Anatomy of a Panic Attack

My panic attacks are completely out of control.  Not just interfering with my ability to work, but actually interfering with my ability to be a decent person.  I’m drowning in my own head and pulling other people down with me.

It sucks.

My body is basically stuck in “fight-or-flight” mode.  I am never calm.  My head hurts all the time because my blood pressure is constantly elevated.  And even the slightest stressors can send my brain into a crazed panic that lasts for days. When the panic takes over the whole world is darker, there’s a rushing sound in my ears and dozens of angry voices scream at me from inside my own head.

I want to run away.  I want to fight.  I am afraid.

There are some horrible demons in my past, and for a long time I kept them shut up tight in closets in the back of my mind and pretended they didn’t exist.  Last year I decided I would rather face them head on and try to heal instead of just coping.  My ex-husband, Norman, didn’t take kindly to the idea of me leaving the law to see to my own mental health, and a nasty divorce ensued.  Which, naturally, made all my mental health problems so much worse.

I just came down off a four-day panic attack.  It started, as they often do, because I do not know how to process emotional pain.  When I am hurt, instead of acknowledging the hurt and working through it, I become angry and try to take control of the situation that hurt me.  And so, having identified a problem in my life, my dysfunctional brain set about making it a thousand times worse.

I get stuck in these doom spirals where I am absolutely certain that the absolute worst-case scenario is the only possible outcome.  It’s hard to put the feelings into words.  It’s like it’s midnight in my mind and all the monsters and demons have come out of their closets and are screaming at me that I’m a horrible human being and I deserve to die alone in the gutter and I can’t hear the people in the real world who are trying to tell me different because there’s a storm raging here inside my head and all I can hear is the wind.

Sometimes this goes on for days.

The truly terrifying thing about my most recent panic attack is that when I look back on it I can actually see that I am improving over recent months.  Just a few weeks ago the panic attacks were so overwhelming that I would actually physically harm myself out of a conviction that I needed to be punished.  That’s definitely a throwback from my delightful childhood that should be addressed by a mental health professional.  Sadly, those are in terribly short supply.

The impulses toward self-harm and suicidal ideations are starting to fade away now.  Probably because I finally have reasonable access to health care.  US healthcare is complicated in the best of circumstances.  Add two cross country moves in two years and a lot of travelling in between, and consistent care of any kind becomes impossible.

After a tumultuous summer and fall which will be elaborated on at a later date, I finally managed to re-establish residency in Louisiana last November.  I immediately registered to vote, and—after a great deal of hesitation and self-castigation—applied for Medicaid.

The amount of shame that went with filling out that application was astonishing.  I still haven’t been able to talk myself into applying for food stamps.

I grew up the kind of poor that thinks taking government assistance is a moral failing.  I would love to say I’ve evolved beyond this belief, which I know in my head and my heart is untrue, but there’s this one nasty little Arkansas trailer trash hillbilly voice in the back of my head who enjoyed berating me for it.

My biggest discomfort was actually that I am A Lawyer.  In my divorce proceedings, my law license has been treated like a holy grail that would give my ex untold riches if I would just get off my ass and use it.  But I can’t.  My brain is broken.

Now because I have this advanced degree and a court has ruled me as “voluntarily underemployed” and imputed me with a six figure salary (and hit me with several thousand dollars a month in alimony and child support orders which I cannot possibly pay right now), I feel like I shouldn’t be allowed to use government assistance programs.  I have been told that I have both the ability and the obligation to provide for myself and others, whether I personally feel capable of doing so or not.  It’s giving me hard-core shame and guilt issues.

Then one day an all-too-insightful friend reminded me that if I were speaking to someone in my shoes I would be encouraging them to use all the resources they could access because everyone falls on hard times and there’s no shame in needing a bit of help.  Then she asked me why I have more compassion for other people than I do for myself.

I didn’t have an answer for that one, so I applied for Medicaid.

I was approved basically immediately because my ass is broke (going to apply for food stamps as soon as I finish writing this, for real).  Then came the really fun part: actually finding care.

The insurance company assigned me a primary care physician, but when I called to make an appointment the receptionist acted all confused and said someone would call me back but no one ever did.  I gave up after only three tries.  I am not big on persistence right now.

By the time I had to leave to see my kids in December, I still hadn’t found care.  The stress of the trip, of dealing with Norman, of having to celebrate a holiday I hate built up pretty heavily.  I managed to make it through the time with my kids without losing it.  Luckily my mom came up to spend Christmas with them and to help me out so when I did have one massive panic attack she was there to keep everything calm.

I tried to make the trip back fun and relaxing, but after the second day it was all terrible weather and treacherous roads and by the time I made it back to New Orleans I was an absolute wreck.

The first week of this year was one of the worst of my life.  I fell into a pit of despair so deep I couldn’t hear reality.  I belonged to the panic.  I didn’t see any hope for the future.  I believed my children and the whole world would be better off without me.

