This update is about a different kind of panic attack and illustrates the uncertainty inherent in mental illness.
These weekly updates share life with OCD as part of my Mental Work Health project to reduce stigma around mental health, especially at work.
Changes fascinate me. They can occur abruptly, or slowly over time. Last week was one of those drastic changes.
I had such a pleasant week following my birthday getaway. I typically see my therapist on Fridays, but she was out of town. We will often do a phone session in that situation, but I told her I was doing well enough that we could just skip. She was a little surprised, given how tumultuous the previous week had been. I was feeling pretty good about life.
At the beginning of the following week, I got some unexpected news. I was surprised at how well I was able to handle it. The people I was with commented on that as well. It was nice to have a clear reminder of just how far I’ve come in the past few years.
As I drove home that day, I could feel the distress swirling inside me. I felt like I might vomit or start sobbing. I called my wife to see if she could handle the evening so I could just go somewhere alone. There were too many kid activities to make that easy. I was able to bottle my emotions up long enough to take care of all I needed to. Then I spent some time writing and processing my emotions.
The next day, I was feeling pretty good. The work day went fine. I saw one of my favorite people at lunch in a chance encounter, and things were going great. The weather turned nasty in the afternoon, so my volunteer blacksmithing time was canceled. That is always something I look forward to, so I was disappointed.
As I was driving home on the freeway, I saw a near accident a couple lanes over. A last-second panicked jerk of the steering well avoided the collision. I felt my adrenaline spike as I witnessed it, and I was grateful I wasn’t involved.
A few seconds later, I noticed my breath changing to sharp, quick gasps. I recognized a textbook panic attack starting. Most of my panic attacks feel different, but I knew that this is common.
But I was still driving on the freeway.
There was a police car in the next lane, so cutting over a few lanes of traffic to make the exit seemed like more trouble than it was worth. I pulled over as soon as I could, and parked on the shoulder. I sat and wept and focused on my breathing, and tried to make space for the panic to run its course. While the aftereffects often linger for hours or days, the acute panic attack is rarely longer than a few minutes if I can avoid fighting it. After a little while, I felt good enough to drive again and made it to the next exit. I pulled into a parking lot and fell asleep for about twenty minutes.
Following a brief nap, I felt fine to drive the rest of the way home. I immediately went up to my room and watched a few hours of Beat Bobby Flay until I crashed in bed.
The next day, I woke up feeling good again. Work went well, if a little long. On the way home, I noticed a bit of panic start to rise up as I was driving on the freeway. It was well within manageable levels, and I made it home just fine. I knew that as Dr. Claire Weekes says, I needed to keep facing the thing that brought me panic until it lost its hold on me.
When discussing the week with my therapist, I laughed ruefully as I admitted that each day I was surprised that I still felt so much distress. “I thought I processed it all the night before!” She laughed too and told me I was still right in the middle of it.
Panic is like any other problem in life. You never know when it will strike. There may be indications that it could be coming, but you can’t know for sure. It could come at inopportune or even dangerous moments.
The truth is that life is inherently uncertain. Many times, the problems that we face are not actually from the difficult situations in our lives. Instead, they come from our own expectations. When we decide how things should go, and they don’t go that way, we get thrown. C.S. Lewis describes this in the Screwtape Letters:
Men are not angered by mere misfortune but by misfortune conceived as injury. And the sense of injury depends on the feeling that a legitimate claim has been denied.
Nothing throws him into a passion so easily as to find a tract of time which he reckoned on having at his own disposal unexpectedly taken from him. It is the unexpected visitor (when he looked forward to a quiet evening), or the friend’s talkative wife (turning up when he looked forward to a tête-à-tête with the friend), that throw him out of gear.
This has certainly been the case in my life. And it is exacerbated by having OCD. I feel significant distress at change. Particularly plan changes. The loss of control that comes when things change out from under you can be triggering.
The key to handling uncertainty is to not fight it. Again from Dr. Weekes1, the second fear, or fear of the fear, is usually worse, and often brings on the nervous illness. Paraphrasing her answer:
Utter, utter, utter acceptance.
The challenge for me in this coming week, and for you, is to practice utter acceptance as much as we can. Be kind. It’s ok to not be ok.
One of the most helpful books I have read was Hope and Help for Your Nerves. The audiobook version is not actually a narration of the book, but rather an audio series by Dr. Weekes on the same subject as the book. Highly recommended. ↩