PARADOXICAL

The faith chronicles

Saturday, November 03, 2012

 

My experience of panic attacks


For years, I didn’t know that I had been besieged by a low level form of anxiety. I had been anxious of so many things in life. Most people are anxious of a lot of things, but I didn’t know that my anxiety was of the neurotic sort – it was coming from a deep conflict, which made my fears excessive compared to the perceived threat, making those fears irrational.

Because I refused to deal with my fears, I paid the high price – the fears developed into full-blown panic attacks and phobias. I avoided these issues for the longest time by medicating the pains I was unconscious of, through various compulsions/addictions (caretaking, oversharing, being the goody two-shoes, etc.). I thought, wrongly, that if I resorted to these ‘drugs,’ I would be okay. While I succeeded in curing my anxieties on the surface, I also succeeded in not facing the root causes of these anxieties. Thus I went through a long vicious cycle of fear and medicating that fear. Meanwhile these fears, left unaddressed, continued to be bottled up until they became explosive and unmanageable, and I was forced to confront them. It’s strange but I have to thank my going through panic attacks because it finally revealed what had been bugging me for years.

***

Most people don’t know what panic attacks are all about. They think it is all about overacting on my part. Neither did I have any idea, so I was unable to explain myself. Could it be a withdrawal effect from anything? (But I had given up caffeine and sugar, for example, and yet I still got panicky.) Or could it be a medical side effect? (I have been taking the antihypertensive losartan for about two years, so who knows.) Is it a mineral or vitamin deficiency (magnesium deficiency allegedly cause palpitations)? Is it merely stress due to recent traumatic events (I just lost my job), fatiguing my adrenal glands, telomeres, or whatever? Is it due to a past trauma, unresolved issues in my childhood (I had tons)? Or horror of horrors: Is something wrong with my heart?

Even most doctors are not trained to handle it, always thinking their patient to have an underlying heart condition, which drives the poor patient to even more panic attacks. When they are not finding the patient’s report of symptoms ridiculous, they can’t help showing how their patience is strained during consultation. That’s at least my own experience of consulting various doctors in Manila: they mostly failed to recognize that the issue could be psychological. Could I blame them? Apparently not, for doctors are not psychologists.

It took a few incredulous friends for me to begin questioning myself about the heart palpitations I often complain about. JJ, in particular, was brash enough to suggest that I see a psychologist instead, although the mere thought offended me at the time. I thought, I might have issues, but I wasn’t about to go crazy yet. I closed myself to the possibility that the problem could have some psychiatric nature.

When other friends, one by one, began to voice out increasingly the same suspicions, a formidable wall of denial I had built up began to crumble. I should thank Z. for informing me that a mutual friend (name withheld) had or continues to have the same problem. Soon, two other people who had been similarly afflicted in the past came forward to tell me they recognized the symptoms I exhibited as the same symptoms they had while having panic attacks in the past.

What are these symptoms? It’s a veritable list of symptoms bound to rattle any doctor unfamiliar with them. Mine typically starts with palpitations triggered by what I presumed to be high blood sugar. Sugar rush, in other words. While it is true that high blood sugar is associated with feelings of being stressed, it turns out that it’s hidden anxiety that actually causes me palpitate for a duration of a few minutes to an hour (or more) before an attack. The real triggers I was unaware of were anything I perceived to be too horrible to contemplate: tragic news stories/movies/novels, losing my reputation as a good person, losing friends, losing my job and being penniless, losing the trust of my boss, losing any of my loved ones, catching a deadly sickness, growing old alone, being helpless, losing my physical health and mental faculties, and most of all, the thought of death and dying.

No matter which trigger, these palpitations always subside in about an hour, but in the several cases of a full-blown attack, these graduate to a host of accompanying symptoms:

dizziness
sudden, faint headaches
spike in blood pressure
random body aches and pains
paresthesia or tingling sensation in the extremities
numbness of arms and legs
chest pains
nausea
difficulty breathing
choking sensation
sweaty palms
profuse sweating
blurring of vision
mental confusion
racing thoughts
temporary memory gap
a thought/feeling of impending doom

Among those listed in medical/psychological literature, the only symptom I haven’t experienced is hallucination or seeing things that I know aren’t there.

