by Matt Haig
There I was. In that enclosed and busy and artificial commercial space. Past the point of no return. My own personal singularity. The rational knowledge, as I looked at Andrea, that I was in the all too familiar process of ruining our day.
I closed my eyes to escape the stimulation of the shopping centre and saw nothing but monsters and demons, a mental bank of creatures and images worse than any hydra or cyclops – my own personal underworld that was now only ever a blink or a thought away.
‘Come on, you can do it. Breathe slowly.’
I tried to do what she said: to breathe slowly, but the air didn’t feel like air. It didn’t feel like anything. My self didn’t feel like anything.
I wiped my eyes.
Opposite Vision Express was a clothes shop. I can’t remember which one. But what I can remember, printed with the weight of trauma in my memory, is that there were mannequins in dresses in the window. The kind of mannequins with heads. Heads which were grey and hairless and with features that hinted abstractly at a nose and eyes, but no mouth. The mannequins stood in unnatural angular poses.
They seemed deeply malevolent. As if they were sentient beings who not only knew my pain, but were part of it. Were partly responsible for it.
Indeed, this would be a key feature of my anxiety and depression over the following months and years. The sense that parts of the world contained a secret external malevolence that could press a despairing weight and pain into you. It could be found in a smiling face on a glossy magazine. It could be found in the devilish red stare of rear tail-lights. Or the too-bright blue glow of a computer screen.
And yes, it could be found in the sinister echo of humanity in a shop mannequin.
One day, when I was ready to face my pain, this feeling of extreme sensitivity would actually help me. It would help me understand that if external things could have a negative impact, then other external things might have a positive impact. But right then I was worried I was losing my mind.
I was convinced I wasn’t made for the reality of the world. And in a way, I was right. I wasn’t made for the world. I was, like everyone, made by the world. I was made by parents and culture and TV and books and politics and school and maybe even shopping centres.
So, I either needed a new me. Or a new planet. And I didn’t yet know how to find either. Which is why I felt suicidal.
‘I’ve got to get out of here,’ I said at the time, wiping my eyes like a toddler lost in a supermarket.
The ‘here’ was broad enough to mean anything from ‘my head’ to ‘the planet’. More immediately, of course, the ‘here’ was the shopping centre.
‘Okay, okay, okay,’ Andrea said. She was right next to me. She was also thousands of miles away. She scanned around for the nearest exit. ‘This way.’
We got outside, into natural light. And we went back to Andrea’s parents’, and I lay on Andrea’s childhood bed and told her parents I had a bit of a headache, because a headache was easier for them to understand than this invisible cyclone. Anyway, I felt varying degrees of bad for many weeks and months, but eventually I began to recover. And, even better, to understand.
A wish
I SO WISH I could explain something to my younger self. I wish I could tell myself that it wasn’t all me. I wish I could say that there were things I could do. Because my anxiety, my depression, wasn’t just there. Illness, like injury, often has context.
When I fall into a frantic or despairing state of mind, full of unwelcome thoughts that can’t slow down, it is often the result of a series, a sequence of things. When I do too much, think too much, absorb too much, eat too badly, sleep too little, work too hard, get too frazzled by life, there it is.
A repetitive strain injury of the mind.
How to exist in the 21st century and not have a panic attack
1.Keep an eye on yourself. Be your own friend. Be your own parent. Be kind to yourself. Check on what you are doing. Do you need to watch the last episode of the series when it is after midnight? Do you need that third or fourth glass of wine? Is that really in your best interests?
2.Declutter your mind. Panic is the product of overload. In an overloaded world we need to have a filter. We need to simplify things. We need to disconnect sometimes. We need to stop staring at our phones. To have moments of not thinking about work. A kind of mental feng shui.
3.Listen to calm noise. Things that aren’t as stimulating as music. Waves, your own breath, a breeze through the leaves, the purr of a cat, and best of all: rain.
4.Let it happen. If you feel panic rising the instinctive reaction is to panic some more. To panic about the panic. To meta-panic. The trick is to try to feel panic without panicking about it. This is nearly – but not quite – impossible. I had panic disorder – a condition defined not by the occasional panic attack but by frequent panic attacks and the continuous hellish fear of the next one. By the time I’d had hundreds of panic attacks I began to tell myself I wanted it. I didn’t, obviously. But I used to work hard at trying to invite the panic – as a test, to see how I could cope. The more I invited it, the less it wanted to stay around.
5.Accept feelings. And accept that they are just that: feelings.
6.Don’t grab life by the throat. ‘Life should be touched, not strangled,’ said the writer Ray Bradbury.
7.It is okay to release fear. The fear tries to tell you it is necessary, and that it is protecting you. Try to accept it as a feeling, rather than valid information. Bradbury also said: ‘Learning to let go should be learned before learning to get.’
8.Be aware of where you are. Are your surroundings over-stimulating? Is there somewhere you can go that is calmer? Is there some nature you can look at? Look up. In city centres, the tops of buildings are less intense than the shop fronts you see at head level. The sky helps, too.
