March 30, 2005

Re-Linking: Panic Disorder (Or, How Jay Mohr Pretty Much Saved My Life)
— Ace

I'm re-linking this because I was just discussing this deal with a poster via email. A couple of people have told me this post actually helped them realize they had panic disorder and convinced them to get the treatment for it they needed.

So, who knows, it's possible there are a couple of newer readers out there who need to read it too.

Long story short: if you're experiencing odd panic attacks -- which you might be calling "anxiety," incorrectly -- you're not going crazy, you're not going to die, and there's nothing wrong with you that can't be fixed -- relatively easily, in 90% of cases.

And you must get it fixed. Don't keep living with it.

Panic gave me the worst years of my entire life. I want those years back, but they're gone forever now.

Posted by: Ace at 03:02 PM | Comments (43)
Post contains 162 words, total size 1 kb.

1 I assume from your post that you are cured? I hope that is true.

Posted by: Jake at March 30, 2005 03:53 PM (r/5D/)

2 You know, the uncharitable side of me might mark that post as the advent of the Serious Ace, and therefore the beginning of an inevitable slide downward from hilariously vulgar fuck-all pirate-conservativism into increasingly frequent bouts of awkward sincerity (sort of like when Stephen Malkmus began sneaking love songs onto Pavement's albums).

But the truth is that it was actually a genuinely powerful post. Few I've read in the blogosphere could have pulled something as painfully personal as that off without making the reader feel slightly embarrassed about reading it (because there's always something awkward about being in the spectator's situation). For sure I've seen a lot of people write posts like that brought the word "MELTDOWN" to mind.

Yours was nothing like that at all. In fact, the reason I thought it was so moving is because I found it applicable in a more general sense as well: I don't have the same problem, but I had to deal with something analogous, and went through the same despondent sequence of emotions before figuring it out and realizing I didn't have to live with it forever. As unbearably movie-of-the-week as it sounds, I thought it was sorta...erm, inspiring. Also, you can sure as hell write. Don't let it go to your head, okay?

(By the way, just to get back into character: you misspelled "cryptofascist" underneath your snazzy death card logo to the left, ya moron.)

Posted by: Jeff B. at March 30, 2005 03:57 PM (037AZ)

3 Jake,

Not cured but controlled. The old social confidence is sort of coming back... in fact, I'm getting a little bit cocky again, the way I was in college (but hopefully not so insufferably).

But, you know, what the hell. Better than sitting in the corner gibbering like a mental patient.


Thanks. I don't do much personal stuff on this blog, obviously. Indulge me on this one thing.

Thanks for the kind words.

PS, fuck you and your so called "standard spellling," dickface.

Posted by: ace at March 30, 2005 04:19 PM (Q6+G6)

4 Thanks. I don't do much personal stuff on this blog, obviously. Indulge me on this one thing.

Well...okay. But I swear to god if I ever read a post from you along the lines of

Posted by: Jeff B. at March 30, 2005 04:30 PM (037AZ)

5 PS, that typo in the above post? That was "in character," so to speak. I was in the zone.

Posted by: Jeff B. at March 30, 2005 04:31 PM (037AZ)

6 oh, no, it made perfect sense, with light exit[ing] and all.

You're a real clever feller there.

Posted by: ace at March 30, 2005 04:33 PM (Q6+G6)

7 It's amazing how much easier some things are do deal with if you just know what they are.

Anyone here ever had a bout of sleep paralysis? You wake up, and you can't move. Nada. Zip. Nothing. Can't talk, you just sorta lie there and freak out. After a bit, you drop back into sleep, or some loud noise happens, and you can move again. It's usually caused by a warped sleep/wake cycle, like jet lag or the like. Harmless, overall.

...but if you know what it is, and it happens, it's actually kinda neat...

Posted by: cirby at March 30, 2005 04:58 PM (fY33n)

8 "Anyone here ever had a bout of sleep paralysis?"

Cirby: throughout my childhood; occasionally I still have bouts. The fantasy that people are coming across the room to stab paralyzed me to death are rare now, fortunately. I still haven't gotten to the "it's kinda neat" stage, though, since I tend to 1) be scared shitless whenever it happens, and 2) wake with a jerk that ruins my nerves for the night. I think they only happen if I eat too much cheese and red wine right before going to sleep, though, so I don't eat lots of cheese and red wine before going to sleep.

Posted by: Andrea Harris at March 30, 2005 05:47 PM (0XThq)

9 Isn't there a theory that sleep paralysis (misunderstood by those who suffer from it) explains a lot of so-called 'alien abduction' stories? I find that to be a fascinating possibility.

