are not alone, and to promote jogging as one tool to help with such issues. For me, running made me feel stronger than I ever had, it gave me back some independence (which mental illness often robs from you) and it showed me how strong the link between my brain and my body is – a link I think we often ignore in the modern world.

In five years of running, I’ve stopped having the panic attacks which paralysed me. I’ve been able to go to places that my anxious brain would’ve prevented me from visiting. I’ve taken on challenges that I would’ve hidden away, and I’ve graduated from a life half lived to one that feels full and exciting – not tinged with fear and endless panic. I still have moments of anxiety and low mood – after all, running is not a cure-all (nothing is) – but I’m mostly able to dig myself out of these moments now, and for that, I credit my daily jogs. I can draw a direct line from that first short run I took to where I am now, and I’m far from the only person to feel this way. As the legendary runner and author George Sheehan once said: ‘The obsession with running is really an obsession with the potential for more and more life.’[1]

The response to Jog On was bigger and more emotional than I could ever have dreamed. I wrote it honestly and openly, hoping that it might help a few people and make my family understand my brain a bit better. But it ended up being a best-seller, and I’ve had thousands of messages from people who read it, either telling me about their own battles with mental health or asking for tips about how to get into running. It made me realise that one person being really honest about their mental health can produce a knock-on effect. Being blunt about my weirdest thoughts and scariest moments seemed to help other people open up and talk about theirs. It’s a hard thing to do – especially when you feel as though other people will judge you or recoil. But it’s really the only way to shrug off the long-held stigma surrounding mental illness and – more importantly – it’s the only way to help yourself. It’s nice being alive at a time in history when we’re dismantling the traditional stereotypes about mental health, but it’s even nicer being able to feel like you can tell an employer, a loved one or a doctor about what you’re going through without fear of mockery or anger.

Despite knowing how important it is to open up to others when we’re feeling low or worried, sometimes it’s still hard to actually do it. I told parts of my story to different people for years – shading in bits and holding back certain details depending on what I felt the other person could handle. And sometimes you just want to have a place to talk about this stuff without having to manage another person’s expectations. So this journal will be an honest place to do that. A space to learn a bit more about mental health, somewhere to start or further your running journey, a place to reassess what you want from running and, most importantly, a home for all the thoughts you want to get out.

There’s a good reason that people have kept diaries for centuries. Though he was far from the first, Samuel Pepys is probably the most well-known diarist.[2] He jotted his thoughts down for ten years between 1660 and 1669 and wrote over a million words – many about his mistresses. (Maybe it assuaged a guilty conscience. If it did, he hid it well.) Cognitive behavioural therapy also encourages the subject to write down their thoughts – a form of brain homework if you like. More on that later.

Pepys might not have made the link between his obsessive record keeping and his own mental health but modern research has. Brain scans have shown a change in the amygdala – the part of the brain responsible for processing our emotions – when we put pen to paper about our worries.[3] Studies have even shown us that writing down our negative thoughts and emotions might help our physical health – prompting fewer trips to the GP and leading to less time off work.[4]

Think of it like a Pensieve (if you’ve not read Harry Potter then firstly, wow, and also, a Pensieve is a stone dish you can put your memories in when you feel like your mind is overflowing with them) – somewhere to offload the stuff that’s worrying you and look at it from a place slightly removed.[5] A thought whirring around your mind gets gloopy and collects detritus as it goes round and round, making it hard to rationalise. But by looking at the thought summed up on paper, we’re able to see it more clearly and – hopefully – let go of the anxiety around it.

I received so many questions from readers when Jog On came out, questions about running, about panic attacks, about how to motivate yourself when it feels impossible, about the best running trainers and even about what ice cream I eat after a jog. So many of these queries will be addressed in the coming chapters – because there’s nothing better than a gaggle of avid readers to tell you what’s important and what you’ve missed. It’s been like free market research and I’m so glad of it. Lastly, I am not in the business of motivational quotes or cheery platitudes. I still struggle from time to time – I don’t live amongst glitter and rainbows.

So this might be a touch more cynical than some journals – but if that’s your thing, then welcome to your running and mental health journal.

One last note – since I’ve tried to tie together advice on running and discussion of mental health, I’ve decided that this journal will alternate between the two. Obviously the sections will merge in lots of places, but I think it’s helpful to concentrate solely on mental health in some places – after all, what’s more important? And equally, when we’re talking about running shoes or how to prevent injury, I’d like you to be focusing on that without getting bogged down in symptoms about anxiety. But you can’t understand why running helps boost mood unless we also look at the times when your mental health is suffering. Also, feel free to read just the running parts or just the mental stuff if that’s what you want to do. My mum read only the peace bits of War and Peace. She is excellent.

