29th October

NOTE:

Since writing this article in 2005, I have written a comprehensive guide on how to cope with and alleviate Depersonalization and its many symptoms. This ebook is available to purchase and download at www.dpmanual.com

Panic Attacks And Perspective

Almost three months ago, on the night of the 31st of August, I suffered an intense panic attack. It came out of nowhere as I was sitting, watching television. In the days and weeks that followed, I tried to figure out what had happened to me (since I did not recognise it as a panic attack). This worry precipitated more attacks, and I began to experience a common related symptom known as ‘depersonalization’. This manifests as a constant feeling of unreality, of not being connected to your surroundings, as if you are watching your life through a screen. It worsens when you feel anxious, and the anxiety and depersonalisation tend to perpetuate each other.

Only when I began researching my symptoms on the Internet did I begin to understand what was happening to me. I read that panic attacks were extremely common, and that though depersonalisation was not usually as persistent as mine, it was not unheard of. I tried a variety of different treatments; meditation, massage, Reiki, exercise etc. Unfortunately, none of these were effective for more than a short time, and the symptoms got worse and worse.

Though I’d been initially thrown into a state of fear and confusion, I was sure that it would eventually pass. Even my doctor’s first opinion was just that – everyone gets down on themselves from time to time, and it will probably disappear on its own. It didn’t, though – and as days and weeks passed, I became more and more used to that horrible mental state; and my certainty that it was just a temporary thing began to erode.

To describe the terror that I felt in those weeks after the attack would be a difficult thing. I felt constantly afraid of the world around me; everything and everyone I knew and loved were suddenly things to be scared of, and I was cut off from them utterly. I was living in my head, watching the world pass by. My enthusiasm for life left me. Getting up in the morning seemed futile; why bother exposing myself to a world of stimuli and fear, when I could stay in a safe, darkened room for the day? I knew, empirically, that I was safe, that I would not go crazy, that I would not die; but I couldn’t feel it. The safety in existence itself that I’d always taken for granted had left me.

Also, though I knew that my anxiety was almost certainly a passing phase, and one that could be treated if necessary, I couldn’t feel that, either. If I dwelt for more than a few minutes on what was happening to me, I would freak out, convinced that I was stuck this way forever. The absolute despair of those episodes is beyond my descriptive ability; I genuinely felt that I was losing my mind, my life was over. As terrible as it sounds, the idea of death seemed like a welcome release. I considered the possibility that I had actually died the night of the first panic attack, and that now I was either in purgatory or Hell, depending on how bad I felt. I stopped sleeping, reading, writing, and eating. I lost two stone. I seriously considered dropping out of a Masters for which I’d been accepted.

As more weeks passed, and I felt even worse, I was considering the possibility that I had some horrible, incurable mental disease or even brain cancer. Those thoughts would lead to more fear – and all of this, of course, was self-perpetuating – the anxiety, the depersonalisation, not eating etc – all part of the same downward spiral. I could see it happening, but I couldn’t do anything to stop it. The more deeply these habits became ingrained, the further away from normality I slid. I tried to remember what I’d been like before all this; I used to enjoy horror movies, now even “Charlie And The Chocolate Factory” seemed terrifying.

The condition reached its worst point when I had to attend a family wedding abroad. For an entire two days of forcing myself to be social and active, my life turned into a movie before my eyes. I was scared out of my mind at every turn, freaked out by every conversation, sick at the sight of food, and convinced that I was ruining everyone’s time. I wanted to curl up in a ball on the floor and weep, though I also knew that doing so would only make things worse. Any admission of defeat would later taunt me into complete submission.

During that weekend, I woke up in the middle of the night with the feelings of panic upon me. I remembered that I had dreamt of panicking - and had woken up with it actually happening. I just couldn’t escape from these feelings of terror, even in my sleep.

