“What type of sandwich, sir?”

I regained my balance and gripped the counter tight with my sweaty hands, staring at the man opposite. He stared back, confused. “… Sir?”

“Huh? A sandwich please.” “Yes. What ty…?” “Sorry, sorry. Ham and cheese would be great … Thanks … Sorry.”

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He placed the sandwich on the counter between us. I wiped my sweaty hand on my shirt and delved into my pocket for cash. The train rocked, I fell forward and head-butted the sandwich across the counter. I went to push myself up, but my palm slipped and I butted the sandwich a second time. I could feel the people behind me getting impatient. The man behind the counter smiled with pity as he dropped change in to my wet hand. My forehead was covered in sweat too. And my neck. And my back. And my crotch. And my armpits. And my arms. And my feet. And my shins. My shins. Even my shins were sweating.

It was room temperature; there was no good reason to be covered in sweat. The train was steady; there was no good reason to be stumbling down the aisle, legs shaking. There was no need to feel faint. Or to be seeing through an ever-narrowing tunnel. Or to have a tingling in my arms. Or for my heart to be pounding through my rib cage. I wasn’t at all hungry; there was no good reason to be buying a ham and cheese sandwich. But I was, because I was having a panic attack and I didn’t know what else to do.

The ever-present anxiety had been creeping up for a couple of weeks. The second the train pulled away I had thought, “Wouldn’t this be a shit place to have a panic attack.” The rational part of my brain said, “This is no worse a place than any other, and there is never any rational reason to have a panic attack,” but it was, as usual, shouted down by the irrational side, screaming, “Oh god! It’s too late! If we’ve had the thought then it’s already begun! There’s nothing we can do! Oh god!” I became light headed as the adrenaline shot through my body.

The trip to the food carriage was an attempt at distraction. Distraction from my own company, from the irrational thoughts – distraction from my own mind. Breathing exercises, relaxation tapes, mental visualisation – these have never worked for me. Breathing exercises remind me that I can’t breathe, relaxation tapes remind me that I can’t relax, and mental visualisations remind me that I’m… well, going mental. Bollocks to going anywhere near my mind. Distraction; that’s the way.

The more you avoid the situations that cause you anxiety, the more anxiety they will cause

Eye contact helps. You feel slightly less alone. Just looking at that server as he handed me my change, that helped. So, as I stumbled along the four carriages back to my seat, I looked about for a smiling stranger. A genial looking middle-aged woman is good. You can imagine she’s a motherly figure, or a hot cougar, depending on the severity of your anxiety. Or both, depending on the severity of your Oedipal complex. An old man’s smile can remind you of your granddad and Christmas and comfy armchairs. For me, an attractive person is best; you can imagine … well, all sorts. But everyone was looking down. Looking at their phone screens or their laptops or their tablets. Their foreheads reflected spreadsheets and Facebook and Minecraft. Their faces were all grey/blue. I started spinning out. Everything looked grey and colourless, and I felt completely unanchored. I was floating with no direction and with nobody and nothing to hold me down. Nothing to aim for and grab on to. Just grey, colourless, lifeless strangers.

I got back to my seat. All I could think was that I’d never be OK; I just wanted to be curled up in a padded white room and given drugs and told everything would be OK. I looked around for one last chance at human reassurance. Nothing. I got my phone out, the final distraction. I spent the next 50 minutes on Instagram, Duolingo, Snapchat, Tinder, Facebook, YouTube. Watching videos of cats looking at cucumbers. Doing a BuzzFeed quiz called “Which Cheese Is Your Love-life?”

I watched Unilad Gifs. I fell down a rabbit hole with the “related videos” dropdown bar on YouTube: Vengaboys to East 17 to Limp Bizkit to Fall Out Boy. Starting again and going from Kendrick Lamar to Jay Z to Beyoncé to Destiny’s Child to Kelly Rowland to Hot In Herre. At one point I watched three Fall Out Boy videos back to back. No one has ever done that before.

The first thing you learn in your NHS prescribed cognitive behavioural therapy, six months after you begged your GP for help, four months after constant panic attacks led to a breakdown, and two months after you bought a book that says all that your trainee CBT therapist will ever tell you, is that the worst thing you can do, when suffering with anxiety, is avoidance. The more you avoid the situations that cause you anxiety, the more anxiety they will cause, and soon enough the number of situations that cause you anxiety will increase. Your life will become narrower and the world will seem scarier.

Facebook Twitter Pinterest ‘Your life will become narrower and the world will seem scarier.’ Photograph: Alamy

But in your pocket is a device that allows you to avoid everything at all times. I thought it would be a coping device at first, but soon realised that your phone can exacerbate the problem as it lowers your self-esteem, increases your fears, and narrows your life to endless scrolling.

The negative effects of social media on mental health have been well reported. Yet, with ever-rising rates in depression, suicide being the highest killer in men under 35, and this being dubbed the age of anxiety, of course there is more to it than just the bright light on your screen keeping you up at night. But it certainly doesn’t help.

Back on the train, I was watching Duck Rotation. Panic and fear had been usurped by humming anxiety and self-loathing. I had spent one hour and 50 minutes of my short time on earth trying desperately to avoid my life. Instead, I was staring at a rotating virtual duck on my mobile phone screen. Jesus Christ!

I took my headphones off and put my mobile away. I knelt on my chair and looked down the carriage. No one looked back, they were all looking down at their screens. What was their excuse?

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We all use the internet as a distraction. None of us are proud of it, but we all find reasons to succumb; whether the reason is depression, anxiety or just boredom. Because the internet is always at our fingertips it is always there waiting for our weaker moments. People are scared of silence and of boredom and of their own thoughts – not just those of us who have been diagnosed with anxiety disorders, but all of us on that train – carriages of people who can’t just look out the window, because they might think about something sad or uncomfortable.

The genie is out of the bottle, so I’m not arguing that we all go back to basic phones and desktops, but maybe we should recognise that using the internet to avoid anxiety can increase the things that scare you, avoiding depression will increase the things that depress you, and avoiding boredom will increase the things that bore you. We have got too good at distracting ourselves from fear. This constant need for relief from reality will not just exacerbate issues, but cause them. On top of lowering self-esteem and ruining your sleep, it will diminish people’s ability to deal with the real world, as it is – silence and all.

As I came out of the panic I told myself that next time I won’t get my phone out. I will sit still with the silence and the fear, and face up to it. Beat it back down with reason. We shall see how that goes. When the tannoy announced that we were arriving in Paddington I gathered my things and walked to the door. Looking down the carriage, I noticed that nearly everyone else was still sitting staring at their screens.

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here