lallieth
Member
When Panic Attacks
By Mike Zimmerman, Menshealth
March 30, 2008
"For 3 months I woke up at 1:30 a.m. every night in a fetal position, praying." ~ Jon, 40, systems analyst
I know what hell feels like.
I knew it that day I was slumped over the hood of my car at a Jersey rest stop -- my heart thrumming like a speedbag, my body soaked and shaking, my lips and fingers numb -- and I still know it now. No peace. No tunnels. No bright lights. Just that knowledge, waiting for my heart to stop pounding, to stop period.
As the ambulance approached, the situation grew surreal. My extremities mutated into petrified claws. I held up those twisted, frozen fingers, asking What the hell is happening to me? But I couldn't speak. My mouth had stiffened to a straw hole -- Sylvester after Tweety feeds him some alum. Stroke? Heart attack? Aneurysm? I was collecting them all.
Despite my condition, the EMTs didn't seem the least impressed. They shoved tubes up my nose. Breathe slowly, concentrate, they said.
When my gurney wheels hit the tiles at Morristown Memorial, I could finally breathe normally. My hands and feet were my own once again. I could move my mouth even though I didn't feel like saying much.
Two hours later, as I shuffled through the sliding doors and back to reality a free and "healthy" man, I must have looked like Marty Feldman after a lightning strike. The doctor on duty told me that I'd hyperventilated from a combination of hangover, fatigue, and caffeine. Not unusual. The paralysis in my face and hands came from severe overbreathing. But now I was fine, he said. What he didn't tell me was that I'd had a panic attack.
I'd just coughed up initiation dues for a club that is more extensive than I'd ever imagined. And membership is on the rise: In a Men's Health Web poll, 20 percent of those who responded listed anxiety/panic attacks as an adverse health effect of the September 11 tragedies. "Anxiety has soared," says Sandra Ceren, Ph.D., a clinical psychologist in California. "That's a big problem for people prone to panic attacks."
No one wants to join this club. But roughly 2.4 million people in any given year are shanghaied into membership by a buildup of stress, anxiety, uncertainty, and in the end, ignorance. For perspective, imagine the combined populations of Boston, Denver, San Francisco, and Washington, D.C., simultaneously freaking out.
Who in the world doesn't have stress? We're constantly pounded with information from all sides: Do this at work, don't do this at home, eat this, don't drink that, and--oh yeah--watch CNN three times a day to make sure you're up-to-date on the latest domestic security risks. No wonder panic attacks have gone mainstream.
Tony Soprano gets them in grand style. They were played for laughs in an episode of Undeclared. And maybe you've used the term as a synonym for a total stress -out. But was it a panic attack? Maybe so...
The American Psychiatric Association defines a panic attack as intense terror that strikes for no apparent reason, usually peaking in 10 minutes, with at least four of the following symptoms: racing pulse or heart palpitations, hyperventilation, choking sensations, sweating, trembling, chest pain, nausea, dizziness, numbness and tingling in the body, chills or hot flashes, a sense of unreality, and -- most intensely -- a fear of losing control, going insane, or dying. This is not the garden-variety, "I have a presentation in the morning" anxiety. This is a full-body reaction as powerful and crippling as an orgasm. But instead of ooh-la-la pleasure, you get oh-my-God terror that can break deodorant in seconds.
Panic disorder develops when several attacks lead to a chronic fear of future attacks. Which can in itself trigger another attack--a vicious circle that spins even when the person knows exactly what's happening to him. But here's a little-known fact: Panic disorder is not just severely debilitating. It's severely treatable. And even more compelling? For some people, it's severely self-treatable. I'm living proof. If you know the basics -- why panic attacks happen, and that they won't hurt you -- you can deflate them, prevent them, and eventually defeat them. And you can do it without taking a single pill.
Panic erupts when your body's fight-or-flight mechanism trips, causing an adrenaline dump that goads you into action. Grizzly bear in your beer cooler? Fight. Dentist with a drill? Flight. Panic attacks happen when the mechanism is triggered without any real threat.
"The brain is wired for survival and doesn't discriminate," says Bert Anderson, Ph.D., creator of the Healing Panic Recovery Program), which has helped hundreds of people beat panic disorder. "It doesn't think out whether a situation is dangerous or not." So what pulls the trigger? You do. And you may not even know it. Epic life changes are usually a factor: a loved one's death, a divorce, bigger job responsibilities, moving. Chemicals don't help: Hangover, caffeine, nicotine, and the illegal stuff all contribute. Then there are the everyday stresses: our new war, fatigue, anticipating a drive on the freeway, an airline flight, a speech. Maybe you misinterpret sensations in your body: chest cramps, head rushes, gas. The resulting anxiety activates fight-or-flight, which sends you down the road to panic. In a dragster.
