My Fight With Panic Disorder

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.

My Grandmother’s Time Machine 2

StanislavVietnam, 1966

“I don’t know, man. You say your mom’s not a Gypsy, but once again, you’re the only guy that walked out of that ambush relatively okay. Hell, you’re the only guy that could walk, Stan. I’m telling you, she put some kind of protection spell on you or something.” Dr. Bill Chambers shook his head as he continued stitching up the bullet wound on Stan’s upper left arm.

His head was aching, and Stan really didn’t care what Bill thought; his right hand reflexively went to the small square of cloth in his right pocket that held the prayer and relic his ma had slipped him before he left. He could still remember her whisper in his ear as he bent to give her a hug when he was getting on the bus to leave. “They will watch over you; no harm will come to you, and you will come home.”

Stan had heard his ma and his aunts talk about “miracles”, or strange occurrences; how one time one of his uncles had heard a voice guiding him to safety during a holdup when he was helping close up a market. He’d always been a practical guy, and he thought long and hard before he joined the Marines to get out of the small town he’d loved as the youngest kid out of seven, but felt increasingly trapped in as he grew up and most of his siblings left. Only his oldest sister, Anna, had stayed; she’d married Mr. Kolesar’s oldest son, and they’d inherited the gas station he owned. Stan figured that at least being in the Marines as a career, he would travel and see different parts of the world, even if it meant he’d potentially be in danger of catching a bullet. It was better than rotting away working in a market, or worse; a factory, quarry, or worst of all – a mine.

It also annoyed him that Bill kept tweaking at Stan about his earlier explanations that his ma wasn’t a Gypsy, she was Rusyn; however, Stan figured he’d rather stay on the doc’s good side and remained quiet while he still felt the pull of the stitches going through his flesh. Bill was one of only two people in their unit that knew Stan’s full name, and a Russian-sounding name was the last thing he wanted people to know. Between the Cold War and the Viet Cong, he didn’t want to die by “accident” due to friendly fire in the middle of a fight. His last name, Mikulak, was bad enough; people always thought it was Polish, for some strange reason. Besides, Bill was the guy that kept them alive in his unit. They’d been in several ambushes and a few outright fights; people bled out and died very quickly sometimes, while you waited for a chopper. Having a real doctor in their unit was an unexpected blessing; Bill didn’t talk about why he was assigned to their unit instead of a hospital.

“Okay, Stan. I’m finished here.” Dr. Chambers placed the last piece of tape on the gauze covering the stitches. “Let me give you a shot of penicillin, and we’ll be done. Want a cigarette?” He turned away to get the bottle and a syringe without waiting for an answer, as Stan reached into his pocket with his right hand, wondering if lighting the match was going to hurt. Luckily, the local anesthetic hadn’t worn off yet, and he clumsily managed to strike the match; he gratefully took a long draw in, feeling his body relax as the nicotine hit his system. “Thanks, Bill. I really needed that. I don’t think I’ve had a smoke in about three hours.”

“Not a problem. But you’re not going to like this. Drop your pants and bend over.”

Stan rolled his eyes, took another drag, and put his cigarette carefully on the window ledge near the table he was on. “Gee, thanks for being so polite.” Bill laughed as Stan stood up, unzipped his fly, and carefully lowered his pants and boxers, wincing as his left upper muscles attempted to flex.

“Be careful, Stan. No major movements for 48 hours until those stitches set.” Stan glared at him, and simply turned around, waiting. The doctor expertly gave the shot, which burned like hell. “Okay, we’re all done. Want me to start any purple heart paperwork, or talk to your commanding officer about it?”

“Hell no. Like you said, I walked out of there. I don’t need a medal for that.” Stan had a flash of his ma again. He shook his head, trying to clear it. “Others aren’t as lucky as I am.”

“No, they aren’t. I wonder why.” Bill smirked back at him.

Stan finally snapped. “Stop it with the damn Gypsy references. I’m not a fucking Gypsy. I’ve told you. I’m Rusyn.”

Bill shook his head, a slight smile on his face. “Seems to me like it’s six of one, Stan. Whatever you have going for you, it’s keeping you alive while others around you have died. You ought to be thanking someone.”

