Panic attacks suck.
At one point I had them daily, often multiple times, and for hours each time – but that was a long time ago. I’m much better now.
I want to talk for a minute about what that really means. What improvement really looks like. Because it doesn’t look like I thought it would, and I don’t see that talked about as much as I would like to.
So here are four vignettes from the last year or so, all of which I consider victories.
I’m at Planned Parenthood, and I am not holding my shit together. I’m not as triggered by exams as I used to be, so normally this annual bullshit is not a huge issue, but this time I have reason to believe it is going to be a lot worse, involving things that are, like, turbo triggering. Also, I still have a lot of lingering hostility over some bad shit that went down at a Planned Parenthood many years ago, so I don’t feel safe at their clinics. I wasn’t expecting it to be as bad as it is, but it’s so bad this time. I drop the pen three times signing in, my hands are shaking so badly.
The wait is long and tears are just pouring down my face, though I’m not sobbing. A nurse comes and asks if I am okay, and can they do anything, and I said “I just have to stick it out. It’s a panic attack. It happens. Sorry if I’m disturbing y’all.” That awful urge to apologize for something that isn’t my fault.
I wonder if other people in the waiting room are having a hard time holding their shit together. I realize this might not be helping. Out of sympathy for a most-likely imaginary person, I manage to stop the tears.
I would take a clonazepam, but I didn’t bring anyone with me to drive me home. Bringing someone with me would mean them watching me lose my shit, and trying to comfort me, and me feeling obligated to be comforted or them being disturbed by my honesty if I wasn’t. It would mean me having to worry about their responses to my panic attack, which is the last fucking thing I need. Calling someone to come get me would mean waiting for them to arrive. It would mean staying here longer than I have to. So I have made the right choice. This is easier.
The exam room is an extremely triggering environment. I sit with the trash bucket between my knees, because nausea is simultaneously a side effect of and trigger for panic attacks. A nice little feedback loop that plays merry hell with my ability to de-escalate these things.
I’m reading Jacqueline Carey’s Santa Olivia. I realize that I’ve read the same paragraph, then the same sentence, five times, and it means nothing. If I turn the page to go back, if I move even that much, I will throw up. I can’t move. There’s a thing I’m supposed to do when this happens, but I can’t remember what it is, it’s that bad. So I start counting the letter “r.” Then “j”. Then “t”.
The nurse and doc come in and the waiting is over. Things get about 40% better. I tell them what’s going on, and apologize again. They are super-nice, and we get the exam done. It’s not as bad as I was afraid it would be. It never is, but the panic attacks don’t care about that. They care about the bad shit that did happen. That’s all they want to remember.
But the turbo-triggering thing I was scared of doesn’t happen, and I get through it with skin intact, and I go home and take a clonazepam and play Borderlands with my husband.
It was all very unpleasant, but I got through it. I’m awesome.
I’m at JoAnn’s Fabrics and I start to feel a gnawing in my belly. My arms and legs get cold and weak. I’m hungry, I think. Then it becomes pain, then nausea, shaking, cold sweat. My thoughts are coming a little too fast.
I’m momentarily afraid I’m coming down with the flu in public, but realize this is probably one of the newer-model panic attacks I’ve been having. The panic attack with no psychological fear component. The one that is purely physical. These are really common with other folks, apparently, but I only started having them in the last couple of years. At first they confused the shit out of me, but now I’m on to them.
I don’t want to leave and then have to come back, so I decide to tough it out. To distract myself, I talk to the nice woman next to me who is wearing a really cute Sailor Moon shirt. I’m shaking, but I don’t think it’s visible. The nausea is terrible. I don’t have my emergency clonazepam, but it takes that stuff a half hour to work anyway.
In the parking lot, I sit in the car and take deep breaths. I reach for something, anything, to think about. I close my eyes and imagine looking out over rolling fields dappled with wildflowers. Blue mist, settling in the hollows, and condensation on the smooth marble under my hands as I lean on the balcony’s edge. There are horses on the hills. The shifting breeze carries the smell of wisteria to me. The dawn is cool and fresh. I am someone else for a couple of minutes. Someone not afraid.
My happy place is thoroughly imaginary but that also means it’s eminently accessible and infinitely flexible. And my imaginary backup people are amazing. One of the best tools I have for dealing with this bullshit. I ask the king badass among them if he ever has panic attacks. Something I never thought to ask him before. He says hardly ever, but . . . yes. Absurdly, I feel better knowing that.
The nausea backs off. Still, I make sure there’s a plastic bag in the passenger’s seat. I want to go home worse than I feel sick, so I begin the drive. I am still not feeling psychological panic.
I count backwards from a hundred aloud, first in Spanish, and then Italian. I have to focus to remember the numbers. I make the highway on-ramp and feel much improved. By the time I get home, I only feel sick, not green in the face.
“Bleah,” I say to my husband. “I’m having a panic attack. Excuse me, I need to lay down for a while.” No drama. Inconvenient, and I do still feel like a fun-crushing joykill, but I’m not crying or screaming or any of that.
This is a victory. I still had the panic attack, it crept up on me, but I navigated it successfully. I was not in emotional distress other than that provoked by the predicament. I coped. I win.
Another doctor visit, this to my general doc. Again, I’ll be veering into triggering territory, and I am afraid. I have a sheet of paper with all the things I might need to say written on it, so if I can’t talk at all, I can hand it over. That’s one thing I don’t have to worry about. A lot of heading off panic attacks for me is being prepared before they happen.