The biggest problem? It's different for everyone. There can be literally hundreds of combinations of symptoms. "The 'right' answer will come from the last person you talked to," says Anderson. Sounds good, you might say, but everyone has anxiety, fear, and potential triggers. Why don't we all have panic attacks? There's no easy answer.
Here's what we do know: how many people suffer panic attacks each year. That panic disorder sometimes runs in families. That women get panic attacks more than men. That the attacks usually flare for the first time between late adolescence and your mid-30s. That they rarely begin in people over 45. Other than that, no one can predict who will have panic attacks, how many they'll suffer, or how severe they'll be.
The seeds were planted in me about 5 years ago. I was running on a hot, muggy day when a gurgling sensation gripped my heart, as if bubbles were popping inside. An arrhythmia. It freaked me out, but I continued running. A week later, the bubbles popped again, but with the added bonus of pain -- like a barbecue fork right into my heart. A split second. But frightening beyond anything I was willing to tolerate. Off to the doctor I went.
The diagnosis: gas. Ha! I didn't believe it for a second. Something had to be wrong with my heart. To check, they gave me the usual battery of tests (EKG, echocardiogram, and more). Same verdict. There was nothing wrong with me...physically.
Above the neck, I was a mess. Exercise -- what was best for me -- had become the source of something truly frightening. So I stopped running. What if the doctors missed something? What if I really did have a heart problem? What if I keeled over in the middle of a run? Or in midtown Manhattan as I was walking to work?
See? This is what invades your mind: tiny seeds. A noxious weed germinates that you cannot control, cannot hack back, and cannot ignore.
That's when the attacks started, usually while I was commuting to work. Brief at first -- a couple of minutes, tops. I would listen to my heart, obsessed with every beat, knowing one day it must stop. If I detected anything strange -- even imaginary -- the adrenaline gushed like a heavy-metal power chord. Then, one hungover Sunday, the Big One hit, the one you just read about that landed me in the E.R. I'd spent a weekend of bacchanalian bliss at my best friend's place: golf, beer, bad jokes. Two hours into the drive home, my mind was a ball of static. Sweat dripped inside my shirt. My nerves hummed as if an electric razor were mashed into the back of my neck. Then I found that rest stop, where every cardiac terror finally boiled over.
Later that night, when I came to my senses, the anxiety was replaced by anger. I needed to know, once and for all, what these attacks were. So I started reading. And thinking. And, eventually, healing. I'd endured the attacks for months, and I'd had enough. Some people endure them for years, even decades.
The question is, how much will you take before you seek help?
For a long time, getting help for panic attacks was kind of like getting Internet service: at first, nothing. Then it got better, and better, and better still. When I landed in that emergency room 5 years ago, I wasn't diagnosed with panic disorder -- the term never came up. I had to discover it on my own. This kind of nondiagnosis once was common. "The situation was really bad 10 years ago," says Stanford University's Frank Wilhelm, Ph.D. "It has improved a lot since then. Panic disorder is now recognized quite well by general physicians."
"The doctor is doing what he is trained to do, simply that," says Anderson. In other words, hear the complaint, examine the patient, assess the problem, prescribe a remedy. "The remedy," he says, "depends on the doctor's level of sophistication."
Which means your best first step is a trip to the ol' primary -- armed with insightful questions about your treatment options.
Experts now point to breathing as an important part of any treatment. Many panic sufferers hyperventilate without knowing it. Prerequisites do not include paper bags and gasping. It's simply "subtle overbreathing," as Curtis Hsia, Ph.D., of the Center for Anxiety and Related Disorders at Boston University, calls it. You use your shoulders and chest to take short, quick breaths, and not your diaphragm for full, normal breaths. This skewed breathing decreases the carbon dioxide in your blood, which inhibits your body's ability to transfer oxygen from the bloodstream to the organs -- particularly the brain.
"A starving brain does not serve the senses very well," Anderson says, and that contributes to fear at the onset of panic.
Thankfully, research has increased. In an ongoing study that published preliminary results last year, Wilhelm--one of the nation's leading experts in respiratory assessment of anxiety--found that changing dysfunctional breathing patterns decreased the frequency and severity of panic attacks in all subjects. The treatment was simple: Teach people about hyperventilation, how to be aware of it, how to control it, and how to retrain their breathing at home.