This set of symptoms, I have learned, comes with other symptoms that show up when I am not having attacks: tinnitus and sensitivity to noise and loud sound, feeling jittery even without having drunk coffee, food allergies (I stay away from fish after I experienced itchiness in my lips one time), and feeling fatigued or stressed out.

The most terrorizing, so far, has been the thought that I might have a fatal heart disease. It used to be that I couldn’t contemplate the very idea. I guess it is a big improvement that I can now write it down. 

Needless to say, these bothersome symptoms debilitate me in unexpected ways. They result in complications or is it intensify preexisting conditions, particularly hypochondria (paranoia over being sick) and agoraphobia (morbid fear of going out of the house) in my case. This has humiliated me, for it renders me overly dependent on my housemates (my younger brothers) for my needs, particularly my day-to-day dietary needs (who will have to get out to buy what I need to cook and eat?).

There was a time I refused to get out of the house for three weeks straight after coming home feeling faint from a panic attack, then reaching home, palpitating for maybe an hour more.

Many people around me thought I was merely being difficult, and this saddened me immensely. In my moment of weakness, I wrote the following outburst in my online diary:

Saturday, November 03, 2012
Ill and misunderstood

No one understands me, not even those who are supposed to know. They think it's all in the mind. They think I'm just being lazy, that I just lack exercise. They think I'm just lacking in faith. This means they think I am weak and all my spiritual testimonies are just mental posturings -- all intellectualism. So be it. I didn't sign up for their approval, although it is something nice to have. What matters is what's between me and my God. Why would I invent this? No one likes this. I wish I could move around as freely as before, work and 'play' as hard as before. I don't enjoy being afraid. It's no joke when your heart thumps at a speed you've never ever experienced before. It's not funny when you feel faint, hoping you'll fall with dignity, your sense of control intact, hoping there's at least a railing you can hold on to or a spot where you can sit and belly-breathe without creating a scene. So what if I'm terrified of death, especially sudden death, especially dying all alone? Most people are afraid of these. And these things do happen anyway, everyday. I just have to listen to the news. People don't know the traumas I've gone through -- it's only I who knows, and I'm not even 100% certain of the earliest details, most especially the whys. Something happened, that's why I'm like this now. I have to give myself some credit. This is my way of coping. For now. But I have to forgive everyone who has ever misunderstood me. Misunderstanding is very much a part of the 'deal,' a part of what I have 'signed up for' when I fell ill of this.

***

Analyzing what went through my mind while I was panicking slowly helped reveal the underlying fears I had. Listing down my panic episodes in a logbook of sorts also helped me clarify some mysterious matters. Thanks in part to tips from panic attack websites, I found out that the most common thought bubbles turned out to be a series of what-ifs:

What if I had a serious heart ailment?
What if I suddenly fainted here? How would I look to all the strangers around me?
What if I died suddenly?
What if I died suddenly alone? Will someone be there for me?
If ever, will someone rush me to a hospital? How? I don’t have money for the hospital – what then?
How would my family, especially my ageing parents, take it?
If I died without confessing, will I go to hell?

At first, I was happy and satisfied with these self-revelations, thinking these were all there was to it. What I didn’t know yet was that these fears had been there underneath my consciousness all along, and that there were far deeper issues involved that I refused to face because they were even more scary.

***

With my mysterious illness revealed to be part of panic disorder, I was now able to search for treatment. However, being out of a job, which I suspect cemented all the triggers that led to a panic disorder, I couldn’t afford consultations with professionals. My friend and counselor A. recommended a psychologist from UP who offered counseling for free, but after contacting her by phone, I learned that she was based in the opposite side of the city.

Another friend, a college professor I knew to have suffered the same in the past, mentioned that that the book The Dance of Fear by Harriet Lerner was helpful to him. Lerner’s penetrating insights about fear, plus the perspective she gave by painting the big picture, indeed proved invaluable to me in so many ways.