I screamed.  I cried.  I broke things.  The whole appalling affair came to a head one night when I completely lost my shit altogether and reenacted that scene from Fight Club where the one guy beats himself up in the other guy’s office.

I felt like I needed to be punished for being a horrible person, so I literally beat myself up.  I gave myself a black eye.  A bad one.

My roommate—reasonably enough—lost his shit because he was worried people would blame him.  In hindsight that was an entirely reasonable concern.  But I wasn’t thinking about him when I did it.  I was thinking that the bad person needed to be hurt.

I think it also upset him just to have to look at the bruises.  I think it might make him sad when I hurt myself.  I should add that to the very long list of reasons I should stop.

I wound up telling people I had been in a car accident and the airbag did it.  That actually happens pretty often and I’m white and sound educated and am a really good liar so no one asked any questions.

I told my chiropractor how it really happened.  (Medicaid covers chiropractors, yay!)  He said he had never seen someone self-harm by punching before. 

At least I’m original.

Anyway so I’m sitting in a bar with a fucking black eye because I’ve lost my mind and I’m a degenerate now when my friend Critter goes “you need therapy.”

And I say “no shit but my last therapist ghosted me and the ones on the Medicaid list don’t answer their phones.”

And he said “call Crescent Care, they’ll take care of you.”

Words that changed my fucking life, y’all.

Crescent Care is a Federally Qualified Health Center.  I myself did not know these things existed until a week ago, so I’m going to elaborate.

FQHCs are health care organizations located in high need areas that are operated by a board of directors pulled from the community in which they are located.  At least 51% of the board have to be actual patients of the facility.  These health centers provide comprehensive care to underserved and underinsured patients.  They are funded by federal grant and cost-based reimbursements for Medicaid patients.

Lady Fortune smiled on me and when I called Crescent Care they had a cancellation opening for a new patient visit less than two weeks in the future.  It’s normally a four-to-six week wait for those appointments.

I was nervous about the appointment.  Wait time for a therapist was four to six months, and I knew there was no way I could keep having panic attacks at that level for that long.

My poor, much tormented roommate tries to help, but mostly he just winds up shouldering abuse while he tries desperately to talk me out of the bad dark screamy place in my head.  He wouldn’t survive a four to six month wait for me to get therapy either.

All of that meant I knew going in I was going to have to ask for a prescription.  I also knew that health care providers don’t like it when you just walk in and start asking for pills.  I was afraid they wouldn’t take me seriously and wouldn’t give me anything.

I was even more afraid they would take me too seriously and lock me up.

I cried through the whole appointment.  I told the poor woman my whole messy story, from the shit childhood through the loveless marriage and the bad divorce to how I used to be so high achieving but now my stupid brain broke and I can’t seem to function on even a basic level.

She said “your brain is not broken.  Your brain just needs a break.  And there is no shame in that.”

And then she set about trying to put the pieces of me back together.

She gave me a prescription to try that works differently than the SSRIs that had failed me before.  She gave me the biggest bottle of fioricet I’ve ever seen to help with the screaming headaches from the peaks in blood pressure.

She got me an appointment with an actual psychiatrist just eight weeks away.  I’ve never seen a real shrink before.  I’ve always gotten my prescriptions from my primary care provider and my therapy from licensed clinical social workers.  This will be an entirely new experience.

I wonder if they’ll finally figure out what is wrong with me.  Check back later to find out.

Perhaps the most magical thing of all was when I told her I was overdue for my depo shot[1] and she checked a calendar and said “nope, your window expires tomorrow” and then just got me one.  No invasive exams, no peeing in a cup.  She didn’t even check my medical records.  I told her when my last shot was and she just BELIEVED me and gave me my next one.

Pure magic.

Anyway, I’ve got some meds now but nothing too strong because PAs can’t distribute controlled substances.  She did mention that as part of why she was referring me to a psychiatrist, and I’m still sane enough to know it’s not a good sign when healthcare professionals thing you need the good drugs.

What can I say?  It was a really fucking hard year.

Imbolc is coming up in a few days.  It is a celebration of rebirth and new beginnings.

I could really use me some of that.

I was straight up losing my shit at the Gregorian new year so I didn’t make any resolutions.

So I’m going to make some Imbolc resolutions instead:

  1. No more self-harm.  That shit is messed up and it gots to go.
  2. Get the panic attacks under control enough to have the kids spend Litha with me
  3. Stop tormenting my roommate and see if it is still possible to repair the damage I’ve already done.  I’ve been in really bad shape the past year.  The poor man could give you a hundred fully justifiable reasons to toss me out on the street and be done with me.

The fact that he stuck around through the horrible shit while Norman bailed after the first crying jag is a crushing heartache to be explored another day.  I just finished one epic panic attack.  I don’t need to start a new one just yet.

Norman’s behavior is not a reflection on my value as a human being.

I will get better.

My children will have the mother that they deserve.

And hopefully, someone out there in the internet universe will find some comfort or benefit to me sharing this journey out loud.

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[1] Depo provera is and injectable form of birth control that is administered every 11 to 13 weeks.

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