Hi everyone,
I just wanted to let anyone reading this blog know that although I have pretty much written all that I can about my journey through panic disorder treatment and probably won't be doing regular blog posts on here, I am still available to help with any questions related to panic disorder or cognitive behavioral therapy. I check my panicremission@gmail.com address weekly so please don't hesitate to contact me if you need advice or think I can be useful in any way.
Going to a therapist for treatment is wonderful but I think it is helpful to have the perspective of someone that has actually experienced the disorder and knows what it is like. I still remember what rock bottom feels like and I don't want any other person to have to experience that if it can be avoided. So please don't be scared to email me and ask me questions or even just use it as an opportunity to tell your story to someone that might be able to relate.
Friday, November 22, 2013
Sunday, October 13, 2013
Guest Post Part II
Here is Part II of guest blogger Jamie's story:
“Have you ever had a panic attack?"
A panic attack? Like, a crying screaming tantrum? I was so confused. My whole body was shaking. How could that have been imagined. Eventually, the paramedics filtered out and the house was quiet. My husband had been notified and was driving home from a nearby port where he was spending the night. When he got home he demanded I go to the Emergency Room, angry at me for the false alarm. I went, waited, did another EKG, and was told the same thing, by an aggravated nurse with absolutely zero sympathy, “sometimes chest pain is not caused by the heart; here’s your discharge papers.” Diagnosis: Anxiety. Go home crazy girl.
That night I could not sleep. Every time my mind would start to drift into dream land my body would jerk awake as if sleep would bring imminent death. It’s not that I was experiencing insomnia… my body, literally, would not let me sleep. I tiptoed upstairs, shook my husband, and asked: “will you please come and sit with me? I just don’t feel good.” Annoyed, he shrugged me off, said “take a Tylenol,” rolled over and went back to sleep. This is the point where I realized I would be on my own with this battle. So I returned downstairs where I sat alone, dizzy, scared, exhausted, and now afraid to sleep. Something was horribly wrong with me, and I needed to see the doctor.
So, that is the back story. Symptoms I experienced during the following months: chest pain, inability to sleep due to that weird impulse to jerk awake, constant vertigo, ringing in the ears, a pounding, flip-flopping heart, an unusual post-nasal drip, a sensation of suffocation, recurring attacks where I would race through the house with my finger on the send button for 911, pacing, trying to calm myself, a fear of driving (passing out at the wheel), grocery shopping (not sure why), taking a bath or shower (passing out and drowning), dying with my children trapped in the house alone (leaving windows open, even in cold weather, so others might hear their cries).
One evening, while sitting slackjawed at the dinner table, my husband lost his temper with me again. I was drawn deep inside of myself, listening to the unusually chaotic thudding of my own heart, while he was telling me a story. He was angry with me for not responding, angry about the whole overly dramatic ordeal, disbelieving, frustrated, and not able to understand. I apologized, brought my mind back to the table, and tried to present as a normal functioning human being. I felt so incredibly scared and alone and he, the one I needed for support, was not interested in it. Panic Disorder is not like cancer or pancreatitis. You don’t receive get well cards; no one calls to see “how are you doing?” Nobody talks about crazy. It’s the proverbial elephant in the room. You are on your own with this one, honey.
To compound the stressors-- crazy, grad school, and new baby, my beloved grandmother called to tell me she was dying from cancer. My mom said she would need help and I said I would fly home to stay with her, since I wasn’t currently working. I was so terrified on the flight. What if I had a panic attack on the plane? I was responsible for the two kids I was travelling with. What if I became unable to care for them? What would happen? But, as miracles do happen, I arrived safely on the ground and into the safety of my family home. But it was no peaceful place, and we all grappled with our emotions, watching my grandma’s swift decline and passing, only three weeks after her diagnosis of cancer.
These distractions did not diminish my own medical concerns. I was hyperaware of everything going on with my body. I often felt like I was in the same boat as my grandma and feared for my own death nearly as much as I feared for her. Together we shared a fear and curiosity of the great unknown. My grandma, much braver than I, knew her fate and faced it smiling, with humor. But as we sat one morning, flushing giant clots of blood from her catheter, she told me how scared she was, and I felt a deep understanding and sense of camaraderie that she would never know. I knew the fear of dying, because I felt it too. With tears we concluded that everything would “be okay.” I don’t think she ever spoke of that fear again. She passed with her family surrounding her, a smile on her face, making light jokes only hours earlier. In her passing there was a great peace. She had crossed her T’s and dotted her I’s, ensured everything was in order for her departure, and then, she was gone. And shortly after her funeral I was going too; back home to face my own demons, and prepare for our upcoming transfer from New Jersey to Michigan.
I checked into the ER again and when the receptionist asked me what was wrong, between sobs I drew imaginary circles with my finger around my ear—the international sign of “crazy.” I now knew it wasn’t my heart, but my mind. I was not reassured. Then, the most amazing thing happened; the ER doctor prescribed Xanax. After so many months of chaos I experienced sleep; deep, uninhibited, fearless, dream sleep. Whoa. It really is in my mind. I began seeing a psychiatrist who immediately diagnosed me with panic disorder— I met the criteria completely. He laughed and assured me I was not “crazy,” as I felt.
I worried I was having a “nervous breakdown,” or a psychotic break, I worried they would take my children away. A regimen of low dose Klonopin brought me back into reality. I was able to function--so many of my symptoms of imminent death dissipated. Before the medication I was afraid to look in the mirror because I imagined an emaciated, red eyed, balding, sickly person would be standing there; but when I looked, it was just me, looking perfectly healthy. How could I feel so deathly and appear so normal—a few pounds lighter, maybe even better than normal. With medication, I began to feel like the person in the mirror again. Life was nowhere near “normal,” I still suffered through panic attacks, but I learned to do it silently. I began to recognize this sense of imminent doom for what it was—a physiological response. Fight or Flight. A whole variety of physical responses to some imagined danger: Hyperventilation, palpitations, chest muscle tension, pupil dilation, the urge to run, save my children, etc. As I grappled with this reality, I began to put my life back together.
Moving to a new location helped immensely. Finishing my graduate work was also a major burden lifted. I feel safer in this new setting. My husband’s schedule changed and he now comes home every evening. I began seeing a therapist, who I lovingly call my “emotional prostitute’’ the one person I can share these ridiculous fears with (for $180.00/hour). I’ve made the mistake a few times of trying to tell friends about these problems (especially after a few drinks), but I feel like such a fool as they become awkward and quickly change the subject; shutting out my heartfelt confessions. I realized, of course, that hearty minded people cannot understand what it feels like when your mind betrays you; when the only safe haven you have becomes your personal prison-- the feeling that you cannot trust your own body to do what it supposed to.
To wrap this up I would like readers to know that I write from a much more comfortable place than I was in a year and a half ago but I am not a cured woman. I am slowly weaning myself from the medication that has been my crutch for so long. Simple life transitions will set off panic attacks (much more minor than before, of course). I feel the warmth of blood flowing through my body with each unnecessary dump of adrenaline, focus on my breathing, and search for a mental distraction. I find great relief in the escape of a good book or a funny TV show. There was a time when I was crashing through the rapids in the river of my life without any control, holding on through a terrifying ride. Now, the waters are calm and I’m able to navigate around the obstacles, relax a bit, and enjoy the scenery.
My marriage has suffered greatly and I am not sure where to begin with repairs. While my husband has likely dealt with anger and frustration at my new distance and fragility I have struggled to come to terms with his hostility toward me in my time of need. I find most of my thoughts still revolve, selfishly, around my own needs. Without distraction I will find myself with furrowed brow, trying to mentally solve some unknown mystery; to figure out what in my life made me break and how I can fix it. These memories I’ve shared were painful to think about, but they are, in fact, just memories. The solution, I believe, lies in the future. I hope that by writing down the past and sharing it here I will be able to leave it behind, focus on my family, my marriage, and the rest of the world that I’ve ignored for so long. I hope others will share their stories and move on with life, as well.
When the dangers are behind us the only thing left we have to fear is fear, itself.
-Jamie M.
“Have you ever had a panic attack?"
A panic attack? Like, a crying screaming tantrum? I was so confused. My whole body was shaking. How could that have been imagined. Eventually, the paramedics filtered out and the house was quiet. My husband had been notified and was driving home from a nearby port where he was spending the night. When he got home he demanded I go to the Emergency Room, angry at me for the false alarm. I went, waited, did another EKG, and was told the same thing, by an aggravated nurse with absolutely zero sympathy, “sometimes chest pain is not caused by the heart; here’s your discharge papers.” Diagnosis: Anxiety. Go home crazy girl.
That night I could not sleep. Every time my mind would start to drift into dream land my body would jerk awake as if sleep would bring imminent death. It’s not that I was experiencing insomnia… my body, literally, would not let me sleep. I tiptoed upstairs, shook my husband, and asked: “will you please come and sit with me? I just don’t feel good.” Annoyed, he shrugged me off, said “take a Tylenol,” rolled over and went back to sleep. This is the point where I realized I would be on my own with this battle. So I returned downstairs where I sat alone, dizzy, scared, exhausted, and now afraid to sleep. Something was horribly wrong with me, and I needed to see the doctor.
So, that is the back story. Symptoms I experienced during the following months: chest pain, inability to sleep due to that weird impulse to jerk awake, constant vertigo, ringing in the ears, a pounding, flip-flopping heart, an unusual post-nasal drip, a sensation of suffocation, recurring attacks where I would race through the house with my finger on the send button for 911, pacing, trying to calm myself, a fear of driving (passing out at the wheel), grocery shopping (not sure why), taking a bath or shower (passing out and drowning), dying with my children trapped in the house alone (leaving windows open, even in cold weather, so others might hear their cries).
One evening, while sitting slackjawed at the dinner table, my husband lost his temper with me again. I was drawn deep inside of myself, listening to the unusually chaotic thudding of my own heart, while he was telling me a story. He was angry with me for not responding, angry about the whole overly dramatic ordeal, disbelieving, frustrated, and not able to understand. I apologized, brought my mind back to the table, and tried to present as a normal functioning human being. I felt so incredibly scared and alone and he, the one I needed for support, was not interested in it. Panic Disorder is not like cancer or pancreatitis. You don’t receive get well cards; no one calls to see “how are you doing?” Nobody talks about crazy. It’s the proverbial elephant in the room. You are on your own with this one, honey.
