Saturday, March 8

Panic Disorder and Me

A woman, age 65, is driving over a bridge when she’s gripped with fear. She gets palpitations and chest pains and begins to sweat. She feels as though she’s about to suffocate, and is certain she’s going to die. She screams, and the friend sitting next to her in the car reaches over and grabs the steering wheel. The passenger manages to pull the car over safely. The attack passes after about 10 minutes, but is so frightening that the woman calls her doctor. After performing a physical exam and finding her otherwise healthy, the doctor tells her that she had a panic attack and recommends a psychiatric consultation.

The first time it happened to me driving over a bridge, there was no way I could let on what was happening. If I acknowledged it, I would die. I was about 22 and driving two people to a VISTA workshop in Philadelphia. The young woman from the office sat in the passenger seat chirping merrily away as we got onto the Delaware Memorial Bridge and suddenly I had the worst panic attack of my life. I felt like the 65 year old woman described above and although I might have wanted to, I didn't scream. After that, the attacks on the bridges became so bad I wouldn't drive over them anymore...and I didn't, not for over 20 years!

Symptoms: Sudden, extreme apprehension, fear, or terror, often associated with feelings that a catastrophe is imminent. Physical symptoms include shortness of breath, palpitations, chest pain, sweating, a sensation of smothering, and fear of going crazy or losing control. During panic attacks, individuals may feel so dissociated from the world, and even from themselves, that they think they’re losing their minds and are out of touch with reality. But panic attacks, in and of themselves, are not a sign of psychosis—once the panic attack passes, the person no longer feels "crazy" or out of control.

I wasn't diagnosed with panic attack syndrome until 1983...mostly because no one knew what to call it. My therapist finally found it in the DSM of that year. It's so hard to describe what was happening to me and in the early days when I first sought out help I really thought I was having a psychotic break. It didn't help that the therapists were telling me that I was "dissociating" and in a "fugue state"--those are the feels of disconnection from the world. It wasn't their fault--they didn't know what was happening to me either. It just added on to my fear and my need to hide what was happening. As the waves of panic would hit me like a tidal wave I struggled and fought for my sanity (or so I thought). I honestly thought I would die or go crazy.

A panic attack usually lasts 5–30 minutes, but it can continue for as long as several hours. Though panic attacks typically occur during the day, they can also rouse someone from deep sleep. Because they cause symptoms throughout the body, panic attacks can be mistaken for neurological, gastrointestinal, cardiac, or pulmonary illnesses.

Luckily, I never got any in my sleep but they would come in waves, usually in the afternoon and they would continue for several hours. It felt like eternity. As one would recede, another one might come on.

A panic attack can be an isolated event, or may occur repeatedly. When people have more than one panic attack, they are often triggered by a particular situation. Some people develop anticipatory anxiety when they are in situations that have induced panic attacks before, such as driving or riding over a bridge, shopping in a crowded store, or waiting in line. The common denominator for such panic-inducing situations is that they make the individual feel as though he or she is in danger and unable to escape. A panic attack can also be a symptom of another anxiety disorder, such as panic disorder, specific phobia, post-traumatic stress disorder, or generalized anxiety disorder. In these cases, however, a panic attack is one of many symptoms.

When I was an interpreter, I had these anticipatory attacks and they were pure hell. I interpreted for some majorly technical classes in the afternoons and the attacks would come around the same time. I dreaded the classes as much as I dreaded bridges...maybe even more. I had to stay where I was because leaving meant the deaf client would miss the message. I think more than anything else, the attacks are the reason I stopped interpreting.

The article I'm quoting from is from Everyday It goes on to explain that about 7% of all of us will have at least one panic attack in his or her life. That's not a lot. Why do people get them anyway? It might be a genetic predisposition to an abnormal response in the brain called "flight or fight." When you go into that mode, all your senses are heightened and adrenaline starts pumping. You see women lifting cars off their husbands. When there's no real danger present, that's when the panic sets in. I think it's entirely plausible for this to be genetic. I have several cousins with the same disorder.

What helped me the most was two things: anti-anxiety medicine and a coping strategy. The therapist taught me that I wasn't going to die or lose my mind. I'd be able to get through the attacks easier by reassuring myself that I would be uncomfortable for a while but that it would go away and I'd feel fine again. That made the attacks easier to manage a little but I still wanted them to go away completely! The only way to do that, I believed, was to totally avoid the situation (i.e. stop interpreting). I really haven't had a panic episode since. Thank God!

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