On Understanding Panic Disorder

I almost don’t know how to start this. “Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year” (1)

I am one of those 18.1% who suffer. When I’m in panic it’s almost as if a doppelgängertook over my body. So many people do not understand what happens and that the person has no control over how they feel. Stress and cortisol flood the body.

Last night I had a panic attack. I actually had several in the past week, and 4 or 5 just yesterday alone. What made my last two particularly long and painful is that other people were home and weren’t reacting compassionately. They live with me and don’t quite understand what I go through, how painful it is, and how little to no control I have over how I feel or can possibly react. I can empathize and understand that it can be scary to someone else – really I can. I don’t want to be in full-blown panic either, believe me – way MOREso than the people around me don’t want to see it.

A key driver is understanding. Panic disorder with panic attacks is not something that can be helped at the moment or have a lid put on it. What makes it all so much worse is when those around you and in society judge you and falsely believe mental health issues are something that can be helped (2). I’m writing this because if my own household doesn’t quite understand what this is about, how can any one else? I need to do my part in spreading awareness.

I didn’t know much about true anxiety either. Why should I? We throw the word around a lot. Many of us live with low -evel anxiety constantly. As a society we are mostly all anxious. Anxiety and Panic Disorder is a little different. “This is not to be confused with nervousness — what most people experience in normal situations. Nervousness and anxiety can both cause similar symptoms, but normal nervousness such as how one feels before making a big presentation or applying for a job differs from anxiety in that it’s rational.” (3) Some things can be helped or talked away from. Normal nervousness is one.

I’ve read a lot about anxiety in the past two years since I’ve been diagnosed. Stress is prevalent in our culture. A large part is due to technology and the bombardment of information. Also, the ability for others to reach into our lives at any moment day or night through social media, texting, email, etc. When I was younger and we had a house phone attached to a wall, either going to someone’s house or calling on that phone was the only way to let the outside in. When you left work everyone was shutdown for the day. No one was on texts and emails creating new things to sort through when you got to work – what you left it as the day before is how it was when you arrived the next morning. These things cause constant low-level stress. A text at 9pm makes our hearts beat faster and creates a false sense of urgency to pick up the phone to read it. Whether the message is from a loved one or your boss, the body reacts as if it’s in danger (heart rate, quickened breath, maybe stomach in knots). While we all might experience that quick burst of anxiety when the cell phone dings at 9pm, after a few minutes it goes away. For those of us with an anxiety disorder it not only doesn’t go away, it escalates.

This article describes it better than I can-

Picture this: you’re asleep at night when suddenly you wake up to the sound of someone breaking into your house. What do you do? You panic, like every sane human being would. You start to sweat, you breathe heavily or struggle to breathe, you feel nauseous, your heart races, there’s a heavy pressure in your chest, so on and so forth.

Now picture something else: all of those symptoms happening when you aren’t actually in any danger. No one is breaking into your house. Nothing is about to harm you or is currently harming you. Your body suddenly just starts to panic anyway. That is a panic attack.”

With panic disorder, the body for no real and current reason goes into full fight or flight mode. It differs for everyone, but for me in particular I’m often triggered by something externally that was threatening in the past. Many times I cannot initially identify the trigger. It is almost impossible too when the brain is flooded and the executive functioning goes offline.

Panic attacks arouse the body to a peak level of excitement which makes the individual feel not in control of him or herself. The mind is preparing for a false fight or flight mode, forcing the body to take over to help the victim face or run from the perceived danger, real or not.” (4) The reptilian brain that all land creatures have to flee or fight is what takes over. Rational thinking is completely shut down. It’s not the time to start figuring out the cause or rationalizing with the individual.

I want to feel normal and not panic more than anything. Riding it out, medicine and therapy are helpful, but it took years for the body to become dysfunctional to this point; it likely will not go away overnight.