To compound the stressors-- crazy, grad school, and new baby, my beloved grandmother called to tell me she was dying from cancer. My mom said she would need help and I said I would fly home to stay with her, since I wasn’t currently working. I was so terrified on the flight. What if I had a panic attack on the plane? I was responsible for the two kids I was travelling with. What if I became unable to care for them? What would happen? But, as miracles do happen, I arrived safely on the ground and into the safety of my family home. But it was no peaceful place, and we all grappled with our emotions, watching my grandma’s swift decline and passing, only three weeks after her diagnosis of cancer.
These distractions did not diminish my own medical concerns. I was hyperaware of everything going on with my body. I often felt like I was in the same boat as my grandma and feared for my own death nearly as much as I feared for her. Together we shared a fear and curiosity of the great unknown. My grandma, much braver than I, knew her fate and faced it smiling, with humor. But as we sat one morning, flushing giant clots of blood from her catheter, she told me how scared she was, and I felt a deep understanding and sense of camaraderie that she would never know. I knew the fear of dying, because I felt it too. With tears we concluded that everything would “be okay.” I don’t think she ever spoke of that fear again. She passed with her family surrounding her, a smile on her face, making light jokes only hours earlier. In her passing there was a great peace. She had crossed her T’s and dotted her I’s, ensured everything was in order for her departure, and then, she was gone. And shortly after her funeral I was going too; back home to face my own demons, and prepare for our upcoming transfer from New Jersey to Michigan.
I checked into the ER again and when the receptionist asked me what was wrong, between sobs I drew imaginary circles with my finger around my ear—the international sign of “crazy.” I now knew it wasn’t my heart, but my mind. I was not reassured. Then, the most amazing thing happened; the ER doctor prescribed Xanax. After so many months of chaos I experienced sleep; deep, uninhibited, fearless, dream sleep. Whoa. It really is in my mind. I began seeing a psychiatrist who immediately diagnosed me with panic disorder— I met the criteria completely. He laughed and assured me I was not “crazy,” as I felt.
I worried I was having a “nervous breakdown,” or a psychotic break, I worried they would take my children away. A regimen of low dose Klonopin brought me back into reality. I was able to function--so many of my symptoms of imminent death dissipated. Before the medication I was afraid to look in the mirror because I imagined an emaciated, red eyed, balding, sickly person would be standing there; but when I looked, it was just me, looking perfectly healthy. How could I feel so deathly and appear so normal—a few pounds lighter, maybe even better than normal. With medication, I began to feel like the person in the mirror again. Life was nowhere near “normal,” I still suffered through panic attacks, but I learned to do it silently. I began to recognize this sense of imminent doom for what it was—a physiological response. Fight or Flight. A whole variety of physical responses to some imagined danger: Hyperventilation, palpitations, chest muscle tension, pupil dilation, the urge to run, save my children, etc. As I grappled with this reality, I began to put my life back together.
Moving to a new location helped immensely. Finishing my graduate work was also a major burden lifted. I feel safer in this new setting. My husband’s schedule changed and he now comes home every evening. I began seeing a therapist, who I lovingly call my “emotional prostitute’’ the one person I can share these ridiculous fears with (for $180.00/hour). I’ve made the mistake a few times of trying to tell friends about these problems (especially after a few drinks), but I feel like such a fool as they become awkward and quickly change the subject; shutting out my heartfelt confessions. I realized, of course, that hearty minded people cannot understand what it feels like when your mind betrays you; when the only safe haven you have becomes your personal prison-- the feeling that you cannot trust your own body to do what it supposed to.
To wrap this up I would like readers to know that I write from a much more comfortable place than I was in a year and a half ago but I am not a cured woman. I am slowly weaning myself from the medication that has been my crutch for so long. Simple life transitions will set off panic attacks (much more minor than before, of course). I feel the warmth of blood flowing through my body with each unnecessary dump of adrenaline, focus on my breathing, and search for a mental distraction. I find great relief in the escape of a good book or a funny TV show. There was a time when I was crashing through the rapids in the river of my life without any control, holding on through a terrifying ride. Now, the waters are calm and I’m able to navigate around the obstacles, relax a bit, and enjoy the scenery.
My marriage has suffered greatly and I am not sure where to begin with repairs. While my husband has likely dealt with anger and frustration at my new distance and fragility I have struggled to come to terms with his hostility toward me in my time of need. I find most of my thoughts still revolve, selfishly, around my own needs. Without distraction I will find myself with furrowed brow, trying to mentally solve some unknown mystery; to figure out what in my life made me break and how I can fix it. These memories I’ve shared were painful to think about, but they are, in fact, just memories. The solution, I believe, lies in the future. I hope that by writing down the past and sharing it here I will be able to leave it behind, focus on my family, my marriage, and the rest of the world that I’ve ignored for so long. I hope others will share their stories and move on with life, as well.
When the dangers are behind us the only thing left we have to fear is fear, itself.
-Jamie M.
Tuesday, October 8, 2013
Guest Post Part I
Hi everyone,
I have talked a lot about my own experience with panic disorder on this blog and I am pleased to share the story of one of my followers and her journey with panic disorder. You will see a lot of similarities with my story - I think it takes most of us a while to realize (and even longer to accept) that all of these symptoms we experience are due to an anxiety disorder, when it seems so obvious that it is a heart attack or tumor or whatever else.
Here is Part I of Jamie's story:
I’ve been given the opportunity to share my personal experience as a guest contributor in this blog. I don’t have a wealth of knowledge or understanding of this disorder. I can’t tell you why it happens, what causes it, how to fix it, or if it will ever really go away; what I do have, is a story, a grudge, and a desire to share my most personal and private fears and frustrations someplace where people might relate. For a year and a half I have been, largely, alone in my struggle with Panic Disorder, and have triumphed through many harrowing private battles. That is not to discredit the few saviors who have helped me; relative strangers who have watched my children, driven me to the Emergency Room, offered companionship in my most frightening hours. My parents who sat with a phone cradled on exhausted ear during late night hours while I begged them not to hang up the phone… just in case. I hope this story will benefit others who share my condition, but I am not writing to you. I am writing to the other 98% who are never likely to read or understand-- the people in my life who are strong and secure inside of their own mind and body. The fearless, fortunate friends, who would secretly roll their eyes or shake their head with disgust if I admitted that I made biweekly visits to a therapist, or visited an emergency room three times with no legitimate emergency except a vague certainty that I was dying. These might think… “Here is a fragile, dramatic, attention seeker, feigning an imaginary ‘disorder,’ for attention or sympathy. A panic attack is nothing more than an adult having a tantrum; time to be a big girl; grow up, deal with life.”
Many people might think this way. These are the same thoughts I, myself, might have had a year and half ago. I will admit that I have had my share of grown up tantrums. Fear of a reality, emotional turmoil, frustration… that is not panic disorder. Panic disorder is life and death. I am dying… right now. I can’t figure out what is going on, but it hurts, it’s not right, and I’m scared. It is serious. I need to get help. Now!
The grudge I mentioned is against my hearty, strong minded friends. I always thought I was one of them; I could handle my share of stress. Admittedly, I’ve always been a nervous person, but it never impacted my life in any profound way. In my younger days, especially in college, I was prone to indulging in an occasional dramatic tantrum when life’s typical stressors (exams, boys, sorority drama, overcoming an addiction to cigarettes) seemed insurmountable. But those raw emotions seem to have gone dormant in later years—thankfully. For several years I lived a quiet, ordinary, and contented life with normal stress, normal reactions, and a normal functioning mind. Then suddenly, something changed. Snap.
My fear was borne of love: A complex pregnancy due to a rare blood incompatibility, weekly visits to a specialist two hours away, a military husband often away and unpredictable, add in work and grad school for spice, and finally, the welcome of a medically fragile baby girl whose life depended on my action and attention. After being anaesthetized during an emergency cesarean gone horribly wrong I woke up alone in a room without a baby. When asked about the baby, nurses skirted around the answer; “Yes, it’s a girl. No, you can’t see her yet; the doctor will be in to talk to you.” She was, I found out, receiving the first of many transfusions; a baby who did not produce red blood cells; a condition known as Hemolytic Disease of the Newborn. Her survival depended on transfusions. Of course I only got to see her for a few minutes that evening, four hours after her birth, before they transported her to an Intensive Care Nursery in Philadelphia…to another state… two hours, an eternity, away.
I was held prisoner in the hospital for two days, away from the one person in the world who needed my love the most. Those horrible pregnancy books that tell you how important immediate physical contact is with a baby and her mother and how much nutrition is gained from that first colostrum filled nursing session… they made my two days without a baby so much harder. They said I would be able to bring any breast milk I could produce with me as soon as I was discharged, so I worked with that Medela until my nipples bled, but nearly no milk. Finally, after two days, they let me out. Armed with a purse full of mostly empty bottles representing my extensive pumping efforts, we headed straight to Philadelphia and a dirty motel 6 offering us a room for $25.00. As we left the hospital I struggled to hold back tears… leaving without a baby; it’s weird and heartbreaking.
Of course we drove straight to Philadelphia and began the daily commutes to the city (or, when I was lucky, the hospital would allow me an overnight stay). Long story short, we had our little girl home in a week. She was perfect and content—but did not make her own blood. I took her for weekly blood tests, but in the mean time we watched her go from cherry red (full of new blood) to cold, pale, and quiet (ready for a refill). And when the lab results would come back that she needed a transfusion again I would have to drop everything and bolt to the Children’s Hospital in Philadelphia, two hours away, to keep her going. Of course, with a husband gone on a boat and a second child at home—this is no easy task. As an introvert I had very few close friends and hated to ask for favors… who would watch my son if she needed a transfusion? Surely anyone would have in our military housing, but I spent hours dwelling over this scenario, just as I had throughout the pregnancy. “Who will watch Collin if I go into labor? Will Nick be home?” And on my darker days…“Will he care if he can’t be there?”
