Posts Tagged ‘panic’

Forward and Backward

I haven’t been posting lately because I felt like I reached a nice plateau in my mental wellness. Summer has certainly been an important factor and also the opening of U.S. cities given our lucky vaccination break. And of course one should be able to take a break from too much introspection. It’s exhausting work to look at the past.

Certainly I’m in control of my own therapy right? Well recently I had a panic attack flare-up.

One was on public transit and the other was on a Sunday night just before bed. The transit one wasn’t so unusual, it use to be a common place for me to feel uneasy and for thoughts to spiral. I just wasn’t feeling really good that morning and instead of listening to myself, I pushed through overcast skies, loud disruptive road construction, and that typical panicked run to an incoming train. Then once seated, feeling trapped, heart racing, unsure why “this” was happening. That was a reasonably anxious situation for me. The one at home at night, not so reasonable.

Or so I thought. I had spent the afternoon with friends at a pleasant coffee shop, working on the ACA Yellowbook. For dinner we went to a Sonoran restaurant that is significant for being the last place I had dinner with my late best friend. Later I watched a pleasant but emotional movie with friends. Instead of winding the day down, I wound up, looking at various personal files including my financial budget.

All these well-intentioned activities on a Sunday piled up more than I realized. I was angsty and emotional. After some last minute evening stretching, I decided to take a blood pressure reading which was naturally elevated. The worry about that reading spiraled into a memory about a doctor who “cornered me” into taking medication. The rest of the night didn’t go quite well. I woke up around 4am and felt like I had slept an eternity already. I just did my best to continue pretending sleeping in bed well into 9am. Good thing the pandemic makes our mornings pretty flexible.

All this happened to say that I can never really take a break from mental health work. As much progress as I’ve made and my friends have congratulated me on, I am still a work in progress and I need to be a lot more careful about what I am exposing myself to. So much work can feel undone by a bad day.

I use to think I had it all together and approached therapy like a quick fix. You want my money? Then give me the minimum amount of sessions to “knock it out.” Some websites say it takes 10-15 sessions, some say 10-15 months. A year or more is often what I hear from therapists directly.

So in addition to dealing with the actual therapy, I have to deal with this constant frustration that I am never healed or never good enough. The alternative is a codependent life that yo-yos between big highs and big lows.

Hopefully one day I can take on any thought or memory and let it slide gracefully off my shoulders. I don’t feel resilient against the wind anymore, but I do feel like I can get back up when I’m knocked down.

That Time I had a Wild Panic Attack in a BART Station

Six years ago I walked onto an outbound BART train at Montgomery Station after work. It was like any ordinary day taking the train home except for the fact that I was particularly incensed by work issues as a then land use planner. Clients were being difficult and I felt trapped. As the doors closed, I stood by the doorway, fired up and ready to go… home, I guess.

The train sped along the various stops, and slowly I started breathing deeply and harshly. My mind was running in circles and trying to tell my body to do something. Once my home stop was announced, I was already hyperventilating. Soon, the body sensations of the bends kicked in and my disassociated mind came back to reality.

I confusingly held onto the bar handle until the train stopped at my station. Something was wrong, my body shouldn’t be feeling this way. Is this a heart attack? The doors opened and I sheepishly walked onto the platform, trying to make it look like all was normal and fine. By the exterior I probably was totally fine but my mind was creating a new narrative.

Instead of powering through and dismissing the obvious work-related feelings, I sat down on the cold concrete bench at Glen Park Station. Something was wrong! My hands tingled, my chest felt heavy or stuffy. I was doing deep breathing, it’s a panic attack, nothing to worry about… or was it?

I regained my senses and walked toward the escalators, pretending very hard that I was a perfectly normal person doing perfectly normal things. The slow escalator ride wasn’t helping. Instead of exiting the station into the light, I decided to sit down on a bench and breathe it out. Maybe this could be something. My mind ran through loops trying to decide if what I was feeling was true or not. I wasn’t in pain, I just felt a little off, a little breathless. Or was I actually just fine and a little scared.