9.Stretch and exercise. Panic is physical as well as mental. For me, running and yoga help more than anything. Yoga, especially. My body tightens, from hours of being hunched over a laptop, and yoga stretches it out again.
10.Breathe.Breathedeepandpureandsmooth. Concentrate on it. Breathing is the pace you set your life at. It’s the rhythm of the song of you. It’s how to get back to the centre of things. The centre of yourself. When the world wants to take you in every other direction. It was the first thing you learned to do. The most essential and simple thing you do. To be aware of breath is to remember you are alive.
12
THE THINKING BODY
Four humours
ONCE UPON A time, in Ancient Greece, doctors explained the human body with reference to the ‘four humours’. Every health complaint could be assessed as an excess or deficiency of one of four distinct bodily fluids: black bile, yellow bile, phlegm and blood.
In Roman times, the four humours evolved to correspond with four temperaments. For instance, if you had anger issues, you would be told you had too much yellow bile, the fire humour. Which means when you tell someone to ‘chill’ you are echoing official health advice from Ancient Rome.
If you were feeling depressed, or melancholic, that was down to an overload of black bile. In fact, the very word ‘melancholia’ stems via Latin from the ancient Greek words melas and kholé, which literally meant ‘black bile’.
This system seems ludicrously unscientific. But in one way, at least, it was advanced. Namely, it did not make a division between physical and mental health.
The philosopher René Descartes is largely to blame for this distinction. He believed minds and bodies were entirely separate. Back in the 1640s he suggested that the body works like an unthinking machine and that the mind, in contrast, is non-material.
People liked the idea. It was a hit. And it still impacts society.
But this split makes little sense.
Mental health is intricately related to the whole body. And the whole body is intricately related to mental health. You can’t draw a line between a body and a mind any more than you can draw a line between oceans.
&
nbsp; They are entwined.
Physical exercise is known to have a positive impact on all kinds of mental things, from depression to ADHD. And physical illnesses have mental effects. We can hallucinate with flu. A cancer diagnosis can make us depressed. Asthma can cause us to panic. A heart attack can cause mental trauma. If you have a bad lower back – or tinnitus, or chest pain, or a lowered immune system, or a painful stomach – because of stress, is that a mental or a physical problem?
I feel we need to stop seeing mental and physical health as either/or and more as a both/and situation. There is no difference. We are mental. We are physical. We are not split up into unrelated sections. We are not an existential department store. We are everything at once.
Guts
BRAINS ARE PHYSICAL.
And besides, thoughts aren’t just the products of brains. As cognitive scientist Guy Claxton writes in Intelligence in the Flesh, ‘the body, the gut, the senses, the immune system, the lymphatic system, are so instantaneously and so complicatedly interacting with the brain that we can’t draw a line across the neck and say, “above the line it’s smart and below the line it’s menial”. We do not have bodies. We are bodies.’ Then there is the issue of the ‘little brain’ – a network of 100 million neurons (nerve cells) in our stomach and gut. Okay, so it is nowhere near the 85 billion neurons that our ‘first brain’ has, but it is not to be sniffed at. One hundred million neurons are the amount a cat has in her head.
When we get ‘butterflies’ in the stomach before a job interview, or when we get hungry before a late lunch, that is our ‘second brain’ talking to our first brain.
So, in other words, this suggests that the idea of ‘mental health’ being separate to our physical self is as outdated as Descartes’ dodgy wig.
And yet we still suffer from the divide. We separate the world of work into mind jobs and body jobs. ‘Skilled’ jobs, which need what we generally see as intelligence and a ‘good education’, and lower-valued ‘unskilled’ jobs which often tend to be manual labour. White collar and blue collar.
There is an intelligence to movement. An intelligence to dance. An intelligence to playing sport. And yet we casually section people off, from school age, deciding if someone is sporty or academic or – in Breakfast Club speak – a ‘jock’ or a ‘brain’. This then determines their career path, whether it will result in a lower-paid manual job or a higher-paid job staring at an Excel spreadsheet. And we divide culture into high and low. Books that make us laugh or give us heart palpitations are seen as less worthy than books that make you ‘think’.
The line we draw between minds and bodies makes no sense the more we stare at it, and yet we base our entire system of healthcare on that line. And not just healthcare. Our selves and societies, too. It’s time to change this. It’s time to rejoin the two parts. It’s time to accept our whole human self.
A side note on stigma
WE AREN’T ENCOURAGED to talk about our mental health until we are mentally ill, as if we have to fake being in 100 per cent full health. Stress simply isn’t taken seriously enough. Or it is taken so seriously that people are ashamed of talking about their bad mental health days. Either way, this leads to more people becoming not just stressed, but ill.
And when we become ill, and might talk about it, we encounter a new stigma.
Too often, we view mental illness as a product of the person in a way we don’t with other illnesses. Because mental illness is seen as intrinsically different, we talk of it in different, more scandalised terms. Think of the words used about mental illness.
