Mental health and physical health

I feel like a fraud. It's taken me this long to write a post for Mental Health Awareness Week as I found out last weekend that my mental health problems stem not just from one chronic illness that causes my physical symptoms, but now two. I know I shouldn't blame all of my mental health problems on my physical health, but they play a significant part.

It is true that sometimes it's difficult to know where physical health and mental health start and end. Which is the chicken and which is the egg? For me, I question whether the physical health problems I didn't know I had caused the anxiety, or if the anxiety was there already. What a lot of people don't realise is the sheer gamut of physical symptoms mental health problems can cause. I've made a list at the end of this post of those I've experienced, differentiating between anxiety and panic attacks.

However my anxiety issues started, they are here to stay. They can be situational such as when I have to teach, go on a date, or travel by plane. They can be due to memories such as seeing a person who reminds me of bad times, songs that evoke negative emotions or anything that brings up when I was bullied at school. They can also be muscle memory as anything that increases my heart rate, gives me butterflies in my stomach or affects my breathing can bring on anxiety as my body equates those functions with an attack. Exercise can be problematic and I avoid being overly excited.

I have chronicled my vestibular problem before and the moments of seemingly random out of the blue vertigo started at a similar time to my panic attacks, which lead to generalised anxiety (GAD). However, after almost three years of again seemingly random out of the blue gut problems, which I initially dismissed as caused by my anxiety, then possibly by a tropical holiday, then by my diet, then by something more sinister, then dismissed as IBS, it turns out they're caused by endometriosis, which can cause dizziness and anxiety, along with other mental health problems. I was passed around the hospital, visiting many different departments, with frequent tests, procedures and treatments over those years; some were disruptive and some were downright disturbing, but I got to know how amazing the NHS is far more than I have ever done.

That said, when you have a history of mental health problems, no matter how great the system is, you will come across people, from the most harried of GPs to the most senior of consultants, who take one look at your medical record and write your symptoms off as psychosomatic or just another manifestation of anxiety. However I knew there was something wrong. I knew my body. That is one of the upsides of having a mental health problem, you become very self-aware, hyperaware almost. I'm an introvert and highly sensitive, so it's more pronounced for me. That's why I love that there's a move to rebrand hypochondria as health anxiety. So any change, yes you question whether it's just another anxiety symptom, but after living with anxiety for half my life at that stage, I knew it wasn't. Apart from the sudden onset and the fact that I was in the best place with my anxiety than I had ever been due to undergoing cognitive behavioural therapy (CBT), I knew the effects of anxiety inside and out; I had lived through the vast majority of them right up to and including a mental breakdown.

So I had to fight, just like I had to fight for my vestibular diagnosis. I wish I didn't have to, but I'm lucky that I haven't experienced as much of the stigma towards mental health as I know others have. Every test they did, there was a valid reason to do it and every time it came back negative, equivocal or there was no improvement, I forced the issue. That's why it took so long, they had to rule out a tropical disease with blood and stool tests, a parasite by sending samples to a special centre, coeliac disease with more tests, food allergies and intolerances with elimination diets, something more sinister with endoscopies, via a leftfield nuclear medicine scan until finally I had the third MRI of my life, which revealed the problem. I could have given up, but the doubters, including me at times, were wrong, my concerns had been validated and once more my perseverance has been justified.

Everything is interconnected and the endometriosis, which with hindsight has been causing increasing severity in my period-related symptoms over the years, but, in medical terminology, has an unusual presentation because the gynecological symptoms aren't significant and the gut problems are far worse. The only pattern, not dietary, not regular and certainly not serious, but still affecting my quality of life, was that time of the month. It is another cog in the wheel of understanding my gradually worsening health where it feels like my body is beginning to fail me and there's no cure, just management. The not knowing, the uncertainty was unbearable, but a diagnosis, that I can live with.

TRIGGER WARNING, these symptoms aren't pretty, but I don't get most of them anymore:

Anxiety:

• Weakened immune system leading to colds and bugs
• Lack of energy and motivation
• Lack of concentration due to racing and spiralling fixating thoughts
• Dizziness
• Breathlessness and shallow breathing
• Muscle tension meaning diarrhoea, constipation and stomach cramps
• Muscle tension leading to pain in the shoulders, neck, back and jaw
• Dental pain due to clenching of the jaw
• Headaches
• Nausea
• Restless legs, jitters and fidgety behaviour, including eye twitching
• Food cravings, usually sugar
• Loss of appetite
• Sudden need to pass water
• Intense thirst
• Sweating, including night sweats
• Hypersensitivity of the skin
• Sleeplessness and insomnia
• Hot flushes
• Reliance on distractions such as TV and alcohol

Panic attacks, in order of occurrence:

1. Hyperventilation (but you don't realise)
2. Pins and needles, usually in the extremities, but starting in the nose
3. Feeling of handcuffs around the wrists
4. Wind: burping and farting
5. Bodily functions stop such as sneezing, digestion and oxygen to the extremities
6. Tight chest so it feels like you can't breathe
7. Heart palpitations so it feels like you're having a heart attack
8. Hot flushes so severe you start to take your clothes off
9. Claustrophobia so you have to take anything constricting off including your bra and jewellery
10. Self-harming through pinching to relieve the pain inside
11. Vertigo meaning severe nausea
12. Throwing up
13. Shaking
14. The need to be as low to the ground as possible, usually on the floor
15. Can't take in food or liquid as throat closes off
16. Severe tension in limbs so you can't move
17. Severe tension in the jaw so you can't speak
18. Need to have people around, but not liking to be touched
19. Feeling of impending doom
20. Whiteout where you lose your vision and feel like you're going to faint

Afterwards I get thirsty but can only sip, the shakes, cold chills, diarrhoea and severe fatigue. That's the adrenaline comedown. It's good to feel the cold as that's the first sign I'm coming out of it. The next day I feel hungover and I often find bruises where I've unconsciously pinched myself.

They say you can't pass out due to a panic attack, but I beg to differ, particularly when they're this severe. Also, they say they only last 15 minutes, which may be true, but you can have another straight afterwards; I had panic attacks all day every day for almost a week which came in waves and left my legs black and blue as I had been pinching them so much. I wish I'd taken a photo so people can see, but also not as it could encourage self-harming and it was that shocking, I don't want to remember.

However writing posts like this is important as it not only helps others understand their own mental health conditions and if I help just one person, then that's a success, but it also shows me how far I've come, what I've lived through and how strong I can be. Some days I need that.

Brain fog

The frog equivalent of fog

Or as I like to call it, my brain frog. Brain fog is a technical term, doctors use it to describe the feeling when you're trying to use your brain, but it's harder than usual: the mental equivalent of trying to walk through mud, or, as it says, thinking through a dense fog. Many of us experience brain fog without even realising it. When you're exhausted, drunk or hungover, you will have gone through brain fog. For me, it's when my vestibular problem hits, when the vertigo is so bad I can't think straight. My concentration is shot, that includes with my eyes, it takes a few more moments for something to sink in and, for me, it manifests the most when I speak. My brain frog is a literal frog in my throat, robbing me of my usual powers of speech. I can be a Mrs Malaprop at the best of times, but it gets worse when the brain fog manifests. My vocabulary gets more limited and the words just won't come out, or the wrong words do, usually ones that are very similar. That's why I call it my brain frog because, when I try to describe it to someone when I'm living with it, I invariably tend to say frog instead of fog.

