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High Anxiety

I'm in the midst of an anxiety attack. I'm trying to write my way through it.

It's been a while since I had a full blown attack like this. In fact, I've only had one since going off the medication 10 months ago.

It started on my drive in to work. Panic attacks are bad enough, but having one while driving is a special kind of frightening. For those who have never had the pleasure of experiencing an attack, let me walk you through it to give you an idea.

It starts off with a shortness of breath. It's almost slight, like something tickling at the back of your mind. Hey, something's wrong, just can't put my finger on it.... and then your brain says, hey, idiot, you're not breathing! Your eyes go wide and you get a tingly feeling in your hands, arms and legs as a surge of adrenaline rushes through your body. Full alert! Defcon 1! You suck in a deep breath but no matter how much air you suck in and no matter how deep into your lungs you push that air, you never feel like it's enough. So you breathe again and again, taking in rushes of air which, of course, just exacerbates the situation because you're starting to hyperventilate. Then your chest tightens up and it feels like your heart has just seized up and turned to stone. There's a rock sitting in the middle of your chest and everyone knows you can't get blood from a stone so now your heart isn't doing what it's supposed to be doing, in addition to your lungs starting to collapse and you can't feel your fingers or your toes, but you know that your hands are shaking and you try desperately to get a grip on yourself because you know damn well this is all in your head and that at least five minutes have passed and if you're not dead on the floor yet, then you must still be breathing and your heart must still be pumping blood, right?

Except all that doesn't matter to a person in the throes of an anxiety attack. No matter how much you know that you are not dying, it still feels like this is the end. I am going to die. DIE. Right here, right now. There is no way you can convince me that my untimely death is not imminent.

Now imagine all this in Monday morning traffic on a busy road. I tried to conjure up all those exercises I learned over the past 25 years that help alleviate the attacks. Multiplication tables. But they just wouldn't come to me. Not even the simple two times tables. I concentrated on the song playing. Pushed the lyrics out of my mouth, which only wanted to form a small "o", like the look of someone in a constant state of surprise. I sing, loud. Four months at sea, four months of calm seas only to be pounded in the shallows off the tip of Montauk Point. I suck in air. In with the good, out with the bad, the mantra my religion teacher taught me in 12th grade when I confided to her that I started having panic attacks.

I finally pull into the parking lot at work, I'm early and the place is nearly deserted so no one sees me practicing some bizarre form of Lamaze breathing as I walk up the ramp and into the doors. When the elevator doors part on the second floor, I practically sprint to my office, drop the keys while I fumble with them, finally get the door open and head straight to bathroom where I don't even bother turning on the lights before splashing my face with cold water.

My office is a safe place to continue on with the attack. Unlike being in my moving two ton car, going crazy while sitting in my office chair isn't going to result in harm to anyone else. It's still quiet here. None of my bosses are in yet. I plug my iPod in, put on some calming music and forego the morning coffee in favor of a glass of cold water.

The biggest myth about anxiety attacks is that the person suffering one has brought it on by thinking too hard about their problems. Mostly, they just come out of the blue. I rarely have suffered an anxiety attack while I was in the midst of wallowing in my problems. The anxiety always manifests itself later, at some unsuspecting time. Like 7:40 a.m. on a Monday morning on Hempstead Turnpike when the only thing I was thinking of - as I passed by Nassau Coliseum - was the fun I used to have going to Islander games.

It's only when the surprise attack starts (and this may be specific to me, I don't know) when I start thinking of everything else, because my brain automatically goes into "what is wrong with your life that is causing you to panic like this" mode, even though one thing often has nothing to do with the other.

So in this case, I start thinking of the phone call from DJ's guidance counselor in which she voiced her concerns about my son (who is home with strep throat today) in regards to his social skills and could I please come in for a meeting with this teachers on Tuesday morning? And I think of my daughter's report card, received in the mail this weekend, which, despite every ounce of effort on Nat's part, resulted in several teachers leaving notes in the end column that her test taking skills are horrible and I feel awful because no matter how hard she tries, no matter how much effort she puts into her studying and her classwork, those test grades are always going to keep her down and she'll never get into the college she has heart set on attending and....then there's the fact that the company that my husband got the bulk of his free lance jobs from went closed up shop this weekend and well, that sort of fucks us up bad for the moment and the next week will be one of feeling like the heavens are raining down dollar signs made of stone on our heads, something that leaves me awake most of the night staring at the ceiling...none of which I was thinking of before the attack hit, but which all come flooding into the brain the second my chest tightens up.