I can tell you what makes it worse for me –

  1. Being with someone during a panic attack that doesn’t understand and gets annoyed or mad if they can’t help me. I can’t be helped at that point. Someone in my face rationalizing it for me feels condescending. Shunning me at that point feels humiliating and akin to abandonment. I’m humiliated enough. Standing in judgment only makes it worse.
  2. Another horror is trying to hide it to not scare other people. I feel further trapped. I’ve had panic attacks on an airplane, in restaurants, at work, while driving, while getting ready for bed, when waking up… Of course no one wants to see or hear it, but other people hiding or pretending nothing is going on just makes me feel like a freak creature that needs to be avoided.
  3. Last but not least on is the shame of having to hide a huge piece of yourself to others. Our society doesn’t look kindly to Mental Health issues. Before suffering myself, I too thought it was the sign of a weak mind and something you can control. Last summer I spent a full month in an IOP (Intensive Outpatient Program). But forbid I let people know. My own step kids and extended family were kept in the dark. I was afraid to tell people at work why I was on FMLA. It may sound silly or it may not, but if I felt that way I would be willing to bet I’m not the only one.

May is Mental Health Awareness month (5). If you don’t suffer from any mental health issues (Yay You!), it’s very likely you know someone who does; you just don’t know they do. Let’s all do our part to bring awareness and be compassionate to one another to avoid shame, humiliation and judgment. We are all human. Let’s treat one another as such.


  1. Anxiety and Depression Association of America https://adaa.org/about-adaa/press-room/facts-statistics#
  2. We Need to Talk. Our Society Has an Issue With Anxiety and Mental Health. https://futurism.com/we-need-to-talk-our-society-has-an-issue-with-anxiety-and-mental-health/amp/
  3. https://medium.com/@gtinari/how-to-handle-someone-elses-anxiety-or-panic-attacks-51ee63f5c23bHow to Handle Someone Else’s Anxiety or Panic Attacks
  4. How to Help Someone Having a Panic Attack https://m-wikihow-com.cdn.ampproject.org/v/s/m.wikihow.com/Help-Someone-Having-a-Panic-Attack?amp=1&amp_js_v=0.1&usqp=mq331AQECAEoAQ%3D%3D#origin=https%3A%2F%2Fwww.google.com&prerenderSize=1&visibilityState=prerender&paddingTop=54&p2r=0&horizontalScrolling=0&csi=1&aoh=15272981860562&viewerUrl=https%3A%2F%2Fwww.google.com%2Famp%2Fs%2Fm.wikihow.com%2FHelp-Someone-Having-a-Panic-Attack%253famp%3D1&history=1&storage=1&cid=1&cap=swipe%2CnavigateTo%2Ccid%2Cfragment%2CreplaceUrl
  5. Mental Health America http://www.mentalhealthamerica.net/may

<a href=”https://dailypost.wordpress.com/prompts/doppelganger/”>Doppelgänger</a&gt;


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The connection and beauty of two negative recent events in my life 

I have a deeper appreciation for life and moving about throughout the day, as I’ve never had before. Two things happened in the past few months that helped me to come to this realization. I started taking an SSRI and I had outpatient knee surgery. Two different things for completely different reasons, but in all honesty both were because I was moving through life too quickly and absentmindedly. Both have completely slowed me down and fattened me up (just a little!) And it’s not all a bad thing.

Back in March I literally lost my marbles and thankfully became completely aware that fooling myself into sleeping more or doing more yoga or meditating more often were going to be my cure. Truthfully, I was unable to do any of those things anymore where I was able to enjoy them. Yoga while it felt good physically did not slow my thoughts or help me to ‘just be’ like it used to. Meditation was a joke. My old tricks for going within and being still did not work any longer. I sat there diligently, but was unable to stop the racing in my head.

I did all I could to keep up with my life. I was (and still am) the most organized person I know. Trust me when I say that everything was as efficient as can be. No time management tips would help, I would read them and feel like I could write a better article and even had tips for the author. Stretched thin. No room for error. One miscommunication between a family member and the whole string of well planned events and pick-ups would fall apart. No way to live.

A few days before the marble losing I went to a routine Thursday morning report out for my organization’s senior leadership. As usual I prepared at the last minute, was in a rush, but put together something beautiful and well coordinated. I went into the usual conference room. My employee pulled up the presentation while I pulled up my rolling chair under the dark large oval wooden conference room table. SLAM! I hit my right knee really hard on one of the legs of the table. All around oohs, ouches, “I heard that”, “you didn’t need that knee, haha” went around. I shrugged it off and trekked on. About 24 hours later I was meeting with my small department of 4 and realized my knee hurt. I wondered why as I plowed through a packed, quick agenda. As I was talking and rubbing my knee I remembered that I hit it the day before and slightly wondered why it took so long to hurt. That night we went out to dinner with some friends at a ski lodge and it hurt even more.