For someone who reads a lot and prides themselves over their use of words, it's frustrating. For someone who usually thinks nineteen to the dozen and has a quick mind, it's horrible. For someone who's trying to write this blog post, it's almost impossible and takes ten times as long. Of all the symptoms of vertigo and the consequences, such as the lack of sleep which doesn't help in itself, the balance problems, the motion sickness, the nausea and the energy it saps from you just getting through the day, the brain fog is the worst as it makes you feel like you're not yourself anymore. It can last for hours and sometimes days, even after the main spinning sensations have gone, leaving you feeling hopeless.

There are ways of dealing with it, not least taking it easier, going slower, triple checking what you're doing, making notes and creating reminders. I rely on muscle memory, especially when I'm getting around, remembering routes, room numbers and people's names. So don't take it personally if I get your name wrong or don't say it at all. Mostly, you have to be kinder to yourself, like me forgiving myself for the little mistakes my anxiety usually berates me over and over again with and managing your own expectations of yourself. Chronic illness is difficult if you remember how you were before; you have to accept the fact that person is gone. So I have befriended my brain frog and have even become amused by it. It's a funny friend and one that is here to stay.

Holiday anxiety

Going on holiday causes me a great deal of anxiety. Don't get me wrong, I love travelling, seeing places, experiencing other cultures, being embedded in a new world. However, the going on holiday, that's an altogether different thing. First off, there's the anticipation. Our recent holiday to Costa Rica took months of discussions, much planning and it's a long flight. So there was a lot of time to think about it, the distance, the difference and the disturbance. For my previous big holiday to The Philippines, I tried to bury my head in the sand, which didn't work out, as it only caused more uncertainty; a week before I was having panic attacks and it was an exceptionally fraught journey. So I did the opposite with Costa Rica, reading two guidebooks cover to cover way in advance of booking anything other than the flights and involving myself totally. Knowledge helps as anxiety is all about uncertainty. So understanding what the place is like, reading up on it and knowing where we're staying and what we will be doing really helped and the result: no panic attacks at all.

A nicer way to travel: horse riding at Arenal

Then there's the actual travelling. Car journeys are tough and we've done some long car journeys: up to Scotland several times (8 hours), deepest Wales (6 hours) and all the way across Europe to Germany (days). I've only had panic attacks a few times on car journeys and they weren't about the car journey: bad weather where vehicles were aquaplaning all over the place; I was already having a panic attack and had been having them for days during my mini breakdown; and due to my balance problem causing me to feel like I was on rollercoaster and I'd just seen the final Harry Potter film at an old-fashioned cinema and it had messed with my head. Boat trips are worse because I get seasick, but I can handle it better as it's easier to combat it. Big boats like ferries are no problem as you can barely feel they're moving. With smaller boats, I just go to the front and watch the horizon, so no panic attacks there. It even gave me a indelibly memorable moment in The Philippines: I was alone at the front of the boat and a whole flock of flying fish just erupted before my eyes. But plane journeys, they've caused several panic attacks. I don't like being in situations I can't get out of easily, not enclosed spaces as such, things like lifts, caves, tunnels, planes, queues, even complicated clothing... The plane panic has got so bad, I've been physically sick and that was on a 4-hour flight. The Philippines took two flights of seven and then eight hours. I was dreadful on the first flight. On the second, I was simply exhausted. However on the flight to Costa Rica, a journey of almost 11 hours, I was fine, apart from a small blip after eating and when I was between films; I just have to keep my mind preoccupied.

I could never be as relaxed as a sloth, especially those at Toucan Rescue Ranch

I had prepared, taking: a book I was already really into and couldn't wait to find out what happened next and another book which was a romcom I had been itching to read; a puzzle book which occupies my mind like nothing else; music and noise cancelling cordless headphones including tracks explicitly designed to combat anxiety, so much so they advise you not to listen to it while driving or operating machinery; a pad of paper so I could get my thoughts down if I needed to; my notes on my book in case I wanted to do some actual writing; and my pills as an emotional crutch. I didn't need any of them; turns out, all I needed was the in-flight entertainment, being careful of what I watched, sticking to family films, comedies and light drama; I saw five films there and five on the way back: Early Man, Ferdinand, Peter Rabbit, Lady Bird and Alan Partridge: Alpha Papa on the way there and Peter Rabbit, Love, Simon, Blockers, I, Tonya and Isle of Dogs coming home. Yes, I watched Peter Rabbit twice, I just loved it so much, which was a surprise as I adore Beatrix Potter, heard bad things about it and probably wouldn't have seen it if not for the flight. I even found some wellbeing videos while investigating what was on offer: BA provides for their customers.

My bedroom on Tresco, in the Isles of Scilly

The other issue is I'm a complete and utter homebody. I like my own bed. In fact, there's only been one holiday where I've slept well and that's because the bed was amazing: Tresco in the Isles of Scilly. I can't sleep on anything that moves, or I can feel moving anyway, so planes are completely out, cars and smaller boats are problematic, but big ferries are fine. Because I was the last person to lock our front door and even though I did it in such a way as I would remember, using my left hand instead of my dominant right hand, I still spent the entire holiday in Costa Rica thinking I didn't lock the door. I had, obviously. But anxiety makes you believe you're an idiot!

I adapt very quickly and we were on holiday for three weeks. Three weeks is a long time and I didn't realise how much I'd adjusted until we got back. It’s enough time for the roadworks that were the bugbear of my daily commute to move elsewhere, for the goslings I see every day to become indistinguishable from their parents and for my team at work to change again. I could no longer overtake anyone on my bicycle, probably due to the lingering virus, rather than being unfit; we did a lot of walking. It's enough time for cobwebs to grow on my bicycle locks. It's enough time for the UK to get better weather than Costa Rica!

Some of the beaches were all but deserted, like this one in Montezuma, despite being beautiful

A strange thing happens when I'm on holiday: I don't get anxiety, not full-blown anxiety anyway, just your ordinary run-of-the-mill anxiety that most people experience, but not me. I was challenged, but my anxiety didn't take over like it usually does, even when I was ill having caught a horrible virus; being ill on holiday far from home is my worst nightmare; even when there was a massive thunderstorm for hours on end, even when we were driving roads with massive potholes (Great Britain has nothing on Costa Rica) along high roads with steep drops in the middle of nowhere. It helps that in The Philippines and Costa Rica, we were visiting family and I had my niece and nephew to concentrate on. Home is not a building, but the people you love. But it's happened on other holidays too. It's like being away from home is a holiday from the worries of daily life, a vacation from reality. I do things that I wouldn't normally do like going surfing when my balance problem should stop me, using an outdoor shower without thinking about the huge bugs and trying new food when I'm a picky eater. I'm trying to hold on to that now I'm home.

Me swimming with trout in a waterfall river

I won't be doing any night walks again though; we did ours from Monteverde, but you can do them from practically anywhere. It was a great experience; there are no pictures as my camera wasn't good enough, though we saw a sloth, kinkajou, armadillo, tarantula, snakes and many birds and insects. We got better photos on our own night walk in Arenal. But it's not something I'll be doing again. I probably wouldn't have booked it for myself, just like the surfing, and for the same reason: my balance problem. It's easy to see how being permanently off kilter would stop me from surfing, but you wouldn't think it would affect me walking around in the dark. However it's one of my biggest problems. We had torches, though when we had to turn them off to see a scorpion in UV light, I had to grab hold of someone for fear of falling over. There was an added complication. My niece wanted to hold my hand, so I spent practically the whole time with her, apart from when I got annoyed at her jumping over things and flashing her torch in my face, but she came back to me. This would normally be fine, but when I'm concentrating so hard to keep myself upright, having to look after her as well and fearing that if I go over, she'll go with me was difficult. However it did help with the anxiety, having someone else to focus on!

