Who’d have Anxiety, panic attacks and psychotic depression?

Have you ever had anxiety, panic attacks, depression or psychosis?

woman walking on gray asphalt road in between trees and rock formations
My long journey through psychotic
depression – Image by Mitchel Lensink

This is the 9th in a series of “My journey through Anxiety, panic attacks, depression and psychosis. Please click here for Parts I, II, III, IV, V , VI, VII and VIII if you wish to read the backstory (It might make more sense).

I don’t know which is worse; the anxiety, panic attacks, depression or the psychosis. But to have them altogether, spelt H.E.L.L.

For those of you who don’t already know, I started writing about my journey some six months ago. I only ever intended to write it in four posts. However, it’s become clear that my journey was a lot longer and more painful than I remembered. That’s made it difficult to get the words down on paper at times. I’ve taken many breaks and written lots of other posts in between, giving me time to reflect and bounce back a bit stronger each time.

Even when it’s over, it’s not

……………. The boys eventually settled but still refused to see their dad or even talk to him on the phone. However, Tony was still bothering me, as was his girlfriend. She’d call and ask to speak to him then hang up on me. I knew it was her and her ugly sister cos I could hear their brats yelling in the background. I was like, she’s got him now, so why she’s bothering me? I’d later find out (via her friend and my mum) that she was p’d off cos all he did was talk about me and the boys. Oh dear 🙁

Tony called one evening on the pretext of speaking to the boys, who happened to be at my aunt’s for the night. On hearing this, Tony went ape! “Why ain’t they at home, why ain’t you got them at home with you? You got a bloke there? In my house?” he screamed down the phone. “I’m coming round there, I’ll effin’ put petrol through your letterbox. I’ll effin kill you and him, you effin whore.” and the phone went down.

Panic stricken, I called one of my best friends, the one who lived the closest and she was round within minutes. We sat on the kitchen floor, watching shadows dancing on the wall as people passed by in the dimly lit street. We glugged our way through the cheap wine Jane had brought and smoked endless cigarettes. Our hearts leapt every time we heard a car door slam. With her constant digging and questioning, I explained bits of the sorry saga. Much as we all loved her, she got off on gossip and it wouldn’t take long for this news to spread.

Visual hallucinations

White lady with long blonde hair and two horns appear to be growing on her forehead
Psychosis; visual hallucinations

After a few hours, there was no Tony and no petrol the the letterbox, and we realised it was all just bravado on his part. Jane left, somewhat disappointed there was no drama, and I got ready for bed. And then it started.

As I brushed my teeth I caught sight of the lumpy horns, peeking through my fringe. No! Just please, no! Nooooo, I screamed at length, but there was no sound. Perhaps I’d imagined screaming? Urgh! The horns looked hideous against my now pure white face and I thought I was going to throw up. However, I only dry wretched; probably because I hadn’t eaten anything in days.

I felt clammy and shivery, and hot, all at once. I was so confused – I didn’t know if all this was real or was it a dream – tho’ I knew perfectly well that physically, I was in the bathroom. The walls were closing in on me and the room spun wildly. Staggering to my room, I felt out of myself, almost like I was floating alongside my physical self. My heartbeat thudded in my ears, and tho’ I lay down, I knew sleep wasn’t going to be kind to me that night.

I wanted someone, anyone, to help me. It felt like I was drowning in quicksand and at any moment I’d be dragged right under. I couldn’t move and felt cemented to my bed. I just lay there as wave after wave of panic swept over and through me. And despite the weekly counselling, this continued each night.

Pleading poverty

Clear glass jar tipped on its side, with loose coins around it
Struggling with anxiety and lack of money

Some three to four months in, Tony suddenly stopped giving me money towards the boys upkeep. The boys and I were gobsmacked, hardly believing he would do this. It was soon time to start getting their school uniforms and money was going to be even tighter than usual anyway. When I called Tony to ask why he’d stopped, he almost boasted “I got two kids to bring up here, so I can’t afford it.”

“You’ve got to be kidding me Tony. You’ve got two sons of your own and they come first. Surely?”

“Well, her ex don’t pay anything toward her kids.”