Two websites proved to be helpful with more information I didn’t know before, because I hounded them for a time: Anxietycoach.com and Anxietyguru.net. From these two websites, I was able to confirm on my own that I had panic attacks. The three or four worst episodes I had were so terrifying because my heart raced to unprecedented speed that I had to take the beta-blocker metoprolol, a drug that had been previously recommended to me by two doctors, the first during a bout of nervousness in front of a stage where I was about to be one of the emcees and the second after a panic attack incident inside a church where I tried to hear mass for the first time. The doctor at the second incident recommended the same drug to me, saying the drug I had been taking as maintenance medicine for hypertension, which I had been diagnosed with the previous year, was inadequate in addressing my hypertension. (I suspect she misdiagnosed me because she took my blood pressure right after I had a panic episode.) 

Physiologically speaking, my major finding from all this, however, is that I am extrasensitive to palpitations, particularly when these get tachycardic (to use a medical term) or fast (around 100-200 beats per minute), equating their occurrence with impending death due to heart attack. Unfortunately, panic attack symptoms mimic the symptoms of heart attack, although other authors say heart attack has a different set of symptoms. I also learned that I am deathly scared of the slightest bodily discomfort, especially any type of physical pain, thinking these are sure to trigger my sure instant demise. This is consistent with my own diagnosis of hypochondria.

An old rap song I was listening to at random also was of great help. Since the song, entitled “Crossroads” by Bone Thugs and Harmony, is about the death of an uncle, the agonized lines “Why did he have to die?” and “I don’t wanna die!” resonated with me deeply. “Crossroads” revealed how I deeply resented God for inventing death or allowing it at all, for making me and others subject to death, especially four friends whose lives were rudely taken away in their youth.

Because of this song, I was able to write this entry in my blog in October 12, 2012:

Confronting death

Why do I remain scared to death of the subject of death, despite the many close brushes I had with it? I should have been used to the feeling of almost dying by now, after I choked on a lychee alone, ran into an oncoming vehicle's path and missing the thing within an inch, ate something poisonous without knowing, figured in several falls, and so on.

Everyday, there is death. It comes as sure as birth. I just have to open the TV or log on to the Internet. Even around me -- babies are born, old people (or not even) pass on. Shoots sprout, and dry leaves fall. Ants lay eggs by the thousands, even as I slap an offending intruder that attempts a bite at my skin.

There's this award-winning Japanese movie titled Okuribito (Departures) that points out that, whenever we eat to sustain life, death is there, a life is sacrificed.  The rice grains had to die, as do the vegetables, fruits, fish, and beasts. They must all die, so you and I could live.

Again, why am I so scared about death? I will die -- that's for certain. It could be anytime from now or after several decades more. It's okay. It won't be the end of me. There is life after this life. (Not "life after death," or so asserted one college professor of mine.) God's love will see me through.

Meanwhile, I savor life, knowing how precious it is in its frailty. But I shouldn't overdo it, as though manically fearful that my time here is much limited. I'm only human, not God; I can only take so much. May God forgive me for my greed for life, which is perhaps due to my thinking that I almost lost it at birth.

Well, I didn't, and truth be told, I've had a fuller life, compared to most people. (Yeah, I would say that.) Maybe not in the conventional way, but I've gone through my 42 years with so much life -- the many ups and downs of it, I mean. I still have a lot to dream of, such that I am unable to say, "I can die anytime now," but the point is, what more can I ask for, considering everything I've been given? It's true that, had I a choice, I would want to live several decades more, but that choice is not mine to make. All I can do is wish.

I believe it is best to surrender my life to God, no matter at what state of completion or incompletion death will find me. God will meet me where I am in my journey.

Dear God, my life is in you. Why am I so afraid to surrender to you? I am not just afraid, I am also very angry.

Yes, I've been angry at you, Lord! For why did some of my friends had to die like that? Dove, Cesar, Malou, Marc..I don't want to die. Or I don't want to die yet. Or I don't want to die like that -- too sudden and too young.