Posted by: Jeff B. at March 30, 2005 05:50 PM (037AZ)

10 That was a great post. I'm sorry I missed it at the time.

I've had something like that a few times, usually after stressful, life-changing events. It's easy to identify the source in that situation. In fact, that's probably not "panic disorder." It's panic/ acute anxiety rationally related to some event, and it wears off relatively quickly in my case, weeks.

But there's that other time.

I found out panic attacks can also come months or years after the triggering event, so that you have to way to link them to the cause. You have no idea the heart rending breakup last fall during your first semester of law school, for example, is the cause of your sudden inability to speak in front of small groups of clerks and in conferences with partners the next summer. You think you've been exposed as a fraud because there is no other explanation. You begin to feel ashamed and unworthy. And then comes the gatuitous side-order of avoidance behavior.

My first one hit me mid-sentence. In a frigging conference. Senior partner. Six or seven clerks. A couple of legal assistants. Suddenly, my throat wouldn't speak.

I had no idea why. The effect cascaded from there. By the end of summer, I was shaken and stirred. After months of researching during spare moments, the following winter found something that best described my problem, PTSD. It fit pretty well, but I hadn't seen combat, arms blown off, explosions, etc. Haven't had that version since then.

I think the standard is or should be more subjective. At times, what might be regarded by others as mild trauma can be experienced as extreme by an individual in a given situation.

Also, if your parents were the type who shamed you often as a kid--a weird form of punishment, I guess, or sickness--there has to be a greater tendency to fall back into that well-worn groove when under stress as an adult. But that's just me talking out my ass. Haven't read it anywhere.

And a dominant parent with a narcisstic disorder would have a tendency to hammer one lesson home above all others: you're not worthy--of [fill in the blank because it's pretty much everything]. This could lead to unexplained fear. Again, however, that's just my 2 cents.

Posted by: rdbrewer at March 30, 2005 06:17 PM (lpbk9)

11 You think you've been exposed as a fraud because there is no other explanation. You begin to feel ashamed and unworthy. And then comes the gatuitous side-order of avoidance behavior.

Oh man, I know all about that. Sucks. You become a different person. A very sucky person.

The actual thing that most frequently causes panic is going from a well-structured environment to an unstructured one. Doctors and actors tend to be the most frequently hit.

Posted by: ace at March 30, 2005 06:41 PM (Q6+G6)

12 For instance, plane travel never bothered Jay Mohr. Never bothered me, either.

Because it's so structured and orderly. You'd think that a panic sufferer would go bonkers on a plane, but not for me, and not for Jay Mohr either.

On the other hand-- car trips would freak me out.

Posted by: ace at March 30, 2005 06:42 PM (Q6+G6)

13 Andrea:
I'm lucky, The sleep paralysis hit me the first time just a couple of days ago. Luckily, I'd read "Toscanini's Fumble" by Klawans, so I knew about the situation going into it.

Sure, the first moments were kinda freaky (wasn't sure if I was dreaming or not for a bit), then realized there was Something Wrong and jumped right to the real problem fast enough to not panic. So I laid there for a moment, testing the situation (nope, no voluntary movement, yes, I could feel my heartbeat, yes I was still breathing, yes, I could feel the sheets all the way down to my feet).

So I went back to sleep, and when the alarm went off I rolled over and hit snooze. All fixed.

Posted by: cirby at March 30, 2005 07:23 PM (fY33n)

14 Man, ace... I have panic attacks, but not as bad as you described. I can generally get outand about with no problems, but if I'm about to go into a meeting or some other situation where I know that I can't leave I start to get panicky.

It's like it's a control thing. And that's why the way in which it really impacts me is that I can't fly. I actually flew up to NY to my brothers wedding... no problem. On the trip home, though, the pilot said (before takeoff) that the latch on his seat was screwed and that we had to sit on the tarmac for about an hour--in the plane--while we waited for someone to fix the seat.

That's when something snapped. I got one of the worst panic attacks I have ever had, and the only thing that made it go away was making them let me leave the plane.

I rented a car and drove back to Florida from Albany. Now, even the thought of being stuck in a little aluminum tube 35,000 above the ground gives me a panicky feeling. It's completely irrational, but I'm afraid that the second the plane lifts off of the ground I will freak, knowing that its the point of no return. As you pointed out, this is a self fulfilling fear. (oddly enough I still feel like I could get in a little Cessna 172 or something and fly around... like I said, I think it's about control).

Do you think that pill could help me to fly? I would hate for this stupid, baseless panic to prevent me from travelling. It could even prevent me from holding certain kinds of jobs when I get out of school.

Dave S.

Posted by: Dave S at March 30, 2005 07:55 PM (96ugy)

15 Hmmm... well, I really don't know. Maybe just for that sort of once in a while anxiety (and that sounds more like anxiety) they'd just prescribe a valium or two for the trip.