I don't bother asking for help or telling anyone what's going on because people who have never had an anxiety attack cannot understand what goes on in a person's brain when they are having one. A pat on the back and a "stop worrying so much" consolation doesn't help. It's not about worry. I've had attacks when life was just peachy and there were no worries in sight. And there's just no way to explain to someone who has never experienced it that feeling as if your world is going to end any second is not that easy to get over. My husband is the only one who has the patience to get me through one of these things, so when they don't happen at home, I'm on my own.

Well, I have you, don't I? Sort of. Whether you read this or not doesn't matter. Feeling as if I'm talking to someone certainly helps. Especially when that someone isn't patting my back and trying to patronize me through the whole episode.

I've been writing for over half an hour now, and it's been a good exercise. My breathing is normal. The tingly feeling in my head has gone away. My hands are steady. My heart is still pounding a bit, but that will subside eventually. A little typing, a little Nick Cave goes a long way.

I think I'll just sit at my desk for a while and repeat Step Back to Hackensack! over and over. (update: Hah!)

[I should take a cue from FAD and make a "posts I'll want to delete" category]

Update: Read this by Rob, who knows of what I write. He describes what I call "disassociation" that comes with attacks well.


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I've had more of these than I care to remember, and probably more of them than I do remember - I have a tendency to block them out after the fact.

The really horrible part is that you're sitting there and you know you're going to die and it starts to look like an improvement and then the mind taunts you: "You're not getting off that easy. First you die, then we finish the attack."

No escape, even beyond the end of life. Is it any wonder these things are so goddamn frightening?

I had a couple of these a long time ago, and I was driving during one of them as well. What a frightening experience. That experience of not being able to breath right ... (shudder)

I hope the rest of your day goes better.

I know nothing about panic attacks, but even in the middle of one, your writing is great.

I hope today gets better for you.

I've had one, and it was ugly as Hell. Took a Xanax to bring me down. (I was close to my doctor's office when it happened.)

Maybe porn will help. :-P

Just a thought - is it the sound of Justin's voice that helps you come back, or is it physical contact, or do you need both? My wife has recurring panic attacks, and most of the time she says my voice helps anchor her to reality, gives her something to focus on that helps shut everything else out.

If it's Justin's voice that helps the most, call him and don't hang up until you can breathe again.

Hang in there. We're all pulling for you.

And you know, I don't know people blaming those who suffer asthma attacks for what's happening to them... but then, I've got lots of relatives who are susceptible to various attacks and seizures (diabetic, epileptic, panic, asthma, etc.)

As Keiran said, we're pulling for you.

And Keith's rec reminds me of a friend whose idea of helpful medical advice during the flu was that one needed some good porn. And then supplied this cure. I wasn't the recipient so I can't tell you how well it worked ... but I'm sure it couldn't hurt. ;)

You're right. One of the hardest things about it is that people around you just can't understand what's happening. I guess I'm lucky that it's never happened to me while I'm driving.

Oddly enough for me, usually when I have my panic attacks, the best thing for me is to get away from people. While I flip-flop between needing human touch and finding the most repulsive thing, I find that I can focus better when I am outside.

Because I lose the ability to associate anything, knowing I should recognize someone and not really being able to causes me a lot more anxiety.

yeah. The worst ones I have are the nighttime ones. You know, right after you get in bed. Or when you wake up in the middle of the night to take a leak or get a drink, and it just jumps on you. bah.

Shank, I've actually had attacks in my sleep. I've woken up choking and gasping for air.

I've had panic attacks so I do understand. It sounded like it started when you thought about your son and his social skills, something you can not control. Then it went on about the rest of their life (your daughter won't get into the college she wants to) Then your husbands work, again another thing you have no control over.