But Wilhelm cautions, "Breathing awareness and training is one important pathwayto control of panic, but not the only one."
Cognitive behavioral therapy, or CBT, has emerged as a powerful uppercut in the fight against panic. CBT forces you to face your panic triggers, so you learn that anxiety won't hurt you.
"Patients reach the point where if they are starting to have a panic attack, they can say, 'Oh, I know what this is, it's no big deal,'" says Hsia.
When a patient begins formal CBT, provoking an attack is often part of the therapy. If it doesn't occur naturally, some patients actually have to induce panic, breathing improperly and allowing their worst fears to consume them -- on purpose, repeatedly. Sound fun? It's a vital first swing of the hammer that will eventually break the disorder. Patients need to see -- the hard way -- that panic is just a conditioned response, nothing harmful. As therapy progresses, patients go out into the world accompanied by their therapists (and eventually on their own) to face repeatedly whatever situations trigger their panic.
"Prolonged exposure to the feared situation is the best treatment," says Wilhelm. "Anxiety is not dangerous, only very uncomfortable. Being able to accept it is an important part of overcoming it."
"What we want is for patients to be able to go anywhere and do anything," says Hsia. "So they can say, 'Even though I have these feelings, they won't kill me.' As they get used to the feelings, they start to decrease."
There is a shortage of therapists qualified to administer CBT for panic, but they are out there. The program Hsia is involved with at the Center for Anxiety and Related Disorders in Boston has sessions that last 8 days or 13 weeks. Other programs vary, but patients should make sure they're getting formal CBT.
A lot of doctors will simply write prescriptions. Antidepressants and other medications are definitely effective against panic disorder, especially in the early stages of treatment. But you may not need those drugs as much as you--or your doctor--believe.
"In the short term, medication is as effective as CBT," says Hsia. Long term, however, instead of learning that panic attacks won't hurt them, medicated patients know deep down that they have a condition that is so serious they need a pill for it. And when a panic attack hits? "They don't know what to do next, other than go back to the doctor for more medication," he says.
Wilhelm agrees. "Physicians are encouraged by the pharmaceutical industry to prescribe medication for this condition, which can be treated as effectively by CBT."
The bottom line: Ask your doctor. For this panicker's money, I don't want to be on anything that alters my day-to-day mood. Plus, some medications -- the benzodiazepines, like Xanax--can be addictive. Then there's cost. And making sure you dose on time. Hey, if there were no alternative, I'd be the first one in line at CVS. But there are alternatives -- good, sensible, effective alternatives that, to this untrained eye, make medication look a little medieval.
Know how I beat panic? I stared it down. I studied the mechanism until I could see the little man behind the curtain. Then it wasn't so scary. When my condition was at its peak -- as my "heart condition" delusions persisted -- my doctor said something so casually brilliant, he basically cured me then and there: "When you have these attacks, other than the anxiety and palpitations, how do you feel?"
"Um...I feel fine."
"Then there's nothing wrong with you."
He was talking about my heart -- not my panic disorder -- but the shroud lifted. I stopped worrying about my chest, and I started listening to my gut, literally: The "bubbles and fork" struck when my digestive system surged to life. I finally heard what my body had been telling me all along. (Cue Cheech Marin: "It's just gas, man.")
Shortly thereafter, my panic attacks all but evaporated -- without drugs or CBT.
Are they gone completely? The full-blown attacks, yes. The anxiety, no. I don't think there's anyone -- Martha Stewart included -- who can banish all anxiety from his or her life. Long drives by myself are still no fun at all since my rest-stop incident. But when that ball of static starts to crackle in my brain, I simply breathe like a normal human should, and let it pass.
Living with panic isn't really living. It breeds with cousins in the anxiety-disorder family: depression, agoraphobia, general anxiety disorder. What's worse, research has shown that panic's long-term pounding on your system might exacerbate any heart conditions you already have. Which means it's time to have an intelligent conversation with your doctor. Make sure you're physically healthy. Then ask about panic disorder. Ask about CBT versus drugs. Be curious. Be aggressive. The faster you get help, the faster you can reestablish a toehold in everyday life. "If you say, 'I want to get over this no matter what,' then you're going to do well," says Hsia.
But first, you must believe that panic attacks by themselves won't hurt you. Believe that they are treatable. Believe that you'll do some of the best treatment on your own. And believe, above all, that this terror must end. For if you believe it, it will.