Klonopin might work for you flying; I just don't know if they'd want to prescribe a lot of of it. But maybe they could prescribe four or six pills.

Posted by: ace at March 30, 2005 08:01 PM (Q6+G6)

16 I think that there may be, at times, a fine line between anxiety and panic. My "condition" began with sporatic, full-blown panic attacks. I thought I was having the heart attack and all of that, but, luckily, it never got to the point where it completely dominated my life.

I think that once you've had a panic attack, anxiety can easily turn into a panic attack, simply because the thought that one MAY be coming causes it.

I think the plane thing for me was certainly anxiety at first, but it quickly turned into a true panic attack. According to the person I was with, I actually shoved the guy sitting next to me out of my way and ran to the front of the plane to get off. Yes, I actually abandoned the person who was flying back to Florida with me in a spontaneous, panicked decision to get off... luckily I freaked her out and she followed me.

I don't know. It may be purely anxiety. I had a doctor give me a little valium once to try to fly (little 5mg pills). I only took 1 or 1 and 1/2 and I still didn't feel totally comfortable getting on the plane (and, in fact, DIDN'T get on the plane).

Maybe I just needed to take more.

Dave S

Posted by: Dave S at March 30, 2005 08:16 PM (96ugy)

17 Well the thing with Klonopin is once you go on it, you have to stay on it, or be very careful about weaning yourself off of it slowly, or else you could get some nasty withdrawal effects (even maybe seizures, IIRC).

So I don't think they'd want to prescribe it just for situational-panic. If you go on it at all, they're going to want you on a certain dosage every day. And if you're only having panic or anxiety sporadically or under certain conditions, they'd probably prefer some other drug.

Posted by: ace at March 30, 2005 08:22 PM (Q6+G6)

18 BTW, does the Klonopin make you drowsy?

Posted by: Dave S at March 30, 2005 08:23 PM (96ugy)

19 And panic isn't just a more intense form of anxiety. Anxiety attacks can be very bad. The difference is (bear in mind, I don't know much; my doctor was clueless; I got this all from Jay Mohr and the internet) is that anxiety actually has an understandable cause, whereas panic comes out of nowhere.

So, I would think that having bad attacks due to flying would be "anxiety," because it's an irrational fear of something. Whereas panic is an irrational fear of nothing really at all (except maybe the possibility of panic).

Whichever it is-- I think they have an awful lot of drugs, and one of them should work for you.

Posted by: ace at March 30, 2005 08:25 PM (Q6+G6)

20 BTW, does the Klonopin make you drowsy?

A little. I don't feel it so much anymore, except when I have to take extra pills when I feel panic coming, or when I drink.

I'm smoking again, and more, so maybe I'm using the nicotine to offset the drowsiness caused by the Klonopin.

Posted by: ace at March 30, 2005 08:27 PM (Q6+G6)

21 Sleep paralysis? That sounds scary, too. Doesn't sound neat at all.

Posted by: ace at March 30, 2005 08:29 PM (Q6+G6)

22 Well... cool. Thanks for bringing this up. I may have a situation soon where I have to fly. I should probably go to a doctor soon.

Can you believe I turned down a week in Europe for work last month because I didn't want to deal with an attack (of whichever kind it is) over the middle of the Atlantic?


Posted by: Dave S at March 30, 2005 08:30 PM (96ugy)

23 Oh, I'm also told that klonopin may cause occasional difficulty getting an erection or having an orgasm, so, you know, you've got to weigh that in, too.

For me, not such a problem. Some say sex is 90% mental; I do that 10% better.

Posted by: ace at March 30, 2005 08:35 PM (Q6+G6)

24 Can you believe I turned down a week in Europe for work last month because I didn't want to deal with an attack (of whichever kind it is) over the middle of the Atlantic?

Yeah, that's what you call avoidance behavior. I pretty much almost cancelled a trip to Europe for the same reason... and then wound up wasting the last two days in the hotel room because I'd had a down-on-the-ground attack in front of the Palace of Justice in Paris.

Posted by: ace at March 30, 2005 08:36 PM (Q6+G6)

25 ace:

Yeah, I can see how it would completely freak someone out if they didn't know what was happening. It's really pretty minor (for most folks). It used to be really rare, too, until jetlag and all-night computer use became the norm.

You see, when you sleep, the body inhibits voluntary muscle movement, so you don't thrash around so much when you sleep. If you screw up your wake/sleep cycle too much, you can get into the situation where the brain wakes up, but the body doesn't get the override to be active again. So you can't move, or talk, or pretty much anything.

