Anatomy of a Panic Attack

Thursday, May 11, 2023

This is a story about a panic attack that threw a top-level, high-performing, rock-solid leader for a loop. For decades she’d been the person -- at work and home alike – everyone turned to for steadiness, for staying power, for perspective, for answers. I will confess, calling my sister is often the first wild thought that comes to mind when trouble of almost any sort breaks out. And so it was strange and disorienting to see her almost dis-assemble a few months ago when she was in Maine for a visit to see my mother who was very ill. (She has since recovered.)
[SHORT READ: This is a lengthier story because my intent is to take readers through the rise of a panic attack and the discovery process my sister went through to locate the right technique that opened the door to recovered stability. Bottom line? When you find the right technique, it will serve you well.]
Coming to visit had been a very difficult call because Amy herself had been quite sick. When double tests for Covid, flu and RSV came back negative and at the encouragement of her doctor who knew this might be the last visit Amy would have with Mom, Amy came to Maine. Nothing unexpected happened the first day of the visit; Amy was well-dosed and reasonably comfortable though not eating much. By the second day, though, she started feeling quite jittery while having a cup of coffee and started to suspect her body was getting overloaded with medication. She began cutting back. The following day, her last one in Maine, Amy was off all medicine, getting by with only some cough drops. Late in the afternoon she tried to join the rest of us with a small pour of pre-dinner wine which is when the real trouble started. She began feeling very unlike herself in the head which was bewildering and frightening; not being in command of her mind is very unfamiliar ground for Amy.
We sat down for dinner a short while later but five minutes in Amy interrupted the conversation to say she wasn’t feeling right and needed to pace around a bit. A few minutes later I found her in the living room on the couch with her knees drawn up like she was trying to hold herself together. I sat down on the couch next to her.
“I feel like I’m coming out of my skin,” she said. I nodded my head. I know what that’s like.
We spent the next hour talking about the difference between panic and anxiety and what to do with yourself when it happens. We did four-square breathing which helped a little. I wrote out a visualization I do every morning which I find very grounding. Amy read it but I could see it didn’t really connect. Amy considered hopping on the Peloton for a slow bike ride as a gentle way to release some energy, but it didn’t feel quite right.
With no real success in finding a solid workable technique we shifted to trying to figure out what was going on to see if that gave us anything to work with. Amy’s hypothesis was the episode had been triggered by a sensitivity to the cold medicine, in turn triggering a sensitivity to coffee, and then to wine and possibly the high sodium content of the sushi she was trying to eat when the panic became overwhelming.
All of that may be entirely true, I said, but I also knew there is a non-rational but nonetheless very influential part of the mind that can get so on board with that line of conclusive thinking it will start to manufacture symptoms to go along with the suspicions. I reminded Amy of the time I’d gotten it into my head that the lowest dose of a thyroid medication I’d been on was the cause of my intense agitation after the very premature birth of a grandchild. By then Leo was home and well so this intensely hyped-up state couldn’t be about Leo I reasoned. I was positive the medication was the problem, so I’d taken to cutting the dose in half and then half again and again, trying to find the exact microgram my sensitive body would tolerate. It wasn’t until a trusted doctor listened very, very empathetically for quite a while before telling me the dose of medication I was on was essentially homeopathic. In an instant I understood this crumb of levothyroxine wasn’t the source of my panic and took the full 25 mcg the next day with no effect whatsoever. (And then got myself to therapy to deal with the trauma of Leo’s birth.)
Hearing this story instantly clarified something for Amy which led us to the right technique for the mind. In combination with slow, deep, controlled breathing and getting grounded in your body, there is nothing like the power of a simple but clarifying mantra for managing racing, unproven thoughts. I threw out some possible options: “It will be alright.” “I am okay.” “I can breathe through this.” “My feet are on the ground.” “I am safe and secure.” “This is temporary.” “I am right here, right now.”
Bingo. “I am right here, right now,” is the one that resonated with Amy and the one that took her all the way home. As she traveled back to Minnesota the next day, every time a flare of anxiety rose up, she disallowed it from fully taking purchase by breathing, repeating I am right here, right now and clasping her hands together and rolling her thumbs as a way to stay in her body and maintain her solid place in time and space. Before taking a sip of coffee or a bite of salty food she told herself, This is not about coffee. This is not about sodium. She uses these techniques to this day when a random whisp of anxiety remembers the neural network that established a little path in her brain a few months ago. And now she moves through the world with a deeper understanding of herself and the fluid ways of the mind.
To a brave and glorious new day of self-understanding,
Afterward: The intent of this story is to illustrate the fluid nature of mental health, how it isn’t something only one sort of person has to manage, how an over-stressed mind isn’t a character weakness, that there are a range of techniques for responding to panic and anxiety, and that maintaining and protecting good mental health is like brushing your teeth: it’s just what you do as a whole human, being healthy. 
NOTE: Not all panic attacks are readily associated with external factors like Amy’s but finding the right technique/s is empowering and applies to all.

ALSO NOTE: Also the symptoms of a panic attack can mirror other conditions such as a heart attack so seek medical care as needed. Don’t automatically assume panic.

AND THE LAST AND FINAL NOTE: Never forget that all employees have free access to Work Force EAP when you need support. Just call 1 – 800 – 769 – 9819.