Newspapers and magazines sometimes talk about celebrities ‘confessing’ to depression and anxiety and eating disorders and addictions, as if those things are crimes. And actual crimes are too often explained as the product of an illness – mass shootings and sexual abuse are often given the media context of ‘mental health problems’ or ‘addiction’ rather than terrorism and sex crimes. In reality, people with mental illness are far more likely to be victims of crimes.
We also don’t really know how to talk about suicide. When we do talk about it we tend to use that verb – commit – which carries connotations of taboo and criminality, an echo of the days when it was criminal. (I have recently been trying to say ‘death by suicide’ but it still feels a bit forced and false on my tongue.) Many people struggle to deal with the very idea of taking your own life, as it seems a kind of insult to us all, if you see suicide as a choice, because someone has chosen to give up on living, this sacred precious thing, as fragile as a bird’s egg. But personally I know that suicide isn’t such a clear-cut choice. It can be something you dread and fear but feel compelled towards because of the new pain of living. So, it’s uncomfortable, talking about it. But talk we must, because an atmosphere of shame and silence prevents people getting the right help and can make them feel more freakishly lonely. It can, in short, be fatal.
Suicide is the biggest killer of women and men between the ages of 20 and 34. It is also the biggest killer of men under the age of 50 (at least in the country where I live, the UK. Other European countries have similarly bleak statistics. In the US, where firearms contribute to the depressing statistics, suicide is the tenth leading cause of death overall, across all ages and genders, though as with Europe, Canada and Australia, men are over three times more likely to kill themselves than women). These deaths are so often preventable. This is why we must ignore the pleas to ‘man up’ and find true strength instead. The strength for men and women to speak out.
The echoes of historical shame are everywhere in our words. For another example, when we talk about someone ‘battling their demons’ we are conjuring up those Dark Age superstitious ideas of madness as the work of the devil.
And all this talk, over and over, of bravery: it would be nice one day if a public figure could talk about having depression without the media using words like ‘incredible courage’ and ‘coming out’. Sure, it is well intentioned. But you shouldn’t need to confess to having, say, anxiety. You should just be able to tell people. It’s an illness. Like asthma or measles or meningitis. It’s not a guilty secret. The shame people feel exacerbates symptoms. Yes, absolutely, people are often brave. But the bravery is in living with it, it shouldn’t be in talking about it. Every time someone tells me I am brave I feel like I should be scared.
Imagine if you were heading for a quiet walk in the forest and someone came up to you.
‘Where are you going?’ she asks.
‘I’m going to the forest,’ you tell her.
‘Wow,’ she gasps, stepping back.
‘Wow what?’
And then a tear forms in her eye. She places a hand on your shoulder. ‘You’re so brave.’
‘Am I?’
‘So incredibly brave. An inspiration, in fact.’
And you would gulp, and go pale, and be permanently put off going into the forest.
Additionally, there is still a lingering toxic idea that people share mental health issues for ‘attention’.
That attention people seek can save lives.
But, as C.S. Lewis once put it, ‘The frequent attempt to conceal mental pain increases the burden: it is easier to say “My tooth is aching” than to say “My heart is broken”.’
We should work towards making this a world where it is easier to talk about our troubles. Talking isn’t just about raising awareness. As the various successful types of talk therapy have shown over the last century, talk can have medicinal benefits. It can actually ease symptoms. It heals the teller and the listener through the externalising of internal pain and the knowledge that others feel like we do.
Never stop talking.
Never let other people make you feel it is a weakness or flaw inside you, if you have a mental health problem.
If you have a condition like anxiety, you know that it isn’t a weakness. Living with anxiety, turning up and doing stuff with anxiety takes a strength most will never know. We must stop equating the condition with the p
atient. There needs to be a more nuanced understanding of the different pressures people feel. Walking to a shop can be a show of strength if you are carrying a ton of invisible weight.
Psychogram chart
(pg = psychograms)
Imagine if we could come up with a way to measure psychological weight as we each feel it. Wouldn’t that be helpful in bridging the mental and the physical? Wouldn’t that help people realise the reality of stress? Wouldn’t that help us cope with the stresses of modern life? Humour me. Let’s call this imaginary unit a psychogram.
‘Oh no, I can’t check my emails. I’ve had my limit of psychograms today.’
Walking through a shopping centre
1,298pg
Phone call from the bank
182pg
Job interview
458pg
Watching the news
222pg
A full inbox of unanswered emails
321pg
Your tweet that no one likes
98pg
Guilt from not going to the gym
50pg
Guilt from neglecting to phone close relatives
295pg
Observing how old/overweight/tired you look
177pg
Fear of missing out on a party you see on social media
62pg
Realising you posted a tweet with a spelling mistake
82pg
A worrying symptom you have googled
672pg
Having to do a speech
1,328pg
Looking at images of perfect bodies you’ll never have
488pg
Arguing with an online troll