Recipe for a Panic Attack: Recognizing the Signs and Admitting My Role in Sinking Down (A Very Long Post)

I had a full-blown panic attack yesterday. I had been in a slow downward spiral for days and didn’t recognize the signs and symptoms. Some of them are typical; some of them are my own that I’ve identified in myself. There was a progression of “events,”, which culminated in purging my thoughts in yesterday’s post (thoughts which are honest and real and truly how I feel), then being slammed with an acute panic attack shortly thereafter. And I did not see it coming. But I should have.

Yes, there’s a lot of shit going on in my life right now. Some good. Some bad. Some great. Some awful. But it’s not all circumstantial. I am somewhat culpable in what happened with me yesterday.

I am writing about this today for three specific reasons:

1. I need to hold myself accountable, but also remember to treat myself gently and kindly. And it feels really fucking good to be able to identify and recognize what’s wrong and how I got to this point.
2. I hope that sharing this helps someone, or someone you know, to recognize the signs, to take the steps necessary to care for your physical and mental health, and to be kind to yourself.
3. I want to thank you all for your support and love – because let’s face it, it’s a form of familial love when you gather around someone and (virtually) wrap your arms around that someone, and I fucking felt it. And I love you for it. I’ve been more positive lately, and I want to explain what (I think) happened to me yesterday.

Here goes.

Circumstantial “Triggers” (i.e. Personal Shit)

I’m gonna tackle this part bullet point style, because some of it you already know and the rest I’m not prepared to talk (in depth) about yet.

• I am being bullied at work. My character, my work ethic, everything. Full on assault. My supervisor is aware of it. And he knows that the problem is Queen Bitch. He refuses to do anything about it and, in fact, is about to move me to another area instead of addressing the problem with her. This means I will be away from the other coworkers whom I’ve grown quite close to. And they will still have to deal with her, because the super doesn’t want to set her off by moving her for what would be the fourth or fifth time.
• I have problems that I can’t afford to deal with right now. Arthritis, connective tissue disease (unspecified), fibromyalgia, periodontitis, chronic headaches and migraines. And that’s not to mention the mental health issues I have, which you already know about. I do not spend frivolously (aside from a book here or there or a smoothie, but it’s not egregious). I am responsible and (mostly) frugal. I’ve worn the same clothes for years, and my car is sixteen years old and in need of repairs. I am not complaining about this. I am thankful that I have clothes. I am thankful that I have personal transportation. I am thankful that I am able to be employed and am. However, I make just enough to keep my bills paid (let’s not talk about student loans) and have just enough cushion to buy a book or smoothie now and then. If I were to lose my job today, I could make it two months. I have enough to do that. That’s both wonderful and terrible at the same time. I am 35 years old. I am educated. I am smart. I am competent and capable. And I am fed up with doing the same job that the two men in my department do, and they both make over ten grand more than I do. (Whew. My bad. I did not intend for this bullet to turn into a rant. Ahem.)
• I am planning a big move this year, on a shoestring budget. I realize some of you don’t agree with this choice. And I get it. But, as previously mentioned, I am 35 years old. And you know what? I’m sick of living someone else’s life. I’m sick of riding in the backseat. I’m sick of following everyone’s rules, rules, rules. There is no tomorrow. There is today. And I need to finally fucking seize the day. I’ve wanted to live in the Pacific Northwest all my life. I do not want to die before I’ve lived the life I want to live. But it’s a costly choice. (Anything worth having is worth fighting for, yeah?) I will have to keep my stuff in storage indefinitely. But with the help of a good blogger friend, I’ve discovered that you can find tiny little apartments outside of Seattle proper, for just a little more than what I’m currently paying as a mortgage. So now it’s getting there that is a bit tricky on my budget.
• I am trying to prepare my house to sell and then sell it. It’s in need of repairs, but I’m close. Closer than I was, at least.
• I’m dealing with a personal issue that has been festering for going on five years now. And it’s all coming to a head. Finally. Finally. But it’s intensely stressful.
• I’ve begun my job hunt in Seattle, and that’s always stressful. Part of the stress here is that I know what the most responsible and safest bet is, but it’s not what I want. I want to finally do something with writing or copy-editing. If I’m not going out to save the world, at least I can do something I actually enjoy doing. We live at least half our lives at work. And that can ruin half of your life if you fucking hate your job.
• Emotional Upheaval. And that’s all I’m going to say about that. For now.