The wait in the exam room is probably not more than ten minutes, but it feels like forever. I start breathing hard, fast. I feel a little sick. My hands are a unsteady. I can’t concentrate to read. I don’t want to use numbers this time. They’re good for driving, but not for waiting. I pace the room and recite the alphabet poem I sometimes use. I tell myself that I am so much scarier than the thing I am scared of.
I feel mildly better after a few minutes of this, but I keep thinking about things that happened to me in the past. Little flashbacks, like a weird sort of mental flinch, only toward the bad thing, not away from it. I feel stupid for letting such a little thing bother me, still. It really, really does, though. I’m still so angry. I’m still so embarrassed. I wish it would go away so I could be more like a normal person. “There is no such thing as normal,” people say. It’s not helpful. I could damn well be closer than this.
But the poem does its work. My voice grows less tight, the pacing less fraught, the words come easier and then trickle off, unnecessary. I sit down, experience an immediate spike in anxiety, go back to pacing, feel better. I am going in gentle circles now, thinking about a scene I’m writing.
The doctor comes in. I don’t need the paper. I can talk. She really listens. I put the visit in the good experience bank and hope against hope that someday it will be enough to balance out the bad. We never have little flinchy flashbacks to good things when we need them. The bad stuff just gallops in like a badly-behaved dog and gets its muddy paws all over everything. One of the many annoyances and unfairnesses of a panic disorder.
I wonder, as I walk back to the car, if it might qualify as PTSD, the doctor-specific stuff. Then I think about battlefield veterans, molestation survivors, and people who have had traumatic injuries, and I feel like a complete wuss until I forget about it and start to think about something else.
I go home and watch some Supernatural and congratulate myself. I can’t be proud of myself for not having a full-blown panic attack – if one really wants to happen, it will happen – but I can be proud that they don’t always get the better of me like they used to. I can be proud of my little toolbox. I think it’s pretty neat.
I go see Pacific Rim with my husband. I know the movie will be overstimulating, and a panic attack will most likely be part of the ticket price. I go anyway, because I feel like I can handle it that day. It is thoroughly awesome.
The first twinges start as we pull out of the parking lot. I observe it with detachment. It’s following the new pattern perfectly. Physical symptoms, nausea and stomach pain, this time with a mild halo of agitation. I have my emergency meds with me but this one isn’t bad yet. It might get worse, or it might go away. I decide to wait it out. I go to the next step in my usual protocol: if it isn’t going away 20 minutes after I walk in the door, I will take half a clonazepam.
I go home and I lay on the couch in a dark room with a cat sitting on my ass. Twenty minutes later I feel fine. I gambled and won. I reduced a panic attack to a set of stimuli, weighed and measured my options, and applied a rational process to managing it. This would have been impossible years before. There would have been no stopping it.
I’ve come so far, I think, feeling proud of myself. But I still have them, and that makes me feel sad.
Still. . . .
I want “success” to mean “never has panic attacks.” It’s hard to accept that “success” actually means “better equipped to handle them, and also they happen less often.” Even when I head them off, it’s uncomfortable. They are a thing I have to think about, plan for, and . . . it’s still very hard, even after all this time, for it not to make me feel weak. I hate them.
If success does not mean “never has them”, though, then having them does not mean “FAILURE.” It just means I had a fucking panic attack. It sucked, but I didn’t screw up.
The only part I have control over is the coping with it. Sometimes “coping” means that I can actually shut it down, control the symptoms, until it goes away. Sometimes all “coping” means is that I manage not to throw up. Seriously, sometimes that is the best I can do.
And the times I utterly blow my Sanity check and lose it, totally freak out, those are part of the illness, too. Panic disorders do that. They remove your ability to Cope With Shit. So not being able to do that sometimes is forgivable. It’s not a failure of strength or will or cleverness, it’s a physiological response over which I have considerable but not total control. Initially I had no control, so this is pretty awesome, comparatively.
Being good at dealing with panic attacks doesn’t mean they never happen. It means that I am not usually scared of the panic attack itself while it is happening. I know what is happening, I know what to do about it, and I know that it will 100% for-sure end. It means that I don’t live in fear of having one. It means that they have become a really obnoxious but ordinary event. Yes, it sucks that anyone should have to be used to them, should have them often enough to be good at dealing with them, but I really do think that the fact that I’m in a place where even if they are causing me terrible fear they don’t scare me anymore is an amazing thing.
So if you are dealing with this shit, know that “better” means “better at dealing with them” and not “all better now.” Know that “coping” means “doing your best and trying to learn from every experience, good and bad.”
On the one hand, sorry to bust your bubble, if you were hoping that it would all go away. It might, but I strongly suggest assuming that it will stick around long enough that learning to deal with them will pay off.
On the other, realize that you actually can get better at this. You probably already feel like you have no control over the panic attacks, and to a considerable extent, you probably don’t. But you have control over how you respond. You can learn to deal with them. You acquire tools. Deep breathing, relaxation exercises, rhymes, numbers, imaginary people. Medication is an amazing tool, don’t let anyone tell you it’s “weak” or “cheating” to take that form of help. It won’t be a trip through HappyFunUnicornLand, but you can learn to deal with it, and sometimes you will be able to kick its sorry ass.
Eventually, the thing that used to beat you into the mud will only be able to bring you to your knees. Eventually, you’ll be able to meet it standing. I can’t promise you’ll beat it every time, it might still kick the shit out of you sometimes, but I can promise that with practice you’ll get your feet under you faster, and go on about your business of being awesome. Being you.
I can promise you that.