Fortunately, this scenario never came up. Miracles happened, stars aligned, and he was home each time Cameron needed an extended hospital stay. A team of brilliant doctor’s hemmed and hawed behind closed doors on solutions to Cameron’s dilemma. They showed me charts they’d created and discussed research on the condition. Then, they introduced me to EPOGEN. Epogen is a very expensive medication used to treat anemia caused by chronic kidney disease in patients on dialysis to lessen the need for red blood cell transfusions. Believe me, I googled the shit out this one! Of course, my daughter did not have chronic kidney disease—what the doctor’s proposed was an off-label-use with the intention of kickstarting my daughter’s bone marrow into production.
Of course the first thing the EPOGEN website said: Using EPOGEN can lead to death or other serious side effects. And they wanted ME to inject her with this medication, twice a week! Every time I looked at the needle I’d get woozy. She looked up at me full of trust and love, then WHAM! I‘d poke the needle into her fat little leg, inject the medication, and the hysteria began. “Mommy, what did you do to me?!” I’d like to say that, after a few turns of this it became old hat, but that would be a lie. I was sick to my stomach each and every time. On top of her weekly blood tests at the lab, IV sites on arms and feet, she was a baby pincushion. Then, after four months, the most incredible news: Her red blood cells were increasing with no transfusion. She was creating her own! I was shaking with joy and relief. Our nightmare was going to have a happy ending. Now we could have a normal life with our new baby. Except for this new nagging issue… my chest pain.
Not indigestion, actual pain; acute pain in the left side of my chest. [Enter Google.] Search: Chest Pain. NO, don’t do it. You won’t like what you see, and neither did I. Every site advised medical consultation. So, as primary caretaker for my two kids I felt it was my responsibility to stay alive, went into the doctor right away to complain of this new pain. EKG was fine. The doc sent me on my way, “sometimes chest pain is not your heart.” So, what the hell else could it be? That night, after tucking the kids into bed I sat down to do some more googling; that is when the nightmare unfolded. The chest pain was almost constant now; I worried and worried.
Fortunately, this scenario never came up. Miracles happened, stars aligned, and he was home each time Cameron needed an extended hospital stay. A team of brilliant doctor’s hemmed and hawed behind closed doors on solutions to Cameron’s dilemma. They showed me charts they’d created and discussed research on the condition. Then, they introduced me to EPOGEN. Epogen is a very expensive medication used to treat anemia caused by chronic kidney disease in patients on dialysis to lessen the need for red blood cell transfusions. Believe me, I googled the shit out this one! Of course, my daughter did not have chronic kidney disease—what the doctor’s proposed was an off-label-use with the intention of kickstarting my daughter’s bone marrow into production.
Of course the first thing the EPOGEN website said: Using EPOGEN can lead to death or other serious side effects. And they wanted ME to inject her with this medication, twice a week! Every time I looked at the needle I’d get woozy. She looked up at me full of trust and love, then WHAM! I‘d poke the needle into her fat little leg, inject the medication, and the hysteria began. “Mommy, what did you do to me?!” I’d like to say that, after a few turns of this it became old hat, but that would be a lie. I was sick to my stomach each and every time. On top of her weekly blood tests at the lab, IV sites on arms and feet, she was a baby pincushion. Then, after four months, the most incredible news: Her red blood cells were increasing with no transfusion. She was creating her own! I was shaking with joy and relief. Our nightmare was going to have a happy ending. Now we could have a normal life with our new baby. Except for this new nagging issue… my chest pain.
Not indigestion, actual pain; acute pain in the left side of my chest. [Enter Google.] Search: Chest Pain. NO, don’t do it. You won’t like what you see, and neither did I. Every site advised medical consultation. So, as primary caretaker for my two kids I felt it was my responsibility to stay alive, went into the doctor right away to complain of this new pain. EKG was fine. The doc sent me on my way, “sometimes chest pain is not your heart.” So, what the hell else could it be? That night, after tucking the kids into bed I sat down to do some more googling; that is when the nightmare unfolded. The chest pain was almost constant now; I worried and worried.
Suddenly, and unexpectedly, the world came crashing down. My chest was crushing in on itself, blood rushed up to my face. Heart attack. What would the kids do if I died here in the living room? With little hesitation I ran to my phone and dialed 911. Suddenly a gaggle of men filled my living room, slapping sticky electrodes on me, running an EKG… my three year old son was running around in excited circles, everything was fine. Fine? The EMT looked at me, and asked: “Have you ever had a panic attack?”
I have talked a lot about my own experience with panic disorder on this blog and I am pleased to share the story of one of my followers and her journey with panic disorder. You will see a lot of similarities with my story - I think it takes most of us a while to realize (and even longer to accept) that all of these symptoms we experience are due to an anxiety disorder, when it seems so obvious that it is a heart attack or tumor or whatever else.
Here is Part I of Jamie's story:
I’ve been given the opportunity to share my personal experience as a guest contributor in this blog. I don’t have a wealth of knowledge or understanding of this disorder. I can’t tell you why it happens, what causes it, how to fix it, or if it will ever really go away; what I do have, is a story, a grudge, and a desire to share my most personal and private fears and frustrations someplace where people might relate. For a year and a half I have been, largely, alone in my struggle with Panic Disorder, and have triumphed through many harrowing private battles. That is not to discredit the few saviors who have helped me; relative strangers who have watched my children, driven me to the Emergency Room, offered companionship in my most frightening hours. My parents who sat with a phone cradled on exhausted ear during late night hours while I begged them not to hang up the phone… just in case. I hope this story will benefit others who share my condition, but I am not writing to you. I am writing to the other 98% who are never likely to read or understand-- the people in my life who are strong and secure inside of their own mind and body. The fearless, fortunate friends, who would secretly roll their eyes or shake their head with disgust if I admitted that I made biweekly visits to a therapist, or visited an emergency room three times with no legitimate emergency except a vague certainty that I was dying. These might think… “Here is a fragile, dramatic, attention seeker, feigning an imaginary ‘disorder,’ for attention or sympathy. A panic attack is nothing more than an adult having a tantrum; time to be a big girl; grow up, deal with life.”
Many people might think this way. These are the same thoughts I, myself, might have had a year and half ago. I will admit that I have had my share of grown up tantrums. Fear of a reality, emotional turmoil, frustration… that is not panic disorder. Panic disorder is life and death. I am dying… right now. I can’t figure out what is going on, but it hurts, it’s not right, and I’m scared. It is serious. I need to get help. Now!
The grudge I mentioned is against my hearty, strong minded friends. I always thought I was one of them; I could handle my share of stress. Admittedly, I’ve always been a nervous person, but it never impacted my life in any profound way. In my younger days, especially in college, I was prone to indulging in an occasional dramatic tantrum when life’s typical stressors (exams, boys, sorority drama, overcoming an addiction to cigarettes) seemed insurmountable. But those raw emotions seem to have gone dormant in later years—thankfully. For several years I lived a quiet, ordinary, and contented life with normal stress, normal reactions, and a normal functioning mind. Then suddenly, something changed. Snap.
My fear was borne of love: A complex pregnancy due to a rare blood incompatibility, weekly visits to a specialist two hours away, a military husband often away and unpredictable, add in work and grad school for spice, and finally, the welcome of a medically fragile baby girl whose life depended on my action and attention. After being anaesthetized during an emergency cesarean gone horribly wrong I woke up alone in a room without a baby. When asked about the baby, nurses skirted around the answer; “Yes, it’s a girl. No, you can’t see her yet; the doctor will be in to talk to you.” She was, I found out, receiving the first of many transfusions; a baby who did not produce red blood cells; a condition known as Hemolytic Disease of the Newborn. Her survival depended on transfusions. Of course I only got to see her for a few minutes that evening, four hours after her birth, before they transported her to an Intensive Care Nursery in Philadelphia…to another state… two hours, an eternity, away.
I was held prisoner in the hospital for two days, away from the one person in the world who needed my love the most. Those horrible pregnancy books that tell you how important immediate physical contact is with a baby and her mother and how much nutrition is gained from that first colostrum filled nursing session… they made my two days without a baby so much harder. They said I would be able to bring any breast milk I could produce with me as soon as I was discharged, so I worked with that Medela until my nipples bled, but nearly no milk. Finally, after two days, they let me out. Armed with a purse full of mostly empty bottles representing my extensive pumping efforts, we headed straight to Philadelphia and a dirty motel 6 offering us a room for $25.00. As we left the hospital I struggled to hold back tears… leaving without a baby; it’s weird and heartbreaking.
Of course we drove straight to Philadelphia and began the daily commutes to the city (or, when I was lucky, the hospital would allow me an overnight stay). Long story short, we had our little girl home in a week. She was perfect and content—but did not make her own blood. I took her for weekly blood tests, but in the mean time we watched her go from cherry red (full of new blood) to cold, pale, and quiet (ready for a refill). And when the lab results would come back that she needed a transfusion again I would have to drop everything and bolt to the Children’s Hospital in Philadelphia, two hours away, to keep her going. Of course, with a husband gone on a boat and a second child at home—this is no easy task. As an introvert I had very few close friends and hated to ask for favors… who would watch my son if she needed a transfusion? Surely anyone would have in our military housing, but I spent hours dwelling over this scenario, just as I had throughout the pregnancy. “Who will watch Collin if I go into labor? Will Nick be home?” And on my darker days…“Will he care if he can’t be there?”
Fortunately, this scenario never came up. Miracles happened, stars aligned, and he was home each time Cameron needed an extended hospital stay. A team of brilliant doctor’s hemmed and hawed behind closed doors on solutions to Cameron’s dilemma. They showed me charts they’d created and discussed research on the condition. Then, they introduced me to EPOGEN. Epogen is a very expensive medication used to treat anemia caused by chronic kidney disease in patients on dialysis to lessen the need for red blood cell transfusions. Believe me, I googled the shit out this one! Of course, my daughter did not have chronic kidney disease—what the doctor’s proposed was an off-label-use with the intention of kickstarting my daughter’s bone marrow into production.