A red-eyed tree frog on our own night walk in Arenal

I must admit it’s difficult being back. Not for the usual reasons: tiredness but not jetlag, back to reality, back to work, back home and the football and Wimbledon being over. It’s for more subtle reasons, other than missing my family of course. When I open my curtains in the morning, it’s not a hummingbird I see but a pigeon, bunny rabbits not agoutis and the birds flying overhead are not vultures, but pigeons. Everywhere is yellow and dry rather than lush and green. In Costa Rica, everywhere is so full of life, wildlife, from birds to butterflies, from lizards to insects. I keep looking at tress moving, expecting to see a monkey and seeing a squirrel, looking at every bird expecting to see something interesting and listening out for rumblings in the sky in the afternoon. My alarm clock is my phone, not howler monkeys, thunderstorms or my niece creeping in to see if I’m awake. The fruit is smaller and less exotic. The potholes are smaller and less numerous.

Me with an owl butterfly at La PazWaterfall Gardens

However the holiday has changed my world view, more so than when I went to The Philippines and Bali, but less so than when I went to Tunisia as a teenager. Costa Rica, for all its wildlife, beauty and landscape, has made me grateful to live here, despite the politics, due to the health and safety (though we have gone too far), advanced infrastructure and less obvious poverty. It has taught me to look around more closely; you never know when you’re going to see a different bird, lizard or something interesting; to walk bare foot and to try new things like swim in a trout-filled river! Above all, I have returned with a renewed sense of confidence, though that has taken a knock as I was stuck in my glasses while waiting for my contact lenses to be redelivered. I'm proud of how well I coped. With that confidence comes an acceptance of unconditional love and friendship; my limpet of a niece didn’t want to spend all that time with me because I have a radiant personality, looked good or am witty, it was because I’m her “Auntie Sarwah.” So my experiences have lead me to an acceptance of who I am, to accept me for me, which is no small thing. I have made a resolution to take the holiday spirit and apply it to my anxiety. Let's see how I get on!

A mother and baby spider monkey, just because

Here are my reviews of the places we stayed, it's mostly about the animals I saw as I'm a nature-lover:

San Jose
The first place we stayed in was my brother's place near to San Jose. From there we visited three wonderful places, though I can also recommend Museo Nacional de Costa Rica in San Jose:

My brother's place

Zoo Ave
You will see wild animals in amongst the rescued ones. You will see animals you won't see anyway else, including a tapir (unless you're very lucky), peccary (unless you're very unlucky as they're dangerous) and pumas (to see a big cat is highly unlikely). You will see how we should always put wildlife before ourselves.

These squirrels were everywhere

La Paz Waterfall Gardens
Known for its waterfalls and its hummingbirds, my favourite part was the butterfly house. They also have sloths, toucans and poison frogs. You won't see one of their residents anywhere else, unless you're very very very lucky and that's a jaguar. The walk down to the waterfalls is actually quite easy, though it is a lot of steps and they'll bus you back up. However just sit by the hummingbird feeders by the entrance or down by the excellent restaurant and you'll marvel at the wonder of nature.

A jaguar at La Paz Waterfall Gardens

Toucan Rescue Ranch

One of the most memorable places I have ever visited. It may be named after the toucans, but they have lots of other animals including big cats like the ocelot, porcupines, raptors, parrots and most famously, sloths. If you want to see sloths up close, baby sloths and how a country should treat its wildlife, then this is the place for you. You will need to book a private tour and you will get an informative and passionate guide to show you round. It may be a tiny place, but it will occupy a huge space in your mind.

This is hard to see, but it's one of the lucky ones as it's at Toucan Rescue Ranch

Casa Frangipani, Montezuma
This was one of the standouts of the entire holiday and we almost didn't go; it was a last-minute change after our flight to Tortuguero was cancelled as the airline had a fatal crash and weren't flying. You will need to take a car ferry there, but it's worth it. We were high up, overlooking the coast so we could see the ocean and we were surrounded by rainforest. We saw more animals in the first day than we'd see staying next to a National Park! Vultures perched on a tree branch, howler monkeys including babies in the trees next to the pool we were swimming in, agoutis bounding around, hummingbirds flitting from flower to flower, flycatchers and other birds chirping from the canopy, leaf-cutter ants constantly marching in line and countless butterflies. The accommodation was nothing outstanding, but it had an amazing balcony, a roof terrace we never used and an outdoor shower only I used. Montezuma, the village nearby has a great Italian restaurant, a bohemian feel and incredible beaches just up the road. I can highly recommend the tidal pools and surfing beaches, where you'll see pelicans diving for fish. Beware, the roads are terrible.

The pool at Casa Frangipani

Club Del Mar, Jaco
On the way, stop off at the bridge over the Tárcoles River to see the crocodiles. We were in Jaco when I was ill, so I didn't explore much, mostly dosing and getting through two tissue boxes, but we saw an iguana climb the tree just outside our place on the first day and it proved to be a regular visitor, scarlet macaws flew over and fed from the trees by the resort's beach every morning and the butterflies again were amazing. The accommodation was the best we stayed in: spacious, comfortable and with superb facilities. The resort itself was fantastic with a great breakfast every day and excellent staff, a lovely pool and beach I didn't use complete with surfing lessons and a chilled-out atmosphere. Jaco is basically a strip of shops and your typical white sandy town beach, not that I'd know.

One of the residents at Club Del Mar lazing by the pool

La Posada, Manuel Antonio
Its location cannot be faulted as it's right next to the National Park entrance, but it's also its downfall because it's in a busy area with street sellers touting their wares all day; the bird whistle sellers were a particular annoyance. However I saw my first and only raccoon here, there were hummingbirds around, iguanas, lizards and giant insects. We never saw any monkeys or sloths though until we entered the park, including on the castaway-like beach which is a must. The staff were so helpful and welcoming, the pool was perfect for our needs and the accommodation was spacious and comfortable. We got a good breakfast every morning and there was a supermarket incredibly close and bars nearby. For the restaurants though, don't go down to the strip, get in the car and drive up to those overlooking the sea, such as El Avion which has an airplane in the middle of it! Do not stay here if you don't like touristy places, stay in Quepos a few miles away and do go on a river trip as the mangroves are very close; it was one of the highlights of our trip.

One of the sights on the mangrove boat tour: a capuchin monkey

Arco Iris, Monteverde, Santa Elena
It can get very hot, sunny and humid by the coast. In the cloud forest, it's colder and wetter, with weather just like an English Summer, except more humid and with regular thunderstorms. Santa Elena is a strange place, a town in the middle of nowhere, high up and with cloud forest all around. The wildlife in our hotel was almost nil, except the resident cats my nephew adored, but the breakfast was the best we had, full of locally sourced and grown ingredients, including on site. The emphasis here is on the environment, and the accommodation and resort reflected this. It was lovely, like alpine chalets and the town has everything you could need, though it can get very busy with its tourist shops. The local cloud forest we visited is easily accessible, but more about the trees than the wildlife, though we did see a coati, but in the car park!