By Mike Zimmerman, Menshealth
March 30, 2008
"For 3 months I woke up at 1:30 a.m. every night in a fetal position, praying." ~ Jon, 40, systems analyst
I know what hell feels like.
I knew it that day I was slumped over the hood of my car at a Jersey rest stop -- my heart thrumming like a speedbag, my body soaked and shaking, my lips and fingers numb -- and I still know it now. No peace. No tunnels. No bright lights. Just that knowledge, waiting for my heart to stop pounding, to stop period.
As the ambulance approached, the situation grew surreal. My extremities mutated into petrified claws. I held up those twisted, frozen fingers, asking What the hell is happening to me? But I couldn't speak. My mouth had stiffened to a straw hole -- Sylvester after Tweety feeds him some alum. Stroke? Heart attack? Aneurysm? I was collecting them all.
Despite my condition, the EMTs didn't seem the least impressed. They shoved tubes up my nose. Breathe slowly, concentrate, they said.
When my gurney wheels hit the tiles at Morristown Memorial, I could finally breathe normally. My hands and feet were my own once again. I could move my mouth even though I didn't feel like saying much.
Two hours later, as I shuffled through the sliding doors and back to reality a free and "healthy" man, I must have looked like Marty Feldman after a lightning strike. The doctor on duty told me that I'd hyperventilated from a combination of hangover, fatigue, and caffeine. Not unusual. The paralysis in my face and hands came from severe overbreathing. But now I was fine, he said. What he didn't tell me was that I'd had a panic attack.
I'd just coughed up initiation dues for a club that is more extensive than I'd ever imagined. And membership is on the rise: In a Men's Health Web poll, 20 percent of those who responded listed anxiety/panic attacks as an adverse health effect of the September 11 tragedies. "Anxiety has soared," says Sandra Ceren, Ph.D., a clinical psychologist in California. "That's a big problem for people prone to panic attacks."
No one wants to join this club. But roughly 2.4 million people in any given year are shanghaied into membership by a buildup of stress, anxiety, uncertainty, and in the end, ignorance. For perspective, imagine the combined populations of Boston, Denver, San Francisco, and Washington, D.C., simultaneously freaking out.
Who in the world doesn't have stress? We're constantly pounded with information from all sides: Do this at work, don't do this at home, eat this, don't drink that, and--oh yeah--watch CNN three times a day to make sure you're up-to-date on the latest domestic security risks. No wonder panic attacks have gone mainstream.
Tony Soprano gets them in grand style. They were played for laughs in an episode of Undeclared. And maybe you've used the term as a synonym for a total stress -out. But was it a panic attack? Maybe so...
The American Psychiatric Association defines a panic attack as intense terror that strikes for no apparent reason, usually peaking in 10 minutes, with at least four of the following symptoms: racing pulse or heart palpitations, hyperventilation, choking sensations, sweating, trembling, chest pain, nausea, dizziness, numbness and tingling in the body, chills or hot flashes, a sense of unreality, and -- most intensely -- a fear of losing control, going insane, or dying. This is not the garden-variety, "I have a presentation in the morning" anxiety. This is a full-body reaction as powerful and crippling as an orgasm. But instead of ooh-la-la pleasure, you get oh-my-God terror that can break deodorant in seconds.
Panic disorder develops when several attacks lead to a chronic fear of future attacks. Which can in itself trigger another attack--a vicious circle that spins even when the person knows exactly what's happening to him. But here's a little-known fact: Panic disorder is not just severely debilitating. It's severely treatable. And even more compelling? For some people, it's severely self-treatable. I'm living proof. If you know the basics -- why panic attacks happen, and that they won't hurt you -- you can deflate them, prevent them, and eventually defeat them. And you can do it without taking a single pill.
Panic erupts when your body's fight-or-flight mechanism trips, causing an adrenaline dump that goads you into action. Grizzly bear in your beer cooler? Fight. Dentist with a drill? Flight. Panic attacks happen when the mechanism is triggered without any real threat.
"The brain is wired for survival and doesn't discriminate," says Bert Anderson, Ph.D., creator of the Healing Panic Recovery Program), which has helped hundreds of people beat panic disorder. "It doesn't think out whether a situation is dangerous or not." So what pulls the trigger? You do. And you may not even know it. Epic life changes are usually a factor: a loved one's death, a divorce, bigger job responsibilities, moving. Chemicals don't help: Hangover, caffeine, nicotine, and the illegal stuff all contribute. Then there are the everyday stresses: our new war, fatigue, anticipating a drive on the freeway, an airline flight, a speech. Maybe you misinterpret sensations in your body: chest cramps, head rushes, gas. The resulting anxiety activates fight-or-flight, which sends you down the road to panic. In a dragster.