I had another severe panic attack on the plane on the way back. At that point, I thought that reality itself had collapsed around me. I genuinely felt like I was watching my sanity leave me, I would never be the same again, and I’d spend the rest of my life in a quiet, darkened room, terrified of intrusions. I felt intensely jealous of all the people living normal lives, watching TV, working boring office jobs, drinking to forget at the weekends. I had vowed never to end up living like that; now it seemed like a Utopian fantasy.

I went on anti-anxiety medication two days later.

There was an immediate, probably psychosomatic improvement. After that, it was an agonisingly slow recuperation, and I had to remember to think about the recovery in terms of weeks, not days (i.e., ‘You feel bad now, but remember how bad you felt on this day last week’). Being on the medication initially made it both better and worse; when I felt ok I knew it was helping, but when I felt bad I thought that the medication - seemingly, my only potential escape from this state - was not working and that, well, that was that and life would be like this from here on in.

But after two weeks there was a marked improvement. I began to read again; though I had to do so out loud to regulate my concentration. I forced myself to walk into town, though the anxiety was insisting that I stay home, stay safe. I watched television and films again without thinking constantly that my life had turned into just that. I spoke to people without thinking that any minute, I might start to panic.

And eventually, I started to experience periods of time in which I felt completely fine, in which I forgot about it completely. There seemed to be an obvious correlation; if I could learn to forget to be anxious, then the anxiety would stop. Unfortunately, the human mind operates for the most part on auto-pilot; if I was to say to you, “Whatever you do, don’t think about pink elephants “, then the first thing you do, whether you like it or not, is think about just that. This truism is a tenet of seduction, suggestion and neuro-linguistic programming (NLP).

If I was not anxious, I would, out of habit, think about how good this was, start contemplating if I was getting better or not, panic, and be back to square one. At first, this pattern happened in spaces of seconds, then minutes, then as I began to improve, hours and eventually days. The very act of thinking about the condition constantly was what made it worse – it had permeated my every thought and action for over a month by then. That habit had been firmly rooted in my daily routine, and everything reminded me to think about it. But eventually, I began to have entire days when it never occurred to me at all; and if I did think about it, it was a conscious decision to do so, and from an objective, non-anxious viewpoint.

Because of the nature of habit, you are denied the opportunity to compare it objectively with old behaviours. A habit isn’t just a finite occurrence that has clear “before and after” stages. It sneaks up on you and welds itself onto your personality. It is something that is learned; and once something is learned and practiced, it is extremely difficult to forget. My habit of thinking negatively was learned in the moments of panic attacks, and practiced in that my every subsequent thought was concerned with fear. Before I knew it, I’d been habitualised entirely with constant fear and anxiety, and a terrifying awareness that if I was going to get out of this at all, it would take weeks, possibly months of recuperation.

This was in the face of a fear that was impossible to get used to; everywhere I looked in everyday life was a new composition of existential dreadfulness, seemingly designed specifically for me. It never got any easier; it got easier to deal with, but the moments of feeling scared, though eventually fleeting, were always fresh.

But eventually, the worst of it left me. Though I am still aware of it at times of anxiety, it’s more of the memory of the trauma, and something I can control. I can’t deny the possibility of a relapse in the future, but the now re-established habit of positive thought makes that prospect more unlikely with each passing day.

In the time since the illness passed, however, I noticed changes in myself. One of the mantras that I had while sick was, “If I ever get out of this, nothing trivial will ever really bother me again – how could it?” Though I knew well that the re-establishing of normal habits would almost certainly overrule this, it hasn’t done so entirely. It may only be a slight change, but the feeling of gratitude for normality is still very much with me. I know it’s a cliché, but what importance do money or material possessions truly hold if you’re not essentially happy? If you can’t connect with your family or friends, if you are cut off from everything that makes you human, that gives life meaning, that tells you in your soul that this is all worthwhile? Never before has the importance of connection in life been obviated in such a way. Connection is all there is, it is the ultimate motivation in life, to know and more importantly, feel, that we are part of something. As the Desiderata says:

‘You are a child of the universe, no less than the trees and the stars; you have a right to be here. And whether or not it is clear to you, no doubt the universe is unfolding as it should.’

Part 2