How I finally beat crippling anxiety
After years of living with howling panic attacks, writer TIM CLARE set out to try every treatment he could find... from ‘zapping’ his own brain to a bacteria transplant and even surgery. So what worked?
WHEN my daughter, Suki, was about eight months old I had a severe panic attack. I was sprawled on the floor, screaming until my throat burned, delirious with terror. I can’t remember the trigger but I still feel the gut-deep dread, the barrelling disorientation, the conviction my life was over. I was going to lose my family and please Mummy, Daddy, Jesus, won’t someone HELP.
My wife had closed the doors between us. I could hear her playing YouTube nursery rhymes to drown me out so our daughter wouldn’t hear her daddy screaming, begging.
Just writing this down five years later fills me with curdling shame. To be so scared I couldn’t stop myself shrieking, even though I knew the noise might frighten my baby. So scared that I couldn’t breathe, my muscles cramped, sweat poured from my prone, flailing body. That my wife had to act to protect my daughter from being scared by her own daddy.
The more I suffered, the more contemptible I found myself.
Over the past 15 years I have been diagnosed with generalised anxiety disorder, panic disorder, acute anxiety, panic attacks and depression. I’ve been called anxious, uptight, stressed, paranoid, hysterical and unhinged.
All with some justification, I might add. I am not easy to be around.
Most of my life has been shaped by fear — anticipating it, reducing it, blocking it out.
For years before Suki was born, I managed anxiety with alcohol and self-harm — drinking until I vomited or passed out, for instance. I had my first panic attacks around this time, in 2006, truly frightening episodes where I felt like I couldn’t breathe or was going insane.
I thought the way I was treating my body was to blame, so I quit alcohol in 2012 and the self-harming. But they had been my coping mechanisms. My anxiety and panic attacks got worse. When my attacks were bad, I’d have several a day, three or four days in a row, each lasting between 20 minutes and an hour. At best, I might go for ten days without one.
I saw the doctor, got prescribed medication, including the antidepressant sertraline, was put on a long waiting list for cognitive behavioural therapy (a type of talking therapy where you learn to challenge negative thought processes), did meditation classes, yoga — and read book after book that promised to teach me how to be calm, de-stress and beat anxiety. But my panic attacks always came back.
After one, in 2019, I managed to make myself even more frightened.
As my terror settled down into the familiar ruminative, rolling boil of worry, I thought of all I’d read about the effects of parental mental illness on children, linking it to impaired academic achievement, a higher risk of developing severe mental illness, even a child’s chance of getting asthma. I sat with that for a long time — the threat of passing this dark inheritance to my astonishing, hilarious, unrepeatable daughter.
In that moment, something shifted. For one last time, I would try to beat anxiety. Surely the answer’s out there. Surely someone knows.
I would approach every researcher I could find in any field whose work was even tangentially related to anxiety, ask what they had learned and apply their findings to myself.
So desperate was I that absolutely everything was on the table, from
The electric headset just left a red patch on my forehead
I found myself weeping on the phone to the Samaritans
the accessible to the potentially dangerous. I tried hypnotherapy and cold water swimming. I experimented with deep breathing exercises. I started running.
I even considered trying to find a surgeon to cut out my amygdala, what used to be described as the brain’s ‘fear centre’, and devoted so much thought to this I actually felt jealous of the research monkeys I read about who had undergone the operation and seemed to be calmer afterwards.
Did my brain really need a fear centre? Why not remove this outdated piece of hardware, this neural anachronism? Why not embrace the possibility of a life without fear? Even given the terrifying permanence of cutting part of my brain out, I chewed on the thought for a long, long time. What would actually happen to me if I found a surgeon willing to do the operation?
Faecal microbiota transplantation, or FMT, was also on my list. It had proven effective at treating patients with potentially deadly C. difficile (a bacterial infection of the large intestine).