As Stan walked out of the small building, the nagging thoughts about his family that had started in his head continued. Many Slovaks had also emigrated to his town, which meant that Slovakian was spoken just as often as Ukrainian when his ma’s family had arrived, and the family spoke Slovakian also because the two areas were next to each other and their home village was along a trade route. His knowledge of Ukrainian, Slovakian, and the in-between Rusyn dialect that his family used was starting to fade with disuse. He could still talk to his ma once he was back home; it just took about a day to become re-accustomed. The problem was he couldn’t write in them. Anna, he thought. She was still fluent; she used to speak all of those languages even as an adult, though he’d only ever heard her speak English to him for the last five years. He decided it was time to write Anna, and enclose a letter for ma that Anna could translate – and ask her just what is was that she and the aunts were always talking about, and what that small square piece of cloth in his pocket really meant.

My Grandmother’s Time Machine 1

Karina

She hoped that the soft thump next to her on the swing was alone. Without opening her eyes, she murmured “Please, Zach, don’t tell me you caught another baby rabbit,” as she rolled her neck, cracking it. Please, no bloody little bodies today, Karina thought as she tentatively opened her eyes, staring into the garden for another few seconds. Her cat was a proficient hunter, often bringing her “presents” both in and out of the house. One morning, Karina had awakened to find a garden snake, neatly curled, lying at the foot of the bed.

Finally, she glanced next to her side on the swing, which was swaying gently from Zach’s arrival. He was curled up alone; no presents for his old, stiff, gray-haired mommy who couldn’t catch a softball even if she had a left-hander’s mitt. His black tail with the tabby watermark striping showing faintly in the sun flicked lazily at the tip; while he probably didn’t realize it, Zach was no longer young either, but it hadn’t slowed down his hunting abilities yet. His eyes were half-slitted, and he was staring at her intently. Karina smiled and reached over to stroke him. “Hi, sweet boy,” she murmured as she stroked his fur. He started his rumbly purr, eyes slowly starting to close as she scrached his ears. She let out her breath, realizing she’d been holding it in fear of seeing another dead rabbit.

Karina had always kept at least one cat, one of many things she’d emulated from her dad’s mother. She  loved her grandmother fiercely, even though it was difficult for them to verbally communicate. Eva had emigrated with her family as a toddler from Ukraine; they were Rusyns, a group of minority people in a country that had been oppressed and were all but gone in present time. Karina was proud of the fact that she was part of a very small diaspora, most of whom had fled to the United States, though at the time it was simply another borderline area in dispute. The 1910 census stated Eva and her family were Austro-Hungarian, though Karina knew there wasn’t any Austrian or Hungarian blood in her veins. When DNA testing had became good enough to give her an idea of where she exactly did come from, she’d done a test. There were several surprises, but those two countries weren’t part of them.

Karina took off her hat and tilted her face to the sun, closing her eyes. The mornings had started to become cool, which was taking longer every year, it seemed. She couldn’t prove global warming had actually really made a difference, but little things like how late the first freeze started, how long warm days hung on – they seemed to matter. She started thinking about hearing her aunt Sofia and her “stera babka”, as her father would teasingly call his mother, talk about the family walking and riding in ox carts from the far side of the Carpathians to Spain, sailing to Canada, and entering the US to settle in an Eastern European enclave in upstate Pennsylvania. It had held a mystical fascination for her as a child; at this late stage in her life, between what happened to Tyler and her daughter, she was simply grateful she still had the house in her life, even if her second cousin lived in it. She was actually okay living in this quiet little fading-out town, like so many others across the state.  She didn’t understand why her dad kept it in the family after his mother had passed on at first, but later thought that maybe some of her assumptions about her father – and Tyler, for that matter – had been wrong from the start.

“Come on, silly boy,” she said as she stood up slowly, knees cracking with age. “Let’s go see what snacks I have for you in the kitchen. Besides, I’m visiting cousin Jean later on today.” Zach hopped off the porch swing agreeably and rubbed against Karina’s legs, purring louder. He bolted in front of her the second she opened the porch door,  running towards the food and water bowls in the corner, then twirling back to look at her plaintively. “Okay, just a second,” Karina softly laughed as she followed him inside.