And the third problem was that I didn’t understand how the external and the internal were connected. I didn’t know how related ‘what you feel’ is to ‘where you are’. I didn’t know that the world of shops and sales and marketing is not always good for minds. A lot of research has been done in recent years about the effect of external environments on our health. For instance, a 2013 study commissioned by the mental health charity Mind and run by the University of Essex compared the experience of walking in a shopping centre with a ‘green walk’ around Belhus Woods Country Park in Essex. Although walking is known to be good for a mind – indoors or outdoors – 44 per cent of the people who walked in a shopping centre said they felt a decrease in self-esteem. Whereas nearly all (90 per cent) of the people who went for the forest walk felt their self-esteem increase. There is an increasing amount of research like this, as I’ll mention later, about how nature is good for our minds. But at the time I knew none of that. Indeed, most of the research hadn’t been done.

It makes sense that shopping centres aren’t easy places to be in. A shopping centre is a deliberately stimulating environment, designed not to calm or comfort, but merely to get us to spend money. And as anxiety is often a trigger for consumption, feeling calm and satisfied would probably work against the shopping centre’s best interests. Calmness and satisfaction – in the agenda of the shopping centre – are destinations we reach by purchasing. Not places already there.

The fourth problem was guilt. I felt guilty about symptoms I didn’t really see as symptoms of an illness. I saw them as symptoms of me-ness.

Another lesson I am still coming to understand – and writing this book is helping me – is that distraction didn’t and doesn’t work. For one thing, shopping centres are deliberately very distracting environments, but they didn’t take me out of myself, only into myself. The bustling crowds of other people didn’t help connect me to humanity. I felt more alone among masses of people than I did when it was just me and one other person, or even just myself.

This was an already familiar tactic of mine: trying to distract myself from one torment by finding another. Years before Twitter, and the mind-numbing compulsive checking of social media, I had the desperate need for distraction. But it was no good. You develop symptoms more by fighting them than inviting them. Distraction is an attempt to escape that rarely works. You don’t put out a fire by ignoring the fire. You have to acknowledge the fire. You can’t compulsively swallow or tweet or drink your way out of pain. There comes a point at which you have to face it. To face yourself. In a world of a million distractions you are still left with only one mind.

The mannequins who inflict pain

WHEN I NOW think of that particular panic attack I think of how the world got in. Even at the time I had an instinctive – if not totally conscious – idea of the triggers around me. Even a shop’s mannequins added to it.

There I was. In that enclosed and busy and artificial commercial space. Past the point of no return. My own personal singularity. The rational knowledge, as I looked at Andrea, that I was in the all too familiar process of ruining our day.

I closed my eyes to escape the stimulation of the shopping centre and saw nothing but monsters and demons, a mental bank of creatures and images worse than any hydra or cyclops – my own personal underworld that was now only ever a blink or a thought away.

‘Come on, you can do it. Breathe slowly.’

I tried to do what she said: to breathe slowly, but the air didn’t feel like air. It didn’t feel like anything. My self didn’t feel like anything.

I wiped my eyes.

Opposite Vision Express was a clothes shop. I can’t remember which one. But what I can remember, printed with the weight of trauma in my memory, is that there were mannequins in dresses in the window. The kind of mannequins with heads. Heads which were grey and hairless and with features that hinted abstractly at a nose and eyes, but no mouth. The mannequins stood in unnatural angular poses.

They seemed deeply malevolent. As if they were sentient beings who not only knew my pain, but were part of it. Were partly responsible for it.

Indeed, this would be a key feature of my anxiety and depression over the following months and years. The sense that parts of the world contained a secret external malevolence that could press a despairing weight and pain into you. It could be found in a smiling face on a glossy magazine. It could be found in the devilish red stare of rear tail-lights. Or the too-bright blue glow of a computer screen.

And yes, it could be found in the sinister echo of humanity in a shop mannequin.

One day, when I was ready to face my pain, this feeling of extreme sensitivity would actually help me. It would help me understand that if external things could have a negative impact, then other external things might have a positive impact. But right then I was worried I was losing my mind.