A hummingbird in the cloud forest

Arenal Observatory Lodge, Arenal
For me, the best place we stayed in, saving it for last! The accommodation we had was a bit odd though, with the sink and toilet in separate rooms, but the shower was brilliant. The roads are shocking, but the place is stunning. We saw more bird life here than anywhere else, including a resident hummingbird right outside our lodge. There were also coatis, monkeys (both howler and spider monkeys), butterflies, frogs, geckos and my Dad saw a kinkajou. Nearby are numerous hot springs, if that's your thing. We went to Baldi as it has water slides and the lodge booked for us as we got a discount. The observatory has everything you need and were very helpful. The breakfast was fantastic and the views by the restaurant and bar are breathtaking of both the volcano and the lake. The grounds are extensive with hanging bridges, a swimming pool, massive jacuzzi, gardens, a waterfall and nature trails. Visiting the frog pond at night is a must. You can go horse riding and take advantage of their other activities. I could have stayed here forever just watching the changing landscape, exploring the trails and seeing some new creature every single day.

The swimming pool at Arenal and the volcano

A few tips about Costa Rica: if you're driving, get a 4x4; don't worry about power cuts or internet outages, they happen; always close the screens on windows and shutters otherwise you'll let the bugs in; revel in the wildlife, Costa Rica is a nature-lover's paradise; Don't spend all your time taking photos, some of my best memories are just sitting and watching the animals, my family and the world around me.

A crocodile chilling out by the bridge over the Tarcoles River

Anxiety: My Past, Present and Future

Wear Your Label

Writing is therapy for me, so if any of you are interested, please read on. Please share this with anyone you feel may benefit from it. If it helps just one person, me, then it's done its job. I've always felt I've been too honest for my own good. Well, I think being honest will do me good right now. I'm going to tell you things I have never told my own family, they may have guessed, but I have never actually voiced these things. I have written about my anxiety before, in this blog too, especially a post for Mental Health Awareness Month. But I didn't go into detail. I want to go into detail now.

You may think you know what it feels like to suffer from anxiety and panic attacks, but you don't, not truly. You've seen lists of symptoms and may have had first hand accounts, but if you've never personally experienced it before, then you can't know. I'm going to make you understand, put yourself in my shoes, show you what it truly means to suffer from anxiety. I'm going to tell it like it is.

Why am I writing about it now? Especially as my last blog post on the subject was so positive; I overly optimistically called it Looking Forward to the Future. I got complacent. I thought I was over this thing. The big holiday I recently went on, that my last blog post was about? It made me think I had turned a corner, that I was capable of more than I ever thought. I am, but while the holiday combined numbers 2 and 3 on my top 5 causes of anxiety, it wasn't the top cause. I decided to tackle the top cause and failed, miserably. I decided to try and date and maybe find my first ever boyfriend. Yes, I am 32. Infer what you will. I went on a date, well a kind of date, the first time in many years. I coped better than I expected. But I had to leave early, though I didn't want to, because I was on the verge of a panic attack. I don't know what's going to happen next, but I'm determined to try and find another date. I battled for a time, wanting to take the easy way out, just give up. But if I do, I can see a life of loneliness ahead of me and no one wants that. There's got to be someone out there for me, so I'm optimistic.

How it feels:

Everyone experiences anxiety differently. There are common symptoms of course, but they can happen in different orders, at different levels and for different amounts of time. So I can only tell you about my own experiences. Many of my panic attacks come out of nowhere, or seemingly so. However they haven’t. They’ve been creeping up on me, sometimes minutes, days or even weeks in advance; the longest game of Grandmother’s footsteps ever. Anxiety is the most patient of life destroyers. It lies in wait, gradually wearing you down by increments. Chipping away at your confidence, at the walls you’ve built up, at your defence mechanisms until it reveals a vulnerability that it can exploit. It can be a crack that it prises open, or it blasts its way through. For such an unobtrusive thing, anxiety tends to have a flair for the dramatic.

Obviously, the unconscious has been working overdrive, preparing for this moment. Thinking isn’t an active thing, it works stealthily in the background. Thinking isn’t a bad thing. But even the best of thoughts, when thought often enough, obsessively enough, can become bad; you just get stuck in a cycle. I can’t say how many times I have woken up actually already in the middle of a panic attack. Waking up is jarring at the best of times, but waking up sweating profusely with a pounding heart and a cramping stomach is deeply unsettling. I have to talk the anxiety through with someone or write down everything it could be. Bringing the anxiety into the light, naming it, defining it and discovering the cause is the way to beat it. It’s the emotional equivalent of Rumpelstiltskin. This is hard if it’s the middle of the night and you’re still half asleep; I got a light for my bed mainly just in case, so I didn’t have to get out of bed. I have selfishly woken people up before because I couldn’t bear to deal with it alone, or couldn’t no matter how hard I tried. The middle of the night is my worst time. It’s dark; the seemingly infinite blackness of night has a way of heightening everything. All that is familiar suddenly becomes alien. There is no comfort in the night if you’ve woken up and you’re alone. You’re not sure what’s real and what’s not. Your mind is confused with sleep. However annoyingly you’re alert and ready because your body has gone into fight or flight mode. You may not need to think, but it’s like you’re navigating through fog. Once I’ve analysed the anxiety to the point of exhaustion, I hit on the right reason. I know, because I instantly feel worse and get more panicky. It’s as if my body doesn’t want me to get better; it’s a last ditch defence mechanism. However when I start to address it, I feel better. It’s been a long road to even get there and then a longer one before I can get back to normal though.

There’s a difference between an anxiety attack and a panic attack. Panic attacks are more severe and anxiety attacks can lead to panic attacks. Anxiety is the devil on your shoulder, constantly dogging you, digging at you, voicing your darkest thoughts, always saying “what if” and “if only”, dwelling on past mistakes, bringing up old grudges. Anxiety is paranoia, it’s your conscience and your darkest thoughts rolled into one. Anxiety is the fear of the unknown, seemingly a good thing, trying to anticipate what happens next, readying you for the future. Anxiety is not your friend. Nerves can be channelled and turned into an ally. Anxiety is nervousness that’s too far gone. There’s no turning it back. It can only be beaten. Anxiety is a bully, voicing the worst about you, setting you apart from everyone else; bullies target what makes their victims different. Anxiety narrows your view of the world. It makes you feel as if you can do no right, as if the world is better off without you.

The Breakfast Club

You focus so much on yourself and your own experiences that you become self-centred and selfish and boring. Yet that’s all you want to know, you don’t have the energy for anyone else’s life; you become a hermit. You feel suffocated and alone. That loneliness comes from the fear that no one understands you, that no one has ever felt the way you do. That voice becomes the only thing that gets you, which is almost definitely a fallacy. In the midst of a crowd, you have never felt so alone. You’re stuck, trapped inside your own head. You go round and round in circles, constantly searching for a way out, which is exhausting. You get bored of yourself so much you start hating yourself. Then you start to get depressed, uninterested in what you once saw as fascinating. Your work suffers as you can’t concentrate. Your mind can never settle on anything for long, apart from the obsessive thoughts of course. You focus on your emotional crutches, obsessive behaviour that borders on OCD, such as mine which is doing things in threes. You have a particular book (usually chicklit or children's books), song (Gotta Get Thru This by Daniel Bedingfield), film (Notting Hill used to work) or TV programme (Gilmore Girls got me through a very dark time) that you rely on, watch, read or listen to over and over again so that it starts to lose its efficacy. This makes you panic all the more. Panic is anxiety that has lost sight of itself. You’ve gone too many times round the hamster wheel. There is no light left in the dark.