MENTAL HEALTH

PART ONE

GETTING HELP

This journal talks a lot about mental health – which covers a HUGE range of issues. I’m going to mainly talk about anxiety because that’s my wheelhouse (I would smash Mastermind if excessive worry was my specialist subject), but that itself is an umbrella term. And mental-health issues often overlap, so I think that you’ll recognise much of this stuff whether you suffer from OCD, social anxiety or panic attacks. All of us afflicted with anxiety speak the same language. And that’s true of runners too. And anxious runners are even more in sync with each other. When I do talks, there’s usually a book signing at the end, and I usually ask people whether they’re anxious, a runner or an anxious runner. Because those are my people. They’re not coming to see me because they love poetry and fine dining. I assume you’re here because you’re also in one of those three tribes (you can like poetry and food too, of course).

First things first. If you’re struggling with your brain and haven’t sought help – go and speak to your GP. This book – NO book – can do more for you than talking to a professional who can help you with diagnosis, therapy, medication and support. It’s hard. A 2004 study by the World Health Organization (WHO) found that between 30 and 80 per cent of people with a mental-health issue don’t seek treatment – and the reasons why vary.[1] If you’ve not sought any help, circle the explanation(s) that fit this best:

Shame

A feeling that you’re not worth help

A sense that nothing can make you feel better

Not knowing where to go

Not feeling confident that your story will be confidential

A worry that you can’t access or afford treatment

A feeling that you won’t be taken seriously

A bad experience with a GP or other medical professional

You want to handle it alone

If your reason isn’t listed, write it in the space below.

I understand all of these concerns, by the way – I’ve felt nearly all of them myself. But here’s the thing: mental illness will not go away on its own, and the longer it continues, the harder it can be to treat. We know that many mental-health conditions manifest in adolescence, and calcify over time. If you seek help you could:

• Lower your risk of further incidents down the road.

• Reduce career and life disruption.

• Remove the need for longer treatment or hospitalisation.

• Gain the tools to help you cope with future stressful periods.

• Learn how to talk to loved ones about how you’re feeling.

If that all seems a bit clinical, what if I told you that getting help might make you feel BETTER, see glimmers of hope and no longer have to shoulder the burden of worry and panic and sadness?

Write down what you’d most like to achieve with some help – for me it was reducing panic attacks and loosening the grip that intrusive ‘what if’ thoughts had on my brain. Yours might be feeling happier, or reducing obsessions, or being able to go on planes.

Seeking professional help for the first time can feel daunting and as though you’re not in control. So it might be helpful to keep one or two things in mind. If you’re nervous about going to your GP, consider taking a friend to hold your hand and, most importantly, remember that doctors see people who are struggling mentally EVERY DAY. One in four people are said to experience some mental-health problems in their lifetime, and your doctor is on the frontline of initial treatment. The other thing to say is that if you don’t feel satisfied with the help you’re offered then ask for a different doctor or enquire about other services on offer. Look, it happens, some doctors aren’t fully au fait with mental-health problems, just like some employers aren’t and some mothers. But their numbers are shrinking and you have every right to sensitive and humane treatment. So if it’s not working for you, don’t lose heart, just try a different tack.

That probably sounded a bit bossy. But it’s important to speak to a professional about mental health first of all. There are so many people out there pushing wacky cures for anxiety and depression, and they normally do absolutely nothing to help people. But desperate people are prone to try anything – I once bought a VERY expensive set of vitamins that online testimonials promised would cure my anxiety. They didn’t even make my hair shiny.

PART TWO

THE ANXIETY UMBRELLA

Anxiety is a mother-fucker. It’s not mild niggles about a work task or a slight panic about the iron having been left on. It’s all-encompassing – a worry about a work task multiplies, mushrooms and becomes all you can focus on. A vague unease in crowds can end up in panic attacks that feel like you’re going to die. A passing thought about germs can end up in an obsession about cleaning. Your brain is on high alert for danger all the time. This is not the same as fear, which is in response to an obvious threat. Anxiety is about future and imagined dangers – most of them enlarged, unrealistic and twisted beyond recognition. Everyone has felt anxious at some point in their lives, but most people don’t become consumed by it. Lucky them.

