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 patient. 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

632pg

An awkward date

317pg

Paying utility bills on credit cards

815pg

The realisation that it is Monday and you have to work

701pg

Having your job replaced by a robot

2,156pg

The things you haven’t done but wish you had

1,293pg

Note: psychological weight fluctuates greatly. Psychograms are a subjective measurement.

13

THE END OF REALITY

‘. . . this collision between one’s image of oneself and what one actually is is always very painful and there are two things you can do about it, you can meet the collision head-on and try and become what you really are or you can retreat and try to remain what you thought you were, which is a fantasy, in which you will certainly perish.’

—James Baldwin, Nobody Knows My Name

I am what I am what I am

YOU SOMETIMES NEED to go back to move forward. You need to face the pain. The deepest pain. And I’ve recently felt ready.

I need to go back.

To before the shopping centre. To a room of surgical whiteness.

‘Who am I?’ I asked, in the Spanish medical centre, during the beginning phase of my first mental collapse.

Of course, when I am well and calm, the question isn’t that scary. Who am I? There is no I. There is no you. Or rather, there are a million Is. A million yous. ‘I’ is the largest word in the English language.

Behind every you there is another you, and another you and another you, like a Russian doll. Is there a base you? A base me? Or are our identities not Russian dolls but just spirals with no end? Is identity a universe you can never reach the end of but which might lead you back to where you started?

Being relatively well, I enjoy the pointless philosophising of such questions. Because there is, I suppose, a clear self doing the asking. But when I was ill these weren’t simply abstract concerns. These were desperate mysteries to solve, as though my life depended on it. Because my life did depend on it. The feeling of me-ness had gone – it had been crowded out – and I felt like I could become trapped in the infinite I, silently floating in panic, with nowhere to land.

Reality versus supermarkets

PANIC ATTACKS OFTEN happen in supermarkets.

I know someone who has had only one panic attack in her life. It happened in a supermarket.

When I used to trawl early noughties message boards for tips on dealing with anxiety, the panic-attack-in-thesupermarket concept came up more than almost any other. I am looking at one thread now that starts: ‘WHY DO PANIC ATTACKS STRIKE YOU WHILE SHOPPING IN A SUPERMARKET?’

Panic is there to help us. As it is for many other animals, panic is our mind and body telling us to do something. Fight or flight. Run from the predator or fight the predator. But a supermarket is not a bear or a wolf or a cave-dwelling warrior. You can’t fight a supermarket. You can definitely run from one, but that will only increase your chance of having a panic attack the next time you have to go there. It might not just be that supermarket either. If you start playing the avoidance game, it might soon be all supermarkets that become triggers. Then all shops. Then the outside world.

People who have never had a period of living with anxiety and panic don’t understand that the realness of you is an actual feeling that you can lose. People take it for granted. You don’t get up in the morning and think, as you spread peanut butter onto your toast, ‘Ah, good, my sense of self is still intact, and the world is still real, I can now get on with my day.’ It’s just there. Until it isn’t. Until you are in the cereal aisle, feeling inexplicable terror.

When trying to express what a panic attack feels like it’s easy to talk about the obvious symptoms: the racing thoughts, the palpitations, the tightness of the chest, the breathlessness, the nausea, the tingling sensations inside your skull or your arms and legs. But there is another more complicated symptom I used to get. One which I have come to realise is at the heart of what my panic attacks have always been about. It is the one called, tellingly, derealisation.

Within a feeling of derealisation, I still knew I was me. I just didn’t feel I was me. It is a feeling of disintegration. Like a sand sculpture crumbling away.

And there is a paradox about this sensation. Because it feels like both an extreme intensity of self and a nothingness of self. A feeling of no return, as if you have suddenly lost something that you didn’t know you had to look after, and that the thing you had to look after was you.

And I think the reason supermarkets are such triggers for this is because they are already derealised. Supermarkets, like shopping centres, are wholly unnatural places. They might seem old-fashioned now, almost quaint, in this era of online shopping, but they are far more modern than our biology.

The light is not natural light. The humming noise of refrigerators sounds like the ominous soundtrack of an artsy horror movie. The abundance of choice is more than we are naturally built to cope with. The crowds and the shelves are hyperstimulating. And so many of the products themselves aren’t natural. I don’t just mean because most of them have chemical additives, though that as well. I mean, they have been tampered with. The tins of fish, the bags of salad, the boxes of sweetened puffed rice, the breaded chicken goujons, the processed meat, the vitamin pills, the jars of pre-chopped garlic, the packets of chilliflavoured sweet potato crisps. They are not natural. And in unnatural settings, when your anxiety is raw enough, you can feel unnatural, too. You can feel as removed from yourself as a packet of toilet roll is removed from a tree. To me, during my panic attacks in supermarkets, the objects on the shelves took on a sinister quality. They seemed alien. And, in a way, they were and are alien. They have been taken from where they belong. I related to that. And that is the root of it, I suppose. I didn’t feel like I belonged. I found it impossible to find a place in such an unnatural and overloaded place. The only thing I knew about myself was the fear. And all the repeated objects in the supermarket were making me worse.