TW: I actually found *myself* triggered as I wrote about this topic which is partially why it’s late. This took several sessions to sit down and write. If you are sensitive like me and particularly prone to anxiety/panic when reading specific descriptions of the symptoms, maybe consider skipping this one. At least stay in tune with your body and your breathing and if you find yourself getting upset, just close it and do something that distracts and relaxes you. I almost exclusively Like things for the sake of smiling and laughing at them later so if you need a quick happy fix may I recommend my Tumblr Likes.
It’s four in the morning on a clear, cool morning. It’s still dark, the pre dawn tendrils yet to pierce the sky. I’m riding shotgun in the papers van with Nicholas, helping but not really helping him do deliveries in the tiny farm town of Scottville: population 2,000-ish. The white metal monstrosity with no back windows rattles as we come to each stop, Nicholas expertly flinging papers through the window. I feel vaguely uncomfortable for no discernable reason. I try to distract myself but the discomfort gnaws at me, incessant. Without me noticing, my breathing quickens.
We’re on the main highway now, heading into Ludington as my hands and feet begin to tingle. At a mere 20, I’ve never felt such a sensation before. All I want to do is ignore it but I can’t; I’m consumed by fear. Terrified, I tell Nick to drive me to the hospital – maybe I’m having a stroke? Whatever is happening to me, something is very wrong and I’m utterly convinced I’m going to die. My entire body is vibrating, the numbness deafening, gripping me in a sensation I will never forget. It’s as if every inch of me is static, black and white fighting on the TV screen in the middle of the night with the volume turned up so loud there’s no way to hear anything else. Nick slams on the gas as I start to sob and scream, desperately praying aloud to God to let me live. I’ve never been so petrified in my life.
When we arrived at the emergency department (bless Nicholas, tearing down US 10 at probably 90 miles an hour in that van), they take my vitals immediately. The vibration is lessening already but I’m still shaken, frightened, confused. My pulse is through the roof. They have me lay down and give me an Ativan. Just the act of lying down makes the static quiet considerably. My distraught state lacking any physical symptoms, they have me there for probably the shortest duration of any ER visit I’ve ever done. It is on this day that I am officially diagnosed with my very first panic attack.
Anxiety Attack vs. Panic Attack
Prior to this incident, I had experienced anxiety attacks before and did not think there was a tangible difference between an anxiety attack and a panic attack. Let me tell you folx – there absolutely is a difference between the two. They share a lot of the same symptoms like uncontrollable worrying, physical discomfort and even pain, and lots of chemicals like adrenaline and cortisol fucking up your day. The major difference is based on three specific dimensions: trigger, duration, and intensity.
An anxiety attack can last hours, ebb and flow while you distract yourself with other activities, and manifest itself via basically any physical sensation your body is capable of conjuring. A panic attack, however, tends to max out at 15 minutes and is most commonly associated with increased respiration, heart beat, blood pressure, and everything that comes with that including chest pain, shortness of breath, and everyone’s favorite: sense of impending doom. You may be thinking to yourself, “I’ve definitely had a panic attack longer than 15 minutes,” and honestly I’m right there with you. According to all that I’ve read, however, this is actually a series a panic attacks occuring one after another. The cycle continues because our feedback loop is broken – whereas someone like Nicholas might get suddenly flooded by adrenaline and go, “huh, that’s weird,” and have all the uncomfortable side effects fade away in 10 to 15 minutes, people like me instead think, “aw shit, here we go again,” and keep feeding the panic beast.
As for the trigger? An anxiety attack is caused by Something. For example, me writing all this makes me anxious. A panic attack comes out of absolutely nowhere. The majority of my panic attacks have hit me while I was watching TV, playing a video game, or otherwise relaxing. My mom used to ask me, “What do you think triggered it?” and I would get so frustrated with myself because I didn’t know. Now that I’m a bit better versed in the topic, I know that there are people who literally wake up out of a dead sleep having a panic attack. This has only happened to me once but holy fuck is it disorienting. Panic doesn’t care how relaxed you are, it’s just here to fuck you up.