Anxiety symptoms

There are physical symptoms too. Your shoulders ache as you hunch over, looking down at the floor instead of up at the world. Your stomach is often upset because it contracts so much. You feel tired and heavy, as if the weight of the world is on your shoulders, usually because you tense your muscles. You wake up feeling exactly the same as the night before because you don’t sleep deeply enough, which can also cause vivid dreams. You feel light-headed because you’re not breathing properly and get out of breath more easily. There are all these symptoms and more. There’s the fact you can't settle on anything for very long, the sweating, self-harm, mine was pinching so bad my legs were covered in bruises. Symptoms trigger symptoms. You are irritable and your temperature changes as you’re not sleeping well, and often not eating well either. You either don’t eat enough or comfort eat. You get sugar cravings, so you gorge on sweets and then your skin breaks out. You stop living and start existing.

However when a panic attack starts, these symptoms get worse. Not just the physical symptoms, but the mental ones too. The walls are down and chaos ensues. You lose all sense of control. Nothing seems right anymore. You feel a sense of doom, as if not just your world, but the whole world is coming to an end, as if nothing good can happen ever again. You get annoyed that no one else can see it, which alienates you all the more. Pins and needles start as you hyperventilate, which makes you feel dizzy and faint. Your equilibrium goes so you feel off kilter. Your limbs start to seize up and your stomach starts churning, this is because your muscles are tense. It’s the bodily equivalent of trying to find a hole to swallow you up. Then you start to think you’re ill which only makes the panic worse. Every thought you have plays out to the worst possible scenario: headaches become brain tumours, nausea becomes swine flu, and pain becomes a heart attack. You feel you can’t breathe at all, even though you can as what you’re doing is breathing too much. Your heart was fluttering before, now it’s pounding so you can hear it in your ears. It rocks your body with its power. Your chest gets tighter, as if you’re being squeezed and even though you’re generally fit and healthy, you think your heart is failing. It’s not failing, it’s flailing in panic, in a fight or flight reflex as it thinks it’s under attack. Ironically, it's the one doing the attacking. The constriction gets too much and you take off all that is tight: jewellery, belts, underwear. You have forgotten the world around you and start living inside your head, no one can get through to you. You hear people trying to help, if you’re lucky and you’re not alone, or unlucky, whichever way you want to have it. You feel their touch, their concern, their threats, but nothing makes any impact. They’ve faded into the background. You can’t bear to be alone but you don't want to be touched. No one can help. You can even provoke worse symptoms such as diarrhoea and vomiting, purely psychosomatic and mind over matter.

Generally, they don’t last. You have to ride it out. Though in my experience they can and did, last for days. Afterwards, you will be hungover, the most exhausted you have ever felt in your life, emotionally and physically. This is due to the adrenalin comedown. You can deal with that. What you can’t deal with is the shame. You will feel weak. You will wonder why this has happened to you. You will feel abnormal. You will become concerned that there is something wrong with you because other people are dealing with things better. Think: no one ever does anything better, just differently. There is something wrong with you, but it’s not anything that you’ve done wrong, or anything wrong with your character.

What you need to do is flip it, twist it and spin it for your own purposes. Stop living in the past as it makes you depressed. Stop living in the future as it makes you anxious. Live for the present, be in the moment (Lao Tzu). Before the anxiety truly takes hold, recognise the early symptoms, mine was the pins and needles, and simply breathe: in through your nose, hold and then out through your mouth. Focus on it. Feel the air filling you up. Take energy from it. Take note of the world around you, distract yourself, something, anything that takes your mind off how you’re feeling. If it’s a situation, be kind to yourself and leave. Then take stock. Avoidance isn’t a good idea in the long-term; you can’t avoid things forever and the symptoms will be ten times worse if you do avoid it. Anxiety doesn’t like being ignored, it only makes it mad and it encourages it. It’s a bully, so it wants a reaction, no matter how small. If it gets one, it spurs it on. Distraction may work in the short term, but it is only a band aid over a gash; it won’t hold, you need to stitch yourself back together.

What’s left will be a scar, a reminder, something you will never forget. But it’s also a mark of a survivor, a reminder that you’re not weak, that you’re actually stronger than you knew. It’s also a reminder to be kinder to yourself; you learn from it. Mental illness is not a sign of weakness, it’s a sign that you’ve been strong for far too long. It will change you. It may be a cliché, but it’s only a cliché because it’s true; what doesn’t kill you only makes you stronger. Other people are a great solace, but you can’t rely on them. Even those who love you unconditionally will lose their patience. You need to get back in tune with your body, that’s why taking a shower or a bath, or doing exercise is the best way of getting over it. Become more self-aware in a good way. Tell someone. You may think it’s obvious you’re having a panic attack, but unless you’re sweating profusely, going to the toilet every five minutes or physically ill, trust me, no one has noticed apart from those who know you best and they don’t care. Those who mind don’t matter and those that matter don’t mind (Bernard Baruch/Dr. Seuss). Mental illness, anxiety, can be genetic, you can be predisposed towards it, or it can be in response to something. You can get back in control, but like an alcoholic, once you’ve suffered with mental health problems, it’ll always be there, waiting for you to trip up, no matter how far you think you’ve come and how long you’ve been free of it. Don't get complacent like I did.

My history
My first panic attack and therefore first recognisable symptom of anxiety was when I was 16 and watching Apollo 13. I was a fearful child, but they were usual fears: dogs, wasps, the dark, nothing out of the ordinary. This was different. I started to hyperventilate when the astronauts’ oxygen supply was running out; I thought I couldn’t breathe. I’ve always had an overactive imagination, but this was the first time it had caused noticeable physical symptoms, other than nightmares of course. I got so bad that my Dad threatened to take me to hospital, which shocked me so much I stopped. It started with pins and needles in my nose, then my fingers started to tingle and I felt as if my wrists were restrained, as if I was wearing handcuffs. My muscles tensed up, including my stomach, so my tummy started to churn and I felt nauseous. As the hyperventilation increased, my head started to swim and I felt incredibly dizzy, so I got off the sofa where I was sitting and hunched on the floor. I couldn’t bear to be restricted, so I took off my bra, from under my clothes, and my jewellery. My Dad tried to straighten my limbs out, but they started to spasm as they were so tense. He rubbed them in an attempt to get them back to normal. I couldn’t stand up. Afterwards I had to rush to the toilet, but not to throw up. None of us knew that this would be just the start. My family has always been supportive and mostly non-judgemental, which is difficult as mental illness can be seen as attention-seeking behaviour and by its very nature is self-centred and sometimes selfish. But they don’t understand, not really. By the way, never ask anyone suffering from mental illness, "are you okay?" Instead ask, "what can I do to help?" They may not have an answer for you, but instead of making them feel worse about themselves, making it harder for them as they are simply trying to hold themselves together, they know you're there if they need you. When trying to help, don't tell them to stop thinking, that's totally not helpful. Don't say it's irrational because believe me, they already know. My family tries their best. That's all anyone can do really, just be there.