I had one yesterday, I was convinced I was having a heart attack & was about to die... why? Because 10 kids didn't bother to show up at my daughters sweet sixteen party Saturday night and she was very hurt embarrassed and upset I couldn't protect her from that hurt, my heart broke for her, but, it was beyond my control, when I began to think about it on Sunday, the panic started.

We get a shot of adrenaline because we want to protect our children from being hurt because we know what it's like to be hurt. Unfortunately, we can not control the rest of the world and protect our children from ever being hurt. But knowing why we sometimes get them might make them easier to deal with.

I hope I helped you in some small way
Michele. I really enjoy reading your blog every day. I grew up on Long Island but have lived in Virginia for the last 10 years. I miss living there. Believe it or not, I miss the people! Yes, even the obnoxious ones! Your blog makes me feel at home, thank you for that!

I got a used copy of Lileks's Notes of a Nervous Man for Christmas. He says he used to have anxiety attacks. He said that anxiety attacks lead to fear of anxiety attacks which lead to fear of situations in which an anxiety attack would be really inconvenient (such as when you're covering the Secretary of State's press conference, and you find yourself in the corner furthest from the door, and you wonder what would happen if an anxiety attack were to erupt, and you'd have to knock all those journalists and cameramen and flunkies and the Secretary out of the way to get out the door, and what the Secret Service would have to say about it.) Then there was the time he drove his car into the ditch.

He was very witty about it, which I suppose he could afford to be, years later.

Hope you get to feeling better.

I've had a few of these myself. Not to the point where medication was required, but enough to scare the bejeezus out of me.

I'm an airplane pilot (little ones). In our training, we are taught that if you start to hyperventilate, you should start talking to yourself. Anything will do - as long as you're talking. The talking forces a normal breathing rhythm and also increases CO2 in your blood a little (hyperventilation leaves you with too much oxygen).

I suspect that it might help with a panic attack. At the very least, you should be able to derail your brain as it's hurtling down the hill.

I'm glad the writing helps.

Anemia and iron deficieny without anemia are sometimes associated with anxiety, irritability and panic attacks.

Especially If you are still craving delicious crunchy ice to chew or feeling run down, it's simple to test for anemia and iron deficiency, and I would recommend it.

Michele said: "Shank, I've actually had attacks in my sleep. I've woken up choking and gasping for air."

Is that what that is? I'm 23 and I have been experiencing panic attacks since I was about 16 or 17. Within the past six months I had to twice force myself awake because I thought I was suffocating.

for a second there, i thought that post was going to talk about the mel brooks movie and i got really excited...


Nothing more to offer than a friendly wave and a well-wish.

I second Charlie above: get well Michele.

Markus, sounds like you just may have obstructive sleep apnea. Try http://www.sleepapnea.org/ or talk to a medico.

i've had one or two myself, but i have a question for you michele:

what medication were you prescribed for the attacks?

my boyfriend has been having them regularly, but being that he has no health insurance, we're seeking to medicate him without the exorbitant expense of going to the doctor. i printed out your post and let him read it, to which he said "holy crap! i'm not going crazy! that's EXACTLY what happens to me!". it was like my telling him what his symptoms described wasn't enough, but your way of explaining it was. please help me out.

Because 10 kids didn't bother to show up at my daughters sweet sixteen party Saturday night and she was very hurt

Damn kids. I had a similar thing happen to my son for his third birthday party (obviously not NEARLY as important as a sweet 16). Thankfully he had a couple of friends to play with, so he wasn't too bothered. But I just wanted to spit, I was so frustrated that none of those other kids showed.

Next year, we went to Chuck E. Cheese, and the whole crowd showed. Whaddya know, you've got to bribe the kids to get them out.

Sorry. We now return you to your regularly (un)scheduled panic attack conversation.

Ditto Keirnan to Markus,

Obstructive sleep apnea is associated with panic attacks.

Panic attacks are often prematurely put off to external stressors or personality quirks; there are some medical conditions linked to panic attacks which can and should be considered by a doc in context of other signs or symptoms or complaints.

