When panic attacks

I overheard a conversation as a kid about a friend of the family who’d given up driving for fear of bridges. Even as a passenger this otherwise normal, sane, professional woman would crawl onto the floor of the car and hide her eyes until she was safely across.

I remember also hearing many years later about a burly, construction-worker type who’d gone to a lab with his fiancée for the required prenuptual blood work when, panic-stricken at the thought of the needle, he curled himself into the fetal position and sobbed uncontrollably for half an hour before the nurses finally were able to draw the blood.

When we hear of such odd and excessive fears, we can’t help but wonder, are these people for real? It wasn’t until I became one of those people myself that I was able to answer that question with a resounding yes. Before then, I’d never had a real phobia of anything. Like all kids I’d checked under my bed for monsters; as an adult I lock my doors, drive the speed limit, try not to walk alone at night; but panic? I would have never thought it could happen.

Then, one ordinary sweltering August afternoon in 2001 while driving with my baby boy to the shore for a family picnic, all that changed. I’d been amusing him by doing my best Julie Andrews at the top of my lungs when my vision began to firmly and abruptly fade to black. In an instant, I felt flushed and chilled, dizzy and shaky, and my heart beat so quickly I knew that any second I was going to faint. At 65 miles per hour. With my baby in the car.

I remember thinking: Dear Lord, please don’t let me crash, please don’t let me crash… while my mind urgently fixed on the quickest path to safety. I don’t recall signaling or checking my mirrors but next thing I knew, there I was on the side of the highway peeling my hands from the steering wheel and trying to figure out what on earth had just occurred.

For months afterward, the dizzy spells continued. I’d start my car and already begin anticipating the shortness of breath, racing heart, hot and cold flashes, and tingling that would come once I reached highway speed. I rerouted my commute, declined invitations, stopped visiting friends and family, and asked others for rides to avoid having to drive on the highway.

And when I did drive, I’d repeat the “Our Father” over and over to keep my mind off my nerves. It reassured me to think God was riding along with me in my passenger seat.

It took many months, and numerous doctors and unnecessary medical tests to learn that the causes I’d made up in my imagination — carbon monoxide poisoning, inner-ear infections, seizures, a stroke, an aneurism, a brain tumor — were far more dire than the actual diagnosis: panic attacks.

Though few people openly discuss their fears, phobias and panic disorders are more prevalent than we think, affecting as many as 20 million American adults, according to the National Institutes of Mental Health.

The NIMH says phobias aren’t just extreme fear of things like bridges, needles, or highways, (or air travel, spiders, elevators, crowded places, heights, etc.); they are irrational fear of that particular thing. For as many as 6 million people, the phobia develops into panic disorder or recurring panic attacks.

“Phobias are real,” Jerilyn Ross, president of the Anxiety Disorders Association of America and director of the Ross Center for Anxiety and Related Disorders Inc. in Washington, D.C., told WebMD Magazine. “The experience of phobia is so unlike what most people know as fear and anxiety. …People with phobias are always aware that their fear doesn’t make any sense. But they cannot face it.”

While the exact cause of panic disorder is unknown, research suggests that a combination of a person’s biology or genes, personality, and environmental factors all contribute to the onset and development of panic disorder, according to the Anxiety Disorders Association of America. In worst-case scenarios, fear of another panic attack is so debilitating, as many as one-third of panic sufferers develop agoraphobia, preferring to spend their lives locked inside their homes rather than face their fear. In many cases, such as when people develop fears related to post-traumatic stress, their brains might “startle” at just the thought of the trauma, and trigger a panic attack.

A friend who lost her father to a fast-moving cancer 20 years ago still can’t go near a casket at a wake because of her panic. Even if she doesn’t recognize it’s doing so, her brain subconsciously connects the sights, smells, sounds of a wake to the trauma of seeing her burly Irish dad reduced in his casket to skin and bones. Before she’s aware of what’s happening, she starts breathing rapidly, her heart starts beating, and the rest of the symptoms of a classic panic attack overtake her.

While I continued to function, I would fret for days about an upcoming road trip, and my anxiety began to creep in when I drove on local roads, especially down steep hills. The heater being on too high, the radio too loud, too much air coming in through the open window or not enough, the kids fussing in the back seat, all could precipitate an attack.

I began having trouble sleeping and remained convinced that the next time I drove, I’d faint at the wheel.

But that couldn’t have been further from the truth, a kind psychotherapist told me a few weeks later, when I finally decided it was time to talk to someone. “Your body is reacting to a perceived fear,” she told me. “It’s a ‘fight-or-flight’ response — the same response you would have to, for instance, being chased by a tiger.”

Learning the physiology of these attacks was the first step in my healing. More than likely, the doctor explained, I’d sung myself dizzy in the car that day and, believing I was blacking out, I naturally panicked.

When we perceive danger, our bodies release adrenaline into the bloodstream which leads to physical symptoms like increased heart rate, rapid breathing (hyperventilation), and sweating.

Under these circumstances, my doctor told me, “fainting is the last thing your body would do.”

This “fight or flight” design, and its modern day vestige of a “panic attack” is a holdover from evolutionary biology, writes Steven M. Kleiner, a Boston psychiatrist, on Health Central’s anxietyconnection.com. “We are built to jump, run, and escape at the slightest roar of a saber-tooth tiger — and our heart and breathing respond accordingly.”

All of this, Kleiner writes, happens in seconds. “If this speed of onset is beneficial in the bush,” Kleiner continues, “the same rapidity of onset is a mismatch for the demands of modern, civilized life.”

The physical symptoms of an adrenaline rush, researchers say, produce the anxiety which produces the physical symptoms which in turn produce more anxiety.

Though some people overcome panic by riding out the attacks, many others need outside assistance, writes John C. Thomas, program director in the Center for Counseling and Family Studies at Liberty University in Lynchburg, Virginia. Often medication may be prescribed at first to help break the cycle. Research indicates that 80 percent of people receive some relief and between 40 and 60 percent achieve nearly full recovery using medication.

Once I learned that I was in no real danger of fainting, I began to recognize my physical symptoms before they took control and started to stare them down. In this way, I could remain relatively calm and keep the fear to a minimum.

Some attacks can be paradoxically managed in part, according to Thomas, by telling oneself that it is only a panic attack and it will run its course. I learned to breathe slowly and be conscious of the physical symptoms, such as muscle tightening and dizziness, in order to head them off before they became overwhelming.

I’ve given up alcohol, which can exacerbate panic symptoms, but have stopped short of giving up another common contributor, my morning coffee. Still, my highway fear has subsided enough to allow me panic-free driving most days. It sidelines me every so often on an unfamiliar road or occasionally after a long day, and I roll the window down or up, turn up the talk radio program, breathe effectively, and say a little prayer for the feeling to pass. So far, every time and without fail, it has. CD

There are five types of phobias:

  1. Natural environment phobias, such as being afraid of storms or lightning
  2. Animal phobias, such as being afraid of spiders or dogs
  3. Blood-injection-injury phobias, such as being afraid of blood or getting an injection
  4. Situational phobias, such as being afraid of elevators or bridges
  5. Other phobias, such as being afraid of choking or throwing up. Other phobias in children include being afraid of loud noises or characters in costumes, such as clowns.


Find support, treatment, and help
The Anxiety Disorders Association of America regularly lists and updates information for new support groups, treatment centers, therapists, and organizations. To search these lists by state, go to adaa.org and click “get help.”

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