Oh, death! Death, death, death, death, death, death, death, death, death, death.

In my great anger, I even uttered a curse at you, like someone possessed. I don't know why I did that, but the reality is I did; I was capable of it. Forgive me, Lord. Forgive me, even more, for assuming, that I am a saint who's incapable of going that low. 

I wasn't just afraid and angry at you. I was terrified of you. But why should I be in terror of a supposedly loving Deity? It's probably because I thought, wrongly, that if I died suddenly, I would go to hell because of unconfessed sin. I'm terrified of dying all too suddenly and of dying alone, thinking I would be alone at it and no one would care. I'm afraid of getting sick without the money and health card for the hospital. I'm also terrified of possibly leaving my family behind, especially my parents, and the great heartache that they would have to go through. I'm terrified of dying at this age because I assume I haven't accomplished anything yet. (This has made me envious of people who I thought are accomplished (forgive me, Lord, for my envies). This perhaps means that I'm terrified that, with physical death, I would also disappear into oblivion. This is another way of saying I'm terrified of death of self, the kind that's forever.

Oh, I'm terrified of so many things. And yet I'm not terrified enough of God. Actually God is my greatest terror -- He who can send me to hell. Nevertheless, I'm terrified of so many things without bothering to question my assumptions at all. Will I really be gone forever and forgotten? Will I really disappear into nothing? Will I really die now, alone, suddenly?

But so what? So be it! When I die, I will no longer fear, as my friend Aline naughtily puts it. I will no longer have to fear, ever. I will no longer have to face the burdens of the living -- including life's many little and big terrors, foremost of which I have listed above.

When I die, God will take care of me, because I have commended my spirit to him. That means I will not really die, I will not die alone, I will not die unprepared since it is God who wills my earthly end by calling me home. I will not be forgotten and will not dissolve into nothingness.

Take all of me, Lord, take all of me, like the song said. I surrender my all to you, right here and right now.

Forgive me, Lord, for the temerity of thinking that I am in control, that I can extend my life for one minute with a new-found food supplement or drug. I forget so easily, Lord, that you are the one who's taking charge, that you are the author of everything -- science, medicine, my body. You govern all the atoms and molecules in the universe. My knowledge (which I thought is encyclopedic enough), compared to yours, is nothing.

Sometimes I wish I would never wake up from sleep again, but I know this is more a desire borne of desperation than a leap of surrender in blind faith. If I want to wake up again or 'pass away,' I want to wake up again for God and pass away for God.

Oh, God, please give me hope, be my strength.

I pray that I won't grow old alone or suddenly faint or die of a heart attack, stroke, heat stroke, aneursym, anaphylactic shock, choking, murder, car accident, or plane crash, but in case I do, so be it. Thanks for breaking my will, Lord.

Take all of me, Lord, take all of me. I surrender my all to you, right here and right now.

***

Despite all the help, however, my panic attacks persisted and even got worse. Ironically, it was when I was reading a book on how to cure anxiety (The Anxiety Disease: New Hope for the Millions Who Suffer from Anxiety  by David Sheehan, M.D.) that I went through another surge of scary panic symptoms. This led me to a frantic search on the internet, and I was led a YouTube video that introduced a material I have never read yet: Barry Joseph (or Joe Barry) McDonagh’s Panic Away Program. This, I found, was different because it reverses all the other advice I had read earlier, by suggesting that the terrorized patient invite more of the panic symptoms so that these will wane and stop for good!

Panic Away Program recommends the sufferer to do the unimaginable: Go through the scare of the entire panoply of symptoms, and when one can no longer take it, dare one’s body to give some more: more panic, more symptoms, and presto! The panic attack gives up. I tried this tack, and it seems effective!

I’ve been in counseling and therapy for four years, but my bout of irrational panic attacks has forced me to confront once again the demons of my past. My past trauma therapy findings indicated three major conflicts: I am confused about fear and anxiety, I have a conflict in father issues (which I extend to how I relate to God the Father), and I have a conflict in mother issues (which I extend to how I relate with women).

