Anxiety, panic and exposure therapy: my experiences
Last year, my anxiety got a lot worse. It was really interfering with my life, stopping me doing things I enjoy and reducing the places where I felt comfortable. When it gets to this point with mental health - where you aren't in control of it because it is in control of you - it's time to take action.
I've been fighting bouts of depression and anxiety for many years now, and while I've tried lots of different types of therapies, I hadn't tried exposure therapy. On the surface, exposure therapy is quite simple. The patient is gradually exposed to the trigger of their anxiety, starting with small and less stressful situations then working up to bigger, more challenging situations. It sounds straightforward, but as anyone who's experienced anxiety can vouch for, it certainly isn't.
Getting a diagnosis
After waiting 18 months on an NHS waiting list, only to be told that I was too complicated to fix(!), I found a therapist through the British Association of Counselling and Psychotherapy. My therapist diagnosed me with agoraphobia, which the NHS defines as such:
'Agoraphobia is a fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong. Many people assume agoraphobia is simply a fear of open spaces, but it's actually a more complex condition'
It made a lot of sense to me. Wide open spaces (long beaches, vast fields, the sky) have long been a trigger of panic for me, and in the past I've frozen on the spot and crumbled in these situations. However, anywhere I can feel trapped (like lifts), anywhere I wouldn't be able to escape (like high floors and aeroplanes) and anything with no exits between start and end (like bridges) have induced the same horrible anxious feelings in me.
One of the best treatments for agoraphobia is exposure therapy. I was warned that it's not a quick fix, but for a condition that's so wide-reaching and consuming as mine, I didn't expect things to get better overnight.
My first proper exposure therapy session came around and I was bricking it. With my therapist, I'd done some prep work so that the exposure would be manageable. I made a hierarchy of things that trigger me so that we could start fairly low down the list, I practiced some coping mechanisms and I forced myself to accept and interrogate any feelings of anxiety or panic that I felt in the run-up.
On a day of heavy rain, me and my therapist took to a waterlogged field - something about halfway up my hierarchy of panic situations. I should point out that we didn't deliberately choose to do the session in terrible weather! It was the only free day we both had. For what it's worth, it was a great bit of pathetic fallacy, with the weather imitating my feelings.
The point of going to the field was for me to experience the vastness and practice walking through the nothingness on my own. I reluctantly wandered back and forth, first accompanied and then alone. At first it felt a bit silly, having the therapist watch me walk from one tree to the next nearby tree, because the fear wasn't too strong.
However, as we got further into the hour, it got a lot harder. I was walking further and making a route through the middle of the field, away from the edge, something higher on the hierarchy of triggers. It was something I hadn't done for years, deliberately so, because the thought alone made me feel like I was having a heart attack. Yet, there I was, soggy from head to feet, tiptoeing my way through the openness. I was doing it!
The experience itself was strange. I knew I was safe, but my mind was telling me I wasn't: 'There's nothing to hold on to', 'you're going to collapse', 'you can't do this'. The first few steps of each exercise were fine – I realised how well I was doing and felt strong, able and confident. But, as I got further away from the edges of the field, fear would bite me in the butt and set my anxiety off, bringing on the wobbly knees, thumping heart, nausea and achey chest. It's like the agoraphobia was having a tantrum because I was trying to ignore it.
In all, I must've walked across that wet field 15 times. When I got home after the exercise, I was exhausted, drenched, but happy. I'd asked my therapist to take a photo of me during one of the exercises so that I could look back on it when I was feeling incapable of facing my fears. I proudly showed it to my partner to prove how well I'd done. My anxiety has affected both of our lives, and while he's incredibly supportive, I know that my recovery matters to us both because agoraphobia has limited us.
Three months on
Since the initial exposure therapy session, I've made regular efforts to deliberately challenge my agoraphobia. I've said yes to routes I'd usually say no to, opted for days out on unknown beaches, plus I've visited parks and fields to try to normalise and enjoy the experience of being in them. I think I'm making progress, and it's incredible to know that I'm winning the tug-of-war between the real me and this condition.
I now see my anxiety as the result of a misinterpretation of a situation; I am free from harm, yet my body misunderstands things and tells me I'm in danger. With repeated practice, more exposure therapy and looking after my mind and mood daily, I'm slowly nearing the agoraphobia-free version of me on the horizon. There are still miles between us, and I still have the odd day where the fear is overwhelming, but I'm on the right track.
If you are experiencing any kind of mental health issue - big or small - please don't suffer alone. Find someone to talk to (e.g. a doctor, a friend, a family member, your partner, Samaritans or Mind). Getting help is scary, as my post illustrates, but life is much better when you are in control of what's going on upstairs. Trust me.