A lot of people in my social media bubble have publicly discussed having panic attacks lately. I generally reach out privately, but I want to share some thoughts publicly about my own management of panic attacks and a panic disorder. Hopefully this will be helpful for others (in addition to being some bookkeeping for me).
All of this is my opinion based on my experiences, it might not fit your situation. If you are struggling mental health wise, I urge you to get professional help rather than trying to go it alone. There is help out there, and it works.
my story
Just over a year ago, I was riding the train home from work in New York. I felt off all day and I tried to caffeinate through it. Once the train doors closed, I felt alone and like everything was closing in on me. My vision got narrow and I felt tingly. A panic attack. I was stuck in the train car hyperventilating under the East River. That was the longest short train ride of my life.
I was doubled over grabbing one of the poles that people hang on to when they are standing and riding. A woman looked at me weird and I thought to myself: I must look crazy to her.
I got off at the first stop even though it wasn’t my stop. I needed to get out of there. I shakily walked two miles to my apartment. I got in the elevator to go up and BAM the panic symptoms started again. I managed them as best I could, got to my apartment, crawled into bed, and just sat there on the verge of panicking. I felt alone, cut off from everything. My head kept spinning. I just wanted it to stop, and it wouldn’t. I didn’t know what to do.
After a few minutes I called my mom to have a familiar voice to talk to and decided to go to the local hospital. I was treated for a panic attack. I went to my parents’ house that night, and stayed there for awhile. Over the next few weeks, I was scared to go outside because I didn’t want to have more panic attacks. I was scared to do just about everything.
I also felt weird. I felt wobbly, all my emotions were stronger, I had trouble focusing, I was teary a lot. I spent an incredibly anxious and difficult month, probably the most difficult period of my entire life, waiting to see a psychiatrist. When I finally did, I was diagnosed with major depressive disorder (MDD) and panic disorder (PD). I remember getting those results back and feeling like I had failed a test, but getting diagnosed was actually amazingly helpful.
A few days later, I was overwhelmed with scary feelings, on the verge of panicking, incredibly angry, and feeling hopeless. I didn’t know what to do so I told my parents to take me to the hospital. I described what I was feeling (which I won’t go into too much detail about here) and was admitted to inpatient. I was very firm that I wanted to go to inpatient, despite being discouraged from doing so. This is how I learned that if you feel like you need a certain type of help, trust that feeling. Personally, I was scared because my mind felt out of control all the time, and I didn’t know what to do about it. That out-of-control-ness scared me more than anything, it made me feel like I couldn’t trust myself, and that I needed help.
I spent 9 days in inpatient and it was one of the best things I have ever done. It was about taking baby steps. For instance, going outside for some walking time scared me because I thought I was going to have a panic attack. That’s the essence of PD: you are scared of having a panic attack and that sort of consumes your consciousness. Everything you do is about trying to stop the panic.
My friend had bought me the Stardew Valley Guidebook for my birthday, and I got very familiar with that book in inpatient and took it everywhere. It was like a security blanket. So I learned to go outside again with the help of my video game guidebook.
I talked with professionals daily and learned more about my brain. In addition to MDD and PD, I was suffering from some combination of obsessive-compulsive disorder (OCD) and/or post-traumatic stress disorder (PTSD). It’s hard to differentiate these in some cases, and I had symptoms that fit both fairly well. Basically, repeated compulsive behaviors to try and reassure myself that I was safe and OK. Very related to the panic disorder.
Getting diagnosed at first is very hard because I felt like I had done something wrong. In time I have come to understand that it is a huge strength to have a diagnosis, because there is very useful treatment. When I got the OCD/PTSD diagnosis, I luckily was referred to an inpatient therapist who specialized in this, and he basically explained to me how my brain worked in our first meeting, without knowing me. I had literally never felt so understood in my life, and I will be forever grateful to him. He gave me a handout which described symptoms I may be experiencing, and I was experiencing all of them.
This I think was my first really big step on the road to recovery: understanding that I was not alone in my struggles, but that what I was experiencing was a common response to trauma. Knowing that my condition was understood by others was just so reassuring, even if I didn’t understand it myself.
I don’t mean to say all of my problems cleared up right there in inpatient: they didn’t. I am still in recovery a year later, I still worry about having panic attacks sometimes, and I am certainly still identifying and working through trauma. But I started building a more solid foundation for my life there, and that was amazing.
Another friend gave me the book The Subtle Art of Not Giving a Fuck, which I also read in inpatient. And it was amazingly helpful. It was about recognizing that trauma is not our fault, but it is our responsibility. This distinction has been crucial in my recovery.
