Dealing with it from the inside

I posted this on FB yesterday, but I think the term “panic attack” is kind of a misnomer. When we say “[x] attack” we normally mean “an attack caused by a/an [x]” – a bear attack is caused by a bear, an epileptic attack is caused by epilepsy, a heart attack… well, in the same way that’s kind of a misnomer too. Anyway, a panic attack isn’t like that. It’s not something caused by panic, it’s something that causes panic at inappropriate things or moments. The problem isn’t that I’m panicking over my bills, my work, or my life choices, it’s that there’s something in my head that’s causing me to react to that (or something else) as though I were being attacked by a bear, and that something will find a stimulus to latch on to, no matter how ridiculous it is. There is a core problem, in some but not all cases a medical one, that causes people to respond to things in an inappropriate manner. It’s not their choice to do this, they don’t want to do this, but despite that they still do.

How do I know that? Because last night at work, and just about as soon as I walked into work this morning, I started having the symptoms of a panic attack (for the record, those for me are: elevated heart rate, respiration, sweating in the absence of heat; increased irritability, impatience, aggressiveness and fear response; irrational thoughts and quick, inappropriate responses to external stimuli. Some or all may be present at any given time.). It didn’t start because I walked in to work, I think (because I deal with that stress just fine every day), but it chose that moment to manifest because that’s the earliest point in my day that I deal with any significant amount of stress. So, strictly speaking, it probably started some time before that, and I only noticed it when it found something to latch on to, and that required just the tiniest bit of stress. That’s how it works.

It’s kind of like an autoimmune disorder, in a way. When you have a regular immune response to something, it is scaled appropriately. When your immune system sees a kidney cell,  it says “Hi kidney cell, how ya doing?” When it sees a virion (viral particle), it kicks it out and says “no ticket.” When it sees a whole invading army of bacterial Nazis (yes, for some reason your immune system is Indiana Jones. No, I don’t know why), it sounds the inflammatory alarm bells and sets off a systemic cascade that recruits a whole bunch of white blood cells to help repel the invasion. When you have something like Crohn’s or Lupus or Rheumatoid Arthritis, your immune system responds to seeing something completely normal – a kidney cell, cartilage, or your own intestines – by setting off the alarm bells and trying to repel the invaders. In this way, a panic attack is similar. A panic attack is your brain reacting to perfectly normal things – school, life, work – or nothing at all by going into fight-or-flight mode, releasing adrenaline into your blood and causing you to physically prepare for the bear to come a-clawin’ at your face.

The way I remember learning about it, many reactions in your nervous system do not involve your brain at all. For instance, when you jerk your knee after the doc hits it with the rubber mallet, for instance, that cascade reaction only involves nerve cells in your leg and spinal cord. Most of the time, your heart rhythm is controlled by your heart. I imagine that to varying degrees, most autonomic functions in your body are that way. It feels like that’s happening here, too, in a tail-wagging-the-dog sort of way. Let me elaborate. It feels like there is something in my body or brain which is outside of my conscious control, which is causing adrenaline to be released into my blood. This causes a whole host of automatic responses that mostly encapsulate the symptoms I listed above. The effect on my brain is to encourage hyper-focus on my immediate surroundings, because that’s absolutely the correct response in a genuine situation where you ought to panic. So, the brain searches for the ‘source’ of the panic, the bear or whatever, and works to eliminate it or remove the situation in some other way. That means that any tiny situation which seems vaguely stressful can become this huge looming thing, simply because your brain decides to latch on to it and make it your whole world for the time being so that you can hyper-focus on it, solve it, and stop the alarm bells. In a normal situation, that would be the best response.

In this situation, that’s a problem. Because there is some persistent, invisible issue at hand, none of the proposed solutions work. Your brain, making a most reasonable assumption, assumes that the thing that it thought was the source of the problem was not. It goes looking for a new source, and the process repeats itself. This results in you panicking about small, meaningless situations and problems-that-aren’t; hyper-focusing on things you can’t address, like bills or why you chose the major you did in college; and just generally being jumpy, irritable, and acting as though every little problem is the end of the world. So in that way, it’s not an attack by panic, it’s an attack that causes panic at inappropriate times or for inappropriate reasons.

Hm. I’ll have to think about this some more. I’ll try to remain calm while I do, and deal with this from the inside.


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