I get panic attacks sometimes. Not so many since I started on Zoloft, but once in a while, yeah. Never had one while driving. Driving actually tends to calm me down. (Not driving like in rushhour city traffic, but open road driving. Damn. I wish it was warm enough to ride my motorcycle. That's even better.)

Waking up INTO a panic attack is probably the worst thing imaginable. It's like waking up into a nightmare rather than waking up FROM one.

Sleep Apnea might be a cause of waking up feeling suffocated. But a PA awakening is almost unbearable and doesn't go away quickly.

For a long time I had to avoid going out in public because the fear of the attacks were enough to cause them. It took a while before I learned to control them. I still have them but can mentally stable myself rather quickly. At night, I don't get that option.

I did have a panic attack while driving, and it was the king-hell attack of them all. Freeway. All lanes but one closed for construction. Stuck in the middle of an interminable National Guard convoy. That was 20 years ago, and I still get a knot in my gut when I swing onto the interstate. O the joy.

My dad has agoraphobia and panic attacks. He's never been able to explain to us what he goes through. Thank you for helping me understand what my dad has lived with for more than 40 years.

Keeping you in my thoughts and prayers...

Panic attacks absolutely fucking sucks!!!
/that is all

Wow. Crazy accurate. I had trouble breathing just reading your post. My attacks, I've found, can be calmed by salt. Seriously, some damned chips and I feel better.

Wow, you described everything quite well. At least it seemed quite well to me since I've never had a panic or anxiety attack before... but I felt like I could sort of imagine it by your description. Truly though, I cannot fully understand what it is like. I know that there are a lot of people that do suffer from them though. I hope and pray for all of you who suffer from them that somehow or in some way, you can find help to end them or reduce the severity of them. Thanks for posting on this... it is rare to see people being so open about something that many people just "sweep under the rug," so to speak. I guess I can sort of understand because I have epilepsy and it's not something I broadcast to the world. So I think you are brave for being so honest. God bless & take care... Janna

I am not claustrophobic, but I am crowd-phobic. I get as close to a panic attack as I would ever like to get by being in a large group of people in an enclosed place. I actually worked at a department store through the holiday season (ONCE) and the only thing that kept me from becoming a screaming mimi is the little island that was my register area! I would stay there and ring up customers during a really busy time even if I was supposed to leave or go on break because I just couldn't leave and try to get through the crowds. I can go to outdoor places with lots of people only because I can look up at the sky, but get me in an enclosed place with lots of people and it's not a pretty sight! The symptoms that you described are very similar to what I experienced, so I can completely sympathize!

I went through those exact same symptoms for several months several years ago, something just wasn't right, I was having to manually breathe because the involuntary muscles did seem to being paying attention, and could hear my heartbeat just POUNDING, it scared the hell out of me. Got to where it would happen every night.

I had heard somewhere to take three slow deep breaths, and purse your lips and exhale with your lips providing "back-pressure", and it seemed to work for me, if I could also think about something else.

Went to the doctor and he looked at me like I was lying to him. He was about to send me away "uncured", until I forced him to "try harder" to figure it out if he wanted me to leave his office peacefully. And the results of the eventual testing revealed low thyroid levels, and after months of incrementally increasing the dosage, I've noticed the "attacks" have disappeared.

Just a thought, but you might want to have that checked out...cant hurt.

oh yeah, i got those once so often. and then as soon as the breathing issues and rapid heartbeat stop freaking me out in and of themselves... then thoughts, rational and irrational, about problems in my life, real and imagined, begin flooding my head. if i am alone, then it's generally fine. but if i am around someone at the time this happens, i am usually met with a "what's wrong?" which lets loose a stream of nonsensical complaints about anything and everything that really have no relation to one another. so basically, i appear to be insane. then after 15 to 20 minutes, it goes away.

I take Clonazepam daily to reduce residual anxiety and Xanax when I feel an attack coming.

Xanax is related to valium and can be addictive, but taking it periodically isn't harmful. I carry it with me all the time, and often reminding myself that it's there has a calming effect, even if I don't take it.

I just wanted to thank you for voicing the feelings that I have never been able to put into words. It really helps to be assured that I am not crazy, and that this happens to other people. Thank you. Sincerely. Thank you.