Comorbid disorders are an emotional knife fight

Imagine, if you will, a scene on the brightly lit stage of my mind.

The setting – an abandoned car-parking building, the year – 1983. Leather sleeveless vests, white socks and greased-up poodle perms are the height of fashion. A fight is about to break out between two oddly similar looking street gangs. One group of no-good youths (personifying my Generalised Anxiety Disorder) side step, *click* their way into view to meet a second group of bad-ass young’uns (personifying my Agoraphobia). Each posse calls forth a champion to fight in their honour. Both men present a veiny, over-tensed arm to be tied at the wrist. With stony glares and eyebrows raised in defiance they unsheathe their flip-blades. The view pans out, we see the dueling pair are surrounded by a mob of gangy-looking no-good-nicks (my IBS, Panic Disorder, Dermatillomania, Trichollomania and a couple of other minor diagnoses, thrown in there for good measure). Each one is just waiting for their chance to jump into the fray and cause some strife.

All of a sudden Michael Jackson bursts into the circle. Our saviour. He will dance to save their lives from gang violence and poor fashion choices; he will show them the way. The way is 1980’s choreographed dance.

Therapy is like a Grammy award winning Michael Jackson dance for my brain.

Now, I realise this is a scene stolen straight from Jackson’s ‘Beat it’ video, but in my opinion, a staged, somewhat unrealistic dance knife fight, is the perfect metaphor for how my brain feels when it is choked-up with anxiety, panic and mental debris. It’s like a dumping ground for old videos, bad memories and random historical facts up in there.


What a therapist might call a “comorbid disorder”, I see as a street brawl between similar South West Los Angeles street gangs. The American Psychological Association defines comorbidity as The experience of more than one disorder at the same time” ( 2015). It is not just that they are experienced simultaneously but more about how they interact with each other. Like a bunch of movie baddies they get each other all riled up; telling ‘Yo Mamma’ jokes, insulting girlfriends, possibly even claiming alternate sexual orientation etc until the level of stress and tension is so high you just know someone is about to get face-stabbed. When imagining a non-anxious person’s brain, I see the same set-up but rather than a knife fight, they settle their problems with a straight up dance-off. In their brains it is as innocent as a ‘Step it up’ movie. You know the ones, where the clueless white girl does ballet at private school but then gets an African American boyfriend and learns how to crunk. If only my brain were so G rated!

It is because of these comorbid disorders – this gang fight in my mind – that when I write about suffering from agoraphobia, I am describing not only my fear of trains, buses and other people’s houses, but also my general anxiety, panic attacks and other issues. No disorder exists in a vacuum. They are triggered by life, by chemicals, sometimes by stubbing your toe on the loose brick in the front garden.

So how can I possibly hope to manage such a chaotic mental street brawl???’ I hear you scream. ‘If there are so many branches of disorders and each one aggravates and inflames the others, how can I possibly juggle that many mental balls to get through the day?’

All I can do is describe what works for me because each person is different. I don’t like eggplant or people who don’t indicate; you might hate ice cream and adorable puppies.

A multi-headed anxiety beast requires a multi-headed management approach to preserve peace and keep all the gangs dancing out their problems rather than stabbing them away.

I see a variety of accomplished – and luckily for me – very patient health care professionals. I take medication to manage the panic (100% my personal choice to medicate, different strokes for different folks etc.) I have learned over the years many techniques from a variety of therapeutic schools: mindfulness, cognitive behaviour therapy and narrative therapy. I have made up a shit-ton of coping strategies for myself such as the distraction game ‘What can I smell?’ and mentally putting bad thoughts in a hessian bag, throwing them on a conveyer belt and out of my mind’s eye. I read books, articles, blogs and interviews. I think about what works for other people and try to find a way to apply it to my own life. It is a ton of work but if I’m honest with you, totally worth it. When I compare my present day coping skills to the explosion of Jason Statham movie proportions my brain was 10-15 years ago, I’m proud and impressed at how far I have come.

All you really need to start is a plan and some tools.

And maybe a chimp called Bubbles.


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