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 or addictions (caretaking,
oversharing, being the goody two-shoes or Mr. Nice Guy, 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, after all.
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 indeed 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 are depersonalization and 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 extra-sensitive 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 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, as a result of these realizations, I savor life now more than ever before, 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 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 soon.
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, aneurysm, 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 to 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 has 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!”