I’m going to give you some personal examples because sharing is caring and I always feel relieved when I hear about other people’s experiences (it makes me feel less alone).

Here are two small examples of my anxious brain – the scale of these episodes differs greatly but both were incredibly distressing:

I am on holiday and I walk across some grass. I feel a sting on the sole of my foot and look down to see a wasp. Immediately, I panic. My brain flies straight to the certain knowledge that I will develop anaphylactic shock from this sting. I can’t breathe – it’s happening fast. I run to the house, and I can feel my lips swelling up, my lungs constricting. I’m clawing at my throat, desperate to get some air in but I can’t and we’re miles away from help. I signal to my family – frantically trying to make them understand that I’m no longer able to breathe as they try and calm me down. I lie down on the bed as my mum strokes my hair and I wait for death. But ten minutes later I am forced to concede that what I thought was an allergic reaction was a panic attack brought on by my powerfully anxious brain. I’m so wiped out by it, and so embarrassed and sad that this is where my mind goes, that I have to have a two-hour nap. That fear of anaphylaxis stayed with me for a further two years. I wasn’t twelve by the way, I was twenty-nine.

Can you think of a time when your anxiety went from zero to a hundred in seconds? It’s good to get it out – I can look back and laugh about it (a bit) now and the more I tell people these stories, the less powerful they seem. No, the less powerful they ARE.

Right, scenario number two:

I am at college and the bus journey was a bit weird, I felt hot and dizzy and things felt ‘off’. When I get to the building, I feel ill and scared and everything looks weird. I panic – but not about anything in particular and that feels even scarier. I make my excuses and leave to go home. That night my head spins as I try to get my brain around why I felt so strange. I tie myself in knots as I explore stranger and more irrational paths trying to make sense of what I’m experiencing. It’s overwhelming doom mixed with a feeling that everything is unreal. And I have no blueprint for that. Eventually I settle on the answer: I must be going mad. Mad like you hear about on Crimewatch. Mad like killers in movies. And it clicks – I am psychotic. I have no proof of this, but that’s where my mind has landed. From that day, I become obsessed with monitoring my ‘mad’ behaviour. I pick apart every thought that pops into my mind – am I paranoid? Did I just think someone was watching me? Do I hear voices? The exhaustion from trying to push back against these thoughts is overwhelming and, on top of all the thoughts which keep coming, I’m experiencing a million physical side effects of anxiety too – adrenaline courses through my body, I feel sick constantly, I can’t sleep, I can’t eat. The mental and physical go hand in hand and egg each other on – it’s a vicious cycle.

This one was an even lower moment in my life, but the two stories have a couple of strong similarities. Can you spot them? No, I’m kidding, you’re not eight and this isn’t Where’s Wally. I’ll tell you:

Catastrophic thinking – my mind (and maybe yours since you’re here) has the amazing ability to go from zero to a hundred in two seconds flat. And it’s never a positive destination. The only places my mind goes are dark and scary. Catastrophic thinking can be described as your brain searching for the worst-case scenario. It might seem like a self-defence mechanism – ‘Prepare for the worst, be pleasantly surprised’ – but it actually kick-starts an anxiety loop. You think about the worst scenario and your brain and body produce a reaction like the one you’d have if that actual scenario was happening. So I imagine I’m in serious medical danger, or feel like I’m going mad, and I panic. Adrenaline floods me, I’m tearful, I can’t breathe and I think the world is ending. When it doesn’t, I don’t pick myself up and feel exhilarated that I’m all safe. I feel wiped out and scared for the next time I feel worries like this. This can make you feel like there’s no point in feeling hopeful about the future or lead to you skipping situations that produce catastrophic thoughts – thereby feeding the loop and reinforcing this thought pattern.

An inability to self-soothe. No, I’m not a baby and yes, this description is slightly grim, but it’s also kind of spot on. In both these cases, I couldn’t pull myself back from panic. I didn’t push back against the thoughts or calm my body down. I was washed away with the fear, and let it take over. That’s natural, your mind tells you there’s something to worry about and so you listen. It’s a primal thing – this fight-or-flight instinct – but with anxiety, you have to learn that your instincts are often wrong. And that’s a hard one to realise – that sometimes your brain and body are working against your best interests. But it’s a vital thing to learn – because understanding the difference between real dangers and imagined ones will eventually help stop your mind seeing dangers everywhere and help you decide whether a worry is worth engaging with or not.