After inpatient I did outpatient. I was panicky still: scared of going new places (or even old places). I was on the wrong medication which took a few months to sort out. But I made some progress. Working with my psychiatrist, I eventually got the medication thing right and that was amazing.
And after outpatient, I found a PTSD/OCD specialist to see weekly. We did exposure and response prevention (ERP) exercises. I had therapy homework. It was incredibly useful and helpful. Working with her was really where I would say I began to improve quickly. I was worried about having a panic attack while driving, so for therapy I had to drive. I was worried about getting stuck in traffic, so I had to go get stuck in traffic. I was worried about PTSD flashbacks, so I had to intentionally replay those experiences in my mind.
This was hard—it raised my anxiety level. But it was effective. Things that scared me started to be less scary. I had one experience of confronting a fear and having my anxiety replaced by a feeling of calm and accomplishment. It was rad. I am forever grateful to her and if I don’t feel like I can manage my symptoms she is the first one I would text.
So here I am, a year later. I’m still recovering but I’m much happier. Possibly happier than I’ve ever been, even though I am still working through plenty of issues and I have difficult periods. I view myself as managing symptoms and learning to do it better and better. I expect this will be a lifelong journey.
my lessons for those struggling
My first takeaway is that there is help. There are people who specialize in what you are going through. There is effective treatment. I have found the most effective therapy to be behavioral, such as ERP. I have not found talk therapy to be effective (for me, it is somewhat counterproductive I think).
My second takeaway is that something like a panic attack is really a symptom of deeper things. For me, it was unaddressed childhood trauma, which snowballed into maladaptive patterns as an adult. This resulted in depression and panic attacks. If you have panic attacks and are trying to manage on your own, I would really suggest seeking professional help instead. You can go at your own pace, and understand the underlying causes of what you are going through. For instance, I am now taking some time off from work and exploring my own past with the new set of tools that I have.
My third takeaway is that if you are having panic attacks, something in your environment is probably not safe for you. The part of your brain that decides if you should run away from things is shouting “RUN!” For me, I ended up having panic attacks because my brain was shouting at me “you are not safe!” and I was ignoring it. I ignored it for years. In terms of safety: it’s very important to find as best you can. A place where nobody is expecting you to get better, so you can have the time and space to do it in the manner that works.
My fourth takeaway is that you need to take care of your brain (or take care of your trauma). Your brain thinking you are unsafe doesn’t have to be for logical reasons. It’s probably illogical: like maybe your home as a child was unstable and unpredictable (like mine was!) and so your brain is now seeing instability in your current life, but your current life is pretty good. My previous response to this was to tell my brain like “hey your current life is good so my feeling of instability doesn’t matter/should go away.” But that was wrong: in fact, I needed to take care of that feeling, understand where it comes from and how to reassure myself. Now, I am doing that and I am making some progress which is cool.
My fifth takeaway is you should probably get off social media, or reduce your usage a lot. It’s bad for your brain. If you are having panic attacks you’re already struggling with stuff, and social media is probably poking at whatever that is even more. If your home life was rough as a kid and now you focus on all of the problems in the world via Twitter, you probably see your childhood home everywhere out there and you have basically turned all of Planet Earth into your childhood house of horrors (like I did!). But actually, that’s not reality. The world is a complex place that includes many good things as well as many bad things. Social media presents you with a very small and biased slice of that designed to elicit as much emotion as possible.
My sixth takeaway is that it is important to remind yourself there are people out there with the same issues as you. This is not a competition, it is not good to go “well some people are more fucked up than me.” But it is reassuring to know that there are fellow strugglers that you can learn from. There are recovery stories you can emulate. There are people you can talk to. You can probably find a therapist who actually struggles with the same thing you are struggling with.
My seventh takeaway is find a spiritual practice and community. At its best, spiritual practice is about reminding ourselves that we are loved, we have dignity, and we are supported in our difficulties and fuck ups. These things are universal needs and universal experiences. I have found my local church to be incredibly reassuring. I have found some community, a place to volunteer, and people who are older and wiser than I am who have some real life experience to share. Go spiritual shopping and you might be pleasantly surprised.
My eighth and final takeaway is that you shouldn’t try to outsmart your brain. Just because something is logically true doesn’t mean that your brain in fact registers it as true. Just because something is logically false doesn’t mean your brain registers it as false. We have lots of complex feelings and responses. These are there for good reasons, and it is more productive to view the feel-y parts of our brains as having wisdom that we can understand rather than as insufficiently evolved appendages. You come with pre-installed software that you want to work with rather than work against.
i hope this is helpful for you
Again, if you are struggling, remember that there is help. You are cared about. I hope my sharing makes you feel less alone.