Anatomy of a panic attack

My body likes to keep me on my toes. No complacency or relaxation allowed, you hear? It annoys me, because I would very much like to turn my brain off and forget about everything buzzing around inside it sometimes.

I’m pissed off because my nervous system saw fit to randomly explode on me yesterday evening. I haven’t had a full on, unwarranted panic attack in months. I did have a disturbing dream in the morning, which probably contributed to me over-reacting hours later when my boyfriend was channel-surfing and left the TV on Jean-Claude Van Damme shooting things (guns being one of my PTSD’s favourite triggers) while he went to look for a DVD, but even so, I’m not usually upset to that degree over that sort of thing these days. When I was having a major PTSD attack a few months ago (due to moving house) I was spending a lot of time watching re-runs of The X-Files, and that didn’t result in panic attacks. So I’m not really sure what happened there. I suppose it was a combination of the dream, the TV and physical stressors – I’d been feeling a bit hungover and dehydrated all day, which was my own fault for getting a bit too excited over my discovery that Malibu was both vegan and gluten free the night before. Oops.

I actually didn’t even realise it was a panic attack at first when I started shaking and feeling really sick and dizzy – I thought I must be ill. I decided I really needed to go upstairs and lie down for a bit, and had to get Jonathan to carry my glass of water up because I was shivering so violently I kept spilling it. The problem with having panic attacks for more than twenty years is that just when you think you know your particular symptoms and how to get rid of them they MORPH into something newer and more interesting. Bastards.

I have learnt over the years that I can’t do anything to stop panic attacks from happening other than trying to avoid doing too much or getting myself too stressed out. They don’t always, or even usually, have a psychological trigger – low blood sugar, crowds, being overheated or tired or any other of those type of biological or environmental stressors can set me off. Despite my intention to do my initial counselling training in CBT, I don’t believe that my panic attacks are caused by panicky irrational thoughts. However, once I am experiencing symptoms of panic for whatever reason, I can get irrational about those and start perpetuating my own anxiety by telling myself worrying and unhelpful things, usually either a) I am going to be sick or b) oh crap, my heart arrhythmia isn’t benign after all. Yesterday I was genuinely worried that I was about to pass out or throw up, and that made me remember going into shock in reaction to a drug I was given in hospital several years ago, so then I started panicking about that memory on top of whatever else was freaking me out. I am my own worst enemy at times.

Once I had got hold of my head for long enough to check that I felt anxious-sick, not virus-sick, and that I wasn’t experiencing any symptoms other than the dizziness which would suggest that my heart was doing weird shit, I decided that I was probably having a panic attack after all. It didn’t take me long from there to calm myself back down. I am very, very good at calming myself down in a crisis. I just really suck at early intervention! I never realise what’s happening until it’s actually happening. Probably because it all happens so quickly, and it’s impossible to predict which combination of physically and emotionally stressful things will trigger a panic attack on any given day. On another day, when I was physically okay and not remotely hungover, I wouldn’t have been bothered by the dream or the guns. Hangovers don’t usually cause panic attacks by themselves either (thank goodness, heh), so it had to be the combination rather than the individual triggers.

Yesterday evening was kind of like a miniature analogy for my recovery as a whole. I believe that genetic, epigenetic and environmental (which does not mean purely psychological – I would say my milk allergy was an environmental factor in the development of my anxiety, purely because it wasn’t diagnosed when I was a baby, causing me so much pain and unhelpful physiological arousal in the interim) factors combined to cause me to develop anxiety, OCD, depression, anorexia and so on. I believe that stress, either emotional or physiological, will leave me vulnerable to relapsing into any of those illnesses throughout my life. But I do not believe that means I am destined to always be suffering. I don’t believe that I am helpless. There are a lot of things I can do to keep myself well, like monitoring my mood and anxiety levels and acting appropriately when I feel like they are getting unstable; keeping up my ED relapse prevention plan; making sure I eat enough even when I’m stressed out and have lost my appetite; talking to people; continuing to practice my usual mindfulness, DBT and CBT techniques when I do find myself more anxious than usual, and so on.

On bad days I wish this wasn’t necessary. I wish I could just LIVE and not have to bear in mind that my body and my brain are rather over-sensitive. I wish, as I’ve said before, that I didn’t have to police myself. I wish I had a different genetic make-up. But on good days I am just glad that I do know myself so well now, so I don’t need to suffer like I used to. On these days I am grateful for my mind and my body and my make-up, because I like who I am and what I’m doing with my life. I get tired and frustrated, but I am also proud of myself, and the novelty of living more fully than I ever have before, rather than fighting just to exist, has yet to wear off.


6 responses to “Anatomy of a panic attack

  1. Poor Katie 😦 I’m so sorry that panic attack struck you out of the blue. External stressors play such a big part in them and overstimulation is a big one for me too (too bright lights and too loud bass beats in the spin studio, for example!) Those action movies are really packed with noise and flitting between scenes/perspectives so I can see how one might set off a panic attack in combination with already being emotionally and/or physically drained. Interesting fact about the Malibu though!

    Seriously, major admiration for calming yourself down and hope you’re not feeling too drained from the experience.



  2. Oh, I’m really sorry you had an episode like that. I love your approach to framing it, though, realizing you aren’t helpless and, even when things are rough, you don’t have to feel resigned to being unhappy. Very interesting analogy to your recovery as a whole. I hope that you have a restful night and a good start to the week, take care. ❤

  3. Really sorry to hear this Katie… I’ve always had high levels of anxiety and have been prone to panic attacks, but I went through a period a few years ago of suffering terribly with panic attacks. Now that I recognise the triggers it’s been easier to avoid them. I find there are two triggers:

    1. OCD-like thoughts, which usually relate to phobias, with one of my biggest phobias being emetophobia.

    2. Sensory overload, such as bright lights, loud noises, and believe it or not, ticking clocks.

    Once they start, all I can do is to lie down. I was told that it is rare to faint when having a panic attack, but I always faint with them 😦

    I hope you’re now feeling better!

    • Sensory overload is another of my triggers – ticking clocks get me too! I’ve been known to remove clock batteries when I’ve been sleeping over at friends’ houses 😉

  4. Grrrr – panic attack out of the blue sucks :-(. Whilst I don’t suffer from ‘panic attacks’ very often I can relate to what you talked about as I often have difficulty distinguishing whether a very physical symptom is being caused by anxiety or by some kind of bug.

    It is indeed crappy that you remain (and may well continue to remain) vulnerable to panic attacks and anxiety, but it is super-fantastic-brilliant that you are able to minimise the amount of suffering that these vulnerabilities cause you through understanding so much more about yourself. I don’t think I’ve phrased that very well but I hope you understand what I’m trying to say. Basically “Yay Katie” for dealing with that episode so well and for living more fully than you ever have before!

    x x x

  5. I can SO relate to this, having had pretty severe panic disorder for several years. I tried EVERYTHING to control them and although the CBT stuff helped to reduce their frequency nothing actually eliminated them completely. They are hugely better now though, something I am very grateful for (and I think in the end a side effect of therapy that was never part of our goal in the first place!) but there is always the possibility of one coming out of the blue. It sounds like you are doing great with managing these though, I’m so glad that you have a handle on it. 🙂

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