Can you write down examples of your anxiety and see what the similarities are? It’s good to spot the patterns your worries take, even if they seem completely different initially.

What can you take away from the comparison? Do both scenarios involve a specific place? Or a time when you’re tired? Begin to notice what common threads link your worries and remind yourself of them when you next feel anxious.

How can you stop catastrophising? We’ll talk about this a lot more as we go on, but here are a few tips:

• Notice what your brain is doing – it’s a lot easier to calm yourself down if you catch the pattern early.

• View the thoughts from a distance. It helps me to internally say: ‘Ah, I see I am spiralling into doom-laden thoughts. I wonder why I’m going there.’

• Evaluate why you’re going there – are you tired? Are you hungry? Do you have a presentation to give tomorrow? Are you pre-menstrual? Sometimes it helps to figure out a real-life fire-lighter that might be stoking the worry.

• Don’t berate yourself too much – it never helps to call yourself a dick. Instead, go easy – a sort of ‘Thanks for trying, but not today’ reply to your mind.

• That said, dispute the worry – don’t discount it completely, but question it. I use this with flying: ‘But planes are the safest way to travel, Bella.’ Might sound small, but it has an impact.

• Figure out what you CAN do to help ease the worry – practical things, like paying a bill or setting aside time to write that presentation. Start somewhere, even if it’s small.

• If all else fails, distract yourself with something comforting – I bake or listen to old Agatha Christie audiobooks when my mind is spiralling. Often doing something with your hands can help quieten your mind.

PART THREE

FIGHT-OR-FLIGHT

The term ‘fight-or-flight’ sounds really dramatic – as though you’re about to go to rumble à la West Side Story. If you’ve not seen the film, go and watch it. Tony. That’s all I’ll say about that.

It’s important for people with anxiety (and those with many other mental-health disorders, from PTSD to bipolar) to familiarise themselves with this very normal human reaction, because it comes from fear – and fear is the sensible and reasonable cousin of anxiety. The cousin who calls your grandma on her birthday. The cousin who trained for years and makes your mum wonder why you never became a doctor. And yes, I am stretching this metaphor, thank you for noticing.

Anyway. Fear is healthy – we need it. It’s how we know to get out of a burning building. And it does this with the fight-or-flight response. This physical reaction – when the human body produces a bunch of hormones to make you faster and stronger in the event of … oh, let’s say a lion attack – is a wonderful thing, but our brains respond identically to both real and unreal danger. So the fight-and-flight mode that equips us to fight terrifying animals can also kick in on a Monday morning rush-hour commute when there is no obvious threat. And for people prone to anxiety … well, this response can start working against us.

The fight-or-flight response does a bunch of stuff to your body when it kicks in – your amygdala (the part of the brain which processes emotions) sends out a sort of distress signal and your body knows to gear up for a scary situation. You produce more adrenaline, your heart rate goes up, you breathe faster and you get a rush of energy. It’s thought that this all happens before your conscious brain has even considered what’s happening (and explains why a person could jump in front of a train to save a person who’s fallen on the tracks).[2]

In a scary situation this is all GREAT! But if there’s no immediate emergency and yet your brain goes on sending the danger alert, then your body keeps producing the adrenaline and this keeps your brain thinking there’s something going wrong. That feeling of excess energy, that pounding heart. Think about how that feels. It’s not nice, huh? So of course if you’re feeling all of those things, your mind is still casting around for peril. And so the cycle begins.

Sound familiar?

It might be helpful here to write down five times your fight-and-flight response has kicked into gear for a GOOD reason. And then write down five times it’s reared its head in an unhelpful way. We need to make an effort to distinguish the normal fear reaction from the excessive and unwarranted fear reaction so that our brains are better able to respond appropriately in a future stressful situation.

Just as with catastrophising, you can help push back against this. It’s exhausting to get trapped in such a cycle. You spend hours, days, weeks feeling full of adrenaline – teeth grinding, sweating, humming with nerves – and then you crash and can be overwhelmed with headaches, tired to your very bones, feel shaky and achy as though you have the flu. And, long term, cortisol (the stress hormone) isn’t very good for you – it’s been shown to prompt weight gain, affect blood pressure and mess with cholesterol.[3] And the rest. Anxiety really is the gift which keeps on giving.

Some things that help put the brakes on this cycle:

• EXERCISE (there may … just may be more about this later).

• MEDITATION AND MINDFULNESS.