The next day Daren and I went into NY city for the evening and we were so busy and so stressed that I didn’t have time to think about my knee. It was the next morning that seemingly out of no where I had my first well overdue panic attack. While I cried the whole way home I did notice my knee hurt, but it wasn’t until past 9pm the next night while getting ready for bed that I even noticed how swollen and red it was. Daren was at a hockey practice, I wanted him to look at it, but I was asleep before he even got home.

Long story short, the next few weeks were filled with panic attacks and knee aspirations. The panic got worst faster. I realized I had to start medicine. I had no where else to cut back. And have you ever tried “relaxing” while in a non-stop adrenaline rush? If you haven’t, take my word that it doesn’t work. I noticed once I started the SSRI how often my body was in fight or flight while my brain started to calm down. Wow, I lived like this all the time? Head starting to chill, body still reacting to outside stressors and knee getting worse.

I first went to a walk in urgent care 5 days after the impact where I was urged to watch my knee for a few days. Don’t run on it, don’t lean on it, call the orthopedist in a week if it doesn’t get better. It didn’t stop swelling, but it stopped hurting. So I didn’t listen and ran on it and did yoga on it and didn’t call the orthopedist for 3 weeks. Who has time for this? At first I was getting it aspirated every two weeks and I would wonder if I should even go back because the swelling stayed down… at least of course a day or two before my next scheduled appointment. Then it started to swell sooner and I was going for weekly knee drains. The 2nd to last time I went, it was swollen when I took my bandage off the same night. And the next time I went to the orthopedist I nearly fainted from the lightheartedness of the doctor trying to massage the fluid out of my knee into the needle. Nothing was coming out anymore. Some kind of wall built up in my knee and no routine procedures were going to help it any longer. I needed to consider surgery or live with this wall that created a big puffy golf ball knee.

It’s funny because I feel like the knee mirrored a really rapid physical rendition of the mental decomposition that I experienced over the past few years. I was in too much of a rush, not paying attention, & unknowingly hurting myself. Then ignoring all of the early warning signs and doing the least amount possible to tend to a deteriorating condition because I was busy, I had important things to do damn it. Until I hit a wall both mentally at first and then one actually built up in my knee. An impenetrable wall that needed medical interventions to break down. Both happened within days of each other. It wasn’t until I really had no choice but to live with the pain or deal with it medically that I realized my decisions to live like I do is harming me. My body is all I have, why wasn’t I taking care of it?
I had some medication adjustments, a rough few weeks. Far and fewer panic attacks. And finally outpatient knee surgery last Monday. I’m not believing that I am a changed woman yet, but I’ve had the MOST relaxing weeks of my life.

Since March I have rediscovered the library. I’ve been reading a book a week or so. Fiction books. Nothing intellectual or about business or world religions or how to live more simply… Just fiction books with no meaning. I’ve also started having bi-weekly massages. Daren and I have been spending more time at home, in our house, making the outside pretty for the spring and sipping cocktails in the evening while reading or watching tv. Fun tv. Not documentaries or the history channel. We watch the Walking Dead and Game of Thrones. I’ve started coloring mandalas thanks to a few of my girlfriends who got me the most coolest yogic pack of goodies for my birthday. I’ve been frequenting the shops right in my town and enjoying what is so close around me. The natural food store, the eastern/Polynesian based massage parlor, the local taverns. I have discovered I love craft beer and IPAs. I often go to the coffee shop in my town now too. There is a green tea matcha latte I just love there. And when I have time I’ll bring a book or my computer and write for fun… like I’m doing right now on the beach, on Long Island. In my old stomping ground where just the roads and trees and weeds look like home. I’ve been going back to sleep in the mornings when I don’t have to rush off for work. The lexapro has made me less anxious and some might say more lazy. In all of my adult life I was raring to go the moment I opened my eyes. Did my body feel tired? Hell yes. But there was so much to do, even on the weekends. Weeds were growing, dishes were in the sink from the night before, there were pets to feed, exercise to keep myself moving, shopping, cleaning, kid shuttling, food to make, some place to go or person to meet or emergency to tend to. The list goes on. Who had time to sleep? I’d be wasting it. My dad taught me that as a young kid. We weren’t allowed to sleep in. In his Italian accent he’d bang on our doors and tell us we were “sleeping your lifes off”.