Of course the first thing the EPOGEN website said: Using EPOGEN can lead to death or other serious side effects. And they wanted ME to inject her with this medication, twice a week! Every time I looked at the needle I’d get woozy. She looked up at me full of trust and love, then WHAM! I‘d poke the needle into her fat little leg, inject the medication, and the hysteria began. “Mommy, what did you do to me?!” I’d like to say that, after a few turns of this it became old hat, but that would be a lie. I was sick to my stomach each and every time. On top of her weekly blood tests at the lab, IV sites on arms and feet, she was a baby pincushion. Then, after four months, the most incredible news: Her red blood cells were increasing with no transfusion. She was creating her own! I was shaking with joy and relief. Our nightmare was going to have a happy ending. Now we could have a normal life with our new baby. Except for this new nagging issue… my chest pain.
Not indigestion, actual pain; acute pain in the left side of my chest. [Enter Google.] Search: Chest Pain. NO, don’t do it. You won’t like what you see, and neither did I. Every site advised medical consultation. So, as primary caretaker for my two kids I felt it was my responsibility to stay alive, went into the doctor right away to complain of this new pain. EKG was fine. The doc sent me on my way, “sometimes chest pain is not your heart.” So, what the hell else could it be? That night, after tucking the kids into bed I sat down to do some more googling; that is when the nightmare unfolded. The chest pain was almost constant now; I worried and worried.
Fortunately, this scenario never came up. Miracles happened, stars aligned, and he was home each time Cameron needed an extended hospital stay. A team of brilliant doctor’s hemmed and hawed behind closed doors on solutions to Cameron’s dilemma. They showed me charts they’d created and discussed research on the condition. Then, they introduced me to EPOGEN. Epogen is a very expensive medication used to treat anemia caused by chronic kidney disease in patients on dialysis to lessen the need for red blood cell transfusions. Believe me, I googled the shit out this one! Of course, my daughter did not have chronic kidney disease—what the doctor’s proposed was an off-label-use with the intention of kickstarting my daughter’s bone marrow into production.
Of course the first thing the EPOGEN website said: Using EPOGEN can lead to death or other serious side effects. And they wanted ME to inject her with this medication, twice a week! Every time I looked at the needle I’d get woozy. She looked up at me full of trust and love, then WHAM! I‘d poke the needle into her fat little leg, inject the medication, and the hysteria began. “Mommy, what did you do to me?!” I’d like to say that, after a few turns of this it became old hat, but that would be a lie. I was sick to my stomach each and every time. On top of her weekly blood tests at the lab, IV sites on arms and feet, she was a baby pincushion. Then, after four months, the most incredible news: Her red blood cells were increasing with no transfusion. She was creating her own! I was shaking with joy and relief. Our nightmare was going to have a happy ending. Now we could have a normal life with our new baby. Except for this new nagging issue… my chest pain.
Not indigestion, actual pain; acute pain in the left side of my chest. [Enter Google.] Search: Chest Pain. NO, don’t do it. You won’t like what you see, and neither did I. Every site advised medical consultation. So, as primary caretaker for my two kids I felt it was my responsibility to stay alive, went into the doctor right away to complain of this new pain. EKG was fine. The doc sent me on my way, “sometimes chest pain is not your heart.” So, what the hell else could it be? That night, after tucking the kids into bed I sat down to do some more googling; that is when the nightmare unfolded. The chest pain was almost constant now; I worried and worried.
Suddenly, and unexpectedly, the world came crashing down. My chest was crushing in on itself, blood rushed up to my face. Heart attack. What would the kids do if I died here in the living room? With little hesitation I ran to my phone and dialed 911. Suddenly a gaggle of men filled my living room, slapping sticky electrodes on me, running an EKG… my three year old son was running around in excited circles, everything was fine. Fine? The EMT looked at me, and asked: “Have you ever had a panic attack?”
Sunday, August 25, 2013
Looking back
Hi everyone,
I wanted to take this opportunity to look back at my journey now that some time has gone by. You might be expecting me to say that I am now "back to normal". And back during my panic disorder treatment I used to ache to be back to normal. I wanted time to rewind and get my life back. I wished that I wasn't at that restaurant where I had my first panic attack. Why didn't I just go eat somewhere else? Why did this happen to me? All of these things.
Not anymore. I am not back to normal, because this disorder and this journey that I went on during my recovery changed me. But you know what? I am a better person, a stronger person and a happier person because of it. I am so glad that I didn't just go back to normal. I am beyond pre-panic disorder me. And honestly, I am so glad that this happened to me. It sounds crazy right? But this disorder forced to me face my worst fears, forced me to the ground over and over. But I fought it. And I won.
Without it, I might not enjoy going out to dinner with friends as much. Not many people know what it feels like to not be able to do that. To not be able to go to a movie. But I do. And because of that, I appreciate my life so much. I stop and think about how lucky I am and how happy I am right now. You can't quite know what it feels like to be happy if you haven't been through the opposite.
The journey through my panic disorder treatment was so hard at times, and even after I stopped seeing a CBT therapist several years ago, I continued the treatment by myself well after that. I worked so hard every day. I know that after going through this, I can do anything. Absolutely anything.
So for those of you that are wishing that you could go back to normal, I will just say that once you go through this, your new normal will be AWESOME so just hang on through it, because it is worth waiting for.
I wanted to take this opportunity to look back at my journey now that some time has gone by. You might be expecting me to say that I am now "back to normal". And back during my panic disorder treatment I used to ache to be back to normal. I wanted time to rewind and get my life back. I wished that I wasn't at that restaurant where I had my first panic attack. Why didn't I just go eat somewhere else? Why did this happen to me? All of these things.
Not anymore. I am not back to normal, because this disorder and this journey that I went on during my recovery changed me. But you know what? I am a better person, a stronger person and a happier person because of it. I am so glad that I didn't just go back to normal. I am beyond pre-panic disorder me. And honestly, I am so glad that this happened to me. It sounds crazy right? But this disorder forced to me face my worst fears, forced me to the ground over and over. But I fought it. And I won.
Without it, I might not enjoy going out to dinner with friends as much. Not many people know what it feels like to not be able to do that. To not be able to go to a movie. But I do. And because of that, I appreciate my life so much. I stop and think about how lucky I am and how happy I am right now. You can't quite know what it feels like to be happy if you haven't been through the opposite.
The journey through my panic disorder treatment was so hard at times, and even after I stopped seeing a CBT therapist several years ago, I continued the treatment by myself well after that. I worked so hard every day. I know that after going through this, I can do anything. Absolutely anything.
So for those of you that are wishing that you could go back to normal, I will just say that once you go through this, your new normal will be AWESOME so just hang on through it, because it is worth waiting for.
Monday, June 3, 2013
Normal Life Stressors
Hi everyone,
It has been a while and I apologize for that. Life has been crazy busy, in a good way. But sometimes when you are super busy and get stressed out it can bring the panic attacks back up again. I have been having several attacks per day lately and as much as I want to be frustrated and angry about it, it is important to remember that this is completely normal and is bound to happen in times of stress and when you are super busy. I just keep in mind that 2 minutes of anxiety every once in a while is okay, I can handle it and try to continue to do what I was doing.
Your attitude towards these periods of stress and anxiety is so important. If you have a panic attack after a panic-free period and think to yourself "Oh no. It's happening again. I thought I was done with this! Why is it happening again? This is not fair. I hate my life" etc....I guarantee that it will take you longer to get back to normal. Do your best to remember that, if you are a panic attack sufferer, it never completely goes away. It will be with you forever. You are not curing yourself, you are learning to accept and live with the panic attacks. And while this acceptance will probably make them go away for extended periods of time, there is a definite possibility that you will experience them again while you are really stressed out or busy. And that is normal. And that is okay. The panic attacks will not hurt you. It does not mean that you are spiraling out of control. Use it as a time to practice the CBT skills that you have learned.
Positive attitude is everything.
It has been a while and I apologize for that. Life has been crazy busy, in a good way. But sometimes when you are super busy and get stressed out it can bring the panic attacks back up again. I have been having several attacks per day lately and as much as I want to be frustrated and angry about it, it is important to remember that this is completely normal and is bound to happen in times of stress and when you are super busy. I just keep in mind that 2 minutes of anxiety every once in a while is okay, I can handle it and try to continue to do what I was doing.
Your attitude towards these periods of stress and anxiety is so important. If you have a panic attack after a panic-free period and think to yourself "Oh no. It's happening again. I thought I was done with this! Why is it happening again? This is not fair. I hate my life" etc....I guarantee that it will take you longer to get back to normal. Do your best to remember that, if you are a panic attack sufferer, it never completely goes away. It will be with you forever. You are not curing yourself, you are learning to accept and live with the panic attacks. And while this acceptance will probably make them go away for extended periods of time, there is a definite possibility that you will experience them again while you are really stressed out or busy. And that is normal. And that is okay. The panic attacks will not hurt you. It does not mean that you are spiraling out of control. Use it as a time to practice the CBT skills that you have learned.
Positive attitude is everything.
Sunday, March 17, 2013
Responding to comment
Hi again. I have received some great comments on here and I just wanted to take the time to respond to this latest one publicly so everyone can learn from it:
Hi Panic Remission,
I am panic attack patient like you and I have several phobias which make my life terrible.
I am also writing a blog in Turkey regarding panic attack and phobias.
Just keep sharing , I think we may be of help to other people.
May I learn whether you have any of the following health problems as well :
Autoimmune Disorder
Allergies
Diabet
Heart Rythm problems
Vitamin D deficiency.
I have been suffering frm Panic Attack since 2007 , and I am both on medication and therapy.
I have Hashimoto thyroiditis, had Heart Rhythm problems which was fixed via EPS Ablation.
I dont know whether I have allergies and Vitamin D deficiency.I will search for it .
I just wanted to eliminate all physical problems that may cause panic attack:(
But I recommend you, if you have not visited yet , visit an Endocrinology doctor for hormonal controls and please share whether you have any of these problems Thanks a lot
And wish you best !
Thanks for your comment!! I am sorry that you are struggling with panic attacks and phobias and think that your life is terrible =( Just keep working on it and think positive - things will get better, I promise! I am not personally diagnosed with any of the health problems that you list above - but certainly it is possible that I have one or more of those, as I have not seen specialists that would be able to make the diagnoses. But it is interesting that you bring this up.