The biggest problem? It's different for everyone. There can be literally hundreds of combinations of symptoms. "The 'right' answer will come from the last person you talked to," says Anderson. Sounds good, you might say, but everyone has anxiety, fear, and potential triggers. Why don't we all have panic attacks? There's no easy answer.
Here's what we do know: how many people suffer panic attacks each year. That panic disorder sometimes runs in families. That women get panic attacks more than men. That the attacks usually flare for the first time between late adolescence and your mid-30s. That they rarely begin in people over 45. Other than that, no one can predict who will have panic attacks, how many they'll suffer, or how severe they'll be.
The seeds were planted in me about 5 years ago. I was running on a hot, muggy day when a gurgling sensation gripped my heart, as if bubbles were popping inside. An arrhythmia. It freaked me out, but I continued running. A week later, the bubbles popped again, but with the added bonus of pain -- like a barbecue fork right into my heart. A split second. But frightening beyond anything I was willing to tolerate. Off to the doctor I went.
The diagnosis: gas. Ha! I didn't believe it for a second. Something had to be wrong with my heart. To check, they gave me the usual battery of tests (EKG, echocardiogram, and more). Same verdict. There was nothing wrong with me...physically.
Above the neck, I was a mess. Exercise -- what was best for me -- had become the source of something truly frightening. So I stopped running. What if the doctors missed something? What if I really did have a heart problem? What if I keeled over in the middle of a run? Or in midtown Manhattan as I was walking to work?
See? This is what invades your mind: tiny seeds. A noxious weed germinates that you cannot control, cannot hack back, and cannot ignore.
That's when the attacks started, usually while I was commuting to work. Brief at first -- a couple of minutes, tops. I would listen to my heart, obsessed with every beat, knowing one day it must stop. If I detected anything strange -- even imaginary -- the adrenaline gushed like a heavy-metal power chord. Then, one hungover Sunday, the Big One hit, the one you just read about that landed me in the E.R. I'd spent a weekend of bacchanalian bliss at my best friend's place: golf, beer, bad jokes. Two hours into the drive home, my mind was a ball of static. Sweat dripped inside my shirt. My nerves hummed as if an electric razor were mashed into the back of my neck. Then I found that rest stop, where every cardiac terror finally boiled over.
Later that night, when I came to my senses, the anxiety was replaced by anger. I needed to know, once and for all, what these attacks were. So I started reading. And thinking. And, eventually, healing. I'd endured the attacks for months, and I'd had enough. Some people endure them for years, even decades.
The question is, how much will you take before you seek help?
For a long time, getting help for panic attacks was kind of like getting Internet service: at first, nothing. Then it got better, and better, and better still. When I landed in that emergency room 5 years ago, I wasn't diagnosed with panic disorder -- the term never came up. I had to discover it on my own. This kind of nondiagnosis once was common. "The situation was really bad 10 years ago," says Stanford University's Frank Wilhelm, Ph.D. "It has improved a lot since then. Panic disorder is now recognized quite well by general physicians."
"The doctor is doing what he is trained to do, simply that," says Anderson. In other words, hear the complaint, examine the patient, assess the problem, prescribe a remedy. "The remedy," he says, "depends on the doctor's level of sophistication."
Which means your best first step is a trip to the ol' primary -- armed with insightful questions about your treatment options.
Experts now point to breathing as an important part of any treatment. Many panic sufferers hyperventilate without knowing it. Prerequisites do not include paper bags and gasping. It's simply "subtle overbreathing," as Curtis Hsia, Ph.D., of the Center for Anxiety and Related Disorders at Boston University, calls it. You use your shoulders and chest to take short, quick breaths, and not your diaphragm for full, normal breaths. This skewed breathing decreases the carbon dioxide in your blood, which inhibits your body's ability to transfer oxygen from the bloodstream to the organs -- particularly the brain.
"A starving brain does not serve the senses very well," Anderson says, and that contributes to fear at the onset of panic.
Thankfully, research has increased. In an ongoing study that published preliminary results last year, Wilhelm--one of the nation's leading experts in respiratory assessment of anxiety--found that changing dysfunctional breathing patterns decreased the frequency and severity of panic attacks in all subjects. The treatment was simple: Teach people about hyperventilation, how to be aware of it, how to control it, and how to retrain their breathing at home.
