Many people have been asking, "What is it with you and these panic attacks?" So here's my story...
I had my first panic attack when I was 22. I had the typical symptoms – racing heartbeat, chest pain and pressure, trouble breathing, lightheadedness, nausea, tingling in my hands. Because cardiovascular disease runs in my family, I thought I might be having a heart attack. I had blood tests done, which showed nothing unusual. I also had an echocardiogram done – given the family history of heart problems, and given that in women, panic attack symptoms are almost identical to heart attack symptoms, the doctor wanted to rule out that I'd not had a heart attack. The echo was normal as well.
Life was stressful when I first started having panic attacks. I was just out of college and hadn't found a job yet, my parents announced that they were separating and would probably get divorced, and that put pressure on me to want to move out. So it's not a big stretch to say I had enough stress to trigger a panic attack. Later on, I found out that several people in my family have had panic attacks, so I have a predisposition to them as well.
I was put on a series of meds, mainly SSRIs, and referred to a psychotherapist. I experienced severe side effects from the meds, even on the lowest doses. One gave me headaches, one made me dizzy, one made me feel as if I had a fever all the time, one made me lethargic. It felt like trading one illness for another. I have been off and on meds as a result.
I have to admit I'm a little indifferent to psychotherapy. One reason is that it's crucial to find a therapist you click with, and given how restrictive health insurance is, this is a huge challenge. I find it more "therapeutic" to talk to people I do click with (and who don't even charge a co-pay): my mom, my sister, my friends, my acupuncturist. Another reason is that I think I'm pretty much "talked out." I know what my triggers are, I know I have a worry type of personality, I know I'm an introvert and internalize a lot of things. I don't find going over these things again and again every time I panic overly helpful. In other words, I've been through the discovery phase of this disorder, and now I'm in the management phase. Oddly, though, I've yet to be referred to a cognitive behavioral therapist, and that is a treatment I would like to learn more about. I've also recently heard about eye movement desensitization and reprocessing, which sounds intriguing.
Most of what I know about panic disorder is from what I've read on my own. The doctors and psychotherapists weren't exactly forthcoming with information. I was simply told that I was panicking when I didn't need to be, probably because of stress, and that meds and talking would make them go away. Although that's true, it's more complex than that. On my own, I discovered that poor diet, mineral deficiencies, lack of exercise, side effects of medication, and certain physical conditions such as hypoglycemia, hyperthyroidism, and mitral valve prolapse can also contribute to panic disorder.
My panic attacks usually occur at night when I'm falling asleep. In fact, I've woken up out of sound sleep because of them. Nocturnal panic attacks often occur in the transition from lighter sleep to deeper sleep. Not much else is known about them beyond that, let alone how to treat them. Consequently, I'm a light sleeper these days. It's a vicious cycle really – panic at night, which leads to sleep deprivation, which means being less functional and healthy during the day, which can cause worry that another attack will occur the next night, which leads to anticipatory anxiety, which can tip right into another nighttime panic attack.
In addition, my attacks seem to have active and remission phases. I can go for months without any attacks, and then suddenly, they appear again. They usually follow a long bout of stressful situations. For example, this summer, I was laid off from work, was unemployed for a month and a half, found a new job, had to put my dog down two days before starting the new job, was in a minor car accident, started a grad school program, and the air conditioner in my condo quit working. All of this happened in the span of a couple of months, and eventually, it was going to catch up with me in the form of panic, which it has in the last few weeks.
Although my panic attacks are uncomfortable and scary, they are less scary than they were when I first had them because I now know what they are, and I can usually pinpoint the stresses that may have triggered them. Knowledge truly is power.
The most important piece of knowledge that I have gained is to take care of myself. There is such a thing as a good kind of selfish. When you look after yourself well, you are better able to look after others. Conversely, when you have depleted your own energy and reserves, you have nothing you can give to others. This is a difficult lesson to learn, and I am still learning it. I am not perfect – I don't exercise as often as I should, I don't eat as well as I should, I put off doing things that I enjoy doing in favor of things I "have" to do, I isolate myself too often. I slip up more times that I care to count, and I pay for it with panic. I see panic as my body's way of saying, "Oy! I'm fed up with being neglected, and this is what I have to do to get your attention and get you to do something about it!" Fair enough.
Although I think meds are helpful despite their side effects, I don't think they're the only solution. I have tried some other things as well, such as yoga, supplements, and acupuncture. In my experience, these are good additions to medication, and can even help to offset some of the side effects of medication.
Currently, I'm on Lexapro, I'm getting acupuncture once a week, I try to get out into the sunshine at least 20 minutes a day, or sit in front of a full-spectrum light when the weather isn't cooperating, I'm taking fish oil and calcium supplements (on the advice of my acupuncturist because they not only enhance the efficacy of SSRIs, but they also should be taken when you're trying to get off SSRIs and are dealing with the withdrawal symptoms), and I've upped my dose of B complex. I'm also eating better, cutting back down on caffeine and sugar (which can trigger panic attacks), walking every day, and getting to bed earlier, which consequently means I'm up earlier and actually getting to work on time for a change. This latest round of attacks seems to have subsided, and I'm feeling human again, thank heaven.
So that's my sordid sob story for those who wanted to know.
