Archives for Physiology
"Just...just do it," she said, looking me straight in the eye. She wasn't a Nike spokesperson: She was my therapist, circa 2004, warning me against the dangers of agoraphobia. "Even if you feel panicky," she said, "Just go. Go out with that friend or this one. Go to the store. No matter how your body feels, just keep going. Don't cancel plans. It'll get worse in the long run if you do." Wise words. Did I always heed them? No.
Have you ever noticed your respiration rate increase during periods of heightened anxiety? It's okay if you have -- it's completely normal and part of the body's fight-or-flight reaction. But what if you're anxious about something that you can't fight or flee from? Then, your quicker-than-usual rate of breathing becomes an annoyance at the least -- and a panic trigger at worst. Perhaps you've read about abdominal breathing in Edmund J. Bourne's classic text, The Anxiety and Phobia Workbook. Breathing retraining can help with panic and anxiety symptoms, he notes -- and I agree. It can. But perhaps, like me, you absolutely hated his 5/5/5 "Calming Breath Exercise" because, let's face it, fellow panickers: holding your breath for 5 seconds between inhale & exhale is...uncomfortable, to say the least. Right? My body hates it! For me, it raises my heart rate, and I still can't quite understand why it's so often recommended. So, what else can we do?
What does a panic attack and a yoga class have in common? If you're anything like me, both panic and yoga can lead you to (uncomfortably) focus on the nuances of breathing. Yes, breathing -- that thing we do, day in and day out, often without realizing it. But after my first panic attack in college, I began to realize that I was breathing -- constantly. The awareness was neverending and disturbing. I struggled with the following thoughts: What if I accidentally held my breath without realizing it? Would my body's physiology wake up and kick-start my breathing again? Is it possible to just stop breathing, randomly, and not start again? WHENEVER I BREATHE OUT, YOU'RE BREATHING IN Thoughts like this became...well, uncomfortable, to say the least. I wanted to go back to the way I'd breathed pre-panic: without awareness. I just wanted my autonomic nervous system to do its thing, to keep me alive via breathing, without making me think about it day in and day out. I just didn't want the burden of having to notice my breath any longer. And then I walk into my yoga class.
Yoga stretches can feel soooo good sometimes. Case in point: three days ago, I had a bad panic attack brought upon by low blood sugar at night. (Sometimes, I'll eat dinner early, and get so engrossed in TV or internet or writing or crafting or cleaning -- or anything, really -- that I forget to eat.) For me, low blood sugar means this: shakes, sweating, and a profound sense of dread. I get nauseous and feel like I am dying. So I ran to the kitchen, chugged a giant glass of OJ, inhaled a granola bar for good measure, and sat down on the floor. (Waiting for your blood sugar to rise is a very panic-filled waiting game.)
To the outsider, panic is often invisible. You can't see the tachycardia or palpitations. You can't see the adrenaline, the air hunger, or the dizziness. But just because you can't see it doesn't mean it isn't there. Popular culture (or at least this Google image search) seems to suggest that panic is this super-detectable experience that causes sufferers to pull their hair, widen their eyes, and clutch their fists or faces. Maybe that's true for some -- but surely not for all. Panic can easily go undetected, and I sure know from experience: just recently, I had a panic attack while in line at my local CVS store. As I laid out my purchases on the counter, I felt dizzy, hot and sweaty, nauseated, lightheaded, and my heart was probably beating around 120 bpm. "Do you have an ExtraCare card?" the cashier asked. "Oh, yep -- let me get it out. Here you go." Beep. "Thanks." She scanned my items none the wiser. I was panicking and she had no idea.