That’s enough personal bullshit. Most of it you already know. But now I’m spilling it again for the purpose of putting my current mindset into perspective and how that, coupled with other factors, resulted in a major panic attack.

Musical Indications

Over the last few weeks, my choices in music have gotten progressively darker and angrier. Now. Here’s the thing. I have an “angry” playlist, but I typically only listen to it when I’m already angry. But sometimes…sometimes it’s a major sign that I’m heading down into deep depression. A steady stream of angry music is dangerous for me. It always has been. It almost always starts out as anger with me. I didn’t recognize it. I wasn’t alert to it. I’ve been feeling so good lately that I simply didn’t see it coming.

It started out fairly tame. I listen to a lot of 90s music, and man was 90s rock depressing. But I listen to a lot of it and am usually okay. I get into it. I jam out. I get “in my feels” (I hate that phrase.). And I’m cool. I’m good.

It started out with some Pearl Jam. “Black.” (My favorite for deeply personal reasons which would be fairly obvious if you pay attention to lyrics.) “Daughter.” (Which makes me absolutely livid, again for obvious reasons.) “Alive.” (Which makes me angrily happy that I’ve made it through what I’ve been through. Because Fuck You for stomping me into the ground and trying to keep me there.)

It then progressed to Evanescence and Linkin Park. The angry ones. I listened to them for days and days. Repeatedly. At work. At home.

That progressed to Eminem. Oh I listened to Eminem even longer than the others. I was getting angrier and angrier. More and more Fuck. You. Fuck. You.

Which then led to days of things like Rob Zombie and Godsmack. Especially Godsmack. A Whole Fucking Bunch of Godsmack. Particularly:

Yeah. I listened to those four in particular Over and Over and Over again. Then I listened to them some more. Over and Over and Over. At work. At home. And Over again. (Also watched the vids because Sully Erna.) This obviously had a negative impact on me. As I’ve said, I listen to angry music now and then. But not for lengthy periods of time. I have fully immersed myself in anger and rage over the last few weeks. Bad. Fucking. News. I was fucking asking for it. And I was also seething beneath the surface and didn’t realize it. And this shit. This shit was gasoline on an ember. How did I not see what was happening?

As you know from yesterday, this anger (as it usually does with me) suddenly shifted to darkness. Depression. Hopelessness. Alice in Chains.

And the final nail in the coffin? My own doing of my own undoing?

I Broke the Cardinal Rule of Psychiatric Medicine

Yep. I’m prepared for this confession to tick some people off. I was read the riot act over this confession yesterday and rightfully so.

I know the rules about not stopping your meds. Never ever ever stop your meds and especially not “cold turkey” as it were. I’ve been through this with arthritis meds. There were some that were doing more harm than good and some that I simply couldn’t afford. So I very slowly and carefully weaned myself off of them. Like a smart, conscientious girl would do.

I also know it’s dangerous to stop meds cold turkey. Long-term physical or psychiatric meds that your body comes to rely upon on a chemical level. I’m wise to the fact that doing so could cause any number of physical withdrawal symptoms, suicidal ideation, self-harm, you name it.

And do you know what I did? I semi-stopped one of my meds. Straight up. No weaning. No consulting my doctor. Just stopped.

It wasn’t why you think. It wasn’t one of those situations where the person starts to feel better and then thinks, “I don’t need to take this shit anymore. I feel better.” As though you’ve taken an antibiotic and your infection is gone for good now. That’s not why I did it.

Why I Did It – Every. Single. Day. Since I started taking this cocktail of psychiatric meds, I’ve been fucking tired. I mean wiped out. No. You don’t understand. That’s not good enough to explain it. When I’m at work, I feel as though at any moment my head is going to slam onto my desk and I’m going to pass right the fuck out. I’ve nodded off in traffic, y’all. That does not happen to me. That could kill me AND you. I’ll be in mid-conversation with the geek squad and totally zone out. I can’t focus on my work. I can’t focus on you. I can’t read. My vision blurs. And all I want to do is sleep. Only I can’t. And even when I do, the feeling never goes away.