I thought that, if I believed in a good God, in a Heavenly Father who loved me unconditionally, then why am I afraid? Why am I angry at him, as I have discovered, much to my own surprise? (I couldn't believe I was capable of being angry with God.) Why can’t I accept whatever His will is, whatever situation I find myself helpless in, whatever he allows to befall on me? Why can’t I simply trust him and his son Jesus? Those well-meaning friends who criticized me were right, after all.

I profess to believe and love God, but the truth is I doubt him and I am even resentful of him at times. My fear of God is greater than my faith to and love of him. I follow and serve God in church and community because I want to earn his rewards or at least avoid his punishments. Have I mistaken God for being like my father whom I have feared and resented growing up, because I felt him to be distant and thought him to be punitive and his love conditional?

Why am I so insecure? Where is it coming from? Does it have anything to do with the mysterious threat I felt while I was still in my mother’s womb, the sense of impending doom whose cause until now I am not sure of? Is that where my sense of the world as a dangerous place coming from? My utter fear of annihilation? My terror at the sure thought of it, and the slightest danger of physical pain and psychological discomfort?

The answers to all these are all maybes for now, but merely asking these questions have helped me a great deal in reaching clarity.

I know that my parents love me in their own imperfect, even highly flawed, way, and I have stopped burdening them with the past and the tyranny of my own expectations, but how come I am still hounded by these dark things that I thought are long past me now?

In terms of massaging my seriously bruised ego, it also helps immensely to know that I am not alone. Most surprisingly, there are certain celebrities I admire that went or go through panic attacks or some kind of phobias: John Mayer who’s allegedly paranoid about going crazy that he keeps Xanax pills inside his pocket, Johnny Depp who’s afraid of clowns, David Beckham who’s afraid of disorderliness, and Robert Pattinson who’s paranoid about being inadequate in his acting role. This doesn’t sound right, but in the purgatory of panic attacks, I’m in good company. Furthermore, if it's any further consolation, the Biblical prophet Jonah also got angry with God. Jonah even avoided God several times, then after following God's command, he resented the result and went away and sulked. 

Henri J.M. Nouwen reminds us that even Jesus Christ had a moment in life in which he panicked:


Many people say, "I am not afraid of death, but I am afraid of dying." This is quite understandable, since dying often means illness, pain, dependency, and loneliness.
The fear of dying is nothing to be ashamed of. It is the most human of all human fears. Jesus himself entered into that fear. In his anguish "sweat fell to the ground like great drops of blood" (Luke 22:44). How must we deal with our fear of dying? Like Jesus we must pray that we may receive special strength to make the great passage to new life. Then we can trust that God will send us an angel to comfort us, as he sent an angel to Jesus. 

These days, my panic attacks have mostly subsided, and I am hoping permanently, although I am still afraid to go out in the sun for fear of fainting (it’s allegedly among losartan’s many atypical side effects, which is beyond my control), which I’m afraid would trigger new panic attacks. But compared to three weeks of being unable to go out of the house, wow, anything else is worth a Braveheart-strength cry of “Freedoooom!”


Comments:
add: Opportunities lost
Just making a survey of the many opportunities I’ve lost under my ‘self-confinement’ (including much earlier days I refused to go out for fear of the sun and the heat) will make me relive the feeling that life was passing me by: reunion with college batchmates, dinner with an old friend and his wife, community assemblies, Sunday masses, monthly confessions, healing mass, a friend’s wedding, two nephews’ and niece’s christening, a brother’s marriage in Laguna, and several travel writing assignments and other office-based job opportunities. If not for the radical faith I choose to cling on to, these past memories would have been bitter for me.

 
friend Marc's wake, friend Alma's mother's wake
 
Panic attacks can be manage through yoga, meditation and exposing yourself under the sun early in the morning. It works well with me. Thanks for sharing.
 
Thanks Billy, I've heard about those three.
 
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