Posts tagged panic attack

Panic and anxiety came up in the film and I’m not sure I feel about how it was done.

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I know that I have major “anxiety” issues, and I accepted the “OCD” diagnosis pretty fast, and so on and so on.  Obviously, I have many well-earned diagnoses; for the most part this is something I don’t forget because they interfere with my life all the freaking time.

The panic disorder was a little less a part of my self-concept, though - it’s easy to tell yourself that you were “just uncomfortable” or that you “made a big deal out of nothing,” particularly when your doctors aren’t completely confident themselves (everyone agrees I’m agoraphobic; the question has always been about panic, particularly since I’m so avoidant in general and because I’ve never had the heart-attack/going-to-die thing the way a lot of people do.)

Read below only if you don’t have problems with physical purity/cleanliness/contamination triggers.

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Blood draw tomorrow morning.  -_-

The goodish news is that the last few haven’t been as deeply horrible as some of the others.  The better news is that I just now remembered that I need to go drink a ton of water right now so that I’ll be properly hydrated.  The less-good news is that I should have been doing that for the last few days.  Ah, well.

For this, BTW, I absolutely will be taking my Ativan.  I would rather take more sick leave (to wait for the side effects to pass) than try and do the draw without it; the recovery time for the medication is significantly shorter than the recovery time from a panic attack or from fainting.  Ativan also cuts about twelve minutes off from my normal “have to lie very very still with my feet elevated” period, which is great.  Means I can recover while reading a book, instead of while trying really hard not to stare at the horrible medical things in the room.

And I went and saw The Avengers (all spoilers are below the fold, don’t worry.)

I had a bit of a panic attack while I was in the theatre - or rather, the start of one.  I missed a bit of the movie because I was super focused on trying to do breathing exercises, etc., so I wouldn’t have to leave.  

It’s kind of unusual for me to experience the stuff I did (classic “oh crap is this the start of a heart attack” stuff - shaking, shallow/fast breathing, sweating, palpitations, dizziness, numbness in my fingers, extreme concern for my own well-being, worry that I’m about to lose control) in the setting I did, especially considering that I was able to sit with two seats between me and the people on each side of me.  Gosh it sure does help when you mark your territory with psych textbooks (no, I’m really not kidding.)  

I suspect it was all the action on screen/intense music & sounds, coupled with the fact I made myself leave the house (i.e., I had to make myself leave the house - I was already anxious.)  It’s possible that sugar/caffeine consumption played a role, but I really doubt it - I didn’t have that much of either, and even copious amounts of both don’t do anything to me.  If I didn’t know that I slept for 13 hours last night, and had been up for less than 8 hours at the time, I’d have said it was due to extreme sleep deprivation.

So I’ve taken an Ativan (the anxiety only came down a little as I left the theatre and got away from all those people,) and we’ll see what it does, or doesn’t do, for me.  It occurs to me just now that part of my reluctance to go places actually might have something to do with being worried about losing control while I’m there, after all.  Hrm.  Score one for the “Panic Disorder with Agoraphobia” side of the scale.

So, anyway, yeah.  On to the movie stuff.  Spoilers, ahoy.

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“What are some skills you could use to to handle the anxiety you’ll be experiencing [in the first group session?]”

And I was so overwhelmed with anxiety over the thought of attending the first group session that I couldn’t answer her.

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I left work at 11 for a psychiatric appointment, which went well enough, really.  Dr. E upped my Vyvanse and recommended I look into a light box since it’s pretty clear my tiredness and lack of motivation is tracking the number of daylight hours pretty closely (and yeah, I AM thrilled that the days are only going to get longer every day from now till summer.)  I’m always a little off-balance after even an appointment like that, though.

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I did my formal discharge interview today (my case manager was on vacation) and I got my official list of diagnoses.  I am so freaking special.

• Axis I: 269.89 Bipolar II Disorder, 300.21 Panic Disorder w/Agoraphobia, 300.3 OCD, 314.9 ADHD
• Axis II: r/o Avoidant Personality Disorder, r/o Obsessive Compulsive Personality Disorder
• Axis IV: Occupational stressors, insufficient social support
• Axis V: 65

Yes, that is six diagnoses.  Six!  On the other hand I went from a 35 (August 31st) to a 65 (October 5th) on the global assessment of functioning, so yay.

I’m a little surprised at the switch from social anxiety to panic disorder with agoraphobia, but given that they retained the AvPD diagnosis (“r/o” means “we haven’t ruled it out, and we’re kind of thinking maybe yes, but we can’t say for sure, so keep working on that,” from what I’ve gathered) that pretty much still encompasses my experiences. 

The panic disorder is fairly mild, if that’s what I really am - I don’t get full blown “I think I’m having a heart attack” panic attacks the way a lot of people do.  Sense of doom, hyperventilation, etc., yes, absolutely.  Although actually, from the DSM-IV it kind of sounds like what I get is “yes, that’s a panic attack.”  And they observed about ten of them (episodes) happening the first week I was there, so…

(You only need four or more for it to classify as a panic attack; I’ve bolded all the ones I’ve had when freaking out in public places, such as grocery stores and group therapy.)

1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded, or faint
9. Feelings of unreality (derealization) or being detached from oneself (depersonalization)
10. Fear of losing control or going crazy
11. Fear of dying
12. Numbness or tingling sensations (paresthesias)
13. Chills or hot flushes

Kind of weird that the only ones I’m really familiar with from talking with other people (chest pain, fear of going crazy, fear of dying) are the only ones I’ve never had in the middle of panic episode.  I quite often fear I’m going crazy when I have time to think about things, heh.

I should really do some posts on depersonalization and derealization.  They’re really high on the list of “Reasons Demeter Thought She Was Crazy As A Kid” and I suspect it’s that way for lots of other people, too.  I remember watching Men in Black and seeing the tiny alien inside the giant body and thinking “that’s exactly how I feel things are sometimes, except I’m not the little dude in control.”  Anyway, when I’m freaking out in public I get those really really badly.  It’s usually that, more than the sweating and other physical symptoms, that makes me want to run.

What the HECK is up with the choking feeling I get when I’m nervous???  Why on EARTH would my body want to keep me from breathing/swallowing when I’m scared - shouldn’t it be more like loosening up so you can scream, or something?  I mean REALLY.

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