• SOCIALISING – studies have shown that a ‘tend and befriend’ response can lower these symptoms of stress – providing safety and security instead of panic.[4]

• LAUGHTER – sounds simple, but has been shown to reduce stress hormones and promote mood-elevating hormones like endorphins.[5]

Above all, it helps to reassure yourself. It sounds silly, but sometimes just saying, ‘I am safe’, as many times as I need to (internally or out loud), can really help calm my body down in moments when I want to get the fuck out of a place that my body is telling me is scary. Try it, see how it feels after you’ve spoken positively to yourself. Our internal voices are so often complicit in making us feel worse – and it’s a ‘skill’ we build up over many years, so it’s understandably hard to break. But with practice, you can make that voice more sympathetic and less willing to just go along with the latest worry that might have popped into your brain. Reassuring yourself is a good way to start. It can be any mantra as long as it’s positive and calming – ‘I can do this’ is another good one.

Write down three things you might say to yourself next time you feel panic rising and keep them at the back of your mind for future use:

PART FOUR

PANIC ATTACKS

Since we’ve discussed catastrophic thinking and fight-or-flight, let’s look at panic attacks – often the end result of the fight-or-flight response. Have you had a panic attack? If you’re reading this book, it’s likely that you have. Some statistics say that 13 per cent of people have had one in their lifetime.[6] And some people will only have one or two – triggered by a stressful period in their life like a new job or a bereavement. Some people will have tons. At that point, you might have panic disorder. That’s an anxiety condition – under the umbrella of issues that anxiety covers. Panic attacks are debilitating. They can make you think you’re dying – so often people who experience them initially think there’s something seriously wrong physically. When I first experienced them, I thought I was having: a heart attack, a stroke, a brain aneurysm. Often you think you’re about to pass out. Let me get this straight first up: YOU ARE NOT GOING TO PASS OUT.

Probably. I’m not a doctor. But many doctors have told me that panic attacks rarely lead to fainting. You might feel dizzy for sure, and the earth might feel like it’s moving beneath you, BUT: during a panic attack, your heart beats faster, and your blood pressure rises. When people faint it’s normally because of a sudden drop in blood pressure.[7] So strike that off your list of worries. I’ve had so many panic attacks I could write a thesis on them, and I’ve never once fainted during an episode. From kissing a boy aged eighteen, sure, but never from a panic attack. Remind yourself of this – it’s important! So many people develop a fear that they’ll pass out and it can bring on the anxiety cycle we talked about earlier. If you feel wobbly, sit down for sure, drink some water, but don’t worry you’re going to stack it right outside Starbucks, because you won’t.

OK, good – moving on. I’m going to write down a list of panic attack symptoms – and you tick the ones you’ve experienced.[8] This isn’t an exhaustive list but these are the very common ones. It’ll be like a fun puzzle exercise, except it’s about mental illness and there’s no fun involved. Tricked you. OK, GO!

Truly horrible bloody things. What’s your worst symptom? Mine is that I can’t breathe. I pull at my throat and gasp a lot. Which makes me think that people must be noticing my freak-out and that can make me more panicky. But here’s the thing. Mostly, panic attacks are happening beneath the surface – like when a serene duck is barely moving on the water but actually its feet are frantically paddling. All the things going on in your mind and in your body feel IMMENSE but are normally not visible to a passer-by. Think about how many times you have seen a stranger having an anxiety attack – I’ve never seen one person experience one and I have them myself. So put that worry out of your head. So many people worry that they’ll cause a scene and look stupid when, in actual fact, human beings are really self-absorbed and barely notice anything you’re doing unless you fall over. Then they notice, trust me (I fall over a lot).

The irony of it all is that actually a really good thing to do when you’re feeling a panic attack coming on is to talk to someone. Make a human connection, look into someone else’s eyes and force your brain to concentrate on something else. And this isn’t only a practical bit of advice. In my quest to get everyone on earth (I’m grandiose like that) talking about mental health, I think it would be amazingly helpful if we could tell a stranger that we’re feeling a bit anxious without feeling silly or ‘mad’. If someone told me they were panicking I’d try and be as helpful and reassuring as possible – as would most people, I think. Wouldn’t it be lovely if we felt able to do that?

There’s lots of advice on how to overcome panic attacks – from your GP to charities like MIND, from eminent psychiatrists to quack practitioners. Some of it’s good, some of it’s unhelpful. I’m not a professional (at literally anything) so all I can tell you is what works for me. And normally it’s a multi-pronged approach – no ONE thing is guaranteed to nail it. What helps is having a toolbox full of things that help and being able to pull them out when needed.