So a few days ago, I was picking up a scrip and the pharmacist wanted to ask some questions of me. Since I’d been on the meds for a while, he asked if he could do a little assessment. He asked me how I’d been feeling, whether I thought they were working. I was at the drive-thru so I could barely hear him (yes, a drive-thru pharmacy). At first, I said, “Fine! Everything’s fine.” But I heard myself and shook my head.

I have sleep disturbances. I wake up in the night.

“Okay. You’re taking the Lexapro at night, aren’t you? Stop it. Take it in the morning.”

Done. The disturbances have mostly stopped.

“Anything else?”

I can’t go to the bathroom.

“Hmm. Nothing should be causing that. Anything else?”

Yeah. No resolution on that TMI issue.

I’m tired all the time.

“How tired?”

It’s difficult for me to be awake talking to you right now. I perpetually feel like I haven’t slept in days and will pass out at any given moment.

“That’s not right. That has to be one of the meds.”

So I start asking him: Clonidine? No, not if you’re taking it at night. Klonopin? Not to the extent you’re describing. And not at the dose you’re on. Lamictal? Not if you’re taking it at night. At this point I’m getting frustrated. He should be telling me instead of me asking one at a time. Vistaril? How are you taking it? Two capsules, three times daily. (His eyes bug out of his head at this.) THAT is the problem. THAT is why you’re feeling this way. Sweet! So I’ll just stop taking it. I’ve never thought that one was helping anyway, because I’m still quite anxious. Do. Not. Stop. Taking it! However, it would be safe to go to one pill in the morning, one at lunch, and two at night. Then talk with your doctor. Okay! Thank you!

I didn’t mention the sexual issues I’m having. Mostly because too shy. But also because I’m not in a physical relationship with anyone but myself at the moment, so it’s not an urgent matter.

So what do I do? Fuck Vistaril. Fuck it. I started skipping both the morning and lunchtime doses altogether, then taking my two at night. I didn’t consider it as being like the others – Lexapro and Lamictal. This went on for days, and I thought nothing of it. I just changed my dosage and thought nothing else of it.

All of these factors combined and merged into one viscous, throbbing mass of creeping doom.

The Result (Payback is a Bitch)

• I started feeling a general sadness.
• I started feeling lazier.
• Anger became a more dominant emotion than usual.
• I became frustrated.
• I became restless.
• My legs started bouncing again.
• My speech got faster.
• I started doing more nervous twitching and hand wringing again.
• I started dwelling on emotional pain: what a bitch my mother is for abandoning me, what a sick fuck my father is for abusing me, what unloving assholes my siblings are for shunning me because I cannot forgive my abusive father, what a self-righteous prick Queen Bitch is, how emotionally cruel my ex could be, how hurtful it was when The Aussie threw me away, how sad I am that I’m not where I want to be right now. I hadn’t dwelt in several weeks. And still. Still I wasn’t alarmed. Still I didn’t see it.
• And then the Big Bad Scary: Suicidal Ideation reared its ugly head for the first time in quite a while since I began medication therapy. Now. NOW I was scared. But I blamed it on the meds. They’ve suddenly stopped working for some reason, I told myself. It’s NOT the meds helping you afterall, if you feel this way. God, I really wish I would die in my sleep. Yeah. Now I was scared. But I didn’t understand it.

Yesterday I woke up in a strange mood. I felt simultaneously hyper and subdued. Weird, right? That’s totally contradictory, but it’s the only way I know how to describe it. I felt emotionally subdued and as though I really didn’t want to be around anyone or talk to anyone or leave the house or bother with anything at all. But I felt physically hyper. My legs would not stop bouncing. My speech alternated between rapid and sluggish. My heart was racing. I couldn’t sit still. All the while…subdued. I had zero appetite, and my appetite has been low for days. But now, even the thought of food kind of made me strangely mad. And I was listening to Layne Staley sing some of the most depressing music there is, but I was in no state to handle it or appreciate it for its haunting beauty. My mind, my thoughts, turned into severe emotional turmoil. And I needed to get it out. I needed to purge.