FMT took gut microbes from the faeces of healthy volunteers and transplanted them into patients via either a tube inserted through the mouth into the stomach or upper small intestine, or via the anus to access the large intestine. The theory was this helped fight off dangerous bacteria linked to C. difficile.
Experts were setting up trials to see if FMT could help with chronic fatigue syndrome or Parkinson’s. Perhaps it would help. It had appeared to have had some effect on fearful mice in experiments.
Eventually, after discussing it with scientists, I ruled FMT out.
When I asked Professor Simon Carding, who researches gut microbiology at the Quadram Institute in Norwich, if he thought I might be able to beat my anxiety using the poo of a very calm stranger, he told me that currently there’s no strong science to justify FMT for anything other than treating C. difficile.
But if I were to try it, he said, the ideal donor would be a relaxed person with a healthy diet. ‘Someone who’s been screened for infections. Someone whose gut microbiome doesn’t contain nasties. Who’s had relatively few treatments. So maybe someone between 12 and 18 is your ideal source.’
I just had to find an angst-free teenager and ask if they’d mind pooing into a Tupperware.
I also tried transcranial directcurrent stimulation (tDCS) — or, as neuroscientist Adam Green of Georgetown University cheerfully described it to me, ‘brain zapping’ — which uses electrodes to pass a weak electric current through the scalp into the brain. It aims to jumpstart the formation of new neural pathways and relieve anxiety.
There is a new wave of consumer tDCS devices you can use at home, which cost between £250 to £400.
Although the evidence for tDCS is patchy, I bought a device — a grey plastic headset with three rubber pads into which I put white sponges soaked in saline solution. Using the corresponding app on my phone, I could control the electric zaps and so I cranked it up — and felt a prickling, burning sensation beneath the pads, like jabbing pins into my scalp.
While results are said to accumulate with use, there’s no ignoring that I didn’t feel less anxious and the only thing my first session stimulated was a sore red patch on my forehead the size of a Garibaldi. I kept it up anyway.
Perhaps unsurprisingly, through all this, I spent considerable time wondering what had caused my anxiety.
I wasn’t always a coward. My mum tells me that as a young child I was ‘fearless’, running off down the beach towards the ocean without looking back, shouting out in class and performing to an audience whenever I had the chance.
The change was gradual. Increased self-awareness, social intelligence and inhibition are, after all, natural
parts of our development, as are the acquisition of fears. You burn your hand on a hot stove, you learn to be wary of touching any stove. You gauge the mood in the room before launching into that fifth rendition of Frere Jacques.
But there were stand-out moments which had perhaps contributed to my state of mind. Intensely distressing bullying at school, which started when I was around 14, provoked my first memorable experience of deep, grinding worry. And when I was seven, my granddad died while we were on holiday together.
I remember Dad drawing a multicoloured potato for my brother — and the alien weirdness of a world where someone could be deleted, then what seemed like minutes later we were colouring and pointedly not mentioning it.
I learned never to speak of what had happened, or my feelings. And because I had wished not to go on holiday, I then worried I had somehow caused my granddad’s heart attack by thinking this.
But while these moments among others probably contributed to my worry, they couldn’t be the whole story. Perhaps it was my genes? I went so far as to do an at-home genome analysis test where I spat into a tube, and the contents were analysed for genetic markers associated with particular conditions.
When I later discussed this test with geneticist and broadcaster Dr Adam Rutherford, I was dismayed to hear him say: ‘Spitting in a tube does literally nothing to explain yourself.’
Genetic analysis, it seems, can help with conditions such as cystic fibrosis because there is one gene, CFTR, largely responsible for it. But with conditions such as anxiety, you may see dozens — even hundreds — of genes that have smaller, but statistically significant links for people with that condition.
I admit, part of me had longed to hear Adam Rutherford say: ‘You’ve got the coward gene. No wonder you’re anxious.’ I wanted an answer.
This whole process of researching and trialling different things took a year. At one point, I felt so bad I found myself weeping on the phone to the Samaritans. I didn’t want to kill myself. But I also didn’t want to live. So what turned my panic around?
