Thus began my descent into the world of acronyms...bewildered doctors, frustrated psychologists, and a three-ring circus of pharmaceutical adventures.

July 17, 2012 12:10 PM

The dining room was jammed to the fleur-de-lis wallpaper with red-faced white guys in blue suits and harried looking waiters in penguin costumes. Not my crowd. I remember hearing a muffled “linguine Alfredo” and the clinking of glasses at another table, and then the film snaps. This, as I’ve come to think of it, was the moment my first life stopped, where the film broke and the reel spun around and around, flogging itself.

Jokers Wild: Author Paul Vandevelder's contribution to the NYT(online)'s Anxiety series, featuring an illustration by Finnish artist Tommi Musturi.
posted by obscurator (5 comments total)

Huh. This anxiety-ridden person had no idea about this series. Thanks for the heads up!
posted by brundlefly at 12:24 PM on July 17, 2012

That was a nice piece. One thing that really struck home was his description of having a pre and post first panic attack life. That first acute, out-of-nowhere panic attack, it's like it breaks you, and you are never the same. You live in fear of the next one, which becomes a sort of self-fulfilling prophecy at some point, and you start to have panic about the possibility of panicking and so on. It is absolutely terrible.

I also really like his physical descriptions, the twitching, the fear of death, the conviction that it is here. That is really quite accurate. I think a lot of folks don't realize just how very physical it is, how it's like a seizure in that you can't control it, it takes you over, fear and panic take control of your brain and your muscles and your nerves. You can't breathe and your chest hurts and you are suddenly orbiting above yourself certain that this is the end. Like Mr. Vandevelder, I hope death is nothing like a panic attack. It's exceedingly common to believe your having a heart attack when you're having a panic attack. Sometimes I fear that when I actually do have a heart attack, I'll just take a benzo and try to come down, thinking that it's just panic, and realize too late that this one actually is a heart attack (this worry also makes me panicky, which is again the horrible ouroboros of the whole thing).

My first panic attack landed me in the hospital (this is getting pretty personal, but we're all friends here right?). I was living alone in Washington Heights, a very lonely, very stressed-out, very anxious college student with some undiagnosed depression and things going on. All of a sudden one night it was a like a switch flipped. I was listening to Fiona Apple's Extraordinary Machine, which had just come out, and which is still kind of triggering for me to this day, which is a shame because it's a great record. Suddenly it was just like a pervading sense of doom, DOOM, sweating, heart racing, chest pain, unable to control anything. I was floating outside of myself. Things were very nightmarish and reality became pretty fuzzy. I am dying, I thought. I need air. AIR. It was the middle of December and I opened every window in the apartment. I paced around, unable to get a hold of myself. I left the apartment, leaving the door wide open (luckily I had great neighbors and I wasn't robbed while I was out), and walked to the emergency room which was just down the street. I called my best friend on the way and she took a taxi from the Lower East Side and met me. I remember telling her on the phone, "I'm at the hospital. I'm dying. I may already be dead. Am I talking to you? This might be hell." She took me home after it was determined I just had a panic attack, stayed with me that night. Thank god for her. Things were never the same after that, though. I too was a pretty happy-go-lucky kid at one point. But man, panic will fuck you up.

The real bastard of the thing is that you can go years in between major panic attacks. It's like just when you start to think, okay, maybe the last one was a fluke, or maybe I'm better now, BAM, there it is.

No less terrible then panic and anxiety are a lot of the treatments. The baffled and/or skeptical medical professionals he came up against are pretty par for the course, which doesn't make it any easier. It's nice knowing he managed to get off everything and stay reasonably okay. Alcohol is actually a highly effective medication for panic and anxiety, but of course it isn't sustainable and the side effects are outrageously bad. Kind of had to learn that the hard way. Weed, which I've had my own love affair with in the past, is a bullshit anxiety treatment. You think it's effective in the moment, but over time it seems to only make it worse and will even induce panic attacks. Benzos can be a godsend but they come with their own special type of hell. SSRIs are actually pretty okay, if they work for you, or until they stop working. Yoga and meditation and cutting out caffeine almost completely from my life have helped me quite a bit. Therapy is good. But there is always the lurking, the sort of baseline hum of worry and the threat of the spike.
posted by Lutoslawski at 1:14 PM on July 17, 2012 [9 favorites]

I agree that the sense of living a different life -- being a different person really -- was very well-articulated. I'm not sure I'd fully admitted that to myself, even, but it's so true. Struggling with panic disorder has been a pretty big part of my life ever since the first attack, about 15 years ago. Sometimes it's eclipsed everything else.

Things are much better now, though. Via cognitive behavioral techniques, working out, figuring out the sources of many of my existential fears, and finding a therapist I click with, I've learned -- or am learning -- to not be afraid of the attacks themselves. That seems to be the only way to really short-circuit the vicious cycle of panicking about the possibility of panicking.

I think the thing I have the most trouble with nowadays is finding the possibility of an attack deeply socially embarrassing. Would everyone think I was crazy? Or ridiculous? Would they laugh? Would they want to let me go from job? Would my partner get fed up with having to deal with me panicking yet again?

Of course, I know the answer to all of those questions is no (most people in my life aren't assholes), but that's still one area where I can feel a bit panicky about the possibility of panicking and have to spend significant effort at times talking myself down. Still, I think that's a huge improvement over fearing that I'm actually dying or literally losing my mind.

Not sure where I was going with that other than to say that there are techniques which work (as the author of the article discovered). Great find. Thanks for posting.
posted by treepour at 2:25 PM on July 17, 2012

Weed, which I've had my own love affair with in the past, is a bullshit anxiety treatment.

Agreed. THC has always been a several-edged sword for me, occasionally triggering some of the worst attacks I've had; trying to convince friends that the stuff was laced or whatever, inadequately-clothed winter wanderings, chest-clutching and slightly more humorous mishaps, as I recently described.
But, it's also been majorly helpful at times, so go figure.

Haven't explored any of the heavier molecular compounds referenced in the linked piece, but (knock on LCD) the major symptoms/triggers have subsided.
posted by obscurator at 6:02 PM on July 17, 2012

Reading this, I feel very lucky indeed that I've come of age in a time when I can have my first panic attack, go to a psychiatrist, and find a small and simple pill that stuns the snake right into submission. For some people, I know it's quite a process going through a whole regimen of medications and treatments to find the ones that click, but I'm fortunate that a mere 10mg of Celexa puts the physical manifestations of my anxiety to rest. I understand not everyone wants to go down the route of medication, but I was getting so wound up in the recursive loop of anxiety that I was starting to spiral into long dissociative episodes. I will always be a naturally anxious person, but I would never have been able to put in the harder therapeutic work if I hadn't gotten those attacks under control first.
posted by mykescipark at 7:28 PM on July 17, 2012 [1 favorite]