There are a lot of medical problems (physical) that can mimic or cause panic attacks. Certain cardiac issues for sure, thyroid problems as you mention, autoimmune diseases such as celiac disease (where you have to go on a gluten-free diet because your immune system is attacking the wheat that you eat and it damages your intestines). This is definitely all true and that is why in my first post about what to do when you are starting your panic disorder treatment, I recommend getting a full evaluation from a doctor to make sure that everything checks out. And I am specifically talking about just a regular primary care doctor here. I'll explain why.
Many of us with this disorder have related problems with hypochondria. A panic attack is associated with intense fear - specifically fear that something may be wrong with our bodies. So we may constantly go to the ER with the fear that we are dying or having a heart attack. Or constantly visit the doctor, desperately trying to find a physical explanation for what is causing all of this.
But you know what? I don't want to live my life like that. I don't want to go to the ER all the time, or go see a million specialists all of the time and get put on a ton of medication.
I am actively choosing to believe that my panic attacks are caused by anxiety, not by a physical disease. And by making this choice, I acknowledge the fact that I may be wrong. Maybe I do have a heart problem or thyroid problem that leads to my panic attacks. Maybe I will have a heart attack and die tomorrow. But to overcome this disorder, I need to, and I do, 100% believe that my panic attack is just a panic attack. And I want to emphasize again that it took me a very long time to be able to have this mindset. But it is very powerful if you manage to get there.
And so far, it is working for me. The brain is a very powerful organ and so even if I had an actual physical disease, it wouldn't surprise me that this type of thinking would still lessen or prevent panic attacks from happening.
And now, just because in my "real" life I have a lot of experience with endocrinology (not as a patient, in fact I have never seen an endocrinologist as a patient), I'm going to turn on the science a little bit and explain why it is unusual - but not impossible - for panic attacks to be associated with Hashimoto's, which typically causes hypothyroidism. Feel free to ignore this paragraph if you want =)
Hashimoto's thyroiditis is an autoimmune disease where your immune system accidentally thinks your thyroid is a foreign pathogen (like a virus or bacteria) and thinks that it needs to destroy it. The thyroid is a very important gland in the body as it regulates everything from your metabolism to growth to organ function (liver, heart, etc). Very important. It does this by secreting two hormones: T3 and T4 - these then go around to the rest of the body and help regulate everything. But how does the thyroid know how much T3 and T4 to make and how much? It gets a signal from the brain in the form of a hormone called TSH (thyroid stimulating hormone). So the brain releases TSH, this goes to the thyroid and tells the thyroid to make T3 and T4. If the thyroid successfully makes T3 and T4, these can go up to the brain and tell it "Yep, here we are, you can turn off the TSH now". This is called a feedback loop: TSH tells the thyroid to make T3/T4, then once enough is made, the T3/T4 tell the brain to stop making the TSH. Okay back to hashimoto's. So your immune system starts attacking your thyroid. And so your thyroid starts getting pretty bad at making T3 and T4. And because you don't have enough T3/T4, you get symptoms like: decreased heart rate, tiredness, weight gain, muscle weakness, hair loss, etc. This is called hypothyroidism because your thyroid is underproducing T3/T4. The opposite of this is hyperthyroidism where your thyroid produces too much T3/T4. The symptoms of hyperthyroidism are: fast heart rate, anxiety, weight loss, sweating. Hyperthyroidism is the endocrine disorder that typically leads to panic symptoms. Now how can hashimoto's cause this too? As the thyroid is being destroyed by your immune system, the parts that are still working start to work EXTRA hard to make up for the parts that are damaged. So sometimes you can get extra T3/T4 in the body and cause the symptoms of hyperthyroidism, including panic attacks. Depending on how much damage is done, a person actually cycle between hyper- and hypo- thyroidism, until finally the whole thyroid is damaged and it just can't make T3 and T4 anymore and you would have permanent hypothyroidism. Luckily both of these conditions are treated with excellent drugs so there is nothing to really worry about with these disorders!
But anyway back to my reasons why you need to visit your primary care doctor: if you go to the doctor and describe your symptoms of anxiety, they will most likely order a bunch of blood tests to rule out many of the physical diseases associated with panic attacks. And I am fairly confident that they will order a test to measure your TSH or T3/T4 because hyperthyroidism is one of the most common physical reasons for panic attacks. And they will listen to your heart. And they will check all of the other good stuff. Now, if they tell you that you are okay, please listen to them. If you go to a cardiologist, they might find some tiny heart murmur or if you go to an endocrinologist they might find a small nodule (non-cancerous lump) in your thyroid. These things are most likely not causing your panic attacks but will require you to go to a billion doctors all of the time and I think it just lowers the quality of life and causes a lot of unnecessary worrying. Especially for those of us who have panic disorder and are hypochondriacs.
One more medically related note: I will look in the literature but I currently do not know of any published, peer-reviewed studies linking allergies, diabetes or vitamin D deficiency with panic attacks.
Oh wow sorry this is so long. I will leave you with this piece of advice that I have been following after learning the cognitive behavioral therapy (with the note that I am currently not diagnosed with any physical diseases so I don't have to see any specialists):
I go to the doctor for my regular physical (no more than once per year, I usually do every other year)
Other than that, I will only go to the doctor if someone else tells me that I should go to the doctor. (i.e. I am so sick that my mom or friend or whoever says "dude you should really go to the doctor")
Thanks again for reading. Please write a comment or email me with any questions you may have. I am here to help!
Hi Panic Remission,
I am panic attack patient like you and I have several phobias which make my life terrible.
I am also writing a blog in Turkey regarding panic attack and phobias.
Just keep sharing , I think we may be of help to other people.
May I learn whether you have any of the following health problems as well :
Autoimmune Disorder
Allergies
Diabet
Heart Rythm problems
Vitamin D deficiency.
I have been suffering frm Panic Attack since 2007 , and I am both on medication and therapy.
I have Hashimoto thyroiditis, had Heart Rhythm problems which was fixed via EPS Ablation.
I dont know whether I have allergies and Vitamin D deficiency.I will search for it .
I just wanted to eliminate all physical problems that may cause panic attack:(
But I recommend you, if you have not visited yet , visit an Endocrinology doctor for hormonal controls and please share whether you have any of these problems Thanks a lot
And wish you best !
Thanks for your comment!! I am sorry that you are struggling with panic attacks and phobias and think that your life is terrible =( Just keep working on it and think positive - things will get better, I promise! I am not personally diagnosed with any of the health problems that you list above - but certainly it is possible that I have one or more of those, as I have not seen specialists that would be able to make the diagnoses. But it is interesting that you bring this up.
There are a lot of medical problems (physical) that can mimic or cause panic attacks. Certain cardiac issues for sure, thyroid problems as you mention, autoimmune diseases such as celiac disease (where you have to go on a gluten-free diet because your immune system is attacking the wheat that you eat and it damages your intestines). This is definitely all true and that is why in my first post about what to do when you are starting your panic disorder treatment, I recommend getting a full evaluation from a doctor to make sure that everything checks out. And I am specifically talking about just a regular primary care doctor here. I'll explain why.
Many of us with this disorder have related problems with hypochondria. A panic attack is associated with intense fear - specifically fear that something may be wrong with our bodies. So we may constantly go to the ER with the fear that we are dying or having a heart attack. Or constantly visit the doctor, desperately trying to find a physical explanation for what is causing all of this.
But you know what? I don't want to live my life like that. I don't want to go to the ER all the time, or go see a million specialists all of the time and get put on a ton of medication.
I am actively choosing to believe that my panic attacks are caused by anxiety, not by a physical disease. And by making this choice, I acknowledge the fact that I may be wrong. Maybe I do have a heart problem or thyroid problem that leads to my panic attacks. Maybe I will have a heart attack and die tomorrow. But to overcome this disorder, I need to, and I do, 100% believe that my panic attack is just a panic attack. And I want to emphasize again that it took me a very long time to be able to have this mindset. But it is very powerful if you manage to get there.
And so far, it is working for me. The brain is a very powerful organ and so even if I had an actual physical disease, it wouldn't surprise me that this type of thinking would still lessen or prevent panic attacks from happening.
And now, just because in my "real" life I have a lot of experience with endocrinology (not as a patient, in fact I have never seen an endocrinologist as a patient), I'm going to turn on the science a little bit and explain why it is unusual - but not impossible - for panic attacks to be associated with Hashimoto's, which typically causes hypothyroidism. Feel free to ignore this paragraph if you want =)
Hashimoto's thyroiditis is an autoimmune disease where your immune system accidentally thinks your thyroid is a foreign pathogen (like a virus or bacteria) and thinks that it needs to destroy it. The thyroid is a very important gland in the body as it regulates everything from your metabolism to growth to organ function (liver, heart, etc). Very important. It does this by secreting two hormones: T3 and T4 - these then go around to the rest of the body and help regulate everything. But how does the thyroid know how much T3 and T4 to make and how much? It gets a signal from the brain in the form of a hormone called TSH (thyroid stimulating hormone). So the brain releases TSH, this goes to the thyroid and tells the thyroid to make T3 and T4. If the thyroid successfully makes T3 and T4, these can go up to the brain and tell it "Yep, here we are, you can turn off the TSH now". This is called a feedback loop: TSH tells the thyroid to make T3/T4, then once enough is made, the T3/T4 tell the brain to stop making the TSH. Okay back to hashimoto's. So your immune system starts attacking your thyroid. And so your thyroid starts getting pretty bad at making T3 and T4. And because you don't have enough T3/T4, you get symptoms like: decreased heart rate, tiredness, weight gain, muscle weakness, hair loss, etc. This is called hypothyroidism because your thyroid is underproducing T3/T4. The opposite of this is hyperthyroidism where your thyroid produces too much T3/T4. The symptoms of hyperthyroidism are: fast heart rate, anxiety, weight loss, sweating. Hyperthyroidism is the endocrine disorder that typically leads to panic symptoms. Now how can hashimoto's cause this too? As the thyroid is being destroyed by your immune system, the parts that are still working start to work EXTRA hard to make up for the parts that are damaged. So sometimes you can get extra T3/T4 in the body and cause the symptoms of hyperthyroidism, including panic attacks. Depending on how much damage is done, a person actually cycle between hyper- and hypo- thyroidism, until finally the whole thyroid is damaged and it just can't make T3 and T4 anymore and you would have permanent hypothyroidism. Luckily both of these conditions are treated with excellent drugs so there is nothing to really worry about with these disorders!