I don’t recall what but some feeling in my body pushed me over the edge into disbelief. I asked a lady sitting nearby if I looked pale and she said maybe. I bought it hook line and sinker, I was having a heart attack, or dying… of something. Anything. This was it. She told the gate agent to call 911. I asked her to hold my hand.

The minutes were agony as I lay on the cold platform. I looked up at the brutalist concrete skylights as if through a looking glass of my mind. I was there but wasn’t. Suddenly the EMTs came rushing in. It was like I wasn’t in my body. They ripped my shirt apart to check for signs and kept asking if I had taken any drugs.

When I got into the ambulance they ran the usual checks, I was completely dazed at this point, expecting the worst. Then in a few minutes they said it looked like I was fine. I was stunned. I didn’t believe them, I wanted verification. Ironically I can remember everything up until about now, I can’t really remember what they did to pull me out of my psychosis. They probably showed me that my heart rate and EKG were fine.

I walked out of the ambulance sheepishly, after declining to not go. My aunt and uncle were standing there on the sidewalk. I cried. We went home.

The entire incident was traumatic and shameful. I locked it out of my mind for a long time, thinking it was a one off. But it clearly pointed to the mental scars of my surgery just a year earlier. I thought I was a ticking time bomb and for long after I poorly managed reoccurring health anxiety. It was my very first public panic attack where I went into the deep end, so to speak. For anyone recovering from surgery, I would highly recommend follow-up with a therapist if any doubts linger in your mind even after doctors have cleared you.

How I Do Panic Attacks

What happens during a panic attack? I always find it refreshing to read new posts on Reddit from people experiencing their first panic attack. So many body systems engage that it’s hard to know what causes what. I just had one the other day and would like to share my symptoms which I hope will help others feel assured that they’re not alone.

What tipped me off was bubbling in my stomach, which was my digestive system doing its thing since I had just picked up some food and was walking home. This didn’t feel right for various reasons but I’ll focus just on symptoms for this post. Upon encountering people on the sidewalk my heart palpitations started going. I can hear them in my head and feel them in my chest. Placing my hand over my chest, I could feel the bumping.

Then I tend to have nervous twitches or tingling that I sometimes feel in the chest and sides especially. Really this is just increased blood flow, but because you are going from zero to running, you notice it a lot more versus if you were to actually build up to it while doing cardio.

My hands get cold and slightly clammy. This is where I often my mind escalates the situation because it aligns with Dr. Google’s diagnosis. I’ll often squeeze my hands as if to pump blood back into them, but the body has already diverted blood to the core.

By now I’m walking pretty darn fast and trying to find a safe haven, which for me is usually getting home. Ironic, since if this were a big problem, going home wouldn’t do much.

Sometimes our own behaviors during panic attacks cause symptoms. For me I tend to hyperventilate by overbreathing and not exhaling enough. The symptoms I get from this are tingling at the edge of my hands below the pinky. If its severe, the hands will curl like lobster claws.

The feeling of shortness of breath tends to wax and wane, and in many ways is mostly in my head since I can honestly take a full breath. More so the muscles are so tense and engaged that I get the sense I can’t breathe. Ironically after my surgery I was legitimately unable to take full breaths for an entire month and truly understood what being winded was.

That’s about it for me. The funny thing is always the symptoms I don’t have. Dizziness and lightheadedness always pop at the top of symptom lists but I have never felt dizzy while standing or sitting, unless I was on an airplane or a car going down a winding hill. Chills and trembling can happen only afterwards while I’m generally calm and coming down. Sense of terror is also an interesting one, I think I do have this but it is very well defined as “something could happen to me, very unlikely, so let’s just make sure we’re in a safe place.”

Obviously if panic attacks happen in inconvenient places like a work meeting (which it has), I have to suck it up and let it roll. At it’s worst during 2020 I was having panic attacks every two weeks but typically it was anywhere from 2-3 months at a time. It’s even happened on a beautiful vacation which is a story for another time.