The term “panic attack” can be thrown around casually, but for the over 2 million Americans diagnosed with Panic Disorder, it means something very specific. Below, Alexandra shares what it means to her, and how she found a silver lining to a scary diagnosis. Her story was originally published in August of 2018, but we’re republishing it today in honor of Mental Health Awareness Month. -Haley
Just over five years ago, my mental cogs shifted. Until my early twenties, I felt good. I experienced pain, but it always stemmed from a socially acceptable source of sadness, like a breakup with a college boyfriend or the loss of a grandparent. I had moments of intense stress, but they were self-inflicted. No one told me I needed Straight A’s; I just wanted them. And I had moments of lowercase-A anxiety — was I smart, pretty, likable? What did people say about me behind my back? If these thoughts and feelings didn’t always feel good, they at least felt typical.
Then I fainted on the subway. I was on the F train, riding from 14th Street to West 4th. I’d taken a SoulCycle class after work and thought I was feeling one with my “pack.” Physically strong. Mentally strong. When the train stopped between stations, I became just the opposite. I lost control of all rational thought. I was alone. Would I be stuck, sweaty and scared, in this subway car forever? And that’s when I lost control of my body. When we arrived at West 4th, I was vaguely aware of people helping me up, and then aware of falling again, this time out of the train and onto the platform. And once more on the platform as the train pulled away.
Blinking to attention, I found a semicircle of bystanders hovering around my feeble body. I’m not sure how long I was out for, but the police had been called and they were there, too. I couldn’t explain what had happened, why I’d fainted, what had gone wrong. I remember worrying that someone I knew would see me as I was carted in a wheelchair to a waiting ambulance. Hours in the hospital led to nothing — I checked out fine. But I never recovered. I never lost that fear of fainting. I never took the subway after SoulCycle. In fact, for a while, I never took the subway at all.
Aside from implementing my new avoidance techniques — which I found impractical but also necessary — my life resumed. Then a few weeks later, after a perfectly routine family dinner, I collapsed walking up the dingy staircase to the starter apartment I shared with my best friend. Back to the hospital I went. Back home with another clean bill of health.
Understandably, I became convinced something was seriously wrong with me. And whatever it was, it was clearly physical. I was fainting. And I was starting to feel off almost every day. My vision would disfigure. I felt like a horse with blinders. I knew more of the world was around me, but I could no longer see it. A heavy fog descended over my brain, making it hard to think straight. I felt disoriented and out of control. Not unlike how one might feel before passing out. And I was lowercase-P panicking.
Countless doctors appointments and one CAT scan later, my internist suggested the problem might not, in fact, be physical — but mental. But how? I remember arguing. Could something going on in my head make me feel so physically frail? The answer, I learned in my first ever therapy session, was yes. I was suffering from Panic Disorder, an uppercase diagnosis that, according to the National Institute of Mental Health, is characterized by spontaneous panic attacks and an intense fear of recurring attacks. Often, but not always, the disorder takes hold after age 20, and it is more prevalent in women. And because the symptoms of Panic feel so real, it’s not uncommon for those who suffer from it to go to the hospital in search of answers.
In the early stages of therapy, I developed two trains of thought, which I still struggle to reconcile. On the one hand, as I learned more about my condition, I felt less in the dark. On the other, I now had a mental disorder, and that frightened me. Familiarizing myself with what to expect was both helpful and preemptively scary. I was horrified that my anxiety was written all over my face. Could everyone tell I wasn’t well, or was this just in my head? I know I am a sincere, thoughtful person. But my thoughts were sincere, and they were physically harming me. I felt powerless to stop this cycle.
It wasn’t just contained spaces that caused my thoughts to crowd in on themselves. Activities I once found relaxing were also ripe for panic attacks. I remember being rescued from a nail salon because I was scared I was going to be stuck with wet nails and have no way out. I remember running out of a hair salon halfway through an appointment, calling my parents and clutching my wet head in my hands in a seemingly safe hotel lobby until the fear let go. I remember feeling ridiculous, pampered, painted and dyed, but with a terror I couldn’t understand.
