Last Sunday, the last day of my thirties, I sat on a Yeti cooler in the shade, the first portion of the Thunderdome torn down and a smaller crew disassembling the rigging, when my worst panic attack to date began its stirrings. Thunderdome means being surrounded with friends, and one of them kindly saw what was happening (I wasn’t responding with my normal energy) and discreetly brought me back to camp and sat with me, quietly. I do enjoy making a scene, but only onstage. I packed up my things between heart palpitations, numb or tingling hands and feet, some chest pains. It felt better to move, so I packed and kept moving. I took half a Xanax, knowing I’d need to drive later, and washed it down with water that yielded a fantastic, new-to-me symptom; my entire tongue shriveling against the sensation of touching it to a 9-volt battery. I jumped back, certain my water bottle had fallen into something, or that I was the victim of foul play. My game friends tasted the water and remarked that it was fine. I left early, a thing I never do when there’s work to be done, and drove myself to town. In the parking lot of the gas station, it became apparent I couldn’t drive. The chest pains were not ceasing, I was too dizzy to stand, and shadows were creeping in around the corners of my eyes. For the first time, I called 911 for myself. For the first time, I took an ambulance ride to a hospital because the EMT couldn’t verify I *wasn’t* having a heart attack.

So, the last day of my 39th year, I got an EKG, and a confirmation that I wasn’t having a heart attack, and multiple admonitions to take it easier.

Because this is the first time this has happened around a large group of people, I think many people were surprised. I was mostly calm. I was completely rational. And this, to most people, is not how they picture “panic attack”. They picture irrationality, hyperventilation, crazy talk.

So here is my FAQ. Yours may vary. There are many like it, but this one is mine.

1) What’s the trigger for it?
There is no exact trigger. I like to keep my life pretty full. My day job, Thunderome, and performing are all things I enjoy a great deal. Sometimes, this means that I am processing many things at a time. It helps to think of it as a computer. If you have something taking up a lot of background memory, other things will start to run more slowly. It doesn’t mean that anything stops functioning altogether, it just means that the normal tasks that you do are being compromised by the larger processes you’re trying to run. Sometimes, when there are too many background processes running, one of the applications, or the entire system, crashes. To the impartial observer, it looks like “Well, she was only actively running ‘sit on couch and relax’, so this makes no sense.” Think a bit less as a trigger, and more as a buildup. Oftentimes, panic attacks hit when I finally have a chance to sit and relax, as though my performer mind has spent all of this time suppressing stress and, when it knows I am finally in a safe place, opens the floodgates.

2) What can I do to help?
You can ask that question. That right there is fantastic. Please don’t ask the question “what triggered it”. My answer is usually “having panic disorder triggers panic attacks.” 🙂 Do ask “do you want me to get your medication?” I’ll be able to answer that.

3) Do you want a hug/backrub?
This may not be the case for everyone with panic disorder, but for me please don’t initiate physical contact. Because this is a medical, not emotional, condition, but one which can appear emotional, I understand the confusion and need to comfort. I appreciate it, and it makes me feel guilty for not wanting to receive the proffered kindness. Then, we hug, and I feel even more panicky. Additionally, engaging in conversation exacerbates it; it’s another social construct that places additional pressure to interact. As with most things about my world, I say what I mean. When I say I prefer to be left alone, I am not trying not to be a bother; I need to be alone.

4) Can you take medication?
Yes, but not if I need to drive anywhere or work. Also, they’re a bit like earthquake; it’s hard to tell how bad it’s going to be, and I wouldn’t want to debilitate myself for the remainder of the day by taking a medication if it’s going to be a small episode. A difficulty is remembering to think halfway through the panic to take the medication once you realize it is a big one.

5) What comes first? The feelings of dread, or the physical symptoms?
I’ve gotten the question a few times, and I love it. For me, the visible symptoms come first, usually when I am relaxed, as I said in number one. So, my hands and feet will start tingling, I will start to get tunnel vision and dizziness, or shortness of breath, sometimes with pressure in my chest. My speech may slur, and I may be unable to form sentences. It could be one or any number of these things. Then, of course the giant brain goes to work. Not that my brain is particularly more giant than anyone else’s, but we are soft, living, breathing, problem-solving things. So, the brain immediately tries to solve the problem. When the brain looks at this list, it does not immediately think “panic”. That’s a big part of the problem, that once the conscious mind starts working on this issue, it becomes a downward spiral of “sure, you know you have panic disorder, but these symptoms are EXACTLY THE SAME as the female heart attack!” Even doctors can’t say, which is why the rule is; take medication and, if you don’t feel better, get checked.

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6) What are you going to do about it?
Working on it. I spent the first moments of my 40s using an app I’d helped to develop to remove the appearance of the EKG tape remnants in the selfie I took of the amazing birthday gift I received from my husband. The irony is not lost on me. If you know me, you know two things (and probably more) – I do not sit and bitch without taking action when there is action to be taken (in fact, a look at my facebook feed would suggest that my life doesn’t have too many hiccups – that’s a deliberate construct, of course), and I hate. Hate. Hate. Down-time. So I must schedule in down-time, and schedule in time away, or it won’t happen. Again. Working on it. I don’t find going out for drinks or sitting in a bar relaxing; the opposite, in fact, and so I must navigate carefully my “down-time”, in the form of hikes, reading, and simply sitting with tea.

Thanks for reading. I appreciate the time, and the non-judgment. Thanks for not thinking of me as fragile and coddling me. I find that intolerable, and it’s being capable that’s gotten me into this. There’s nothing about my life right now I don’t enjoy – no wasted time, no unenjoyable activities, no pointless drama. So now that my life is full of wonderful things, I have the task of managing the time and energy spent on them. It’s a good, a delightful, problem. I look forward to working on it… during hikes and with tea.

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History; my original post on panic, for reference.