The Big Long List of Symptoms
When it comes to the sensations we experience during an anxiety attack or panic attack, the truth is that you can feel pretty much anything with either. While some symptoms are more prone to a panic attack rather than an anxiety attack, it’s absolutely not unheard of for a person having an anxiety attack to feel chest pain or throat tightness. This is not a scientific list by any means; instead, here are the following symptoms that I’ve experienced during an anxiety or panic attack:
- Shortness of breath
- Chest tightness
- Muscle spasms
- Chest pain and pressure
- Numbness and tingling literally anywhere and everywhere
- Air hunger
- Throat tightness
- Difficulty swallowing
- Difficulty concentrating
- Fear that I’m dying
- Chills and shivering so uncontrollable not even a hot bath stopped them
- Diarrhea (I call this one “anxiety shits” bc I get them almost every time)
- Jitteriness or feeling “on edge”
- Restlessness, insomnia
- Abdominal pain
I could probably come up with more if I sat and thought about it long enough. Like I said earlier, whatever your brain is capable of conjuring, you are capable of feeling during an attack.
For almost a decade now, I’ve ran the gamut of symptoms. It’s made me wonder if I have asthma, heart disease, autoimmune disorders, and everything in between. Health anxiety is a particularly strong fixation of mine. It’s usually detrimental. Unfortunately however, my worrying has been reinforced as I discover health issues I have that no doctor seems interested in testing or treating me for unless I press them (hypothyroidism, hypertension, deviated septum and inflamed turbinates). They’re much more content to write it off as my anxiety. Right now I’ve more or less demanded a test for Cushing’s Syndrome as I’ve reached a really interesting point in my panic attacks where they lack the racing thoughts and instead my inner monologue is really just tired and bored. After so much cognitive behavioral therapy (CBT) and meditation, I’m pretty good now at detaching from the situation and looking at things objectively – so while my body is trembling uncontrollably, my stomach in knots, my bowels ready to let go, I’m making myself take deep breaths and mostly thinking, “This again?” Even now, I have some low level anxiety symptoms that I’m simply ignoring because, what else can I possibly do?
Taking Control Of Panic
I stopped asking “why is this happening?” and started asking “how do I make myself feel better right now?” when I’m in the midst of a panic attack or on the precipice of one. If you suffer from panic attacks, this is the one thing I hope you retain and take away from this post because it’s truly the most helpful thing I’ve ever learned to do. This crucial shift in thinking is what has enabled me to lower the amount of full blown attacks I have more than any benzo. I still ask “why?” later; maybe I should give it up altogether but I’ve had to be an advocate for my own health when far too many doctors were perfectly content to write off my non-mental health issues as simply anxiety (see above). Instead I just designate “worry time”, when I do a lot of Googling and whatever and once the half hour is up, I’m done researching. There’s another good tip: stop Googling your symptoms while you’re panicking. Try to trust your body and that if you were truly dying, you would know it. Easier said than done, I know.
One of the most important things to accept is that you really don’t have any control over when or why panic happens. Another easier said than done tip and truth be told, I’m still working on it myself. It’s easy to get frustrated with yourself because you had plans to do X, Y, and Z today but you lost hours to trying to fight off panic, panicking anyway, and recovering from said panic. Try to be patient with yourself like you would be with a close friend if the same thing happened to them. If I’m really honest, part of the reason I have no interest in working is because my panic disorder has made my ability to manage a proper eight hour shift five days a week almost impossible. I almost deleted that I’m so embarrassed by it. Fucking capitalism. I feel guilty for trying to work through what I pray is really the last mental health disorder I need to untangle.
There’s really no such thing as a “cure” for mental health disorders however I have more or less successfully found a state of remission with both my borderline personality disorder (bpd) and depression. I hope to find a similar equilibrium with my anxiety and panic. While I’ll likely spend the rest of my life having to rewire neural pathways and correct cognitive distortions, it’d be really wonderful to have my final panic attack and live the rest of my life without them. Either way, I’ll still be alive and that’s what really matters at the end. A life with a disabling mental disorder or other chronic condition is still a life worth living.
With the current state of the world, it’s kind of unsurprising that I’ve been so anxious. A pandemic is pretty much a hypochondriac’s worst nightmare. I’m fortunate that my particular brand of health anxiety is less fixated on infectious diseases as it is on chronic health conditions. Being considered a more “at risk” population due to my hypertension makes me vaguely nervous, especially considering my aptitude for catching ridiculous shit like German measles and meningitis, but I’ve found the answer to be turning off the news and focusing on self care more than ever. There’s nothing wrong with that. I hope you do the same and try to be gentle with yourself. Nothing lasts forever so spend the time you have on this earth loving instead of fearing whenever your brain will let you.