But now those things I just had to get up for didn’t seem so important. They could wait. They would be there yes, but they didn’t loom over my head like before. When I have given myself permission to try in the past I wouldn’t be able to go back to sleep. But now I spontaneously just do. Even when I intend to get up, sometimes I do and other times I can hear my body; and it tells me that it would like to sleep a little longer. And I’m a better person for it.

However, this past week took the cake in slowing down and chilling out. I had the surgery on Monday. It didn’t hurt too much at first. I got dressed and walked into the house from the car. I sat on the back deck with a book and my leg up. And I slept. For hours. I’m sure it was the anesthesia, but gosh it felt good. I woke up in time for dinner. We ate on the porch with my leg up. It was starting to hurt a little more. I asked Daren if we could walk Koji. I wanted to move but by the time we made it across the street I was really faint. Daren helped me back in and onto the couch. I stayed there the rest of the evening with some tea and the company of my family, the pets and Game of Thrones. I felt faint going upstairs for bed, in the middle of the night when I had to get up to use the bathroom and again the next morning when I came downstairs for coffee. I stayed home from work that day. Daren set me up with my computer, some books, tea, and the remotes. I slept even more. The house was nice and quiet. The animals slept all around me. I got up a few times and made some lunch and decided to get my shoes (extremely slowly) on to walk down the street. No more faint feeling. Nice & slow. I had no where to go and nothing to do and realized for the first time in a long time that it had been several days since I felt any kind of stress. My body too… No stress. No pumping heart or fight or flight. Just homeostasis.

Our cul de sac looked so sweet shining in the sun after a morning full of rain. I hardly walk down my own street or know my neighbors. Their houses look so much like ours but they all have their own unique little decorations and landscaping.

A co-worker offered to pick me up the next day. I accepted the offer. I walked slow into work. And moved slowly all day. I had to wonder why I always felt the need to take on too much, rush around or cram it all in? I took my bandages off on Thursday and really noticed the difference in my legs while on the ferry in Friday on the way down to Long Island for Memorial Day weekend. I saw and felt the swelling of the right leg and curves of the other. My feet, my nails, the differences in my knees. Yesterday morning in the shower I was amazed at the great beauty of legs in general. The veins, the joints, how they bend and move and carry us through life. I’m so lucky to have working legs. Anyone who has them is lucky. We take them for granted. I made myself some breakfast and ate in the sunroom while watching the birds. I was in awe of the food. I had an egg white omelette with mushrooms and some blueberries and raspberries on the side. I was thinking about each single raspberry and how with some water and the sun each little bump grew very slowly over the course of each day until they were perfectly ripened and picked off the vine. I ate each berry one at a time marveling in the sweet taste that I so often take for granted. I want to and need to slow down.
We spent the day outside yesterday. I figured out how to do 60 minutes of yoga and not need to lean on my knees or bend them more than 45 degrees. Food tastes wonderful. The trees are so alive with their new spring leaves. With each passing day that the SSRI helps me relax and my knee is healing I’m so thankful for life and I can feel the ever so subtle differences in my healing. Both mentally and physically. One little piece of healing at a time. The same way that each little raspberry grows a little piece of each bump each day. Life is so beautiful. I want to bask in it and kiss it, dance with it and roll around and laugh with it.

This morning I woke up at 6:30 when Daren got up to drive Kieran to his new job at the country club. I felt inspired and started to write this. Then I stopped. Instead of writing I just wanted to experience! I opened the blinds to one of the windows in Daren’s old bedroom and saw the sunny trees and just listened to the sounds of different birds. I laid back down and enjoyed the silence and birds and serenity. I started to get sleepy and pulled up the covers to go back to sleep. I want to turn over a new leaf and be more with nature. I did ask to cut back some hours at work and thankfully the powers that be said yes. I want to feel this way without a knee slowing me down or medication in my body. That means I need to do things a little differently. We all need to live a little more and “do” a little less. Be present a little more and absent a lot less. Every single stinking moment is important and it’s our choice to live in it and be grateful for it, or be absent and regret the past. I’m so ready to live more in the here and now and so thankful I am learning this before I let my life slip away another minute. Namaste.


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