I will be 56 years old next week. I’ve had classic panic attacks since I was 19. But why am I writing about it tonight? Because, once again, I read an article saying PD is treatable without medication. Truly – congratulations if you can control this debilitating disease with Cognitive Behavior Therapy (CBT), I, however, and many others, have been through hell and back until we found medical doctors that told us “you have a chronic illness and need medication to be normal, and there’s nothing wrong with that.” I’m going to tell my story – as personal, as embarrassing as it is to admit you have a mental illness to the world – because if I help even one person who has this terrible disease, you’ll know it’s treatable with the right medication – and you’re not alone. At least, this is my humble knowledge gathered from the viewpoint of someone who has had it for 37 years. I wish I had found something written about this disease from a patient’s viewpoint in my most desperate hours, telling me there was treatment and life without daily panic attacks.
The first one started like so many of ours do. Your heartbeat quickens out of nowhere. You begin to feel your chest tighten, and it becomes hard to breathe. The room/car/sky seems to tilt slightly, and you almost feel like you’re having an out-of-body experience, except you’ve never had one before; nothing seems quite right. Fear takes hold of you out of nowhere, and you are positive that you are about to die, that your rapidly beating heart is about to stop in a few seconds. You start shaking uncontrollably, trying to hide it from everyone around you, while your mind is silently screaming at you to leave; you don’t want to drop dead in front of everyone. At this point, you are barely connected to reality. If you are lucky, you manage to get out of the room (if you are around people) and stumble to the restroom/nearby tree (or pull over to the side of the road, because you can’t manage to drive anymore), where you sit shaking for the next 20 minutes in the stall farthest from the door (or against the tree, or in your car), praying that whoever finds your body finds you in a semi-dignified pose. Eventually, the episode slowly starts to fade away. As soon as you can manage it, you frantically look up your symptoms on WebMD. You’re lucky. In 1980, there was no WebMD. I just shook in the stall alone and looked up symptoms in the library later.
The first time this happened to me, I was a sophomore in college at dinner; I ended up in the stall, making up excuses to my friends and not able to eat a thing. PD patients often develop associated fears with the circumstances of where the panic attack occurred. Because I was eating dinner, I started associating eating with my panic attacks. I thought that perhaps I was ill. Unfortunately, by the time I went to the health center, I only weighed about 100 lbs. Since this was 1980, they originally misdiagnosed me as anorexic. I had lost 12 pounds. I unfortunately started self-medicating (alcohol) enough to start eating again; stupid, I know, but the therapist at my college wasn’t listening to me. I hovered at a low weight for years, with constant attacks in multiple situations (crowds of unfamiliar people, heights, driving over long bridges), until I had 5 straight days of almost all-day attacks. At this point, I had health insurance finally, and went to a LCSW & psychiatrist – and was finally diagnosed at 24 with panic disorder (PD). I’ve seen psychiatrists, psychologists, LCSWs, therapists, and internists/GPs. I’ve been treated with: CBT, EMDR, Chinese herbs, Bach flower remedies, herbal tinctures (or capsules) in combination, aromatherapy, aromamassage, hypnosis, regression, meditation, breathing techniques, CO2 (paper bags/cupped hands), *all* types of antidepressants, specific vitamin/mineral regimens, benzodiazepenes, off-label atypical schizophrenic drugs (heavy sedation/low dose). I’ve had a completely clean MRI of my brain as recently as two years ago after a fall (to ensure I didn’t have a concussion), so I know there’s no tumor in my brain or visible abnormality; I simply have classic panic disorder.
After many years of my life, trying every non-pharmaceutical way to get rid of my PD, I realized, as did the doctors, that I truly had a chemical imbalance, like diabetes. Which meant I needed a medication to rebalance my brain chemistry. I then became a guinea pig for the psych community for every antidepressant in the book (which didn’t work – why would it? I wasn’t depressed) – and having multiple side effects they claim are “rare” – which isn’t true; patients talk – I gave up on antidepressants. Next came the benzodiazepenes- Xanax. IT WAS A MIRACLE. Yes. Caps for a reason. For the first time in my adult life, I was normal again. I’d forgotten normal. But no – that, alas, was not the perfect ending yet. They kept trying to find every other pharmaceutical mixture in the world other than Xanax to keep me on long-term. Every time, the panic attacks came back. And most insurance after 1990 no longer paid for psychiatrists or therapists, so all of this was out of pocket.
Finally – in the late 1990s, I found a doctor who would Rx me Xanax. When she retired, I found another doctor who has placed me on extended release Xanax, with regular Xanax for breakthrough attacks. I now live a relatively normal life. The amount I take is within the guidelines of the APA for PD. I’m stable on my dose. And I’m no longer scared all the time about my attacks.
Thanks to the doctors that were understanding and treated me with the drug that gave me back my life. That believed me about the horrible side effects of the antidepressants. You are true healers. If only other doctors realized that there are PD patients like me. I lost years to this terrible disease. If you have it – don’t give up. There are doctors that prescribe benzodiazepenes for PD patients. You can get your life back.