If you’ve had one, you know. Panic attacks are awful. Your entire world feels like it’s ending, and you can’t escape the absolutely crushing sense of doom. You can feel it come on, and if you can’t escape the downward spiral, that’s it. You’ve lost the battle. You can’t tell yourself otherwise, because you’ve lost your grip on what is real and what is not. You cannot escape the prism of your mind, and what’s worse — it’s not even a prism you recognize. These thoughts are not yours. The voice that says you’re dying doesn’t belong to you.
Occasionally I know where they come from, like when I’m sitting alone in my apartment, eating something, coughing, and then immediately becoming convinced I’m going to choke. It sounds silly, even to me, but you cannot imagine the sheer terror that cough strikes. Other times an attack may arise at the most arbitrary of times, a time when I otherwise feel safe and secure. It’s like one of those handheld scalp massaging claws grabs the top of my head and squeezes tighter and tighter until I can’t think, see or feel anything but the exquisite pain of pure panic. The choking sensation may go away, but the panic can last for minutes, hours, sometimes the duration of the day. It drains the life from me, and fatigue takes hold, only leaving me feeling less equipped to tackle any perceived danger that may come my way. It’s exhausting.
If I can’t stop it, I have to wait it out. Not being in control is incredibly difficult, especially for me. I hate being in a taxi (because yes, I still struggle with the subway), en route to a dinner with friends, excited, only to have the excitement unfairly snatched away from me when my mind turns. My heart begins to race. My vision blurs. I call everyone I can to have them tell me I’M GOING TO BE OKAY. But ultimately, the only voice I can hear is the one in my head telling me otherwise.
Identifying the root cause can halt the physical symptoms in their tracks. Cognitive Behavior Therapy, I’m told, can help with this. The problem is that, often with Panic Disorder, the reasons aren’t obvious. They jump out at you, blindfold in hand, ready to torture you, a nightmare come to life. When they release their hold and you wake up, so to speak, you know it wasn’t really real, but wasn’t it?
Medication can also be incredibly successful in helping individuals with Panic, precisely because the disorder has so many physical manifestations. While I struggled intensely with the decision to use an antidepressant, I am acutely aware today of how important medication has been for me over the past few years. Many individuals, including myself, begin to suffer from a fear of “going crazy” — which is actually one of the classifications of the disorder. But that would mean completely separating from the world around me. People who panic, or suffer from anxiety, feel too much. I am too connected to my surroundings. Medication helps me dissociate in a way that is productive.
Nearly a year ago I convinced myself, with the help of one too many wellness reads, that I could cure my Panic Disorder. Turns out, regular exercise, a gluten-free diet, limited alcohol intake, a healthy social life, a successful marriage, a loving and supportive family, a fulfilling career and copious amounts of bath products, candles, and organic food didn’t fix me. If anything, I felt worse — and weaker — when these supposed cures didn’t work. No amount of dry brushing, green juice or digestive enzymes could cleanse me of my Panic. So I returned to medication, in combination with a balanced lifestyle, and found wellness on my own terms.
But wellness always has a shadow. I know the shape of my shadow: It’s Panic Disorder. The fact that it has a name doesn’t quell the unease it provokes. There’s fear associated with giving a voice to something that’s following you. I’m constantly anxious about my next attack. Writing this was difficult — what if talking about it makes me anxious? Isn’t it best practice to ignore the things you want to go away?
When it comes to Panic, I can now confidently say no, it’s not better to let it be. Peeking behind the curtain has helped. In this moment, I understand my mind is making me do this. I acknowledge that I need medication to keep the panic at bay. I know I will suffer from another attack and I accept that.
One thing that makes me feel better is that I’m not alone. I rely heavily on my husband, parents, sisters and friends. They may not relate, but they give me the reassurance I need that I’m still me. My normal just looks different now than it did five years ago, and that’s okay. Likewise, I’m here for the comments, the chorus of strangers, undoubtedly some of whom will identify my story as their normal, too.
Alexandra Willkie Pasanen works as a fashion buyer and freelance writer covering fashion, art and lifestyle. She’s based in Brooklyn, New York. Follow her @willkieeee.