They used to call it "hag-ridden," because people would wake up, unable to move, and they'd panic, so the body would kick out a lot of adrenaline, making them hyperventilate and such. So... they'd be in complete terror, and unable to move. Since it's on a borderline state between sleep and waking, you also get some dream/nightmare crossover for a lot of folks.

The mind invents - some people would "fill in" an evil hag, sitting on their chest, keeping them from moving. Nowadays, it's aliens.

But, as I said, it didn't hit me that way, because I figured it out really fast. I guess in a lot of ways, I have the opposite neurochemicals you have, because I'm very, very difficult to panic.

Posted by: cirby at March 30, 2005 09:50 PM (fY33n)

26 Cirby--Me too. Even when I ought to panic, I don't.

D&D players will recognize the origin of the succubus--from a page of the Monster Manual that made quite an impression on this adolescent geek.

Posted by: See-Dubya at March 30, 2005 10:01 PM (PUZhO)

27 Calling it sleep paralysis sounds like baloney. How about "dreaming you're awake when you aren't." If you pay attention to the clues during these times, when you do wake, you see that's the case. The lamp didn't fall over, the door wasn't opened, you didn't manage to edge off the side of the bed, etc. I found a few times these dream-wakefulness periods coincide with apnea. I (finally) woke and found my head and neck in a weird position, making it difficult to breathe. The growing sense of danger during the dream parallels the growing need for air.

RDBrewer, dreamonaut

Posted by: rdbrewer at March 31, 2005 03:07 AM (lpbk9)

28 oops - posted to the wrong place -

It is wonderful you have found some relief and care enough to share it with others. I'm so glad you're only "emotional" (you wuss) and not "mental" like me .... Now that you have a diagnosis, it looks like there are a lot of different options if you need or want to move to another drug.

Myself, I have these weird anxiety attacks that only surfaced in the last five years. My doctor offered and then kind of talked me out of prescribing an anti-depressant that can be taken "as needed". Her thought was that they seem to be temporary, in my case, lasting a finite amount of time.

I was kind of upset at myself for declining after I had left and I did a little research on St. Jon's Wort, etc. I didn't like having to take something daily for attacks that were unpredictable and not a daily occurrence.

I found "Kava Kava". It's supposed to be bad for you, but it has worked really well when I take it. And I figure I take it so very seldom now that it beats the alternative - suffering.

I only take it when that familiar weird pulsating blood rush that heralds the start of an episode for me would happen - you probably know what I mean. I have never yet had to take a second dose the same day!! which does amaze me.

Weirdly enough the attacks have also decreased to where I take it less than once a month. Just knowing that a simple pill will make me more levelheaded and less likely to flip out is so so comforting.

This is probably not good advice for true Panic Disorder. I think mine is more of an anxiety thing - but who knows?

Anyway, thought I'd mention it in case anyone reading this experiences, ha ha!, the mental one

p.s. I've had the night paralysis before about 15 years ago - frickin' scary!

Posted by: psflanagan at March 31, 2005 03:33 AM (Bg7xX)

29 Klonopin is great for flight anxiety and works just fine when taken situationally. Better, in fact, because you won't have a resistance to it. But doctors may be reluctant to prescribe it since they may feel you're using an elephant gun to chase rabbits.

Here's one reason why it works so well--it causes amnesia in many people. You won't even remember the flight. Soon you may find that you're not afraid of freaking out anymore and a huge source of anxiety is removed. Then, after a couple of event-free flights, you may find that you need a smaller dose.

And then one day you will realize you are no longer afraid of flying, that the anxiety you knew was irrational from the start just isn't there anymore.

Of course, about that time you'll look out the window and see an engine on fire or you'll hit turbulence that makes you puke on the swarthy, angry fellow next to you and the process starts all over again!

And I am speaking from experience here. Flight anxiety just popped up one day and a few years later just left. The Klonopin didn't just control my anxiety, it helped me cure it. Better living through chemistry!

Posted by: spongeworthy at March 31, 2005 03:50 AM (uSomN)

30 rdbrewer-

Nope, sleep paralysis is a real event. When they get people who are prone to it and slap EEGs on them, their brain is awake but their body won't move. The mechanism is fairly well understood, and is quite common among people with certain disrupted sleep patterns.

You *can* slip in and out of the dream state, which is where some folks fill in their "hags" or "alien abductions." But the "lay there and not be able to move while awake" bit is quite real.

Posted by: cirby at March 31, 2005 05:33 AM (fY33n)

31 See-Dub, I remember that succubus entry in the monster manual all-to-well.

That's funny, and a nice flashback to my D&D days!

Dave S.

Posted by: Dave S at March 31, 2005 05:46 AM (c1Og1)

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