The moment

The most public panic attack I had was while watching The Lord of the Rings: The Fellowship of the Ring, when the black riders were sniffing out the hobbits under the tree, I thought I was going to die. Not in the now hyperbolic sense which teenagers state on social media, but I literally felt as if I would stop living. I had to leave the cinema and once I was out, I was fine, but I couldn’t bring myself to go back in there. My friend said I was claustrophobic as an easy answer to explain my behaviour. The plus side was it made me read the books before seeing the next film in the series and I was fine watching The Two Towers, even though it was a much darker, more intense and violent film.

The worst panic attack I had was when I was home alone. By now, my anxiety had become so bad I was having several panic attacks a day, caused by the littlest things, even a TV advert or a random comment could set one off. I was having trouble eating, fighting through what I called the ‘upchuck reflex’ to get anything down. In a funny yet desperately unfunny incident, one of my friends had to force feed me a chocolate chip muffin to get me to eat; I was shaking so bad and feeling so cold, even though it was Summer, she had to do something. It was affecting my friendships, and due to the mental fallout, it would ruin at least two of them, it stopped me from embarking on my first relationship and would continue to do so with the poor guy for years to come, or anyone for that matter. I’ve thrown up on a date before, in front of them. The anticipation of another date was so bad, I had to leave it early. So my latest foray into romance was a big improvement!

Charlie Brown

When I woke up that day, the day of the worst panic attack, it was too early and yet my family had already left the house and from then on, it was panic central. I was supposed to be going to work. I tried to watch Notting Hill, which was my go-to film at the time and one of my supposedly fool proof distraction techniques. It didn’t work. I phoned a friend, but she couldn’t help with just her disembodied voice. I phoned the out of hours NHS number, the lady tried to help. I continually phoned my parents and they finally cut me off as they were trying to drive my brother to university and I was going to cause an accident. I somehow got up and ready, somehow late despite waking up way too early. I was moving slowly as my legs had seized up, I was so tired and wasn’t breathing properly. I made my slow way to the bus stop as I couldn’t walk properly and phoned work as early as I could, saying I’d be late, probably making up an excuse. I got to work in the end, but had to get off one bus and wait for the next where luckily I met someone I knew who was very talkative, diverting enough to be distracting and didn’t need much input from me. I did a day’s work, even working alone for a time, absolutely fine.

In the time since then, I have had darker episodes, once contemplating suicide standing next to a busy road, thinking how easy it would be just to step out. In hindsight, I probably wouldn’t have died unless a big truck or at least a bus was going past just at the right moment. I also relied too much on alcohol to get over social anxiety and to drown the feelings. That didn't end well and it was lucky I never got into drugs or smoking. I gave it up after my third hangover and barely touch alcohol now. Over the years, I have still suffered with anxiety, but there were varying degrees of it, where it ruled my life or quietly simmered in the background, biding its time. I deferred university a year, ostensibly to earn money, but actually to regain my confidence and get on top of the anxiety. I got a decent degree, though presentations made the anxiety rear its ugly head again, worsening my grade for the piece as my breathing affected my delivery. I held down several jobs, found my vocation in life, learned to drive, passing the test 5^th time as my anxiety was too much; I only passed because I thought I failed from the off like I did the 4^th time and relaxed.

I got to know this bedroom very well, in all lights

By far my worst time with anxiety was Bruges. I had just finished my second degree distance learning, studying when I wasn’t at my full-time job, working damn hard to get my dissertation in on time, handing it in a few months later than I wanted and then we went on holiday. It was my nephew’s birthday and we’d decided to visit them in Germany and then go on to Bruges for a mini break. I should have seen it coming as I was on edge on the run up to the holiday, I wasn’t eating or sleeping well and I was covered in bruises from where I had been pinching myself. I wanted to believe it was just the stress from finishing my studies, but it wasn’t. I went from being spectacularly busy to doing basically nothing. The symptoms got worse; I couldn’t really sleep at all, waking my brother up who was sharing a room with me to help me through it and the panic attacks that eventually came, or reading trying to distract myself, but finally that stopped working altogether which made me panic even more as I’d never been unable to read before. I wasn’t eating properly and finally when we got to Bruges, I stopped eating altogether; at the height of it all, you couldn’t see the skin on my legs it was so covered in bruises from the pinching. We did see a bit of Bruges, a few of the sights, but it was hell for all of us as everyone was tired and I wouldn’t be left alone so they had to drag me around everywhere and someone had to be with me at all times. At one point, my Dad went and got me some medication in the middle of the night, but despite having nothing in my stomach, barely even water, I just threw the pill straight back up again. I pawed at my Mum and hurt her. She bruises easily, but the hideous bruise I made on her arm haunts me still. They were long long nights, I always feel better when the sun comes up. I started to improve on the journey home, which was very uncomfortable as we had driven; the journey through the channel tunnel was one of the worst experiences even with the relief we were finally going home. My thoughts were running wild, full of fears of the things that could delay us or even prevent us getting home altogether. Luckily there was little traffic and everything went well.

Those few days felt like an eternity and I was either having a panic attack all day every day or constant panic attacks one after another. The doctors say the body can’t sustain it, but mine somehow did. They always say panic attacks will subside, but mine never did until I got home. When I got back, I was so tired and malnourished, I moved back in with my parents and they took me straight to the doctor, who signed me off work for 10 days, told me I needed to start eating again or else he’d have to intervene, but he wasn’t duly concerned yet; I didn’t really lose that much weight which was the bizarre thing. He’s the one who first prescribed me diazepam. Through the TLC from my parents, gentle coaxing with my favourite foods and some of the deepest sleep I’ve ever known, I was well enough to go back to work. My boss was very understanding, which I’m extremely grateful for and allowed me time off to go to counselling; it just meant leaving a little early once a week. There was no stigma attached, only the emphasis that I laid on it.

Grey's Anatomy

After trying all sorts of different therapies: hypnotherapy (couldn’t relax enough), meditation (the room would spin when I closed my eyes and I couldn’t find a good position (see below), neurofeedback (answered some questions), standard counselling (answered more questions), mindfulness (which I continue to try and practice), I still suffer with mental illness, especially anxiety. There were several triggers, some expected, some unexpected and they all ganged up on me, arriving in my life all at once. Some of them were actually supposedly positive things, some were a mixture of both positive and negative and some were decidedly negative. They all acted together. However there was one factor I did not know about, that could have been building up for years before, or started when the anxiety hit, I will never know. I've written about this before in a previous blog post, but I'll summarise it here. Around the same time as the anxiety began, along with the panic attacks and eating disorder, I started to have attacks of vertigo. Not the fear of heights, vertigo is a symptom of acrophobia, the fear of heights: it’s when the room/world starts spinning. At first I thought it was simple dizziness, but the room doesn’t spin when you’re dizzy, that’s vertigo. Then I simply put it down to the anxiety. But it progressed from once in a blue moon to appearing more regularly, getting more violent and lasting longer, anywhere from 12-48 hours. It incapacitated me. I had to go through several diagnoses before I got the right one, pushing for a specialist: labyrinthitis (the attacks didn’t last long enough), migraines, menieres (no hearing loss) and finally they said I have vestibular damage. After tests, it was found I only had 23% left of my right balance organ, so I’d been permanently off kilter for almost half my lifetime. This disorder can make my anxiety worse, or the anxiety can make it worse, especially with the breathing. However knowing hasn’t cured my anxiety, it helps, but my body has learned the behaviour: now ironically any symptom of anxiety can trigger anxiety or even a panic attack, from nausea or an unsettled stomach to increased heart rate. For instance, I had to leave Centre Court of Wimbledon because I was so excited to be there, my heart rate reached such a level my body thought I was having an anxiety attack and almost lead me to actually having one!