• Focus on your breathing. In situations like this, there’s a right way and a wrong way to breathe. You probably take shallow breaths when you start to panic – and many people start to hyperventilate (inhaling deeper or taking quicker breaths than usually).[9] Normally, you breathe in oxygen and breathe out carbon dioxide (hello GCSE science). But when you hyperventilate, the carbon dioxide levels in your bloodstream drop. You start to feel sick or dizzy, and this provokes more panic. So you need to calm your breathing down. Easier said than done, I know. I begin by taking one big breath and telling myself, ‘I CAN breathe.’ Breathe in through your nose, and put one hand on your chest and one on your stomach. Notice the breath move through your body – you should feel your stomach move but your chest should remain pretty still. Keep doing this for as long as you need to until you’re convinced that you can breathe.

• Find a quiet place to sit down. If you feel like you’re going to faint (even though you’re not), take a seat, but don’t hunch up. Keep your chest broad so that you can keep on taking proper breaths.

• Notice your surroundings. It helps me to focus on the sky, or on an interesting building, or to watch a dog walk past. Anything to centre you back in your surroundings.

• Try not to rush away. The instinct is SO strong to get the fuck out and head for ‘safety’ but, in doing so, you can set up problems for yourself in the future. If you feel scared in a place and leave before you calm down and realise that there’s nothing to really fear, then your brain tends to designate that place as ‘unsafe’. Then you start to avoid places and your world can get really small really fast. So stick it out if you can. Just as an example, leaving the scene of a panic attack meant that I later avoided:

– Planes

– Lifts

– Busy spaces

– The centre of London

– Sainsbury’s

– Theatres and cinemas

– Motorways

– Coaches (not really, I just don’t like coaches. Not enough toilets)

• Focus on your senses. Touch something soft, stroke your own arm, smell the air. Panic attacks can make you feel very far away from your own body – try and reconnect with it.

• Talk to someone – make eye contact. Stroke a dog, smile at a waiter. It can help to make you see that you’re not in danger. If there’s nobody around, call a friend and tell them that you just need two minutes to talk – a little encouragement from my sister really helps when I’m feeling like I might have an attack.

• Expect that afterwards you’re likely to feel exhausted, trembly and sometimes a little teary. The adrenaline has dissipated and your body is wrung-out. Get yourself some food, drink lots of water, sit down for a bit. Keep warm – often panic attacks leave you cold and shivery. Be nice to yourself; don’t berate yourself, don’t tell yourself it’s pathetic. Nobody asks to have panic attacks – it’s not a sign that you’re weak or incapable. Tell yourself that you’re OK, you handled it well, you’ve done well to get through it. Anxious people have minds working against them, the last thing you need is to add fuel to that.

It’s important to know that while panic attacks are a beast, you will not die. They feel awful and, boy, do they take it out of you, but they cannot hurt you. Knowledge is power, and the more you understand why you’ve had an episode and the more you KNOW they’re not dangerous, the less hold they have on you. With that in mind, it might be good to write down a bit about two times you had an attack and the events surrounding them. It’s helpful to know your triggers and arm yourself with that information.

There are lots of ways to help prevent panic attacks – and again, you’ll find your own tools. But here are a few suggestions:

Avoid caffeine – anxious people have so much adrenaline, we don’t need any more encouragement.

Avoid nicotine and wine – but I guess you know this one anyway.

Try yoga/breathing exercises/meditation – which are all known to help with stress and calm people down.

Exercise – yup hi, we’ve got this one covered.

Get enough sleep – sleep disturbance is often high in people with mental-health problems and it contributes to anxiety FOR REAL.[10] However you do it, make it a bigger priority.

Eat regularly. When my blood sugar drops I can feel my anxiety climbing. I try and eat every hour, which is fun and also makes me feel like a baby. Try not to forget to eat and then grab a sugary doughnut. I mean, for sure have doughnuts, but just make sure you have proper meals too.

Do things that scare you – this sounds sinister but we’ll get to it and it won’t sound so odd, I promise.

When a situation is looming that you find scary, plan for it. I research routes in advance so that I’ll be somewhat familiar with them. I sometimes look on Google Maps and see what a venue looks like – not to plan my exit but just so I feel comfortable when I get there. This is all a way of me having an element of control over my worries. I accept I can’t plan everything ahead, but I can show my anxious brain some research and say, ‘Hey look! This doesn’t look so bad, does it?’ So much of learning to tackle anxiety is reframing your thoughts and changing the narrative in your brain. Can you start here by writing about a situation coming up soon that is making you feel a bit nervous? What would help you to stop dreading it and, if not look forward to it, then at least not let it weigh too heavily on your mind?

