Anatomy of a Panic Attack

I haven’t had a panic attack in about two years, so I suppose I was due for the one that occurred last night. I won’t rehash the trigger points–they really aren’t that entertaining–but as I got the hamster wheel I loosely call my mind to slow down, I started thinking through the construction of a panic attack. Mind you, this will follow my attack, and each individual is likely to have any manner of different experiences in the umbrella of what we call panic attacks, so please take this for what it is.

In reflecting on last night and the attacks of the past, I can safely say that I don’t see them coming, though there are always signs of impending doom. Generally, I’m depressed beforehand; perhaps not significantly, but enough to notice. Since depression doesn’t always signal an impending attack, it doesn’t make for much of a harbinger. The last two times, though, I was rapid-cycling, for lack of a better phrase. I am not bipolar, though, as I have pointed out, I have experienced extensive periods of hypomania and depression, and I tend to move very quickly between them (often in as little as 72 hours). Since my mother is bipolar, this terminology is familiar to me and, as a layman’s phrase at any rate, a fairly apt description of what happens.

On Saturday, I awoke to a significant depressive mood; I could even feel it in my legs, which hurt lamf for that whole 25 miles run. Yes, I did complete the run, figuring there was nothing better to be doing than to try to short circuit the depression with an influx of endorphins. It was not precisely a good run, but the mood seemed to lift a bit. The low-mania came back on Sunday, triggered largely by my failure to eat properly, but, again, I managed it reasonably well. I went a bit pogo-stick for a while on Monday then crashed yesterday evening as the anxiety took hold.

Part of the problem is my failure to recognize my symptoms of increasing anxiety. I *thought* that I had handled several incidents of late and the above-described moods fairly well; in reality, I had mostly buried them or not dealt with them in an appropriate way, largely in an attempt handle anger in ways that are more conducive to sharing habitats with other human beings than I am often accustomed to. In other words, I was being dishonest with myself. This is not altogether unsurprising in an addict*; we are masters of dishonesty–especially when it comes to ourselves. The pattern of dishonesty and vacillating emotions should have been a clue, and are pretty clear now that I glance back upon them**; I was reeling toward a break.

The attack came on, as they often do, with little warning and with an outwardly irrational cause. My very first panic attack, when I was 16 or 17, occurred on the campus of Duke University, when I became overwhelmed by what I would never be and where I would never attend and who I would never live up to. These thoughts, which might have been merely annoying for some, became locked in an obsessive loop for me on the campus (it was the cathedral, specifically, and it’s vast space that set me off). I could not stop the hamster wheel, and, eventually, it got moving so fast that there was little more to do that break down.

Such is typical for me in a panic attack: Some event or place triggers an obsessive loop (the hamster wheel); the trigger is, outwardly, likely to be relatively innocuous. To know the path my brain takes would require having resided in my head for years (which, incidentally, I don’t recommend for the faint of heart). The obsessive loop becomes faster, particularly as I try to derail the wheel. My heart rate increases. I cry and hyperventilate. I don’t want to be touched, and will run away if someone tries to do so. Until the anxiety subsides sufficiently, the attack will continue, sometimes for more than an hour. I cannot stop the wheel or the tears once they begin until I can slow my heart rate and remove myself from the trigger. For hours afterward, though I will be emotionally and physically spent, it takes little to set me toward panic again, though I am usually able to self-calm more quickly during the aftershocks.

I’ve heard people describe their first panic attacks in terms of heart attacks–not knowing what was happening. This did not happen to me the first time, I knew I was breaking down (the benefit of familial mental illness, I guess), even if I didn’t have terminology for it, and these days, I know exactly what I am dealing with, almost from the outset (though, oddly, it often takes an hour or more after it ends for me to be able to articulate the phrase “panic attack.” No clue why that is.)

