I am 17, 18 when someone tells me I am having a panic attack.
I am sitting in my therapists office and I start to hyperventilate and my heart is thumping and I think I am going to die.
I think the thing with panic attacks is that in movies they are dramatic, over the top; actors doubled over, gasping for air, clutching their chest- a heart attack or respiratory failure is imminent. An ambulance is called, maybe they are given CPR. So I am surprised to hear the term applied to me, but it makes sense. As it turns out, I have them a lot.
I’d assumed that panic attacks were heart attacks lite, but my therapist explained that in addition/instead of making you feel like you were having a heart attack, they could make you feel like you were losing control or that you were going to die- the beliefs that characterised my attacks when I first began to suffer form them. One I was aware of this, I could see that I experienced them every night- often more than once.
For the first few years of my illness, the panic attacks were triggered broadly by my ‘mood’. Anxiety and depression were welded together, indistinguishable, each feeding into the other. So there was no single incident per se, just a melting pot of different things, simply being, feeling, overwhelmed. And each night once I started thinking about one of those things, the rest would inevitably snowball together and what had started out as a concern over finding the time to study for my religion class test would transform into a full blown existential crisis, a conviction that I was losing my mind, really going crazy, that death was the only possible end point for all this; and I would be left exhausted, curled up in a ball, face pressed against the cool tiles of the bathroom floor, lying in a pool of tears and snot. Sometimes I would pace the room, snapping my fingers, or sit doubled over squeezing myself tight, trying to rid the physical ache just below my ribs, or scribble angry, frantic words onto a page, gasping for air, nose stuffed, unable to hear from crying too hard.
Time stretches when you’re having a panic attack; seconds feel like years, thoughts race, screeching in your ear; the voice in your head thundering at decibels so loud your ears ring shrill; you can hear the backdrop of your pulse thump thump thumping, afraid the blood is going to come pumping out of your ears; chest tightens, an engulfing ache at the pit of your stomach or your heart squeezed tight in a vice; body vibrating, folding in on yourself, clutching your limbs tight against your chest, physically trying to Hold It Together. And when it’s over, when the panic peaks and falls, and eventually, passes, everything is dead and eerie quiet. And you notice that the clock is still tick, ticking, that your parents are still sleeping soundly in the room across the hall, that your room looks the same, everything still in its place; that you were not, in fact, swallowed whole by the ache in your chest.
Panic attacks, you see, feel like violent storms, a swirling vortex, a tornado spinning out of control. I am always surprised when I emerge from the abyss that everything around me is still in tact, that no one heard, or came charging into my room to see what all the commotion was about. They feel like large, violent storms, everything swept away by a shrill noise, a deafening howl in your head, but quite often, they are completely silent. Quite often, the tears are streaming down my face, my mouth wide open, wincing in agony, but I emit not a single sound.
When I moved to university, the anxiety seemed to get worse- I was open to a whole new world of possibility- and a whole new host of things I could get anxious about. The panic attacks become less often triggered by my mood and more by, well, anxiety. Public transport is a huge trigger. Lecture halls and tutorials another. Living with flatmates. I get on well with them, enjoy living with them, but some days I am gripped by irrational fear and instead camp out in my room until I hear the voices quieten down and bedroom doors shut behind them before I emerge. The city centre triggers me. Bridges and tourists and busy shops and heaving streets and dodgy alleyways to the bus depot. I develop intense, irrational fears of being raped, or mugged, or attacked; I sit frigid on the bus, daring not to move, power walk down the streets, legs burning, jumping out of my skin any time someone walks behind me, or past me. And so I sit in lectures or tutorials, or in my bedroom or on the sofas with my flatmates or on the bus or hurry down the street, bag clutched tight to my chest and I am panicking and I am trying not to cry, not to die, not to lose control, trying to keep composure. And sometimes I will have to lean against a shop window, hunkering down on my knees to stop myself from fainting, or will stand quietly in the corner of a busy hall while everyone introduces themselves so I can try regulate my breathing, or I will slip into a dark lecture theatre so no one will see the tears pricking in my eye; and the panic attacks are happening and noise is rushing through my ears and my heart is going to rip through my chest and my legs are so wobbly that I feel I am walking for the first time and I am twisting my scarf around my finger and I learn that what happens in movies- with the hyperventilating and the collapsing on the ground clutching your chest and the ambulance showing up to cart you off to hospital for CPR is not really an accurate depiction of a panic attack because day in, day out I am having them and I am standing at the edge of the room and no one knows I am there because I am having a panic attack, they just think I am a girl standing at the edge of the room, and they do not know that I am losing my mind, that I am having a heart attack, that I am going to die, that you don’t have to look like your pulse is thumping at 130bpm or your heart is ripping through your chest or you are hyperventilating for it to still be true. And that realisation terrifies me- because I am struggling, really fucking struggling…I am having a panic attack and no one can tell, and truthfully, I doubt anyone would believe me if I told them.
Chest pains are part in parcel with panic attacks, but towards the end of Summer 2013, chest pains arrive and they don’t leave. For weeks. When no peak and fall of anxiety occurs, I become convinced I must really be having a heart attack this time. The chest pains are crippling, incessant; simply, my heart feels like it is trapped in a vice, that someone is cranking it tighter and tighter, or is stabbing me in the chest. After a few weeks of increasing conviction that I am Seriously Unwell, I arrive home one weekend, book an out of hours GP appointment, am put through a battery of tests and told simply at the end, I am ‘just’ anxious. I am given a weeks supply of diazepam and sent home. By the end of the week, the chest pains are no more. Problem solved.
