I liked my first therapist a lot. We were from the same Northern county, we were roughly the same age, our first conversation was about Devil, a recent M. Night Shyamalan film about five people in a lift, one of them being the devil, which I'd seen the night before to ease my first-day-at-therapy nerves. It was stupid. Our weekly sessions were right after lunch, so once or twice she finished up a sandwich while we went through the preliminaries, the office smelling pleasantly of canned tuna and cucumbers. Eleanor was good, although she was only a few months out of her Masters. In the end, our eight-week course of therapy didn't take. It isn't Eleanor's fault. It isn't really anybody's fault, although it took a while for me to admit that.
Here's what happened: I was training as a speech therapist, maybe two weeks away from the end of my final placement in the Whittington Hospital -- the one up in Archway with the black cat standing guard over the A&E entrance -- and so about two weeks away from the end of the postgrad course I'd been enrolled in for the past two years. I'd been living in London on half of minimum wage for all that time. I'd stopped eating meat because I couldn't afford it, I'd learned to love lentil soup; graduating was going to be fucking sweet. I might even be able to afford spaghetti on special occasions.
The short version of "what happened", the one I give out at parties, is: "it didn't work out." This is the long version.
My 11:45 appointment is with a 50-ish-year-old man recovering from a mild-to-minor head injury that damaged the language centres of his brain, amongst other things. Relatively speaking, he's doing quite well at this time; my job today is to run through a basic communication test to see how well he can communicate and how well he can understand other people when they talk to him. It's a test I've done enough times that I've spent an evening at home making up a standard form to save time. I don't know why my chest hurts. I don't know why I can't breathe. Why do I feel like I'm drowning?
The patient was discharged two days later. His linguistic facilities were already on the mend by the time I saw him, although he needed to come back to the Whittington for a bit of physiotherapy. Wear your bike helmet, kids.
Me, though? I ignore the stabbing throbbing pain in my chest and go about my usual business: write up the results in the patient's file, grab my flask of lentil soup from the staff room, go see my 12:15 in Oncology. There is a snag, though, in that I've apparently forgotten how to read. As in, I don't know what these words on this piece of paper say. As in, I think I wrote some words, but more likely I made some incomprehensible squiggles and closed the manila folder. In the staffroom, I mention this to my supervisor. She hauls me down past the big black cat to the Accident & Emergency waiting room.
The details are tedious, apart from when the first doctor who sees me, a second-generation Chinese dude with a fantastic Cockney accent, peers over his glasses and asks me if I've "been smoking some waccy baccy" and I fail to lie. "Once," I said, "I got bored of The Blues Brothers. I thought that was impossible."
"I fell asleep and woke up and it was still going."
It's probably not related. What happened upstairs wasn't anythingnew, particularly; just the tail-end of what that first doctor offhandedly describes as a two-year-long panic attack. Sure, in hindsight it's obvious, even clichéd -- an estimated one in five of us have some kind of anxiety and/or depression, but at the time I thought it was generic stress. I was in a class of 120, and more than a couple of us had already dropped out with stress-related issues. Postgraduate training as a speech therapist is a four-year course condensed into two, and your student loans don't even stretch that far. "It happens to everyone", you say to your increasingly worried friends and family. "It's not a thing."
So when you think something's wrong you shove it aside and ignore it. Everybody has something, you say to yourself at 4am. You stare at a wall for a month. You stop sleeping, or you sleep too much. You haven't been outside this week. You haven't eaten in a couple of days, or you haven't stopped eating. Everybody else, you think, is having the same problems. You suck it up.
And then, I don't know, you have a mental breakdown and don't go back to university ever again or leave the flat for a month. Everything changes, down to and including your sense of identity. Before this you were a well-known and loved cocktail bartender notorious for entertaining your guests to the point of taking home triple-figure tips, and an endearingly terrible stand-up comic on Newcastle's small and insular circuit. Before this you were described by a coworker as "a cocky motherfucker," but in a nice way. Before this you could answer the phone, read your emails, talk to people without sweating through your clothes, drag yourself out of bed and away from Parks and Recreation long enough to shower a couple times a week. You tryreally hard not to see the 2009-2011 period as a complete waste of time and money but no matter how much you learned or how much you grew as a person or how many fantastic people you met or how many young kids' lives are demonstrably improved thanks to the work you did with them it's so hard to hang onto those concrete things because now your brain is working against you like a duplicitous first mate on board the Good Ship You. You cry a lot and fail out of CBT interventions like everything else in your life until you wake up and it's a year later and you're unemployed and everything spirals further, ever further downwards.
A couple of years of anti-anxiety medication and therapy later, I'm largely fine. I'm not the same as I was pre-2009, but that's the nature of the thing. I have fears, irrational thoughts. They're not as bad these days, but they spiral out of control pretty quickly: recently I'm worried that my aching joints are more than just a side-effect of the medication. Unchecked, this train of thought leads me down a Google hole of "how much are wheelchairs" and "what burrito places have ramp access".
Money, work, friends, family, my health both physical and mental, the fear that I'll be found out as a fraud and abandoned -- these are the worries. They're largely irrational and I know this intellectually, but when you're awake all night on New Year's Eve wondering how much you could get for your pancreas to pay off your student debts there's only so much you can do for yourself on a logical level. The anxiety and fear is a part of you now, and this is what's hard to get across to the lucky four in five who haven't experienced it: the sheer game-changing scale of it all.
One day, a few months after everything spiralled out of control, I had an interview at a new restaurant in the centre of London. It was a group interview. The recruiter liked me but told me to be "less nervous."
Now, what I should have done is make a fart noise in his face and marched out of there with my middle finger triumphantly aloft, but the economy was in the toilet and I needed the job, so I just went outside afterwards and had a panic attack in the middle of Oxford Street.
Coping strategies are context-bound and pretty much work for you and you alone, so you have to make your own, cobble them together from what you know relaxes you, what brings you back down from the mast. Therapy can teach you the self-reflection you need to work all that out, medication can regulate your brain chemistry, other people don't like either of them and can kind of sweat it out by running or meditating or whatever, and that's fine too. You do you.
Me, I got fired from an exhausting job that was making me nervous and depressed again and so then I went and made up a new job that I love and which somehow I make a living from and which has brought me into contact with good people who both understand and give a shit and those are the people you want to know. I can't recommend this for anybody else, not least because the economy is still in the toilet and frankly I'm surprised every day that it worked out at all, but it's an option.
Talking helps. Visibility helps. It's good to know you're not alone in having a brain that works against you, which is why the blog, which is why all the awareness days and weeks. A good quarter of you reading this are likely to come up against some form of mental illness in the future if you haven't already.
So I guess the one piece of advice I'm qualified to give is this: talk to someone, all right? Take care of yourself.