But anyway back to my reasons why you need to visit your primary care doctor: if you go to the doctor and describe your symptoms of anxiety, they will most likely order a bunch of blood tests to rule out many of the physical diseases associated with panic attacks. And I am fairly confident that they will order a test to measure your TSH or T3/T4 because hyperthyroidism is one of the most common physical reasons for panic attacks. And they will listen to your heart. And they will check all of the other good stuff. Now, if they tell you that you are okay, please listen to them. If you go to a cardiologist, they might find some tiny heart murmur or if you go to an endocrinologist they might find a small nodule (non-cancerous lump) in your thyroid. These things are most likely not causing your panic attacks but will require you to go to a billion doctors all of the time and I think it just lowers the quality of life and causes a lot of unnecessary worrying. Especially for those of us who have panic disorder and are hypochondriacs.
One more medically related note: I will look in the literature but I currently do not know of any published, peer-reviewed studies linking allergies, diabetes or vitamin D deficiency with panic attacks.
Oh wow sorry this is so long. I will leave you with this piece of advice that I have been following after learning the cognitive behavioral therapy (with the note that I am currently not diagnosed with any physical diseases so I don't have to see any specialists):
I go to the doctor for my regular physical (no more than once per year, I usually do every other year)
Other than that, I will only go to the doctor if someone else tells me that I should go to the doctor. (i.e. I am so sick that my mom or friend or whoever says "dude you should really go to the doctor")
Thanks again for reading. Please write a comment or email me with any questions you may have. I am here to help!
Friday, January 25, 2013
The importance of taking things slow
I have written down a lot about riding out panic attacks, talking to your amygdala and staying put during attacks. The one thing I need to bring it is the importance of doing it all correctly. If you have been avoiding movie theaters for the past 10 years you might think that it is a good idea to jump right in. And maybe with other aspects of life, this is a useful tactic. But when you are retraining your amygdala, it is very important to go slowly. If you do not think that you will be able to appropriately use the "skills" that I have laid out here, it actually might be better to tackle whatever you are facing at a later time.
Here is an example.
I was in the middle of my CBT treatment for panic disorder. I was 4 months in and it was around the holidays so we were taking some time off. And I was going through a stage where I could constantly feel my heart beating at all times. And it would trigger a panic attack whenever it got pretty high, which of course would make it even higher and it would spiral out of control. Well I was walking up the stairs in my house one day and I felt a pop in my chest and suddenly my heart rate was insanely high. Like I couldn't even count the beats, it just felt like it was fluttering around. And I freaked out and got my boyfriend to drive me to urgent care. By the time we got there, I had actually calmed down a bit and my heart rate slowed to 120-130 or so but as a precaution they forced me to go to the ER where I got to spend my entire Saturday.
Anyway after that incident I was basically terrified of stairs. Yes, stairs. I know how ridiculous it sounds. And I have to walk up a few flights of stairs to go to work every day. Being determined to fight my panic disorder, I forced myself up the stairs every day only to have really severe panic attacks to the point where I had to get to work 20 minutes early just so I could go through all of that and calm down before I actually had to start working.
It turns out that this was the wrong approach. By going up the stairs and having panic attacks, I was confirming to my amygdala that what I was doing was scary and dangerous. What I learned is that I should only go up the stairs if I was truly mentally prepared to face a panic attack - let the adrenaline wash over me, talk to my amygdala, and throw myself into the CBT. If I was rushed that day or just didn't feel like I would be able to use the skills appropriately, it was better to take the elevator. And by doing this, it made my recovery SO much faster!
So the lesson here is that if you are just having a bad day or are exhausted or think you will get overwhelmed with triggering a panic attack - don't do it. And I'm talking about situational panic attacks here, like where you know that if you go into that movie theater or you go into that store you WILL have an attack. If you are not in the right mental state, do it when you are ready. When you are determined and think to yourself - I want to get over this. Let's f*%ing doing this. THAT'S when you go for it.
Here is an example.
I was in the middle of my CBT treatment for panic disorder. I was 4 months in and it was around the holidays so we were taking some time off. And I was going through a stage where I could constantly feel my heart beating at all times. And it would trigger a panic attack whenever it got pretty high, which of course would make it even higher and it would spiral out of control. Well I was walking up the stairs in my house one day and I felt a pop in my chest and suddenly my heart rate was insanely high. Like I couldn't even count the beats, it just felt like it was fluttering around. And I freaked out and got my boyfriend to drive me to urgent care. By the time we got there, I had actually calmed down a bit and my heart rate slowed to 120-130 or so but as a precaution they forced me to go to the ER where I got to spend my entire Saturday.
Anyway after that incident I was basically terrified of stairs. Yes, stairs. I know how ridiculous it sounds. And I have to walk up a few flights of stairs to go to work every day. Being determined to fight my panic disorder, I forced myself up the stairs every day only to have really severe panic attacks to the point where I had to get to work 20 minutes early just so I could go through all of that and calm down before I actually had to start working.
It turns out that this was the wrong approach. By going up the stairs and having panic attacks, I was confirming to my amygdala that what I was doing was scary and dangerous. What I learned is that I should only go up the stairs if I was truly mentally prepared to face a panic attack - let the adrenaline wash over me, talk to my amygdala, and throw myself into the CBT. If I was rushed that day or just didn't feel like I would be able to use the skills appropriately, it was better to take the elevator. And by doing this, it made my recovery SO much faster!
So the lesson here is that if you are just having a bad day or are exhausted or think you will get overwhelmed with triggering a panic attack - don't do it. And I'm talking about situational panic attacks here, like where you know that if you go into that movie theater or you go into that store you WILL have an attack. If you are not in the right mental state, do it when you are ready. When you are determined and think to yourself - I want to get over this. Let's f*%ing doing this. THAT'S when you go for it.
Monday, November 19, 2012
Medication Revisited
I have written about my views on
medication in the past but I felt like I should revisit it.
Browsing through panic disorder
message boards on the web, it has surprised me how many people are taking
multiple medications in order to escape from their panic disorder. I
completely understand the thought behind this: They say that a panic attack can
be the most frightening experience of a person's entire life. And I can
say that it is for mine so far. Even Vietnam war veterans have said they would rather go back to that experience
than go through another panic attack. Why would you not want to take a pill and make it
all go away? I get that.
One major problem I have is the
notion that taking a benzo or SSRI is treating a person's panic
disorder. This is wrong. That is like saying that giving pain
killers to a person that broke their leg is treating the broken limb. It
is not. Yes it alleviates the symptoms, but take away the medication and
you are back at square one. The only way to treat panic disorder is to
understand the biology behind it and use CBT to retrain your brain to respond
differently to your thoughts. I hope that by reading through the rest of this blog you can start to understand why this is the case.
Medication to panic disorder is just a
security blanket: Imagine you are on a crowded bus and start to feel panicked
so you reach into your purse to grab a pill. But you can't find
any. What do you think this will do to your anxiety level? To the
severity of your panic attack? Yes, it will be WORSE. Remember, with this disorder you need to show your amygdala that a panic attack is not scary or dangerous. By taking a pill, you are telling it that yes the experience was scary or dangerous so you took a pill to make all of those feelings go away. You are only going to make it harder for yourself when you decide to treat your panic attacks for good.
What bothers me is how many people
try the CBT thing and decide "It doesn't work for me". In my opinion, these people were not trained to properly use these techniques,
or else they have not spent enough time working hard to learn the techniques. For the first 4 months of my
therapy, I thought I was trying, and I thought I was doing everything right. But you know what?
Each panic attack scared the hell of out me and I wasn't able to use the skills
properly. It takes a LONG TIME to be able to do this. It takes a
lot of practice and a lot of patience. But if you tell me that it "doesn't
work for you"....I will just have trouble believing that. If you work hard and honestly
give 100% of yourself, it will work. Trust me. Please put down your medication and
start actually treating your anxiety disorder!!
Thursday, October 18, 2012
Uh oh...new sensation
Sorry for the long delay in posts. I felt like I was writing to myself and no one was finding the site. If you are reading this and have any questions or comments please please do not hesitate to contact me (panicremission@gmail.com). I understand if you want to remain anonymous so just leave a comment on the site or create a random email address. This disorder can be debilitating if not managed properly and I want to help in anyway I can. Thanks guys.
Okay so by now you hopefully have a
pretty good handle on riding out a panic attack. It sort of runs through
the same motions each time and you just breathe through it and continue what
you were doing. No big deal. But sometimes there is a new sensation
that can throw you off - maybe your panic attacks are largely focused on chest
pain and chest tightness but then one time you feel like your throat was
closing up. And you haven't experienced that before. You get scared
and suddenly you are back to fearing the panic attack, or at least fearing this new sensation to the point that it leads to a panic attack. I like to do two
things in this situation.
1) I don't normally advocate looking
up sensations online. I am a hypochondriac, as I am sure a lot of people
with panic disorder are. Looking up medical stuff online is just a bad
idea, it will make you feel worse, not better. The ONLY time I think it
is okay to look up a sensation is to confirm that it is due to anxiety (and you
probably should just take your own word for it, and not even look online).
If you are EVER going to look something up online, type the following
into google "[your sensation here], anxiety". There is also this
website that lists anxiety
symptoms: http://www.anxietycentre.com/anxiety-symptoms.shtml I
sometimes find it helpful to review the list, and just remember how many crazy
sensations you can feel as a result of anxiety.
2) Put some humor into it. You
have trained yourself to be okay with a physical sensation. Be okay with
having a headache, being dizzy or having chest pain. And now suddenly you
have this sensation that your throat is tightening up and you can't breathe.
Its almost like your body is *searching* for a sensation that will get
your attention (at least sometimes it feels like that!). When this
happens I try to have the attitude like "Well I see you've found something
new to try, amygdala...you're going to try to get me to believe that I can't
breathe huh? Well you are doing a pretty decent job, I mean my throat
feels pretty tight. Unfortunately, I can still breathe. See? I'm
breathing in....and now I'm breathing out. Good try though." Sometimes I will be working or doing
something and feel a sensation and I will even smile a little and be like
"oh amygdala, what are you up to now you troublemaker?"