But Wilhelm cautions, "Breathing awareness and training is one important pathwayto control of panic, but not the only one."
Cognitive behavioral therapy, or CBT, has emerged as a powerful uppercut in the fight against panic. CBT forces you to face your panic triggers, so you learn that anxiety won't hurt you.
"Patients reach the point where if they are starting to have a panic attack, they can say, 'Oh, I know what this is, it's no big deal,'" says Hsia.
When a patient begins formal CBT, provoking an attack is often part of the therapy. If it doesn't occur naturally, some patients actually have to induce panic, breathing improperly and allowing their worst fears to consume them -- on purpose, repeatedly. Sound fun? It's a vital first swing of the hammer that will eventually break the disorder. Patients need to see -- the hard way -- that panic is just a conditioned response, nothing harmful. As therapy progresses, patients go out into the world accompanied by their therapists (and eventually on their own) to face repeatedly whatever situations trigger their panic.
"Prolonged exposure to the feared situation is the best treatment," says Wilhelm. "Anxiety is not dangerous, only very uncomfortable. Being able to accept it is an important part of overcoming it."
"What we want is for patients to be able to go anywhere and do anything," says Hsia. "So they can say, 'Even though I have these feelings, they won't kill me.' As they get used to the feelings, they start to decrease."
There is a shortage of therapists qualified to administer CBT for panic, but they are out there. The program Hsia is involved with at the Center for Anxiety and Related Disorders in Boston has sessions that last 8 days or 13 weeks. Other programs vary, but patients should make sure they're getting formal CBT.
A lot of doctors will simply write prescriptions. Antidepressants and other medications are definitely effective against panic disorder, especially in the early stages of treatment. But you may not need those drugs as much as you--or your doctor--believe.
"In the short term, medication is as effective as CBT," says Hsia. Long term, however, instead of learning that panic attacks won't hurt them, medicated patients know deep down that they have a condition that is so serious they need a pill for it. And when a panic attack hits? "They don't know what to do next, other than go back to the doctor for more medication," he says.
Wilhelm agrees. "Physicians are encouraged by the pharmaceutical industry to prescribe medication for this condition, which can be treated as effectively by CBT."
The bottom line: Ask your doctor. For this panicker's money, I don't want to be on anything that alters my day-to-day mood. Plus, some medications -- the benzodiazepines, like Xanax--can be addictive. Then there's cost. And making sure you dose on time. Hey, if there were no alternative, I'd be the first one in line at CVS. But there are alternatives -- good, sensible, effective alternatives that, to this untrained eye, make medication look a little medieval.
Know how I beat panic? I stared it down. I studied the mechanism until I could see the little man behind the curtain. Then it wasn't so scary. When my condition was at its peak -- as my "heart condition" delusions persisted -- my doctor said something so casually brilliant, he basically cured me then and there: "When you have these attacks, other than the anxiety and palpitations, how do you feel?"
"Um...I feel fine."
"Then there's nothing wrong with you."
He was talking about my heart -- not my panic disorder -- but the shroud lifted. I stopped worrying about my chest, and I started listening to my gut, literally: The "bubbles and fork" struck when my digestive system surged to life. I finally heard what my body had been telling me all along. (Cue Cheech Marin: "It's just gas, man.")
Shortly thereafter, my panic attacks all but evaporated -- without drugs or CBT.
Are they gone completely? The full-blown attacks, yes. The anxiety, no. I don't think there's anyone -- Martha Stewart included -- who can banish all anxiety from his or her life. Long drives by myself are still no fun at all since my rest-stop incident. But when that ball of static starts to crackle in my brain, I simply breathe like a normal human should, and let it pass.
Living with panic isn't really living. It breeds with cousins in the anxiety-disorder family: depression, agoraphobia, general anxiety disorder. What's worse, research has shown that panic's long-term pounding on your system might exacerbate any heart conditions you already have. Which means it's time to have an intelligent conversation with your doctor. Make sure you're physically healthy. Then ask about panic disorder. Ask about CBT versus drugs. Be curious. Be aggressive. The faster you get help, the faster you can reestablish a toehold in everyday life. "If you say, 'I want to get over this no matter what,' then you're going to do well," says Hsia.
But first, you must believe that panic attacks by themselves won't hurt you. Believe that they are treatable. Believe that you'll do some of the best treatment on your own. And believe, above all, that this terror must end. For if you believe it, it will.