I really like Google's autocomplete feature because it makes me feel like I'm rifling through the world's garbage. That sounds weird, I know. Let me explain further: A curbside trash bag filled with old to-do lists, kitchen waste, and empty product packages can teach you a lot about the creator of the waste. If you snoop hard enough, you can likely determine all sorts of details about the person -- and their culture -- based upon what they toss in the trash. It's like archeology. Dirty and stinky, yes, but still archeology. Searching Google and seeing that little autocomplete drop-down menu can be as revealing as trash, albeit in a more anonymized way. You can use it to take the pulse of the English-speaking world on virtually any topic, from religion to famous tech leaders to anything else, like this:
(If you missed the first three parts of this story, click here, then here , and then here.) The scene: a small road off of a two-lane state highway in the woods. The cell phone coverage: first none, then a single bar. My panic state: full blown. I was laying down in my car, following the EMT-in-training's instructions to avoid sitting up or moving around, and I was scared nearly to death. I shook, I gasped for air, and I palpitated. I hated every single second that slowly and dreadfully crawled by. No matter how hard I tried, I couldn't even conjure up the energy or the clarity of mind to reach for my Ten Rules for Coping With Panic worksheet that lives in my wallet. I was in the middle of nowhere, I was stuck, and I couldn't escape without help. Not only was I about to receive medical help, but I'd had to call my husband and ask him to drive 40 miles to be with me. Ugh. Failure. The word kept repeating in my head: failure failure failure.
(If you missed the first two chunks of this story, click here first and here second.) This is the story of (one of) the worst panic attacks of my life. It happened in the middle of nowhere on a country road, geographically equidistant between my parents' house and my own apartment. Thirty-five miles both east and west of the closest "safe" place, and I felt both physically and mentally unable to complete the drive in either direction. I pulled back onto Schoolhouse Road after trying (and failing) to backtrack to the state park parking lot where I'd last had cell reception. I couldn't do it -- I felt lightheaded, the trees and the road and the sky felt cartoonish, and my body was uncontrollably shaking. I parked on the road between two houses, reclined my seat, and waited. And waited and waited and waited. I periodically checked my phone for service as I tried (unsuccessfully) to quell my symptoms. I managed to find a Xanax in my jacket pocket. I swallowed it with water and, for about a minute, felt a mild improvement thanks to the placebo effect. ARE YOU OKAY? Some young kid in a giant white pickup truck rolled up to my window and asked me if I was okay. "Yeah, I'm fine," I lied. "I'm just waiting for something. Thanks for checking." He drove off. Had I just missed my only opportunity to get help? My panic level increased.
(If you missed the first half of this story, click here first.) So, there I was: holding my cell phone and sitting in the driver's seat of my car on a small side road in the woods with no reception. Yeah. AM I GOING TO DIE? I was shaking like a leaf and I barely had any control over my limbs. What should I do next? I tried to think, but only one thought kept breaking through into my consciousness: you are going to die. You are going to die. You are going to die. First, because of how lightheaded I felt, I instinctively tugged at the lever that reclines the driver's seat. Wouldn't laying back -- and thus increasing bloodflow to the head -- prevent me from passing out? Yeah, that sounded good. It sounded like a good idea... ...for about three seconds, that is. It sounded like a good idea until the very fact that I was lying down in my car made me all the more aware that I was having a terrible panic attack. It's superstition, I guess: My panic resume boasts some real doozies, many of which involve either driving or being a passenger in a car -- and for the worst of those attacks, I laid back in the seat to keep that light-headed feeling at bay. The very fact that I was reclining reminded me of other panic attacks, which, in turn, made my panic worse.
The title alone tells the story...right? But allow me to fill in the gaps and explain why, over the past week, I've been doing so much mental hopscotch over this incident. Panic disorder sure has its ups and its downs. And sometimes -- and this is the part that's incredibly confusing and frustrating to both sufferers and their loved ones alike -- those ups and downs are back-to-back events. Case in point: last Monday, I had a huge "win". I drove 60 miles (by myself!) from my apartment to my parents' house...AT NIGHT. IN THE DAMN DARK. WITHOUT PANICKING. (This is crucial, people. Absolutely crucial. It's been forever since I've done something of that magnitude in the face of so many triggers [driving, driving at night, being alone while driving, and driving where cell reception is poor]. It's the kind of thing, really, that filled me with so much hope.) Then, more small wins: I attended a funeral service for a family friend on Tuesday (without panicking!) and joined everyone for lunch afterward (without panicking!). And, afterward, I spent the afternoon and evening with my dad -- I love him to pieces, of course, but we tend to butt heads sometimes -- and my anxiety level remained low for the entire time. Low low low. Like, I-feel-like-I've-taken-Xanax-without-taking-Xanax low. I was pleased with myself. And with my progress. ...AND NOW FOR SOMETHING COMPLETELY DIFFERENT Then, enter Wednesday morning.