How I Accidentally Had an Endoscopy, Or: Anxiety & Me
9 Feb 2016
This post contains excerpts from the early chapters of Walking on Custard
Worrying has always been my primary way of dealing with the world. And for most of my life, I thought this was normal. (Except for when I got worried that I was worrying too much…)
Occasionally, I’d get stuck in anxious loops which stayed with me for days, taking away my ability to focus on anything but some imaginary impending doom.
In between, I tried to forget about these anxious times, hoping that if I pretended they didn’t exist then they’d just leave me alone.
But anxiety would sneak back up on me, even when everything seemed to be going well. One day I would wake with an uneasy awareness. That feeling would expand and multiply until it was out of control for months at a time until finally—without obvious reason—everything would settle back to normal.
I never understood these anxious periods. I couldn’t possibly talk about them, as I believed I was just being weak. I couldn’t see any reason to feel so bad, so telling anyone about it would only reveal how pathetic I was being. I just endured it until everything rebounded close to normality, when I would go back to avoiding thinking about it.
I might go years between such episodes, and each time I’d believe—if I thought about it at all—that my anxious days were behind me.
This changed after one of the worst anxious episodes in my life, which lasted for nearly a year without explanation.
I was sitting at my desk at work when it began. My life was broadly satisfying. I was cheerfully settled into a new job, and my social life in a new city was budding and full of fun. I was experimenting with writing a book (I wrote one, it was rubbish), and had just done my first proper stand-up comedy gig, to more or less universal acclaim (of the people who’d been there, obviously, which was more than enough for me). And I was dating a girl I’d secretly liked for months before we finally got together. All was well.
Yet, on this day, suddenly, I felt awful. I had noticed a slight unease earlier, but now my head was spinning and my heart was pounding. I was terrified. I wondered if I was going to collapse. I imagined the embarrassment of falling apart in front of my colleagues, and forced myself to sit still and stare at my monitor, hoping that no-one had noticed what was going on. Whatever it was.
I went to the little office kitchen and looked outside at some trees. Possibly somewhere in the back of my mind I thought this would help me connect with nature and make me feel better.
In fact, the normality of everything outside contrasted with my spinning sense of falling apart, and I felt worse still.
I left work early and went to the doctor, convinced I must be ill. Something was wrong with my stomach, perhaps. Certainly there was pain there. And I felt dizzy and tired and extremely scared. In the back of my mind was an insistent thought that I was severely sick. I could not shake the thought.
This non-event was the beginning of a lengthy anxious period. Every day was a conflict with myself. I woke up feeling a heavy dread, with my chest tight and my heart pounding. I couldn’t concentrate on conversations with friends, only pretending to listen while my inner monologue was desperately screaming about how awful everything was. I said no to social engagements I wanted to go to because I felt terrified I’d fall apart there and embarrass myself and everyone would know what a fraud I was.
I dreaded everything. Mostly, I dreaded continuing to feel like this. But I couldn’t see how it would stop, so I sought to explain how it started.
I was certain there must be a physical cause. Certainly there were physical symptoms: stomach aches, headaches, bowel problems, racing heart, dizziness and shortness of breath.
Surely these must point to the underlying cause. I simply had to find what was wrong and then take some medicine, and all would be fixed. Or so I hoped.
I searched online. I diagnosed myself with every disease humans can catch, and probably some that they can’t. I saw multiple doctors, and signed up for blood tests, urine tests, fecal tests, miscellaneous scans, allergy tests, reaction tests and the bar exam. (Well, maybe not the bar exam. But I would have if I’d have thought it might help.)
One day I even had a surprise endoscopy.
Well, it wasn’t exactly a surprise. Obviously I knew I was having an endoscopy. A certain amount of co-operation is required, after all. The surprise was that, somehow, I hadn’t really considered what an endoscopy meant.
If you don’t know, it involves a scope going, er… in your end. Pleasingly, the word describes itself: End-o-scope-y.
I optimistically believed it would be a quick in-and-out procedure, so to speak. I’d nip to the hospital, there’d be a momentary discomfort, and I’d soon be on my way, finally armed with the answer to what’s wrong with me.
Five minutes, at most.
Two hours later, as I lay in a hospital bed, naked but for a backless gown (having reluctantly handed in my clothes, my mobile phone and my wallet), I wondered if perhaps I should have told my colleagues—or in fact, anyone at all—that I was going to the hospital for a procedure and that I might be late to work.