PART FIVE

PHYSICAL SYMPTOMS

Our minds and bodies are closely linked. Yes, that sounds mega obvious, but honestly, how often do you really take time to think about what your body might be telling your brain when it aches and feels tired? Or connect your low mood to the fact that you’re getting over a bout of the flu? Yes, we all know that we’re one connected being, but I think mostly we tend to view our brains as one thing and our bodies as another. I suspect many of us put our brains on a pedestal – prizing intellect – while seeing our bodies as cart horses, pulling us along. And that’s not even touching on how many of us hate our bodies, see them as inferior, lacking. Too big, too short, too hairy …

The philosopher René Descartes proclaimed that the mind and body were two separate entities – with the mind a thinking but immaterial thing, and the body an unthinking but physical presence.[fn1] Prior to this, the mind and body were closely linked according to Christianity – and many illnesses were attributed to the victim’s conduct, explained away with the notion that the person must have ‘sinned’.[11] This meant that for the soul to ascend to heaven, the human body had to be intact. So theories like that of Descartes helped pave the way for medical innovation, but dismissed the bearing that the mind and body have on each other.

Nowadays, medical professionals increasingly approach treatment in a more integrated way.[12] GPs offer advice on exercise for a range of health problems and in some cases cancer patients are offered yoga and meditation to help cope with their treatment. Some surgeons even compile playlists for operating theatres, based on research that suggests that music can help reduce pain before, during and after a procedure.[13]

And yet Descartes’ philosophy still holds a grip on some of us. In extreme cases, people take pills for their mind, go to the gym to hone their body – or worse, sit inert – and never connect the dots. I didn’t, not for thirty years of my life. Many people with anxiety become huge hypochondriacs (ME!) and STILL don’t link up their aches and pains with their mental health. Online forums are full of scared people talking about twitchy feet and pins and needles and back ache and nausea and stomach upsets. But OF COURSE our bodies are influenced by our minds. The mind is a powerful thing. It can make you feel cripplingly ill without anything being actually wrong. Except that’s bunkum – because OF COURSE something is wrong there – something is very wrong, it’s just not in your body.

The book It’s All in Your Head by Suzanne O’Sullivan explores this in the most sensitive and empathetic way I’ve ever read.[14] O’Sullivan is a consultant neurologist, and treated many patients – some of whom were not actually physically ill.[15] She had patients who went blind, lost the use of their limbs, had seizures and who were convinced they had terrible illnesses that were going to be fatal. As O’Sullivan says, ‘In 2011, three GP practices in London identified 227 patients with the severest form of psychosomatic symptom disorder. These 227 constituted just 1 per cent of those practice populations – but estimates suggest up to 30 per cent of GP encounters every day are with patients who have a less severe form of the illness. If psychosomatic symptoms are so ubiquitous, why are we so ill equipped to deal with them?’

O’Sullivan treated these patients as seriously as she did those with more tangible illnesses. But many people, upon being told that they had a psychosomatic illness, were affronted, dismayed, in denial, and unwilling to believe it. They felt as though they were being accused of faking a problem, which is not the case at all. Their problems were as real as those of other patients. But the root cause was different.

I’ve felt like that, to a lesser extent. Affronted when GPs haven’t taken my low blood sugar seriously. Confused when migraines were put down to anxiety and not a brain tumour as I was convinced. My low energy was tested, and my insomnia discussed, but suggestions that I might be feeling things that weren’t ‘real’ was very upsetting. Why? Why would a mental-health issue feel less valid to many of us than a broken leg, say? Partly it’s the stigma, isn’t it? That a broken leg feels serious, totally genuine, more worthy of sympathy – a mental illness might be weak, or seen as our fault, or dismissed as attention-seeking.

Well balls to that. We need to start being comfortable with mental illness being just as worthy of help and attention as anything else. But in order to do that, we need to understand how deeply our minds can affect our bodies. As I’ve said, the first time people have a panic attack, they often don’t know what on earth is going on and think they’re dying. This is a common example, but it’s far from the only time that anxiety will show itself physically, and it can be really terrifying.

