Panic Attacks, Pills, and Progress

Over the last 6 months or so, I’ve been having fairly regular panic attacks. Once they started, the frequency increased exponentially, starting at once a month to once every two weeks. That doesn’t count all the times I almost had panic attacks and managed to calm them down.

At some point in the middle of developing a panic disorder, I had convinced myself that I wasn’t actually having panic attacks. That they were just “anxiety attacks” – this may still be true, though. What I would call a panic attack might just be a very severe anxiety attack.

There is a difference between the two. Panic attacks generally are rooted in the fight or flight physiological reaction in the brain and are often unprovoked (a stressor is not required). Anxiety attacks are physical symptoms of anxiety that are as a result of stressors.

Often, a panic attack itself would cause anxiety. My body would freak out and then my brain would go: oh, this is like anxiety, let’s think about stuff that’s awful and scares us. And it would escalate the physical symptoms further.

One particularly bad week, a panic attack sent me home from work.

Afterwards, I generally feel depressed, which started to worry me more – I fear depression almost above all else. I’ve been down the dark road to rock bottom, and, more than anything, I don’t want to go back there. I’ll take the anxiety and relentless obsession any day over that. At least with anxiety I can be an active participant in life and other things.

Anyway, it hadn’t occurred to me until relatively recently that the depressed feeling was most likely a “come down” from all of the heightened physical symptoms. So, I told myself over and over again that lethargy was just lethargy and the “depressed” feeling was not necessarily a sign of depression.

My panic attacks have become less regular since I started on a daily low dose of an anti-seizure/anti-panic medication called Klonopin. I take it as a baseline to prevent early-early-morning anxiety that was waking me up around 4 AM daily. This has a sort of “trickle down” effect. If my anxiety is lower in the morning, it won’t escalate as quickly into an anxiety/panic attack.

For weeks at a time, sometimes without a single day off, I started obsessing before I was awake; thus, I begin my day at an already-heightened anxiety and stress level, and then it really only increased from there. I would spend my entire time in my morning shower (which is my wake up and focus time) beating back obsessions like “Do I ACTUALLY love my boyfriend?” “Does my boyfriend ACTUALLY love me?” “What if he’s lying to me about [fill in the fear]?” “What if I’m an awful person?”

Much as I hated the idea of taking medication (and I still do, every day), the daily 0.25mg of Klonopin I take really takes it down a LOT. I still have some obsessions and still have to work sometimes at it, but now I feel more ABLE. Now that a lot of the really high-level anxiety nonsense is gone – for the most part – I can focus on tackling the bigger issues, including panic attacks.

I think that because of this, I don’t have the panic attacks “often” anymore (this is a relative term). To boot, any incident or episode of anxiety has now become a minor anxiety attack (minor hyperventilating mixed with a crying spell), and they are easily diffused by me when I’m alone and even more quickly and easily when I’m with my significant other. Even with friends near, the anxiety diffuses more quickly. I have one friend in particular who sometimes rescues me from the stairwell when I trap myself there.

I had been going to therapy every week for months and months, and I recently moved to a different town, making it more difficult for me to get to my therapist’s office. Up until my most recent session (two weeks ago), I hadn’t been there in a month.

This month, I had a really severe panic attack at work. Then a few days later, I had two minor anxiety attacks. In the week following, I was down on myself for all of the piled up anxiety attacks. I felt that I had lost control of myself or “let” myself have the anxiety/panic attack(s). That I was somehow responsible for not being in control of myself enough (perfection alert, perfection alert).

When my therapist asked me how my month went, I said “Well, I had a panic attack on a Friday at work and then two minor anxiety attacks the following Sunday.”

She asked me what had been happening in my life this month and this is the list:

-I moved out of my parent’s house. (Moving is fucking stressful, yo.)
-I didn’t get to take my dog, whom I adore, with me.
-This is the first time I’ve been on my own since I was 20.
-I had been working overtime with a lot of pressure to perform daily and produce double volume while maintaining quality.
-My significant other has been undergoing some pretty major life changes in the last month and there are a lot of uncertain things in his life.
-I’ve been training for a marathon which is now into some pretty high mileage runs on the weekend.
-I get up at 4:50 AM every morning for work and I have a 3 hour round-trip commute.
-The only down time I have anymore is on the weekends.

My therapist’s reaction to all of this, including my panic attack and anxiety attacks, was a big smile and: “You only had one panic attack this month?? Even with all of that going on?”

It hadn’t occurred to me that it was JUST one panic attack, on top of everything that was going on AND no therapy for four weeks. I had pretty much endured a hellish month without really batting an eyelash. I had that moment of realization that makes me hopeful for the long-haul: I am getting better. Slowly but surely, I am getting better, and maybe sometime soon I won’t need the medication anymore.

That’s a pretty big victory, I’d say.

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