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against us.

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      The fight-or-flight response does a bunch of stuff to your body when it kicks in – your amygdala (the part of the brain which processes emotions) sends out a sort of distress signal and your body knows to gear up for a scary situation. You produce more adrenaline, your heart rate goes up, you breathe faster and you get a rush of energy. It’s thought that this all happens before your conscious brain has even considered what’s happening (and explains why a person could jump in front of a train to save a person who’s fallen on the tracks).[2]

      In a scary situation this is all GREAT! But if there’s no immediate emergency and yet your brain goes on sending the danger alert, then your body keeps producing the adrenaline and this keeps your brain thinking there’s something going wrong. That feeling of excess energy, that pounding heart. Think about how that feels. It’s not nice, huh? So of course if you’re feeling all of those things, your mind is still casting around for peril. And so the cycle begins.

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      Sound familiar?

      It might be helpful here to write down five times your fight-and-flight response has kicked into gear for a GOOD reason. And then write down five times it’s reared its head in an unhelpful way. We need to make an effort to distinguish the normal fear reaction from the excessive and unwarranted fear reaction so that our brains are better able to respond appropriately in a future stressful situation.

      Just as with catastrophising, you can help push back against this. It’s exhausting to get trapped in such a cycle. You spend hours, days, weeks feeling full of adrenaline – teeth grinding, sweating, humming with nerves – and then you crash and can be overwhelmed with headaches, tired to your very bones, feel shaky and achy as though you have the flu. And, long term, cortisol (the stress hormone) isn’t very good for you – it’s been shown to prompt weight gain, affect blood pressure and mess with cholesterol.[3] And the rest. Anxiety really is the gift which keeps on giving.

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      Some things that help put the brakes on this cycle:

      • EXERCISE (there may … just may be more about this later).

      • MEDITATION AND MINDFULNESS.

      • SOCIALISING – studies have shown that a ‘tend and befriend’ response can lower these symptoms of stress – providing safety and security instead of panic.[4]

      • LAUGHTER – sounds simple, but has been shown to reduce stress hormones and promote mood-elevating hormones like endorphins.[5]

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      Above all, it helps to reassure yourself. It sounds silly, but sometimes just saying, ‘I am safe’, as many times as I need to (internally or out loud), can really help calm my body down in moments when I want to get the fuck out of a place that my body is telling me is scary. Try it, see how it feels after you’ve spoken positively to yourself. Our internal voices are so often complicit in making us feel worse – and it’s a ‘skill’ we build up over many years, so it’s understandably hard to break. But with practice, you can make that voice more sympathetic and less willing to just go along with the latest worry that might have popped into your brain. Reassuring yourself is a good way to start. It can be any mantra as long as it’s positive and calming – ‘I can do this’ is another good one.

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      Write down three things you might say to yourself next time you feel panic rising and keep them at the back of your mind for future use:

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       PART FOUR

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       PANIC ATTACKS

      Since we’ve discussed catastrophic thinking and fight-or-flight, let’s look at panic attacks – often the end result of the fight-or-flight response. Have you had a panic attack? If you’re reading this book, it’s likely that you have. Some statistics say that 13 per cent of people have had one in their lifetime.[6] And some people will only have one or two – triggered by a stressful period in their life like a new job or a bereavement. Some people will have tons. At that point, you might have panic disorder. That’s an anxiety condition – under the umbrella of issues that anxiety covers. Panic attacks are debilitating. They can make you think you’re dying – so often people who experience them initially think there’s something seriously wrong physically. When I first experienced them, I thought I was having: a heart attack, a stroke, a brain aneurysm. Often you think you’re about to pass out. Let me get this straight first up: YOU ARE NOT GOING TO PASS OUT.

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      Probably. I’m not a doctor. But many doctors have told me that panic attacks rarely lead to fainting. You might feel dizzy for sure, and the earth might feel like it’s moving beneath you, BUT: during a panic attack, your heart beats faster, and your blood pressure rises. When people faint it’s normally because of a sudden drop in blood pressure.[7] So strike that off your list of worries. I’ve had so many panic attacks I could write a thesis on them, and I’ve never once fainted during an episode. From kissing a boy aged eighteen, sure, but never from a panic attack. Remind yourself of this – it’s important! So many people develop a fear that they’ll pass out and it can bring on the anxiety cycle we talked about earlier. If you feel wobbly, sit down for sure, drink some water, but don’t worry you’re going to stack it right outside Starbucks, because you won’t.

      OK, good – moving on. I’m going to write down a list of panic attack symptoms – and you tick the ones you’ve experienced.[8] This isn’t an exhaustive list but these are the very common ones. It’ll be like a fun puzzle exercise, except it’s about mental illness and there’s no fun involved. Tricked you. OK, GO!

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      Truly horrible bloody things. What’s your worst symptom? Mine is that I can’t breathe. I pull at my throat and gasp a lot. Which makes me think that people must be noticing my freak-out and that can make me more panicky. But here’s the thing. Mostly, panic attacks are happening beneath the surface – like when a serene duck is barely moving on the water but actually its feet are frantically paddling. All the things going on in your mind and in your body feel IMMENSE but are normally not visible to a passer-by. Think about how many times you have seen a stranger having an anxiety attack – I’ve never seen one person experience one and I have them myself. So put that worry out of your head. So many people worry that they’ll cause a scene and look stupid when, in actual fact, human beings are really self-absorbed and barely notice anything you’re doing unless you fall over. Then they notice, trust me (I fall over a lot).

      The irony of it all is that actually a really good thing to do when you’re feeling a panic

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