I was convinced I wasn’t made for the reality of the world. And in a way, I was right. I wasn’t made for the world. I was, like everyone, made by the world. I was made by parents and culture and TV and books and politics and school and maybe even shopping centres.

So, I either needed a new me. Or a new planet. And I didn’t yet know how to find either. Which is why I felt suicidal.

‘I’ve got to get out of here,’ I said at the time, wiping my eyes like a toddler lost in a supermarket.

The ‘here’ was broad enough to mean anything from ‘my head’ to ‘the planet’. More immediately, of course, the ‘here’ was the shopping centre.

‘Okay, okay, okay,’ Andrea said. She was right next to me. She was also thousands of miles away. She scanned around for the nearest exit. ‘This way.’

We got outside, into natural light. And we went back to Andrea’s parents’, and I lay on Andrea’s childhood bed and told her parents I had a bit of a headache, because a headache was easier for them to understand than this invisible cyclone. Anyway, I felt varying degrees of bad for many weeks and months, but eventually I began to recover. And, even better, to understand.

A wish I SO WISH I could explain something to my younger self. I wish I could tell myself that it wasn’t all me. I wish I could say that there were things I could do. Because my anxiety, my depression, wasn’t just there. Illness, like injury, often has context.

When I fall into a frantic or despairing state of mind, full of unwelcome thoughts that can’t slow down, it is often the result of a series, a sequence of things. When I do too much, think too much, absorb too much, eat too badly, sleep too little, work too hard, get too frazzled by life, there it is.

A repetitive strain injury of the mind.

How to exist in the 21st century and not have a panic attack

1.Keep an eye on yourself. Be your own friend. Be your own parent. Be kind to yourself. Check on what you are doing. Do you need to watch the last episode of the series when it is after midnight? Do you need that third or fourth glass of wine? Is that really in your best interests?

2.Declutter your mind. Panic is the product of overload. In an overloaded world we need to have a filter. We need to simplify things. We need to disconnect sometimes. We need to stop staring at our phones. To have moments of not thinking about work. A kind of mental feng shui.

3.Listen to calm noise. Things that aren’t as stimulating as music. Waves, your own breath, a breeze through the leaves, the purr of a cat, and best of all: rain.

4.Let it happen. If you feel panic rising the instinctive reaction is to panic some more. To panic about the panic. To meta-panic. The trick is to try to feel panic without panicking about it. This is nearly – but not quite – impossible. I had panic disorder – a condition defined not by the occasional panic attack but by frequent panic attacks and the continuous hellish fear of the next one. By the time I’d had hundreds of panic attacks I began to tell myself I wanted it. I didn’t, obviously. But I used to work hard at trying to invite the panic – as a test, to see how I could cope. The more I invited it, the less it wanted to stay around.

5.Accept feelings. And accept that they are just that: feelings.

6.Don’t grab life by the throat. ‘Life should be touched, not strangled,’ said the writer Ray Bradbury.

7.It is okay to release fear. The fear tries to tell you it is necessary, and that it is protecting you. Try to accept it as a feeling, rather than valid information. Bradbury also said: ‘Learning to let go should be learned before learning to get.’

8.Be aware of where you are. Are your surroundings over-stimulating? Is there somewhere you can go that is calmer? Is there some nature you can look at? Look up. In city centres, the tops of buildings are less intense than the shop fronts you see at head level. The sky helps, too.

9.Stretch and exercise. Panic is physical as well as mental. For me, running and yoga help more than anything. Yoga, especially. My body tightens, from hours of being hunched over a laptop, and yoga stretches it out again.

10.Breathe. Breathe deep and pure and smooth. Concentrate on it. Breathing is the pace you set your life at. It’s the rhythm of the song of you. It’s how to get back to the centre of things. The centre of yourself. When the world wants to take you in every other direction. It was the first thing you learned to do. The most essential and simple thing you do. To be aware of breath is to remember you are alive.

12

THE THINKING BODY

Four humours