From the brilliant film Ever After

The last time before this anxiety attack, I managed to stave off a full scale panic attack. It was after a bout of illness, which again could have been psychosomatic, caused by anxiety because I experienced an anxiety attack then. I was about to go on the biggest holiday of my life, literally the biggest as it was for the longest time and the furthest away. I've described it in a blog post. This obviously caused a great deal of anticipation, my biggest problem, stress and anxiety. I had got into thinking it was a bad idea, that I couldn’t do it and fears of ruining the holiday like I did in Bruges reared their ugly heads. I had cyclical thoughts and talked them through with my brother. I quite wisely went to the doctor, explained the situation and he gave me some diazepam. On the day we were leaving, I had to take one pill to even get to the car. I had to drive as well, only a short way, but still. Then I had to take one on the first plane and finally when we got there to even get through the night, I didn’t really sleep that first night. I kept them with me at all times during the holiday, but never needed another pill, my proudest achievement. Ashamed at the weakness I’d showed, I threw myself into the holiday and my brother said I was his highlight of the whole holiday, even above seeing his first seahorse.

The holiday taught me that I'm stronger than I realise. But it also taught me that I will never be free of the anxiety. I know I will have to live with anxiety forever, but I know how to help myself and being indoors, not exercising, not looking after myself, just watching TV and lying in bed, no matter how tempting, is only going to make matters worse. Be kind to yourself, but also challenge yourself. That's the key to living with any mental illness. I just hope I can take my own advice.

Bittersweet victory

This blog post has been 15 years in the making, almost half my lifetime. If you're thinking we didn't really have the internet and blogs back then, you'd be right. It's not that I've been writing this post since then, but the events detailed here have taken this long.

Trust me I'm a doctor

If you take two things from this post, morals if you will, they are these: never taken a doctor's word as gospel and the things you thought you knew change on you. This post will be of interest to anyone who feels disappointed, short-changed or unsure after an appointment with a doctor. I too often accepted a diagnosis from a doctor, even when it didn't feel right. I have a problem with authority figures, underneath I see them as humans, just as fallible as the rest of us, but I always quail before them. Carefully rehearsed speeches go out the window when I enter their office. So I quietly defy them in that I do my research afterwards and thank goodness for that or I wouldn't be where I am today. The registrar wrote me off yesterday; it was my last appointment with him and I'm now in the hands of the physios. In the nicest possible way, he hopes to never see me again and I couldn't agree more. My Mum got a bit teary as this has been years in coming and she praised me for sticking with it, holding my ground and forcing the doctors' hands. I just see it as coming down to a mixture of desperation and stubbornness, but there must have been some self-belief in there too. The victory is bittersweet for me because of the time it's taken, the toll it's taken and the things I've missed out on because of it. But finally, it's at an end. I'll take you down the only road I've ever been down.

One word of warning: I've always been open and honest about things, so here's me being open and honest about my health and if it helps one person either understand me or themselves better, then this post has done its job. So if you ever wondered about me, my clumsiness, vagueness and my anxiety, or your own clumsiness and dizziness, then read on.

Have you ever felt dizzy with no apparent cause? Does vertigo plague your life that can't be put down to anything else? Do you get anxious for no particular reason? That's been my life ever since I was 16, when I started to have attacks of vertigo that came out of the blue, that incapacitated me so I can't lie down without making it worse, I can't walk in a straight line and I can only find one position when the room isn't spinning: half sitting and half lying down in a weird position. These attacks steadily got worse and more frequent. They lasted one or two days and knocked my energy for longer. A common misconception is that vertigo is the fear of heights, but that's acrophobia. Vertigo is one of the symptoms of acrophobia, like when you look down at the world far below and everything starts spinning, that's vertigo. It feels like a combination of being drunk without the good bits and the worst hangover of your life. Some car journeys, especially those along winding country roads, can feel like a rollercoaster. General day to day life is made harder, particularly with concentration levels and my energy is sapped quicker.

Vertigo

Over the years, I've been diagnosed with many different things, as the symptoms got worse. First a GP diagnosed me with labyrinthitis and was given tablets, but when I went to see a specialist, they told me it couldn't be labyrinthitis because the vertigo didn't last long enough. Then I got diagnosed with migraines, but the next specialist palmed me off with tablets which gave me distressing side effects. So I stopped taking them, plus I didn't think it was migraines as I didn't get headaches or any other symptoms apart from the vertigo. Then after a particularly bad bout, I was told it was Menieres and that there was nothing that could be done. I couldn't accept that and researched it. I'm stubborn and curious, a bad combination most of the time but not with this and it was just as well I am. One of the firm symptoms is hearing loss, so I went and got a hearing test. You can get a test done for free from Boots, but you have to pay for a copy of the results. So I went back to the doctor, again being referred by my GP and was told it couldn't be Menieres as I would have hearing loss if I was experiencing vertigo. My hearing is actually better than average and one good thing that has come out of this protracted diagnosis is I've discovered why I am so acutely sensitive to high pitched sounds like cutlery, because I hear it louder! The amount of doctors I've seen, pills I've taken and shouldn't have and diagnoses I've been given is depressing. Anyway, after a few simple balance tests last November, I received the diagnosis I had been waiting for: a correct diagnosis at last. I have vestibular damage to my right balance organ.

No one knows why it happened; it could've been a blow to the head, lack of blood flow or a virus, which is the most probable. But suddenly my life made sense, why I'm clumsy and am always bumping into things, why I can't walk in a straight line in the dark, why I have difficulty travelling and always get car sick. The attacks of vertigo over the years were the organ gradually degrading. It was a confusing but enlightening time for me. I was a gymnast, I've even got a certificate to prove I could do a cartwheel across a beam, so why did I suddenly have no balance? As the attacks of vertigo only happened once in a blue moon, I never connected the two until much later.

Blue moon

However after this epiphany moment, I received no more help; I just had to live with it. The only suggestion was to exercise, maybe do some martial arts. I exercise every day and I tried to do some martial arts, but it was impossible, because I couldn't balance. But like the passive, non-confrontational and introverted person I am, I let it slide and just carried on regardless. Until a heavy head cold knocked me sideways and I had to go on heavy duty motion sickness medication to even function. I wasn't going to take medication if I could help it, so I forced an appointment with a specialist and finally found a doctor who not only listened to me, but gave me time. He was as determined as I was to get to the bottom of it. From this point on, I couldn't fault Addenbrooke's Hospital or the NHS; they have been brilliant. After years of suffering, just living with it and getting on with things, I've finally been told the definitive cause, well, two causes: BPPV and a damaged balance organ on the right-hand side. The BPPV is easily fixed though.

BPPV stands for Benign Paroxysmal Positional Vertigo. It's basically where calcium deposits in the brain are dislodged and float around where they shouldn't be. The fix is a series of nauseating and mildly painful head manoeuvres to move them back. BPPV causes positional vertigo, which means vertigo if you look up or down, or hold your head in a certain way and if you roll over, or if you do anything with your head too quickly. It blighted my sleep as I toss and turn a lot in bed. So whenever I rolled over from left to right, I'd wake up or sleep more shallowly because of the vertigo. to be fair to the doctors, mine was very subtle and it's not surprising that they missed the eye movements that they look for by hanging my head over the edge of a bed.

