[lit-ideas] Panic Attacks -- LONG
- From: Paul Stone <pas@xxxxxxxx>
- To: lit-ideas@xxxxxxxxxxxxx
- Date: Mon, 15 May 2006 16:19:51 -0400
I wrote this last week, partly just so I could write it for myself, but
also to illuminate certain people about what clinical panic disorder
actually is. After writing it, I felt it was a little too personal to share
with you, but since the thread is still going, I edited it a little and
I've decided to send it. This is just one person's battle with this
potentially disarming affliction.
JK: Yeah, I'm familiar with what anaphylactic shock is, it just seemed
irrelevant to the conversation. I'm talking about someone with no history
of asthma, no sudden incident such as a bee sting or what have you, who
suddenly is completely unable to exhale for a matter of several
minutes. A frightening experience, but survivable. My question, I guess,
is does that qualify as a "panic attack", and if so or not, what forms of
behaviour do panic attacks take?
When I was born, I was diagnosed with a 'heart murmur' (two days old) and
they gave me medication to take for the first few years of my life. My
parents kept a careful eye and had me to the doctor regularly to do the
same. Eventually, the doctor decided "he's grown out of it". I played all
manner of sports (hockey, baseball, soccer, wrestling etc) all through my
youth and early adulthood with NO noticeable physical problems -- in fact,
my stamina was always better than most of my teammates'.
After high school, I decided to take a year off to work instead of going
straight to university. I wasn't very happy about this decision -- once I
started working -- since most of my friends had moved away and I was
working as the manger of a pizzeria. One summer night -- it was probably
110 F in the kitchen, I was rolling dough out and I felt 'strange'. It was
almost as if my heart skipped a beat, I looked down to see a vein bulging
out of my forearm -- previous to this, my veins had rarely even shown, let
alone bulged. Within a few seconds, I was in a full state of panic,
hyperventilating, grabbing walls so i wouldn't fall over etc. The owner of
the pizzeria phoned the ambulance and they came in a few minutes, and took
me to the hospital. The doctors showed enough concern for me -- apparently
healthy 19 year olds just don't HAVE Heart Attacks. After the doctor took
my blood pressure it was very high, like 180/110, he gave me nitro-glycerin
under the tongue and asked me all kinds of questions about heart attack
symptoms -- do you have any pain in your jaw, do you feel short of breath,
any pain or numbness in the shoulder or left arm, crushing sensation on
your chest, nausea, vomitting, did you pass out -- they put me in a cardiac
ICU with the EKG and a automatic sphygno (bloodpressure cuff that inflated
every 30 minutes).
Meanwhile, I WAS FREAKING OUT, convinced I had minutes to live, destined to
die alone, with no one attending me in a busy emergency room.
The next day, my parents came to get me and took me home. Apparently, I was
all right and in the next three years, I went through dozens of tests which
all attested to this. 8 different doctors of different types agreed "it's
all in your head", so after about 6 months of debilitating panic, I began
to see a psychiatrist. He was a panic specialist and by the third meeting,
he had actually helped me conquer my fears. I continued to have panic
attacks, but they weren't debilitating and I learned to intellectuatlize
them to the point where I convinced myself I would live through them. As
the psych. put it, the common feeling is: "oh my god, I'm going to die, and
goddamnit, I'm going to run away from all these people and die alone, cause
it would be embarassing to die here"
With each successive survival, the panic lasted shorter and shorter periods
of time. From the worst time -- about 2 or 3 hours, which took days to
fully physically recover from -- a full blown panic attack is a very
physical occurrence and wipes you out. It's like going out for a fast run
-- to the shortest: a momentary panic, followed by perhaps 30 seconds of
fear, followed by self-reassurance, followed by relatively normal life
until the next attack.
The most confusing thing about panic attack is that they are almost always
out of the blue. They usually happen when the person is inactive -- I never
have them if I'm concentrating or doing physical activity or otherwise
indisposed. It's almost always when I'm sitting, relaxed, not thinking
about anything that they hit. That's why it's so scary because the body
says 'what was that?" and the mind says "I don't know, but it's not normal"
and the person freezes and awaits the next symptom. As they do this, they
often either, hyperventilate or stop breathing and so begin to feel faint,
so then they panic again and wait for next symptom and so goes the vicious
circle. It only takes milliseconds to panic and start the 'fight or flight'
decision making, but it takes hours to come down from that initial panic.
So... by this time, I was a little bit dependent on xanax since it worked
within minutes of me taking it. It was nearly three years later and I was
in control of my life again, in university, doing well, very happy with
what i was doing... gainfully employed etc. There was no reason to panic --
I thought. As far as I was concerned, that period was just some adversity
that I got over.
One day at work, I felt 'weird' again, unlike I had ever felt before... so
I got my mom to drive me to the hospital -- I practically had to BEG her
because as far as she was concerned "yeah, yeah, you're having a panic
attack" -- stigma (even from family members) promotes the 'cry wolf'
syndrome -- but I felt in my heart I wasn't JUST having a panic attack. So
I went in there and a kindly old internist listened to my chest, heard
something 'funny' and took my complaint more seriously than the previous 4
or 5 visits to emergency. He phoned a friend of his who was a cardiologist
and the Cardio. diagnosed a 'heart problem' over the phone. A week later, I
was in a major hospital in London getting a battery of very unpleasant
catheterizations, dye jobs, contrast xrays etc. and they confirmed the
cardiologist's suspicions.