Afterward? The Panic Attack that I didn’t realize was already brewing hit me. Hard. Forcefully. Punishingly. Terrifyingly.

The Panic Attack

It had already begun, and I didn’t even know it. I had no awareness of what was happening except that I felt like shit and wanted to go home. This is hard. This has all been hard to get out. But I’m going to keep going, no matter how ashamed I feel – because I know that I Should NOT feel ashamed. And maybe this will help someone to identify their own signs and symptoms, or those of someone they love. And it’s good for me. It reinforces these things for me. So. Here’s what my panic attack looked like.

1. Heightened frustration.
2. Serious stomach distress.
3. Heart racing.
4. Restless.
5. Bouncing my legs.
6. Rocking back and forth in my chair.
7. Eyes darting to and fro, nervously, anxiously.
8. Breathing rapidly, suffocatingly.
9. Hot. Had to shed layers hot, despite it being cold in here.
10. A strange out of body feeling, as though I was watching this happen but was helpless to stop it. As though I was detached and other from myself.
11. Mind racing, racing, racing, making less and less sense, getting more and more frantic, growing more and more irrational.
12. Feeling crazy, insane, like I was seriously going out of my fucking mind.
13. Feeling like this was never going to end. Ever. And this state would now be permanent.
14. Gritting my teeth, rocking, rocking, leaning forward and holding my head in my hands.
15. Squeezing my head.
16. Shaking. Violently shaking.
17. Pulling my hair.
18. Wanting to hit myself. But I was in the room with others. They couldn’t see me, but it’s the only reason I wasn’t screaming in rage.
19. And finally I had to run to the bathroom to throw up.

At some point in the midst of all of this, I thought about the Vistaril and had a brief question in my mind. Is that why this is happening?

And no, I don’t think that’s all that was wrong. I know it wasn’t. Because I’d already had that anger and rage building, building, building. But I do believe that I made a mistake in doing what I did with the medication. I do believe it was a factor in what happened to me yesterday. And I do regret not listening to the pharmacist.

When it was over, I felt exhausted and spent. I took my Vistaril (I had it with me). Talked with a WordPress friend about what was going on (actually during the panic attack, too) – and I’m more grateful than you know.

This morning I took my single Vistaril. And now I’m about to take my lunchtime one. And I’m tired. I’m tired as fuck. I could go to sleep on my desk. Right. Fucking. Now. But I’m going to take it. And when I meet Dr. Feelgood for my next appointment, I’m going to request we try something different for anxiety. Because this is not working for me.

Lessons Learned

• Be more aware of your behaviors and reactions.
• Pay attention to your patterns and routines. When you break them, reach out. If it’s fixable, fix it. If you haven’t changed anything, fucking reach out. For me, I could have told people here. People who may have recognized that I was spiraling out of emotional control.
• Do. Not. DO NOT significantly alter your meds without consulting your doctor or pharmacist. And fucking LISTEN to what they tell you. HEED it.
• Do not settle for meds that make you feel poorly. Be your own advocate and be ballsier. Ask for better meds. Do it. FUCKING DO IT. Your life may literally depend upon it.

In the aftermath, I still feel subdued. I’m still shaky and bouncy. My appetite is good. I just had a full lunch. I don’t think I ate at all yesterday, which isn’t normal for me. I’m tired as fuck. I’m still down.

But it is better than yesterday. By a long shot. Maybe I am sliding down into a depressive state. And if I am, that’s okay. It’s part of who I am. How I am. But I must take better care of myself and pay better attention to my mind, body and spirit.

And never ever forget to breathe.

And please, if you’re suffering, reach out. If you think you have no one to reach out to, reach out to me. We’re all in this thing called life together.

So I thank you. I thank you for being here for me. For encouraging me. For commiserating with me. For telling me to chin up. For telling me to stop fucking listening to that bullshit while I’m in the throes of a depressive cycle. For telling me you get it. For telling me you’ve been there. For simply being here. I thank you.