Today, I can see a combination of things helped. (I should point out that what didn’t work for me might work for you.) First, exercise and diet. I’d eaten the same breakfast and lunch almost every day since school. Breakfast: four Weetabix with milk. Lunch: a peanut-butter sandwich, a cheese sandwich, crisps and a chocolate bar. Dinner was whatever was in the fridge, or a takeaway.
It meant I never had the stress of figuring out what to eat. Choosing meals made me really anxious, like it was a test I could fail.
I’d read how the gut was a new frontier in mental health. That excessive inflammation had been linked to depression and anxiety. Inflammation increased if you were overweight or if you ate a lot of sugary, fatty food.
Porridge became my best friend. I upped my fruit and veg. The fibre filled me up and helped regulate my blood sugar, blood pressure and inflammation.
Alcohol remained off limits. Drinking is ‘the ultimate dirty drug; it sort of whacks every neurotransmitter in the brain’, neurobiologist Stefan Brugger at the University of Cardiff told me.
Lots of articles said ‘research shows’ or ‘science tells us’ exercise reduces anxiety. I started running, got a cheap, mini step machine, balanced my laptop on top of my filing cabinet, and did an hour’s writing each day while walking.
I started losing weight. My running distances increased. I went from 5k to 10k to half marathons, to a weekly long run of at least 18 miles. I lost a stone, then two, then three, dropping from a 6 ft man of just over 16 stone to 12st 13lb.
I also embraced cold water. I should say the first time I tried a cold shower, I screamed. Shrieked as if I were being murdered.
A few days later, I tried again. It hurt. Still, I counted to 60, twisting and rotating to make sure no part of me escaped. Then I couldn’t stop laughing. My body tensed as hard as it could, then just relaxed. Anaesthetist and researcher Mark Harper told me: ‘Essentially, getting into cold water creates a stress response. When you first do it, it’s a really big stress response. The more you do it, the less that response becomes. It doesn’t go away, but it comes right down.’ As your cold-shock response decreases — so the theory goes — so does your physiological response to all stress. Today, I still love occasional cold showers as an emotional reset — they blast the panic out of me; I aim for three minutes. I’ve also embraced deep breathing exercises, which work well as an emotional circuit-breaker when I’m feeling panicky — essentially you perform controlled hyperventilation. After 30 to 40 deep breaths, you partially empty your lungs and refrain from breathing for between 60 seconds and four minutes — hypoventilation. When you feel the urge to breathe, you inhale, holding the breath for ten to 15 seconds. The first time, I experienced a rush of calm, followed by a strange euphoria. Tensions and worries melted away. Many researchers I spoke to — in psychology, neuroscience and physiology — wondered if such breathing exercises might work as a form of exposure therapy or ‘challenge’, helping me unlearn negative associations between rapid breathing and the horror of a panic attack. I’ve also discovered the power of a to-do list. It sounds too simple to work but takes off a cognitive load. And psychologist Dr Tim Pychyl, head of the Procrastination Research Group at Carleton University, Canada, told me to always ask: ‘What’s my next action?’ Sometimes it’s as simple as switching on my laptop. I try not to get caught up in worrying if I can face doing the task — I just ask what the next tiny step I need to take to move myself towards it is. Today I cope with more than I ever thought possible. I no longer take antidepressants. I still experience anxiety and discomfort — although I haven’t had a panic attack in more than two years — just like I still get achy legs from running. Instead of beating myself up, I recognise anxiety as evidence that I’m exposing myself to challenges. That I’m doing my best — for myself and my family.
AdApted from Coward: Why We Get Anxious And What We Can do About It by tim Clare, published by Canongate on May 5 at £16.99. © tim Clare 2022. to order a copy for £15.29 (offer valid to 17/5/22; UK p&p on orders over £20), visit mailshop. co.uk/books or call 020 3176 2937.
I experienced a rush of calm, my worries melted away