I was fortunate last night to have the care, concern, and support of far flung friends, without whom I am certain I would not have been able to settle down, think, and go for the peppermint tea and Oreos (an excellent post-panic attack remedy, incidentally). As Anne Lamott has noted about herself, one of my most common prayers is “thank you, thank you, thank you” (the other being “help me, help me, help me”—there were plenty of both last night). I sent up the flag online that I had triggered, and I want to thank, again, Hooch, Soonie, Z, and Blue, as well as Rip, Avarweth, and Silly (I love handles, don’t you?) for jumping in immediately to console and advise and commiserate. And a thank you, too, to rhyte, who saw my remark, recognized it for what it was, and sent excellent reminders to help calm the anxiety, including a favorite duffism: “Be Still and Pray.” What a fabulous group of women you are; thank you, thank you, thank you.

So, my mantra for the week (typed weeks at first, but rhyte is right (*grin*) with her other reminders to take life in small chunks) to come will simply be that duffism: Be still and pray. The aftershocks are still here, though they are faded to the point that they are noticable to no one but me. I wish you all well, whereever and whoever you all. Be still. Be calm. Reach out–>you are not alone.


*A clarification of terminology: in these pages, I tend to use alcoholic and addict somewhat interchangeably, though, in the main, the former refers to alcoholism (duh) and the latter to drug addiction. I do this as a reminder to myself–in order to be honest with myself, really. Alcohol was my primary drug of choice, but I craved depressants & opiates of any variation–I maintained a profoundly tight grip on my pill popping desires (because, you know, THAT is sign of a “real” problem <–note sarcasm) to the extent that I don't take anything–even Motrin, very often (and I never take acetaminophen, because it knocks me right the fuck out. Seriously. Give me a bottle of Jameson, and I am the life of the party. Tylenol in any amount–out for hours). I've popped depressants from time to time, stayed away from the drug of my dreams–heroin (along with most other opiates)–because I knew even without taking it I'd sell my soul for a good nod. I'm all about shutting the brain down, so cocaine and speed never interested me, nor anything else (uh, well, except Sir Caffeine) that would replicate my "up" moods.

**Saw the best explanation of Benjamin’s Angel of History (Thesis IX in On the Concept of History) recently, in Steven Johnson’s fabulous book The Ghost Map, which chronicles the events surrounding the cholera outbreak of 1854 in London and how that outbreak shaped the modern understanding of “city.” He notes at the outset, that Benjamin’s Angel can be understood in terms of such an outbreak, where we see the piles of bodies of those killed by pestilence overtime, but the “Angel of History” sees their stories and connections. Addiction works similarly; we can see the chains of catastrophes of our past, though it takes “hitting bottom” or some other traipsing into sobriety for us to assume the vision of the Angel of History, who can see us for who we are, rather than just for our series of wreckages.

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3 responses to “Anatomy of a Panic Attack

  1. Wish we lived closer. It's really uncanny the way so much of what is happening to us is syncing.

  2. ShannonElizabeth

    Be still and pray. Yes. I am crying right now. So cool that I ran into your blog today.

  3. I’ve always wondered if alcohol, being a depressant has more effect on brain chemistry than what is currently known in the medical field.

    When I tried anti-depressants for situational depression, they only made things worse. For me, exercise and a healthy diet have helped the most during times of situational depression. For a panic attack, I just ride it out.

    There may also be a connection between marijuana use and subsequent panic attacks when someone no longer uses. Maybe many drugs have that effect, I don’t know?

    One of my favorite tracks is Lithium and I always felt that Kurdt was singing about his muse or the spirit(s) he was channeling which can also be labeled as a creative or driving force. Maybe even just plain possession or a tormenting spirit. I’ve always wondered if the lyrics where from the point of view of the spirit to Kurdt, or vice versa.

    It must’ve been quite something to be around that creativity. When he’d have an episode and break down in tears afterwards that was probably hard to watch. It’s a powerful force and something thats not fully understood even by those who open themselves to it. At least he did what he wanted, that really was the whole of his law.

    It’s weird how Hendrix was also 27 when he passed and it’s been said he was afraid of the ‘hellhounds’ that were on his trail.

    Maybe they were just depressed, yeah right.
    I’ll try the ‘Be Still & Pray’ option, it’s the best I’ve seen.

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