You just have to do whatever it takes
to get away from *fearing* the sensation. I know it is hard, but fear is
what fuels panic so you never want to give it that fuel.
Saturday, September 8, 2012
Remission and Relapse
Okay so with all of your hard work
and talking to your amygdala and riding out a panic attack, the panic will
definitely lessen but I am hesitant to say that it will go away completely (but
for some people it might!). For the rest of you, it definitely won't
bother you as much, and you will be able to continue to live a normal life but
it would be a lie to say that you will never have another panic attack in your
lifetime. So I consider this to be a "remission". In
medicine, remission means that you have a chronic illness but that you are not
experiencing symptoms at the present time.
Unfortunately, bad stuff can happen -
maybe you lose your job or a parent is sick and you start to feel a lot of
stress. The symptoms may slowly start to creep back up to you. You
have to try and recognize that you are feeling this way because you are
stressed out. Not because you have a life-threatening illness. With this new stress, it is possible that you will relapse a little bit into your old state.
Try to use this knowledge to your advantage and practice the skills that you have
learned. What has happened to me in the past is that I will be stressed out about work or relationships or what have you and have a couple
of days where I am experiencing a few panic attacks per day (which I ride out
fine). But when your body goes through a bunch of attacks like that it can start
to take a physical toll. Suddenly you are hyper-aware of every little sensation in
your body and your muscles are probably really tight and sore - this can create anxiety. Recognize
this series of events so you do not think something is wrong with you. Yes,
you might feel out of sorts for a few days after the fact. Don't let this
turn into a cycle of thinking something is wrong, having a panic attack and
then feeling worse and then worrying and then having another attack etc etc.
Remember that during a stressful time, a relapse may occur. That is
okay. Deal with it the best that you can. Remember that your body
might not be quite right for a little while after that but that is normal and
nothing is wrong with you. You are not spiraling out of control, you are not going back to the beginning. You might have a few "off" days, but everyone does right? With our disorder you have to make sure to recognize that this is normal, it is part of being a human being and you will feel better shortly. Keep a positive attitude about your condition. Attitude is everything with panic disorder.
Wednesday, August 29, 2012
A word about medication...
Okay so I thought I would say a few
words about medications for panic disorder. The typical medication prescribed for panic
disorder are benzodiazepines (xanax, klonopin, etc) and SSRI/SNRIs (prozac,
zoloft, etc). Benzos act on your brain and basically calm down your brain
if it is overexcited and your neurons are firing way too much. They act
pretty quickly, within minutes, and so people like to take these when they feel
a panic attack coming on because it will lessen or stop the attack. When I have taken these in the past I could almost feel them slowing my brain down. SSRIs are pretty complicated
so I won't get into the mechanism of action but these are antidepressants and
keep you in a "happier" basal state, I guess, so that you aren't as
prone to feeling anxiety on a daily basis. You take them regularly every day. SSRIs would be considered more
of a long term, in-the-background sort of thing whereas a benzo is short-acting
and would be taken at the onset of a panic attack to achieve instant
results.
I think both of these medications are
great, and they have their purposes with other medical problems. But not
ours. Our problem is essentially a fear of the fear response. To
get over this you need to prove to your brain that this fight-or-flight
response is NOT something to be scared of. But if you are someone that
pops a xanax every time you have an attack you are telling your brain "Yes,
amygdala, this is a VERY scary and dangerous situation, so I am going to take this pill and make it go away". You are confirming to your amygdala that there was in fact a
dangerous or scary event going on. This is the opposite of what you want
to do.
Think about it: what is so scary
about a panic attack? It is the fear of death, of going crazy, of having
something terribly wrong with you, of passing out. If you are having an
attack and you take a xanax and then your attack goes away....guess what - you
just confirmed that you were having a panic attack and it is not some life
threatening illness. It means that you are not going to die, you are not
going crazy, you do not have anything terribly wrong with you and you are not
going to pass out. This, if anything, should give you all of the
confidence in the world to go out there and power through a panic attack and
start to retrain your amygdala.
If you have been on medication for a while I know it will be very scary to get off of it. But if you want to get rid of this disorder for good,
you have to show your amygdala that a panic attack is nothing to be afraid of. And unfortunately you can't do that with medication as a security blanket.
Sunday, August 26, 2012
Don't Leave
Okay so I think the single most
difficult thing for me during my panic disorder treatment was staying put
during an attack. Your mind is telling you to leave whatever situation
you are in - to run away, to go home. And it is extremely hard not to listen to it.
You just feel this intense need to escape. This is all part of the
fight-or-flight response: your body is responding as if you were faced with a
bear. Of course it is going to tell you to run away!! But to overcome panic disorder you need to show your amygdala that there is actually no real danger.
You are not faced with a bear and your life is not threatened in any way.
In order for your amygdala to understand this, you can't give into
this need to escape. If you have an attack at your desk at work and then
you go into the bathroom to calm down, you are indirectly telling your amygdala
that yes, there was danger at your desk, it was very scary so you
"escaped" from your desk. Your amygdala will then recognize your desk as dangerous and you will continue to have anxiety and/or panic associated with being at your desk at work.
To break this cycle, it is absolutely imperative not to give into the need to flee the situation. You just have to sit there and breathe through the attack. It actually helps to talk yourself (or as I prefer, your amygdala) through the situation. If you are having a panic attack at
your desk at work, you can say something like "Oh so I see that my
fight-or-flight response must have gotten triggered by some set of cue at my
desk. Interesting. Well I am just going to sit here and continue to
work on this document. There is nothing dangerous about the situation I
am in so there is no reason for me to get up and leave." The trick
here is that you cannot be angry with yourself because anger actually comes
from a very similar emotional place as fear so you don't want this to trigger
further attacks. You just have to be matter-of-factly with it. Just
observe your emotional and physical response with curiosity. And don't get up. I know how hard it is to stay put with all of the adrenaline coursing through you - you might squirm a little and that is okay. But try really hard not to get up and leave.
Another mistake that I have made in the past is to try to
figure out what the cues were that triggered the attack. I became almost
obsessed with figuring it out. The problem is that when I didn't find a
"satisfying" answer I had a lot more trouble coming out of my anxious
state. The best thing to do is try not to overanalyze the situation.
Just say "Yep, something here must have triggered my panic attack.
Okay. Well that's fine. Doesn't matter what it was. I'm
just going to continue what I was doing". (this is very hard, just
to warn you!!). The good news is that if you can manage to do all of
this, to stay put and talk to yourself without anger and to not overanalyze
what trigger may have caused your panic, your attack will probably last about
90 seconds (this is how long it takes your body to break down the adrenaline
that has been released).
I don't know about you, but I can handle 90
seconds of discomfort every once in a while.
Sunday, August 19, 2012
Handling a fear of passing out
Okay so just a quick side note for anyone that is worried
about riding out a panic attack with a fear of passing out / fainting /
becoming unconscious. First of all, it is extremely extremely unlikely
that someone would lose consciousness during a panic attack. Why?
As you are now aware, a panic attack is your body going into fight-or-flight
mode and this involves, among everything else that is explained below, an
increase in your blood pressure to deliver oxygen to your muscles so you are
ready to fight or run. Fainting, or passing out, involves low blood
pressure - your brain doesn't have enough oxygen and since it is all the
way up there at the top of your head, the easiest thing for it to do is cause
you to lose consciousness, thus ending up on the ground where your blood
doesn't have to fight against all of that gravity to deliver oxygen to your
brain (again, a defense mechanism, this isn't going to harm your body at
all). So anyway with your high blood pressure during the attack it is
HIGHLY unlikely that you will ever pass out. I know it feels like you
might, trust me!!! But it just won't happen. You might feel
lightheaded, yes, and that is probably due to you hyperventilating without
realizing it which is why the breathing exercises are so important. And
you don't have to breathe in super super deep - just a natural, slow pace like
in....1....2....3....out...1...2...3. Focus on filling your lungs with
oxygen and then emptying them completely. It is also easier while sitting
or lying down because that way you will breathe with your diaphragm (lower chest) instead of
your upper chest, which helps even more.
The one thing I have noticed with my
panic attacks is that since you feel like you aren't getting enough air
(sometimes called "air hunger"), you tend to do a lot of inhaling but then sort
of forget about the exhaling, or don't exhale completely. The exhale is
really important and I can get into all of the details about blood oxygenation
levels if necessary but just trust me that you want to inhale completely and
also exhale completely - focus on your exhale during the attack if you realize
that it is a problem for you as well. You don't want to be taking huge
breathes and then not exhaling because this might lead you to feel more
lightheaded or dizzy (which isn't dangerous so don't worry but it is
just unnecessarily uncomfortable). Okay good luck!!!! Email me if you need help or advice!
Thursday, August 16, 2012
First Step to Remission
Okay so the first thing you need to
do, although I'm sure most of you have already, is go to the doctor and just
make sure that everything checks out. Let the doctor listen to your heart
and lungs and really listen to them when they tell you that everything sounds
good. And I think it is really important to find a doctor who understands
your condition and doesn't make you feel bad, or disregard what you are
saying. You will need to be honest with them and tell him that you have been struggling with anxiety. Depending on how the doctor reacts, you should be able to tell if you have found the right person for you or not. It needs to be someone that feels comforting. Someone who understands what panic attacks actually are and does
not blame you for your condition. So let this person give you a full
physical and try as hard as you can to believe them when they tell you that you
are okay.