The actual endoscopy wasn’t as scary as you might think. But in my state of constant anxiety, I worried about what they might find, and struggled to stay calm. With hindsight, the procedure itself wasn’t anything to be afraid of.
Several hours later, I uncomfortably boarded the bus home. I never made it to work that day. But I did have a story that greatly amused my housemates that evening.
Some days in this drawn-out anxious period I’d feel better, some worse. But every day I awoke with a creeping alarm, fearing that today would be the day I’d “lose control” or “lose my ability to cope”. I wasn’t sure what I was failing to cope with, exactly, but it was clearly something. It felt as if every day I developed a new phobia. I became terrified of driving, of getting trapped in traffic, or being on a train, or in a crowded place like a theatre. I was afraid I was going mad, that there was something deeply and irretrievably wrong with me.
And every day I searched for more possible causes, figuring that if I could just understand why then I’d finally be able to fix everything.
Maybe it’s some subconscious trauma. Maybe it’s delayed grief for the death of my father. Maybe it’s carbon monoxide poisoning. Maybe it’s the onset of mental illness. Or brain cancer. Or an allergy. Am I getting enough exercise? Or doing too much? It could be my environment. My life choices. The place I live. Did I say brain cancer already?
Even—finally—accepting that there was nothing physically wrong with me didn’t help. Now I couldn’t understand how to fix myself mentally. Was I broken? There were a thousand different ways the anxiety manifested and I couldn’t see any connection. My frightening online research indicated I had several anxiety disorders. At least!
I was afraid of the feelings. I was afraid they’d never stop. Or that they’d get worse. I was afraid of everything.
Nobody around me knew that this was going on. I certainly didn’t let on. Not due to lack of trust in my family and friends, but out of shame.
It was essential that I maintained my image, and that everyone continued to see me as being “sorted”. Capable. Able to handle whatever life throws at me. I couldn’t face the idea of admitting I was falling apart for no explainable reason.
Finally, one night I lay awake, once more terrified for no evident reason. I was afraid and furious in equal measure.
“I shouldn’t be feeling like this! This makes no sense!”
Eventually, exhausted, I gave up. I remember thinking “Okay. This is how I feel now. I am anxious. I guess I’d better just get used to it.”
And, in that moment, the anxiety disappeared.
Not entirely—and certainly not forever!—but it lessened. For the first time in months, I suddenly felt peaceful.
This baffled me. I hadn’t solved anything! I was no closer to the root of the anxiety, to that elusive answer I craved. But I was able to sleep that night, and this experience marked a turning point.
At the time, I had no idea what I had done, or why it had helped, but now I understand: I hadn’t solved my anxiety, but in ceasing to fight I switched off my anxiety-about-the-anxiety.
It turned out that most of my anxiety was rooted in thoughts such as these.
My thoughts were powerfully habitual. (They still are! It’s impossible to avoid habit. Our brains naturally find grooves for themselves. The best we can do is to learn to accept this, and to manage it so our thought habits are as helpful as possible.)
In particular, my thoughts were habitually unhelpful, as well as being mostly invisible to me. While it seemed as if anxiety crept up out of nowhere, in reality it was often triggered by a stray thought that had built up its own momentum powerful enough to bring me crashing down.
It took me a long time to understand this. I had to practice observing, noticing, and managing my thoughts, and developing new ways to think about myself, my life, and the world in general.
I suspect the work required for this mind-management varies greatly from person to person. For me, it involved some therapy, plenty of self-observation and analysis, and practicing catching thoughts as they arise to replace them with new perspectives. It required me to deal with the way I feel about myself. And to engage with my inner critics in new ways, to transform them into more helpful inner voices.
This work was long, and occasionally difficult. But it was worth it. Today, I feel confident that I can handle it when anxiety surfaces for me again.
Neil Hughes is the author of Walking on Custard & the Meaning of Life, a comical and useful guide to life with anxiety, and The Shop Before Life, a tale about a magical shop which sells human personality traits.
Along with writing more books, he spends his time on standup comedy, speaking about mental health, computer programming, public speaking and everything from music to video games to languages. He struggles to answer the question "so, what do you do?" and is worried that the honest answer is probably "procrastinate."
He would like it if you said hello.