“That’s not our problem,” I muttered and he repeated it so his ugly sister girlfriend could hear. So she joined in, shouting in the background, “We ain’t got the money. You can’t have what we ain’t got.”

I was so p’d off and told Tony I wasn’t happy, adding “The boys’ school uniforms need to be bought soon.”

The selfish git growled, “You put them in them posh schools, you effin’ pay for it, and their uniforms.” and the phone went down. This was becoming a habit!

Bring in the big guns

Young woman with straggly long hair, chewing her nails, peering out of a window
This is what anxiety looks like but it feels so much worse!

I nearly jumped out of my skin when Dan came up behind me, gave me a hug and said “You need to take daddy to the Child Support Agency (CSA) mama. It’s not fair on you. He needs to give us some money.” To be honest, it’s not something I’d ever considered but the boys were adamant they wanted me to. So I did. And guess what? When Tony received a letter from the CSA, he packed his job in! He was working for my brother at the time and my brother was p’d off with me ‘cos he needed Tony at work.

He returned to work after a few weeks and he delighted in taunting me, “The CSA’s off my back now and every time you effin’ call them, I’ll jack my job in. So you’ll get nothing!” I was fuming, how can he not want to support his sons? And boy was I cheesed off with my brother keeping him in employment, knowing that he was refusing to pay for his children. He knew everything I’d been through. He knew how Tony had been hitting and cheating on me and now this.

Reduced to charity

I was struggling financially, which didn’t help the anxiety and panic attacks. My aunty mentioned a charity who might be able to help – you just had to be a single-parent from Scotland, living in London, with a parent who had armed forces attachment and had no head. Okay, I made the ‘no head‘ bit up. A lovely little old lady with a Scottish accent turned up at our house with her clipboard and some forms to fill in.

Having taken down some details, she insisted the organisation would provide a substantial grant for the boys’ uniforms. Furthermore, they’d give the boys have £100 each per month towards their books and other needs, right up until they left school. She hadn’t even asked to see any forms of identity or proof that my dad had actually served in the Royal Navy. I could breathe again and this, together with the feeling of relief, far outweighed the considerable shame I’d felt at having to accept charity.

Back to normality

Four young people outside bar enjoying drinks
Relaxing, free from anxiety —
Image by Clipdealer.com

The boys seemed settled, and happy to be back at school in their shiney new uniforms. They were popular boys and constantly had a stream of friends over to stay. I was back at uni and started to go the the local pub once a week with my peers. They were all 10-15 years younger than me but they didn’t make me feel out of place. I laughed when they said I was known as the yummy mummy, way before it was fashionable.

I got chatting with one of the guy on my course, ten years my junior, on yet another evening out after uni. Long story short, we started dating and within months we were talking of marriage. Urrgh, I could cringe now. I realise in hindsight that I got married on the rebound and I knew it would bug the hell out of Tony ‘cos I’d refused to marry him. We had a huge white wedding, all paid for by me, the following year.

Sometime in between the first and the last dance the DJ, who I’d known forever, twirled me round the dancefloor. How we laughed as we reminisced about the old days. Suddenly DJ Dan was dragged from my grasp and my new husband was roaring, “She’s my wife! Get the f*ck off her!” What the? His Geordie accent rising way above the cockney chatter and Aerosmith’s “I don’t want to miss a thing.” All eyes turned as they both stumbled out the front door. DJ Dan’s brother hot on their heels. I followed, knowing that despite my oaf of a new husband’s lunacy, two on one just wasn’t happening.

Was the honeymoon period over?

After wedding gate and Sunday pub lunch with all the family and close friends, off we went on honeymoon to the beautiful Greek Islands.

Big red question mark with little white caricature of a man
Clipart.com

Unfortunately, I’ve got to rest up. I’ve been ill again and can only do things in short burst. I’ll be back and in the meantime, I look forward to reading any comments and I’m happy to answer any questions, as always.

What causes mental illness?

While I can’t give you all the answers, take a look at this model which helps in identifying and treating mental illness.

The Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition, has defined depression as 5 or more of the following symptoms that are present for 2 or more weeks and cause significant emotional distress and/or impairment in functioning:

Getty.com
  1. depressed or sad mood
  2. short-tempered or easily annoyed
  3. loss of interest or enjoyment in hobbies or activities that was previously enjoyed
  4. feeling of worthlessness or guilt
  5. thoughts of death or suicide
  6. difficulty with concentrating or making decisions
  7. feeling tired or fatigue
  8. feeling restless or slow
  9. changes in appetite such as overeating or loss of appetite
  10. changes in weight such as weight loss or weight gain, and changes in sleep pattern.1 

According to the National Institute of Mental Health, depression occurs due to a combination of genetic, biological, environmental, and psychological factors.2

Genetic vulnerability refers to the inherited characteristics passed on from parents to children that make it more likely that a person will develop a mental illness or addiction.

Biological theory suggests that depression is caused by an imbalance of naturally occurring substances called neurotransmitters (Serotonin and norepinephrine) in the brain and spinal cord.

Depression is said to be almost twice as likely to affect women than men and tends to have different contributing causes in women than it does in men. Contributing factors include reproductive hormones (biological)

Psychological and environmental/social factors—such as lifestyle choices ie too much alcohol, past trauma, low self-esteem, substance abuse and loneliness can also play an enormous part in depression.

Treatment for depression consists of participation in psychotherapy, taking antidepressants, or a combination of both. However, many individuals don’t participate in psychotherapy or antidepressants due to factors such as side effects, lack of access/resource, or personal choice.

According to Agius et al 2010, the Stress Vulnerability Model is an extremely useful model for identifying and treating relapses of mental illness. We accept that humans carry genetic and other predisposition to mental illness. However, the question arises as to how stress impacts on a person in order to cause mental illness to develop. Furthermore there arises the issue as to what other effects such stress has on the human body beyond the human brain. 4.

The Stress Vulnerability Model explores the interrelationship between all these factors, and the genetic component which in large part constitutes the ‘vulnerability’ part of the model. Such problems occur in many Psychiatric illnesses, including Depression, PTSD, as well as Schizophrenia.

Vulnerability Factors predispose individuals to develop mental health problems e.g psychosis, clinical depression. Problems are triggered by stress. If vulnerability is high, low levels of environmental stress may trigger distress. Use and effectiveness of coping strategies goes some way to explain why some have problems and others don’t.

Let’s take a look at the model and I’ll share how my vulnerability lead to a psychotic depression:

Look along the bottom where it says Vulnerability – high to low. For me, because mental illness runs in the family (genetic) I have a predisposition to mental illness. I grew up with mum as single carer for four children, I was shy and had low self-esteem (psychological). We moved a lot, I went to more than ten schools and each time I was bullied because of my new accents (social/environmental), then there’s the childhood abuse (psychological), so — I have a high vulnerability to mental illness.

Now look at the left-hand side where it says stressful events: my ex had a baby with someone else, then the breakdown of my relationship, my ex was cheating, I experienced domestic violence, one of his girlfriend’s plagued me for eighteen months, I wasn’t sleeping, I felt suicidal, I was now a single parent and didn’t have any real coping mechanisms other than to bottle it all up. Therefore, you can add up all the stressful events and my arrow is very high, as in the diagram.

Follow that curve in the model and you’ll see how I have an extremely low stress threshold towards mental illness. Hence my psychotic depression, anxiety, panic attacks and anorexia.

While I still have a predisposition to mental illness, there’s been a huge reduction in my stressful events so I now have a higher threshold for stress.

So, back to the chart — Along the bottom line, I’m at the end, on the right ‘high vulnerability’. But along the left side, I’m presently low down on the scale as I have minimum stress at the moment (trace along the chart with your finger). So you’ll see, I’m currently in the mental health category, rather than mental ill-health.

Is this your empty toolbox? Photo by worthpoint.com

I still experience depression and anxiety but they tend to be reactive. I still take medication and I have an extensive toolbox of coping techniques that I can use, when necessary.

I found this model really helpful when working with patients and they liked how it might explain why they developed a mental illness. If you have a mental illness and you wonder why, try using the above chart to see if it’s helpful in determining the how or the why me?

Does this model fit with your ideas? Where would you sit on the graph? Do you think vulnerability needs more explanation? I’d really appreciate your thoughts.