They did quite a few tests, including an MRI of my head to rule out anything sinister, pumping my ears with water which was horrible, tracking my eye movements with funky knightrider glasses and balance tests. As for the damaged balance organ, it is very weak and may yet get worse, nothing is certain with this. I've lost 77% and it means I'm permanently off kilter and unbalanced. This may seem very very bad, but apparently like you can live with just one kidney or just one lung, you can live with just one balance organ. You just have to retrain your brain and reset your balance. So I'm seeing a physio and hopefully I will have my equilibrium back. My body grounding itself and my sight, they are as much balance organs as the balance organ. I know everyone gets motion sickness to some degree, anyone who has tried to navigate around their own house in the dark or rides rollercoasters for instance, knows what I'm talking about. My body gets royally confused and takes ages to reset itself. The symptoms may wear off for you after 10 minutes or so, but for me, it could be days. After long car journeys, I've lost a day before due to not being able to sleep because even with the light on, the room starts spinning the second I close my eyes and with no sleep, the next day is shot. Your balance comes from three things: your eyes and brain, your body and your balance organs. With one of them out of action, I only have my eyes and body. When either of those are compromised, I'm screwed. So if it's dark, if there's a disconnect between my body and eyes like when I'm travelling or even in crowds and everything is moving so fast around me, that's why I get the vertigo.

Here's a rollercoaster I can't believe I went on: the Dragon Khan at Portaventura, Barcelona

Lastly, I've written about this before, written about it on this blog before, but for the same amount of time as I've been living with vertigo, I've been living with anxiety and panic attacks. I always thought that the vertigo was a symptom of my anxiety and it can be. But it turns out, while it doesn't help as hyperventilation and irregular breathing can make your head swim, tense your body up and cause dizziness, the anxiety can also easily simply be a symptom of my balance problems. If the world feels off kilter, if you're permanently off balance, if you have no equilibrium, then of course you're going to feel anxious. And anything that exacerbates the symptoms would make you feel anxious, like public speaking when you have stand up for a while, often higher up than everyone else, like travelling and like socialising. I always thought that the anxiety caused my physical symptoms, racing heart rate, sweating and yes dizziness, but it seems too much of a coincidence as the anxiety and vertigo attacks started around the same time, that they are completely connected. My anxiety has a physical cause and if I can get my equilibrium back, maybe I can live anxiety-free. But that's a false hope as it's been too long and my body has got used to being anxious. If I get stressed or excited, by going on a rollercoaster for instance, which I wouldn't do anymore anyway because of my balance problems, but I would get the same symptoms as anxiety and it would bring on a panic attack as the increased adrenaline is now a signal that my body takes to induce a panic attack. So there are certain things I have to be careful of doing now. I even had to leave Centre Court at Wimbledon when I was there for the London 2012 Olympics because the excitement at just being at a place I had longed to go to ever since I was a kid became too much and it induced a panic attack. Stupid, right?

Me at Wimbledon Centre Court

My body has been doing a good job over the years of compensating, of living with the low grade nausea, of the world whirling around me. It never ceases to amaze me how adaptable the body is. But it also means I have many habits to break that I have built up over the years to cope with it all, some may be too ingrained to change, but we'll see. The physio has already identified a few bodily and posture problems. She has given me the exercises to reorientate myself, to allow my brain to get used to having only one balance organ. It's the only treatment. But she's also given me exercises to help realign my knees. I felt like a fraud in the gym at the hospital as there was a guy in there with an obvious brain injury just trying to get his limbs moving again, so I have him in mind the next time I feel too tired and want to shirk doing my exercises. I have a long body and short legs and I hunch over, not from being lazy, but because I'm trying to lower my centre of gravity to help me balance, or at least that's what I tell my Mum now after her years of nagging me to sit up straight! I also can't stand up for too long and when I do, I put my knees together for support, I even cycle like that. This has weakened my knees and I could start having problems in 10-15 years and even with my hips if I keep cycling the way I do. The impact that this has had on my body and mind is incredible. It will be interesting to see which things are genuine causes of anxiety and which are generated by the vertigo. It will be a journey of discovery, but one I'm more than happy to embark on. I'm determined to get over the anxiety if I can, to sit up straighter and to live my life more. Battling the balance problems took a lot of energy, so here's hoping I have more to play with! Most importantly, I have an answer, a reason and explanation for something that blighted my life for far too long and this bittersweet victory is all mine. I can change.

If any of this seems vaguely familiar to you, any of the symptoms, then read on.

BPPV symptoms

Does your Mum always tell you off for not sitting up straight? It may not be laziness, but because it isn't comfortable dizziness-wise. Having your head at a weird angle may help and you may be doing it unconsciously like I have.

Have you always thought you have low blood pressure, even though you've had it checked and it was fine? Do you find it difficult to stand up for too long, feel dizzy after standing or sitting up too quickly and get head rushes? This may be BPPV because sudden head movements or prolonged time with your head at a certain angle can cause dizziness. You can imagine what it was like working at a computer for me. My concentration was shot!

Did you used to be a heavy sleeper, turned into a shallow sleeper and then a very light sleeper? It could be down to rolling around, tossing and turning in bed at night. This might be due to stress sure, but it could also be rolling from right to left or left to right, depending on what side these damn crystals are at. I used to wake up with vertigo, with my covers off the bed or tangled up because of it.

Vestibular damage symptoms

Do you dislike travelling, not seeing new places or holidays, just because of the travelling part? Not for the usual reasons of the time it takes, airport angst, fear of flying, traffic jams, motorways and sea sickness? When the plane banks, does it feel like you're going to pass out? Can you not look out of the side windows of a car without feeling dizzy, even on the shortest of journeys? Do busy places make you feel anxious? Anything going at speed around you, whether it's when you're on a train or in a car or people walking fast around you, anything that confuses what speed you're actually moving at can bring it on.

Have you never particularly liked theme parks or rollercoasters? Going upside down is the worst thing you can do for balance and to disrupt BPPV as well, for obvious reasons.

Have you never liked, not enclosed places or due to claustrophobia, just places you can't get out of easily like planes, lifts and caves? Banking in planes makes me feel like I'm going to pass out. Lifts make me anxious. Caves are usually dark so see below.

Are you scared of the dark, or did you not get over your childhood fear of the dark until later in life? For me it was my 20s, was this why? No light means I have no means to orientate myself. The balance organ is the only thing you can rely on in the dark and mine is compromised.

Are you clumsy, always bumping into things, falling off curbs, up stairs...? Do you have to look straight ahead when walking, can you not look down or up or side to side? I can't count how many times I've injured myself or sprained my ankle because I haven't kept my head on an even keel, I've been looking at something up in the sky, behind or around me. Of course, again, bad things happen when you're not concentrating or concentrating on something other than walking, but you don't get dizzy generally.

Are you teetotal or near enough? I never really got into alcohol, apart from a brief misguided time as a 16-17 year old. Was it because the vertigo attacks were like being drunk, but without the nice bits? Why would I induce that, make it worse?

Question these symptoms and see what you come back with. You'd be surprised how many of us are wandering around with damaged vestibular organs and/or BPPV.