Sunday, January 31, 2010

Panic (An Epilogue)

The question I've heard, more than any other since my book was published is "How'd you get over your panic disorder?"  And I will attempt here to answer.

Before I answer, a disclaimer: I will never write a self-improvement book or spiritual book for the following reasons.  1. I am not one to dole out advice on "how to" get over panic or anxiety because I am not wholly sure that I really "got over" mine.  Perhaps it just ran it's course, after all.  Or, perhaps it was a combination of things that I do not have the formula for.  2. Everyone is different.  3. Who knows, it might come back.

OK, so now that that's out of the way...  No, I have not suffered from Panic Disorder since the summer of 2003.  I almost brought a panic attack on, however, when I wrote that opening scene of Musical Chairs because I meditated on that day for hours, trying to remember exactly what it was like so that I could recapture the fear, and in a small way, the sensations did come back.

Because I open with this scene and then close with a loose sort of resolution, which covered more than panic, but an entire lifestyle shift, I will take this opportunity to explain my prescription for coping with the attacks while they lasted.  No, it wasn't anti-depressants or anti-anxiety medication that did it.

I began with a bunch of false starts with various psychoanalysts.  I've said this often, but it's worth repeating: finding a good psychoanalyst is like finding your significant other.  It's magical when it happens, but there are a lot of people who just fall short of establishing that perfect balance, that perfect rapport.  Besides, many psychoanalysts are a touch insane (there's a reason people like myself were drawn to study the subject, after all).

I found a therapist I didn't like, but who knew his shit.  He was a cognitive therapist, and although I did not get better under his care, I credit him with giving me the tools I needed to cope with panic.

A panic disorder begins with a quickening of the heart rate and a sort of change in vision or perception of the scene around you.  Things become magnified or the pace and rhythm of the world is quickened, and it's because sensory perception is off--suddenly the person suffering is in fight or flight mode, and yet in daily life, such as a work setting or driving down the road, this can be perceived as the body's failing in some way, and often the thought is that the person is dying.  This thought will then quicken the heart rate and breathing further and proceed to freak the person out even more, until the attack peaks.  Most attacks last for 10-20 minutes at most, but this time span does not make the experience any more bearable.  Logic, as far as I remember, goes out the window, and the last thing a person thinks is "Oh, not to worry, this will be over soon."  Instead, she thinks "The doctor is wrong, I know my body, I'm going to die." And hence, the panic continues.

So logic does not cure panic.  In panic, there is no room for it.  What there is room for, and this is a technique that the aforementioned doctor recommended to me, is repetition.  The repetition of anxiety is inevitable, and to counter-act these thoughts of doom and demise, a person must be armed with a sort of equally repetitive script.  Mine went as follows: "I am in control of my own thoughts.  I am not worried.  I am in control of my own thoughts.  I am not worried...."

Seems overly simple, right?  Well, that, it was explained to me, is the key.  A person must come up with one or two lines to always repeat to his or herself when the panic begins.  So, when I would begin to feel a chill and the racing of my heart, I would begin repeating this mantra Ad nauseam, until the attack was over.  This didn't work the first time, but after the third or fourth time, I began to recite the mantra, almost in a chant, and it slowly began to be something that came as quickly as the panic had, a programmed response.

I also repeated anti-worry mantras at bedtime and during the day, when I remembered, thinking this would be a way to prevent future attacks.  It was my personal meditation and chant, and I think it was incredibly important that it was short and easy to remember.

The other thing I did was reduce the amount of caffeine in my diet.  This was a prescribed lifestyle change that I have since turned my back on, but at the time I think it really did help.  I merely replaced my lattes with decaf lattes (which still have caffeine in them, especially if you are used to Starbucks or Dunkin' Donuts) and then, eventually, to black and green tea only.

Finally, I wrote about it.  Every time I had an attack, I would get out my notebook and jot down the sensations, as soon as I could.  This put them in perspective, and helped me to know what to expect when another attack came on.

So again, this is only what worked for me.  I would like to credit therapy, but the truth of the matter was that I began with so many therapists and only continued seeing most of them for a handful of sessions that I'm not sure that I was a model patient.  I did get a bunch of helpful information in these sessions, however.  I also did my research online and found chat rooms for those with severe anxiety, conversations in which I never partook, but I always found solace in hearing others' similar experiences.  So here's mine.


  1. Just as you "...found solace in hearing others' similar experiences," you are offering the same. This blog and your book are examples of very honest and open writing. To use a clishe, you are "paying it forward." Perhaps you don't feel that's self-improvement or spiritual, but it is certainly an amazing gift.

  2. It may sound "overly simple" but you are right! The approach you describe (or something similar) seems to work best. Good to hear you got past the panic attacks. Your memoir sounds fascinating. (First read this on Red Room.)

    All best,
    Blair Kilpatrick (a psychologist and writer)


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