Now you need to do something that
will probably seem really scary. But hopefully from what you have read in
my previous posts and from what you hear from your doctor, there is absolutely no
risk to doing this. You need to ride out the panic attack. You
need to let the adrenaline wash over you and teach your amygdala that the
fight-or-flight response is not dangerous. Up until this point, your brain thinks that panic attack is a dangerous and potentially deadly experience. In reality, it is not. But you will need to teach your amygdala that. In order to prepare for this
you need to practice a few techniques. One of these is the ability to
separate yourself from your thoughts (it sounds really weird, okay, but just
trust me on this one). So just take 10 minutes per day and sit down in a
quiet area and just notice what you are thinking. Without any judgement
about the thought. Just be aware of what you are thinking. So just
say to yourself: "Okay I am now having the thought that I should be doing
dishes. Now I am having the thought that this is really boring. Now
I am having the thought that this exercise is incredibly stupid....etc"
(and yes, until I realized the power of this exercise, a lot of my thoughts
tended to be about how I thought this whole listening-to-your-thoughts thing
was stupid - and that is perfectly fine but remember there is no
judgement. Just notice the thought, period). One of the
other benefits of this exercise is that, at least for me, I ended up feeling
noticeably calmer after this 10 minute break. Just sit or lie down, set a timer and close your eyes...
Anyway this ability to
separate yourself from your thoughts is really important because during a panic
attack your mind will be flooded with thoughts of "I'm going to die"
"I'm having a heart attack" "I can't breathe" "I hate
this" "I need to go to the ER" etc etc. and you need to be
able to recognize that these thoughts are actually symptoms of the panic
attack just like heart palpitations and dizziness are symptoms. These
thoughts are linked to your fight-or-flight response and will keep coming up
with each panic attack but that doesn't mean they are correct and that you need
to listen to them or believe them. So if you can separate yourself from
these thoughts, and just notice "okay, I'm having the thought that I can't
breathe" it is actually super powerful. Instead of thinking "I can't breathe!!!!!!!!" it is "I am having the thought that I can't
breathe". This reminds you that you are only having a thought that
you can't breathe, not that you actually can't breathe. And this shift in
thinking is really critical for you to retrain your amygdala.
Now in the moment of a panic attack
this takes a LOT of practice. The fight-or-flight response is such a powerful
response that it is very difficult to do the above exercise in the heat of the
moment (especially if you are not at home) but if you keep practicing it
becomes so natural that you can do this shift in thinking in any context.
But since it is so difficult, I want you to just have one goal in mind for the
first few panic attacks that you ride out: just breathe. Sit down and just
focus on breathing in and out very slowly. If you can start to recognize
your thoughts as thoughts, that is awesome. If not, just breathe.
Breathe and know that it will be over in about 10 minutes (and if you really
are just breathing through it, it will be much shorter). And importantly,
NEVER feel bad about yourself if you fail, if you forget everything you are
supposed to practice in the heat of the moment. This stuff is SO
HARD. Even just to sit still is so difficult, I know it is. You might be panicking for 20 minutes before you remember to focus
on your breathing. That is fine. Do not get mad at yourself, do not
judge yourself. Recognize how hard it is to do this and celebrate every
single baby step you make during this process. I cannot emphasize this
enough. If you are constantly berating yourself every time you forget
these exercises during a panic attack it will slow your progress.
Celebrate any possible positive change from the last time you had an
attack. And also recognize that there are good and bad days. This
is completely normal, and in no way does this mean that you are taking steps
backwards (even though it might feel like it, try to be positive!!). The process of retraining your amygdala does not happen overnight. It is a tough road but one that is so well worth it. I know that you can do it. Just start simple: Breathe.
So the first steps towards
getting over your panic attacks are the following:
1) Get checked out by a doctor and
try as hard as you can to believe them when they tell you that you are fine.
2) Try to sit in a quiet place for 10
minutes per day and notice what you are thinking without judging your thoughts
3) Sit through a panic attack (don't
run away, don't pace, just sit) and focus on breathing in and out. Let
the adrenaline surge through your body and just breathe. The panic attack won't hurt you at all. It SUCKS but it won't hurt you.
4) Try to notice your thoughts during the panic attack,
and recognize that they are symptoms of the panic attack itself. They are only thoughts, they are probably not true.
Good luck. I am proud of you for taking this step forward. I know how hard it is. If you have questions or need help or support do not hesitate to contact me: panicremission@gmail.com
Wednesday, August 8, 2012
Fight or Flight response explained II
So you can probably start to see the
difficulty with the situation that you are now faced with. Every time
your heart rate increases, or you feel a little lightheaded, your amygdala wakes
up and senses "danger" and does the only thing it knows how to do to
protect you: initiate the fight-or-flight response. Giving you the exact
same feelings that you have come to dread and hate. And not only that,
every time you are in that same restaurant, maybe at around the same time or
with the same people - if your amygdala decides that this situation seems
an awful lot like that one other time where there was danger, it will press the ON button and initiate the fight-or-flight response. You will probably
leave the restaurant (after all, your mind is telling you to run away) and
eventually the response will go away. Then your amygdala will think, okay
good I survived that dangerous situation. And then it will catalog
all of the new information about that experience. What you were wearing,
what you were thinking, what you ordered.
You know how it seems like you have
panic attacks completely out of the blue? I tend to think that that isn't
exactly true. Example: maybe you have a panic attack while you are at
home eating some cheerios wearing a red shirt and thinking about the ninja
turtles. Cheerios, red shirt and ninja turtles are now cataloged as
"dangerous". So now lets say you are at a grocery store and you
happen to be wearing that same shirt. And then you walk past the cheerios
in aisle 5 and the box is advertising a free ninja turtle action figure with
every purchase. Your amygdala recognizes cheerios + red shirt + ninja
turtles = danger and presses the ON button. To you, it feels like you are
having a panic attack for no reason at a grocery store. But actually it
is your amygdala working incredibly hard to protect you from what it
believes to be dangerous.
So the amygdala starts to gather this
enormous amount of material that it thinks is dangerous. I mean seriously
it is probably an unbelievable amount of material, especially if you have had
panic attacks for a while now. To the point where yes, the attacks do
seem unpredictable because you can't possibly remember every detail about every
situation in which you had a panic attack.
But armed with all of this knowledge,
this understanding of what is actually going on - you can start to do
something about it.
Monday, July 30, 2012
Fight or Flight response explained
Like I described earlier, the purpose
of the fight-or-flight response is to give you the best possible chance of
survival when you encounter danger. One of the first things that happens
is an increase in your heart and breathing rate. These are beneficial for
either fighting or fleeing - your lungs take in more oxygen and your heart
pumps faster to deliver that oxygen to your muscles so you can punch harder or
run faster. At the same time, your body doesn't want to waste energy on
anything that isn't immediately important to your survival. So it
completely shuts down your digestive system, and not only that, it doesn't want
you to have any extra weight while you are running away from your
attacker. So whatever food or liquid you have in there needs to leave ASAP. It also redirects blood flow away from your limbs so that if your
arm is ripped off there is less blood loss. Your sweat glands are turned
on so you are nice and slippery to make it harder for your attacker to grab
you. Your pupils dilate so that you can better see your attacker's next
move. Okay so that all makes sense if you are trying to run from a
bear. What if you are just sitting in a restaurant? What does it
feel like?
You notice that your heart is
racing. It is extremely uncomfortable and you wonder what is wrong.
Your breathing rate increases - which you might not notice but you do feel
a side effect of your accidental hyperventilation: feeling lightheaded and
dizzy. Your body turns off your digestive system so now you feel nauseous
and maybe like you need to throw up. Your body redirects blood away from
your limbs - so now your arms and legs start to feel tingly or numb. You
start to sweat heavily. Your pupils dilate and this screws up your vision
- either making your peripheral vision blurry or maybe blocking it out
completely giving you tunnel vision. Your senses also become extremely
heightened. Every noise seems louder, smell seems stronger. And I
don't know if I have read this anywhere but just from personal experience I
also know that you lose the ability to think rationally. Your body has
just initiated this ancient animalistic program and there is not very much room
for you to use your brain and think clearly during this fight-or-flight
response. The only objective is to survive by fighting or running away.
So suddenly you get really sweaty,
your heart is racing, you feel lightheaded and nauseous, your vision is blurry,
your legs are numb and at the same time your mind is screaming at you to
"run". The only problem is that you are not faced with an
attacker. You are not about to protect your child from a tiger. You
are sitting quietly at a restaurant minding your own business.
So how did this happen? Maybe
you were in my position, where you skipped lunch and had really low blood
sugar. So you start to feel lightheaded - your brain needs sugar,
and it is politely suggesting that you eat something relatively quickly.
And you accidentally misinterpret this suggestion. You instead start to
worry: "What is happening to me? Something is wrong" and with
that fear, your amygdala wakes up and says "Oh there must be danger
here!" and presses the ON button, initiating the fight-or-flight
response. As you are wondering what is wrong with you, you start to get
more "symptoms". Sweaty, heart palpitations and tunnel
vision. And you start to worry even MORE: "What is happening to
me?!" Your amygdala sees that wow, there is a LOT of danger here,
obviously it did not give you quite enough adrenaline so it presses the ON
button again. Now you feel dizzy and nauseous and your legs are
numb. And now you are completely distraught and think you are about to
die because your whole body is in chaos.
The good news is that you are not
about to die. As awful as it feels, your body is actually trying to
protect you. Your body was designed for exactly this type of
response. Think back to the days of our ancestors living on the
plains. They probably had to watch out for lions and other predators
every single night. They probably had this fight-or-flight response go
off several times a day for their entire life. It will not hurt you. Your amygdala sensed danger and it is doing the best job it can to
prepare you to survive.
So you are sitting at a restaurant
and you feel all of these symptoms. And you don't realize that it is your
amygdala trying to protect you. You think that something is seriously
wrong and your body is falling apart. You think that you might pass out
and die. You are scared of the increased heart rate, at the
dizziness and numbness. You are scared because your vision is
blurry and you feel like you can't breathe. And your amygdala, wanting to
always protect you from danger, remembers all of the details about this
event. It remembers that increased heart rate = danger. It
remembers that dizziness = danger. It remembers the name of the
restaurant, the position you were sitting in when you started to feel dizzy,
who you were with, what you were wearing and what you were thinking. It
is trying to do a good job of remembering all of this information so that next
time you are faced with this same "danger" it can press the ON button
and protect you.
There is one problem.
This "danger" that the
amygdala has now cataloged and stored is the very same physiological response
that it uses to protect you. Your amygdala now thinks that the
fight-or-flight response = danger. And what is literally the ONLY thing
that it can do? Press the ON button again.
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