My first panic attack happened a year before the condition began. It was before an exam, and I was so overwhelmed that I lost all ability to concentrate and ran around my residence helplessly seeking a sense of calm.
Journal making is key to understanding disease. Journaling is a scientific process of record keeping, an observation chart rich with qualitative details. The act of Writing Down improves memory, through forced recollection for the recording event at your bedside, and through reassurance that the source text will now forever be available.
Nearly every doctor will tell you to keep a diary of your difficulties, whatever they may be, in the hopes of tracking down the fox that lurks in your system. I wrote a diary that I kept fairly up to date, until I started therapy, which was very helpful for doctors to see symptoms, potential triggers, timelines and frequencies. Namely, I typically have a panic attack every 2.5 weeks. I still have pre-panic thoughts and symptoms about every 2.5 weeks. But therapy has given me tools to keep these pre-panic items in the pre-panic zone where they belong.
It is because of diary writing that I have a record of my thoughts during a couple of panic attacks. Including, interestingly, the one that began it all.
April 6th, 2010. Dinner and a play with my family. “Art” playing at Bluma Theatre . I have just concluded my presidency with a community group, with a short speech and a goodbye, and a distinct sense of unreality.
I hop in the car, we go to dinner – and on looking at the menu and hearing my family argue about whether or not my father was going to grab the waitress and add soup to the order because my mother forgot to mention it when we ordered, and he didn’t want to be a bother, and everyone wading in on the it’s no big deal discussion, I begin to freak out.
At first I won’t sit still. Then I can’t listen to them anymore and try to chat with my mother about other things. I can’t focus. I have no appetite; I can’t eat. I have to go to the bathroom to wash my face.
I return. No improvement. I begin to worry about having the tickets, who was paying the bill, getting there on time, getting home, getting other things done…
Another bathroom trip. This time I talk to myself: chill, what’s the matter with you, you’re just at dinner with family, what’s going on, just get through the evening and you can get things done, breathe a little, you’ll enjoy the play, just get through the evening…just get through the evening. More water.
Breathless, I go back to my family, part of me wishing they knew something was wrong. Part of my trying to find some way to get out of the obligations.
The car ride scares me. And then the theatre: huge, packed, tall, open space but crowded in.
When we sit down at our seats, I grab my journal and begin to write, desperately hoping that the seat to my right will stay empty. This is what I wrote:
At this moment I’m about to see ‘Art’ @ Bluma/Canstage. I’m so full of emotion and energy and panic. I really want to run and hide and cry and I don’t even know about what. Every time my Dad fidgits I feel like screaming or whimpering. What is wrong? What’s going in me right now? I’m so afraid and upset and sad and excited and irritated and stressed and obsessed and thinking thinking thinking. Why are there so many people in here? It’s so warm but if I take off my coat Dad’ll move and I have no space and no air and I need to be in the dark, alone or with someone to hold me or not because if they touch me I’ll explode. I want my swing. I’m upsetting my parents because I don’t want to go back to their house tonight, but I can’t cry freely there. It’s starting.
May I say I hate copying my journal writing because – I mean, I’m sure anyone who has reread things they wrote months ago can relate – it’s hideous. It’s so overwrought. I don’t care that I was panicking: I can’t cry freely there? What is that?
I am trying to get beyond the sad, sad writing and ridiculous sounding emotions, and realize one telling and crucial factor about the above: I have never misspelled “fidgets” before in my life. I never misspell.
As ridiculous as the above might sound, that is actually a fairly honest representation of my brain. My handwriting is rapid, messy, huge, and nearly illegible. It actually starts with trying to describe my afternoon and then I give up and just start writing down what I’m feeling. I had no idea what else to do in order to stay calm and not run away. My body said, “Leave, leave, leave” and every socialized muscle reacted with, “No, no, no”. I curled up as small as I could in my seat, and took out my journal and scribbled. Activity. Occupation. Distraction. Desperation. I just wanted to stay sane. I had no idea what was happening.
Panic disorder is defined by repeated, unexpected panic attacks, including extended periods of time in which the sufferer worries persistently about having another panic attack (CAMH, 2011). Many describe panic attacks as a sudden tidal wave of the need to escape, with sudden, overwhelming thoughts such as losing their minds, that they are dying, or that they have no control over themselves or the world. A panic attack involves some or most of the following symptoms:
– the above listed thoughts and fears
– racing heart
– shaking, trembling
– shortness of breath, suffocation, choking
– chest pain
– chills or hot flashes or both
– dizziness, numbness
– sense of detachment or disassociation from oneself or the world
These symptoms arise very quickly, and are described as being completely without warning. Many people describe panic attacks as lasting for hours, some last as little as minutes.
That’s panic disorder. That’s really all there is to it. After a year and a half, these symptoms are so familiar to me that I write them now with no trace of feeling or attachment. But when I first read the brief internet description of panic and anxiety disorders, the relief brought me to tears.
If you had these symptoms, all of a sudden, what would you think? What would you do? Imagine yourself having them: who are you with, what do they think, how do you look? What do you do to keep going?
Have you ever filled in surveys, medical forms, questionnaires and so forth, and for the most part, you say, no, no, no, no, nope, not me, no problem…Have you ever wondered what it’s like to say yes? I used to wonder what it’s like to have a form describe you – to “fit”. It was almost a wish to be normal. As if being described gave me a family that knew the inside parts of my brain and body as well as I did, and the world would be a little less lonely.
It sounds a little silly. I mean, one can look at forms and guess, that’s the heart disease part, that’s for family history, or, they’re trying to find out if I’m a zebra or an antelope. It’s easy to know what the forms are looking for, and it would be easy to pretend to fit in. It’s not about wanting to be sick or wanting care, but it’s about wanting to belong.
Anyway, my truthful conscience kept me honest, and it was rewarded in the best, ironic fashion. Now I truthfully belong. I began to laugh when I went through the questionnaire outside the psychiatrist’s office. Each form was titled with names that have become very familiar: BAI, BDI-II, Social Phobia Inventory, PDSS.
Panic Disorder Severity Scale. I was with my boyfriend. I laughed harder as we filled in Mr. PDSS. I scored a sort of perfect grade. Yep, yep, wow, yep, that’s me, how many times now, yep, yep, a lot, yep…I was shocked that they knew even to ask certain questions! How did they know that I thought I was going crazy?
Relief and fear settled together. I had a disorder. I fit a category. I had company. I had treatment. But I had something.
Enter the journal. A source for diagnosis; a method for treatment. Now that there was a reason, a scapegoat even, it had to be beaten into my head that panic is panic, and not a tyrant. Journal writing reinforces through the act of Writing Down the facts of panic: where, when, what, and eventually, why. The act of keeping a panic journal is a solution in itself. It shows the repeated patterns to be what they are: habit. By adding journal writing to the habit, you add the reinforcement of, It’s Just a Panic Attack. An attitude which is shockingly prevalent in this whole post.
Knowing the reason has been half the battle. The rest is perseverance. I have not had a panic attack in 4 months now. But I still, with the same tri-weekly frequency, get the stepped-the-wrong-way-in-the-jungle-now-you’re-in-quicksand-no-no-adrenaline-panic-shit-stop-halt-NO! And I stop it. It isn’t a stick held out from above. It is like an act of God. With nothing but will power, I simply cause the quicksand to harden, change its molecular structure and be climb-able rock.