On the face of it: when I add up the cost of my anxiety ...

I knew something wasn’t right as soon as I woke up. I was due to fly Portugal last week for a much-anticipated holiday, but instead of feeling excited, I felt heavy, pregnant with pent up stress. And then it happened: heavy clouds of slimy anxiety coating and blackening everything in its film.

All I wanted to do was sit on the sofa nursing a tea and watching anodyne TV, but I packed my suitcase, got on the train to the airport, and checked in, with my mind whirring in a frenzy of fizzing panic.

As soon as I stepped onto the plane, I wanted to get off. Not just because travel exacerbates my anxiety when it’s raging, but also because the cabin was packed to the brim with passengers in high spirits. In the confined space, the noise felt overwhelming. I had to marshal my mind to behave ‘normally’, talking myself through it in stages, as one might a small child who’s misbehaving: “Sit in your seat, Madeleine, then do up the seatbelt. Don’t make a fuss and, no, you mustn’t run up the aisle howling at the crew to let you off, that would be a bit of a spectacle and people would think you were insane.”

This tempting instinct to bolt is commonly known as fight or flight, and as I wasn’t expecting to have the opportunity of fleeing, I was contemplating helping myself in the ‘fight’ part with one of the Diazepam I carry in case of just such an emergency. But then came an announcement from the pilot which offered me a way out. “We are looking at a delay of up to four hours before taking off. We’ll push away from the airport soon, so if you’d prefer to disembark, please make your way to the front now.”

Half an hour later, I was standing in the terminal with fellow refuseniks who’d ‘voluntarily disembarked’. I waited for my turn to explain to customer services why I’d chosen not to remain on the plane, in order to be granted my refund. Other people’s reasons appeased the staff: a recent operation, the prospect of a missed connecting flight, cancer of the leg that meant long periods of sitting were impossible.

When my turn came, the group - by now bonded through the odd camaraderie of strangers who’ve shared an experience - eagerly pushed me forward. John, who I’d spent most the hour in the queue talking to and in whom I confided my reason for having disembarked, gave me a reassuring smile.

“I couldn’t sit on a packed plane for four hours while waiting for a take-off slot,” I began. Taking a deep breath, I spoke a truth I’d rarely vocalised, “because I suffer from anxiety . It's worse when I travel, and a busy plane with raucous men drinking would probably make me feel really panicked.”

I wish I could say that such a landmark moment for me, in which I candidly and unapologetically revealed an uncomfortable 20-year truth, was met with some cinematic response befitting a Richard Curtis film - applause or hand-shaking maybe?

I struggle with public transport when panicking, so often takE pricey black taxis. I find it difficult to share car journeys and rooms on holiday, which creates added expense

But no, the dour customer services man simply tutted and shook his head, and John leaned in to whisper, “it doesn’t look like you’re going to get your refund”.

On my way home and with John’s words ringing in my ears, I considered how much 20 years of panic attacks had cost me. I mean actually, in pounds. You see, when John made that quip about my refund, I hadn’t even considered getting one - this episode was just going to join the endless cancelled trips, missed planes, rebooked trains, as well as skipped dinner parties, birthdays and theatre trips I’d booked and then realised on the day that my mind wouldn’t let me go. Yet again I would be pounds poorer with no lovely experience to show for it.

Until recently, nobody cared in the slightest. This isn’t said out of bitterness - it is a statement of fact. I started having panic attacks  when I was 14. I was extremely open about them, telling people exactly what they were like - a moment of extreme fear combined with physical feelings such as nausea and a pounding heart. I’d explain that they affected me probably because I’d seen my aunt die as a young girl, but also maybe because I was just prone to them. The consensus from teachers, friends, and boyfriends was that they sounded shit but that I couldn’t use them ‘as an excuse’ to ‘get out of things’. I got so used to hearing that response, that I started to lie. I’d attribute my absences to physical illnesses such as the flu or a bad cold which couldn’t be so quickly dismissed.

MORE GLOSS: Panic attacks in your 40s and 50s? This could be why

In those excuses, I found a way dodge the judgement that came from having anxiety. But not the cost. I went to my GP, who referred me for CBT  (cognitive behavioural therapy). But it was only a sticking plaster. For me, it didn’t delve into the root causes of my anxiety sufficiently. For 16 years, on and off, I’ve paid for psychoanalysts who help me to unknot and unravel the thoughts that might go on to cause my panic attacks. I struggle with public transport when panicking, so often end up taking pricey black taxis. I find it difficult to share car journeys and rooms on holiday, which creates additional expense.

And then there’s the cost that’s harder to quantify but which I suspect has been great: that of missed career opportunities. It started when I was at school and couldn’t enrol in the Duke of Edinburgh programme as my agoraphobia –  an offshoot of my anxiety – demands a little shell in which to retreat. The prospect of not having a room of my own was unbearable. I couldn’t take part in swimming competitions despite being a strong swimmer - the idea of gulping in water when under pressure set my anxiety off. Ditto horse riding, which I continued to do but not competitively as I came to fear jumping in case it made me feel nauseous.

I realised things like that may have cost me a spot at a top university after my English teacher pulled me aside and said, “academically, you’re ripe for Oxbridge, but they like to see you doing those extracurricular activities –and not doing them can really count against you.” (In the end, I applied to universities that allowed me plenty of freedom in my course and ended up at Queen Mary’s in London, where I managed to make up in my dissertation what I lost in points for missing lectures when my anxiety didn’t allow me to attend).

A Level stress prompted another bout of attacks. I fled my German aural exam less than a quarter of the way through. Feeling panicky, trapped and on the brink of vomiting I was unable to focus on anything but the nearest door. The price of that? A Grade C, despite being a fluent German-speaker thanks to my Austrian mum

I was keen to try script-writing and landed a position as assistant to the legendary actor Peter O’Toole, who was working on a film at Pinewood Studios. My hope was to work my way up to the writing rooms. On day one, I had a panic attack that was so extreme that I couldn’t leave my bed for hours on end. My friend Ollie had to call the production company and tell them I was very poorly and wouldn’t be able to take the job. Once I’d associated a panic attack with a particular place, I couldn’t contemplate going there.

MORE  GLOSS: How to deal with an anxiety attack hangover 

Then there was the internship at a newspaper I that couldn’t complete, the job at a glossy magazine I had to leave as my mental health faltered, the job at a top daily paper as an editor I couldn’t take because I knew that the long commute combined with long hours would be a ticking time bomb for me.

Oddly, I don’t feel angry when I consider the towering cost both monetary and personally of my anxiety and panic attacks. Yes, it would’ve been nice to have been more like my peers, to have had more agency at times in my own life, to go to work in an office without worrying that on that day my mind would decide to ambush me. But more than half my life has been spent this way, and it’s now hard to separate the panic behaviours from my personality, so thoroughly are they entwined. As a result, I’ve carved out a career as a journalist where I am able to primarily work from home and mostly maintain a routine that keeps my mind and body on an even keel so that my anxiety is kept at a minimum.

Through my experience, I unequivocally know this to be true: we are living in new times where mental health is concerned. Twenty years ago, I was laughed at in the face by a coach driver when I said I needed to sit right at the front near the exit on account of my panic, but this week (which happens to be Mental Health Awareness Week), I phoned the airline for that refund John suggested - and I got it without any lying. It was a small triumph, but one which made me realise the tide is changing enormously.

Follow Madeleine  @madeleinelovesthis