Panic Disorder Sucks. But I Can Accept That.

It’s graduation day!  Panic disorder led me to a partial-hospitalization program.  Choosing to accept that I will have panic disorder forever led me to graduation.  Here’s how I got there:

I am still learning to manage my bipolar disorder, and trust me, I am far from having it down.  But this time I’m off work because of a mental illness I thought was secondary.  Panic disorder didn’t agree and has moved over to the driver’s seat.  The cycle of “I can’t breathe” and “I’m worried about how I can’t breathe, so I can’t breathe” has been debilitating.  It has been months of having a tight chest;  months of breathlessness;  months of repetitive deep inhales that never seem to satisfy my lungs; months of intermittent dizziness and tingling in my fingers due to hyperventilation; and months of living in fear of the next full panic attack.

Panic attacks are a strange phenomenon.  I am still struggling to understand what panic disorder means for me.  Many peoples’ experiences with panic attacks include fear of dying.  When I had my first panic attack, I rationally knew exactly what it was, and I knew that I was not dying.  This rationale did not make the panic, the intense fear, or the severe discomfort any less distressing.  My husband wanted to take me to the emergency room after one full hour of not being able to calm my mind or my body, despite his ferocious googling with collective failed attempts at quieting my panic attack.  I knew it wouldn’t be worth the expense; this was ‘just’ a panic attack after all.  The after-effects of this panic attack (chest tightness, breathlessness, and fear of another panic attack) lasted several weeks.  This ultimately earned me the diagnosis of panic disorder in 2019.  The criteria for panic disorder in the DSM-5 includes: experiencing of recurrent and unexpected panic attacks, with one or more attacks followed by at least one month of fear of another one and/or significant maladaptive behavior related to the attacks.  Yeah…this fits.  And it’s maddening.  I consider myself to be an intelligent person. I work in a medical environment.  Shouldn’t I be able to ‘outsmart’ panic disorder?  If you ask my psychiatrist, she’ll say no…

I think there is a misconception that a panic attack has a specific trigger.  While this is true for many, it is not true for me, or for most people with panic disorder.  I have been racking my brain to self-reflect and process the events leading up to the most severe panic disorder episode I have had to date.  The best way I can describe it is: The Perfect Storm.

First, there were clouds.

• Did you know we are in the midst of a global pandemic?  I think it has been enough to cause anxiety for even the most mentally healthy of us.
• Did you know we are in the midst of a national crisis of social unrest?  I am a sensitive person, and experiencing movements like Black Lives Matter affects me greatly.  It makes me feel there is no hope for this country, because treating people equally and with compassion sounds obvious to me; yet the reactions of the country have been unsettling to say the least.
• In my own small world, my husband and I have been experiencing difficulty with getting pregnant.  Taking the appropriate “next steps” with fertility felt stressful, lonely, sad, and time-consuming.

After the clouds, came the rain.

• I started a weekly Dialectical Behavioral Therapy (DBT) group, largely focused on coping skills around distress tolerance and emotional regulation.  I knew many of the DBT skills already from a history of learning them in individual therapy and partial-hospitalization; yet I seemed to be struggling more than everyone in the group.  I was disappointed and frustrated with my progress.
• Wearing a mask for 9 hours per day at work with little respite while you are breathless is exacerbating and exhausting; especially while trying to maintain my “perfect” and professional outer shell at work. (To clarify, I am PRO-MASK.  But I also want to validate for all of you with anxiety disorders that I see you wearing those masks even though it is hard!)

After the rain, came the thunder.

• I skipped all of my therapy appointments for weeks.  Just because I was over it.

Then…the lightning struck.

• After all of the panic symptoms continued to increase, I hit my breaking point.  I had a panic attack (three, actually) WHILE PRACTICING MINDFULNESS.  I was biking with my husband along the Little Miami River which was beautifully lined with wildflowers.  The cardiorespiratory effort alone caused multiple panic attacks.  This was confusing and terrifying.  I had no control; my body was in charge.  Then later came: “I can’t take this anymore!  I give up.”

But the truth is, I don’t give up.  I let myself believe in the moment that I had given up. This is where turning the mind back toward acceptance and hope comes into play.  It took weeks to get there and my panic disorder symptoms are still lingering, but I’m here to tell the story.  It’s ironic that on my last day of this partial-hospitalization program, we are covering the topic of “Radical Acceptance.”  My spiritual self believes that this is the universe telling me, “You can do this!  Continue on your path toward acceptance!”

This is how I started the program thinking: Panic disorder sucks; and now I’m leaving the program thinking: Panic disorder sucks, and will probably always suck, but that’s okay I can accept that.  And what I can see now that the storm has lifted, is that with each panic attack, I feel more confident I will overcome the next one.  With each punch life lands, I become more confident that I will get back up; more confident that I will keep fighting, keep surviving, and best of all, keep thriving.