Aside from the host of ways anxiety has messed with my mind, it’s also done a number on my body. This is not a comprehensive list BY ANY MEANS, but here’s a list off the top of my head:

• Made my eyelid droop and flicker (I thought it was a stroke).

• Given me rashes, psoriasis and weird red blotches all over my body.

• Made my hair thin.

• Given me tension migraines that lasted for days.

• Made me vomit.

• Made my whole body shake so wildly I thought I was going to die.

• Given me stabbing pains in my chest.

• Made my back ache so much that moving was difficult.

• Made me feel as though my limbs were detached from me (that one is weird).

• Made my vision blurry.

• Made me so tired I found it hard to move.

• Made me lose my memory. Seriously – anxiety can mess with MEMORY.

These things were all very real to me. Not made-up, not fake, not attention-seeking. That’s how strong the mind is. There’s a list floating around the internet that I stumbled upon a few years back called something like ‘100 anxiety symptoms’ and I ticked ALL of them off. It was such a relief to realise that these physical issues could be explained – and a relief to know that I wasn’t alone in dealing with them.

I’m not suggesting that you chalk up all physical ailments to anxiety and never get medical help (norovirus is not all in your head). I am saying that we should all stop and think when we feel a niggle, a pain, a tingle and ask ourselves how our anxiety level is. That isn’t about minimising the physical discomfort or pain we’re in, it’s about taking our mental health seriously and connecting the dots. So here are two little exercises to help unite the mind and body a little more.

Write down all the physical symptoms of anxiety that you’ve experienced, heard about or googled (you know you’ve googled symptoms, don’t lie to this journal). Can be big or small. I’ll start with a common one.

OK, keep that list to hand, add to it when you experience a new symptom – get familiar with the way anxiety manifests itself in your body.

Now make a note of a situation when you felt ill, ‘off’, wrong or rundown. Think about what was going on that day – were you worried about work? Were you having anxiety attacks a lot in that period? No need to be Sherlock Holmes – just jot down anything that comes to mind.

As I said, the impact of anxiety on our bodies is very real. It might all stem from your mind, but an upset stomach is undeniably rubbish. Headaches can knock you out all day. Vomiting can force you to leave important work events. Mental-health-related issues account for the majority of sick days taken at work, and we’re often more likely to tell an employer that we’ve got flu than to explain that our bodies have been taken over by worry.[16]

Anxiety can make it feel as though your body is breaking down sometimes. Night sweats, exhaustion, cold chills (I used to have to blow-dry my feet before I could sleep sometimes) and a propensity to pick up colds made me feel many years older than I was. Those colds might not have been a random coincidence either. There’s growing evidence that when extreme stress and worry continue for a prolonged period of time, the immune system may be weakened.[17] In fact the health consequences more generally can be significant. Anxiety has been linked to heart disease, respiratory problems and digestion issues.[18] I say this not to freak you out (please don’t freak out, I’ll have to give my book money back) but to show you that your anxiety is SERIOUS and VALID and you deserve to be taken seriously and not feel as though it’s not important. It is, and you’re not ‘imagining’ it.

Anxiety makes our minds miserable, but it also makes living in our bodies uncomfortable and painful and tiring. So there’s even more reason to make changes and seek help – you might be able to put up with worries, or have all the symptoms of the flu, but both at the same time is more than one person should have to tolerate.

And the great thing is, the more you understand the ways that your mind and body impact on each other, the more you can break the cycle of anxious thought – adrenaline – more anxiety. There’s nothing radical to suggest here – no potions or expensive equipment to buy. It’s the old classics as usual – sleep, exercise, good nutrition, training your brain to look at things differently (learning to reframe negative thoughts), and listening to what your body needs. Are you full of nervous energy? Maybe a walk would help dissipate some of that. Feeling cold and shaky? Have a hot bath. I hope these suggestions don’t sound too like Pippa Middleton’s party manual (‘consider a cake’, etc.). They can feel obvious but, unfortunately, there’s no quick remedy which fixes all of these physical things. There’s a reason the suggestions given by professionals all tend to be framed around exercise and wellbeing – it’s because they work. And the more you look after your body, the less the symptoms will invade on a daily basis. Since I started running five years ago, I’m ill much less. I sleep better. I don’t feel overwhelmed with adrenaline and I don’t have so many weird and frightening body niggles which used to send me straight to Google to see if it meant I had cancer.

Write down five things you know help with physical symptoms of anxiety:

Try to do at least one a day for a week and see if you feel differently.

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