So... after three years of accepting that "it's all in my head", it was in
fact all in my heart. I went through a series of reactions.
1) From the moment the doctor told me what it was -- and it was serious,
it required open heart surgery -- I was elated. I was so happy that it was
fixable.
2) I was pissed off at all those other doctors to who I had told my history
(they thought I had a blockage when I was a baby, murmur etc.) and they
told me it wasn't a physical problem.
3) I was mortified that, after three years of completely unnecessary
torture, it was going to take up to another year for the Ontario health
system to be able to do my surgery.
4) NOW... I had a psychological problem. The panic attacks came back
because now I actually had a real, confirmed reason to be frightened. I
became completely dependent on xanax, and started taking 4 to 5 times what
I had been taking occasionally (as required) just to quell the utter
despondency I felt upon waking most mornings. And at night, i was
frightened to go to sleep, because I was afraid I'd never wake up.
5) I resolved that I'd have to wait, but I was pissed off at all those old,
fat, hairy, white males who smoked too much and didn't exercise who were
lying in front of me in line for surgery, while I -- an otherwise healthy
22 year old with a good 50 years ahead of him, was dying. I wrote to every
official I could think of and got replies from most of them, although to
this day, i don't think all my complaining helped. And so it was, after
about 8 months of waiting, on december 10th, during end of term exams, I
got the call "be here this evening".
It's extremely hard for anyone to agree to even minor surgery,
relinquishing complete control to some dude who views you as a machine and
a number. But... as I sat in the backseat that evening while my dad drove
me the two hours to the hospital, I was almost as fearful as I was the very
first night I was afflicted. There was never a question about getting it
done, but the doing was brutal. I had to voluntarily walk into a hospital
and let them cut me open and do major invasive cardiac surgery. I now had a
real reason to panic, but I was at peace. For some unknown reason, and very
uncharacteristically, I was supremely confident that I would make it
through. I didn't even let the possibility of death enter my head. Two days
later, after they had starved me, shaved me, bathed me in what felt like
caustic soda, and drugged me to a mopey delirium, they woke me up at 6 a.m.
and wheeled me down to the O.R. I said the "i love yous" to my parents and
my then girlfriend and counted backward from 100. I think I got to 94. I
woke up about 28 hours later with a tube in my throat and every other
orifice, plus a few they had made new for me, and feeling pain that I've
never felt before. Morphine was my friend for 3 days.
Without giving all the gory details, I left the hospital after only 9 days
post surgery, just in time for Christmas and to face my 'new life'. Never
again did I take xanax and just a few months after surgery, my b.p. was
down to a very acceptable 110/80. I was 'cured'.
But was I? No, of course I wasn't. Once you have a panic attack, you can
NEVER UN-HAVE it. That experience is with you and after three years of
living between them, I had become so ridiculously body conscious that I was
a textbook hypochondriac. And the pisser was it was a manufactured panic
disorder. So... yes, I have an angry inner child and he's constantly
screaming "Those fuckers have done this to me!"
Fast forward, here I am almost 18 years later, still playing hockey,
biking, whatever I want and apparently, physically healthy. But I still
have panic attacks daily. Like a wise soul once said to me "you can't
control fear, but you can control your reaction to it". I refuse to take
drugs because I know that it's too easy to become dependent on those sorts
of things and I also don't want to wander through life as some misdiagnosed
"bi-polar" under sedation. I've searched on and off for some real
psychological answers, but, without exhausting huge sums of money [which I
can't afford] on psychologists, there really isn't an option for me to get
psychiatric treatment unless I get committed -- this is one reason I take
every opportunity to bitch at the "great" Ontario healthcare system
because, regardless of whether Harold Bloom is over Freud, the Ontario
doctors apparently officially ARE not condoning any psychotherapy as
legitimate (i.e. paid for by gubment). Once again, relinquishing control of
my life, is something which I completely refuse to accept, so I go through
life, with a 'disease' that was foisted upon me by 8 different doctors who
'knew better' than I did.
And the kicker is that I'm going to be 40 this year and I'm in the middle
of the 'heart attack'' years. As Mike said a few days ago, what manifests
itself as a heart attack could be panic and vice versa. So how is one to
know? Every time I have 'that feeling' -- something that I'm completely
unwilling to explain here because it could cause some to experience it --
there's that little thing that says "paul, maybe you ARE having a grabber
this time". So far, I haven't, so I have to balance what have become
"normal" symptoms with other, often new symptoms and make a decision pretty
much at least once a month about whether I need to go to the emergency.
The only 'good' thing about being in my situation is that when something
really bad happens, I don't panic, because I'm already 'up' for anything.
It's very good for dealing with extremely adverse circumstances, but how
often do THOSE come along?
Take it from me, don't research panic attacks. Don't suggest to a doctor
that you might be having them, and for goodness sake, if you REALLY believe
that you have a physical problem, don't stop exhausting the tests that will
rule out the problems. Before you know it, you'll have a big fucking problem.
paul
##########
Paul Stone
pas@xxxxxxxx
Kingsville, ON, Canada
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