Except it’s not. Since then, I’ve been plagued with these reoccurring bouts of anxiety- for a few weeks, perhaps more than a month at a time- each day waking up feeling my heart in a vice. Instead of the usual gradual, then sudden stab of the chest, the 10, 15, 20 minutes of excruciating pain, unwarranted panic, racing thoughts, that peaks then subsides, I suffer from a cruel twist- weeks of build up, dreaded anticipation, bubbling yet never quite boiling over, not quite as intense or draining as a full blown attack, but more relentlessly enduring. Occasionally, of course, things do bubble over, sometimes with a small trigger, sometimes, it’s completely random.
At work I have silent panic attacks at the tills. One day, I can feel one coming on and each time I turn to ask my supervisor if I can run upstairs for a glass of water, another customer drops an overflowing basket on my till. After over an hour, I am positively hopping, the vice around my heart cranking tighter each minute I remain on the shop floor. Another day, after a particularly horrific two weeks of chest pains, rock bottom mood and a visit to the MH Duty Officer who asks if I want to be admitted to the ward (which I don’t), I know that I simply cannot be there any longer and tell my manager I am having chest pains. I am sent home, my work colleagues wondering the next day how I made such a speedy ‘recovery’. At my back to work interview, I shamefacedly admit to my manager that I have anxiety, aware that my manager is more than likely rolling his thinking ‘seriously?’
For a couple of months there is nothing; I am busy smiling at customers, asking them for their signatures just here, handing them the pen with a flourish. It is the weekend and I am feeling glorious and I am, as of today, one year out of hospital! Hurrah! I am making phone calls to other stores, and answering unknown number calls and making announcements over the tannoy and I am chirping away to my colleagues and I am that nicely buzzed, highly productive kind of hypomanic. And then suddenly there are chest pains and after an hour or so I think ‘ok, nope, these aren’t subsiding’ so I decide I will ask my supervisor if I can pop upstairs but suddenly there are customers and the customers do not stop coming and every time I spin round there is another one there, and really, it has only been about fifteen minutes since I decided I would ask to go upstairs, but I begin to get frantic and then finally the customers stop and I ask if I can go and take one of my tablets and I am told of course, but I’ll have to call someone over to cover for me, and she is taking an age to come and a customer comes over to ask about something and I hang back because I cannot hear what she is saying because I am dizzy and I let the supervisor answer her question and I am starting to get really shaky and my heart is beginning to tear through my chest and everything starts to speed up and I am sucked into my head and everything is spinningspinning and I am in the little office at the back of the desk trying to Focus On My Breathing and I mutter ‘oh fuck oh shit oh jesus‘ and I walk in a little circle and my pulse is deafening in my ear and I am going to cry I am going to cry I am going to burst into tears I want to scream, to tell the customer she needs to LEAVE because I CAN’T DO THIS and I AM HAVING A FUCKING HEART ATTACK AND I AM TRYING NOT TO BLOODY CRY and eventually my cover arrives and the customer leaves and I ask my supervisor if it is ok if I stay upstairs for five minutes because Iamhavingapanicattack and she says of course go go and I burst through the door and race towards the stairs begging, pleading for no one to stop and ask me a question because I will, I really will cry then, and one of my colleagues calls me back and she is walking s o v e r y s l o w l y and I am marching on but she is talking and I am thinking ohgodohgodpleasestop and finally I am through the staff door and charging up the stairs and I tear open my locker and swallow a buspirone, then another for good measure and I pour a glass of water that is too warm, then another, and I sit and jig my leg and try to b r e a t h and then it hits and I feel stupid, I feel pathetic, I feel like an attention seeker. So I wash my glass and pee and then I head back downstairs and I am still trying to slow my breathing, am folding my arms tight against my chest because I feel small and my hands still shake and my legs still feel wobbly and the knife in my heart is still being twisted, my chest still being stabbed and I wobble wobble like jelly back down the stairs, mortified, simply m o r t i f i e d that I TOLD AN ACTUAL PERSON OUT LOUD that I was having a panic attack. And I am back on the shop floor even though it is very much the last place I need or want to be and I still cannot breathe because I am being Ridiculous, Stupid, Idiotic and as I get nearer to the desk I hear my supervisor call me back and she asks, voice hushed, if I am ok, says so long as I’m ok, that I should have told her and I feel tiny and embarrassed and pathetic. And my cover looks at me and asks me if I am ok and I do what I do best and grin and say ‘yeah I’m grand’.
I spend the rest of the shift putting things back onto the shop floor and I rifle through baskets and I think I want to die. And it is the first suicidal thought that has crossed my mind in months and it scares me that anxiety can make me feel That Bad, and it upsets me that it was so out of the blue, and it leaves me feeling shaken, very shaken, exhausted, the way is always does. And again I am aware that the world is still ticking over, that The Worst didn’t happen, that everyone, bar my supervisor, is unaware that anything was so very wrong in the first place, that I am the only one affected by the swirling storm that just tore through my head. And the chest pains don’t subside and my eyes begin to droop and I learn that double my buspirone dose Will Not Make It Stop any sooner. And I get home, and 5, 6 hours after it has happened my heart is still tachy and my body still shaky and my psyche still wobbly, and I vow that on Monday, I will start bringing my diazepam to work. Just incase.
And I am drained. Because panic attacks are fucking draining. And they are like long running sentences with no punctation, with one thought just bleeding into the next and the next, into one loud crescendo. Then nothing.