What a Panic Attack Looks Like From the Inside

I sit at my desk, head in my hands, staring at my monitor, but not seeing anything. To passing co-workers, it likely looks like I am reading something on my monitor, but my skin is crawling and I can feel every breath I take in. My inhalations are shallow and unsatisfying and something within me is telling me to run.

I am having a panic attack. Today, it was triggered by work-related stress, a co-workers accusations, my inability to separate someone’s opinion of me from reality. Tears are prickling at my eyes, and I get up and walk outside. I sit in front of the building, the sun warming my skin, hoping fresh air will help me to get control of my breathing. In and out, in and out.

Even as I am panicking, I am evaluating. Mini, mild, moderate, or major? Mini attacks are the most common. They come on quickly and build up slowly until I just feel like something is not quite right in my brain. When these happen, I tell my boyfriend “I don’t feel well in my head,” and he offers me hugs or a shoulder to cry on. They usually end within 15 minutes with him making me laugh through my tears. That small release allows me to go on with my day feeling a little bit stronger. This is not that.

Moderate panic attacks like this one are less common for me these days, and I’m caught off guard. When I’m unable to get control of my breathing outside, I go back in and start contacting people to see if they can pick me up. I feel like I can’t be at work anymore, but I don’t feel safe to drive myself home. I am unfocused and my body is buzzing with adrenaline. During a panic attack, your adrenaline levels can spike by 250% or more.

My physical symptoms are different depending on the severity of the anxiety I’m experiencing. In moderate or major attacks, the most common for me are hot flashes, an out-of-body sensation, shallow breathing, feeling out of control or unable to regain control of my emotions, and my skin crawling or tingling. Sometimes there is trembling or a ringing in my ears.

I suppose I could feel lucky that when I panic, I never worry that I am dying. I know what is happening to me, and I have a good support system for getting through it. These symptoms can be so severe for some people that they think they are having a heart attack.

They are also largely invisible from the outside.

Chest pain, nausea, dizziness, a choking feeling, a racing heart, shaking, or the feeling that you are going crazy do not make the same visual impact as a broken arm or a bleeding wound. That doesn’t mean they hurt any less, and I cannot imagine going through this alone.

I try not to make eye contact with anyone or give anyone reason to ask if I am okay, because that will make it worse. No one can come get me, and 45 minutes in I feel the hormones coursing through my veins begin to subside. I start to feel like I can take a breath again, and that I might just be able to make it through the 3 hours until I go home. I tell my boyfriend it’s dissipating and that I think I’m okay for now.

Though the overwhelm of the attack itself is over, my elevated anxiety lasts through the rest of the afternoon. When I get in my car after work, I immediately burst into tears from the stress of being so uncomfortable and anxious for the last several hours. I will be low-energy and have a shorter-than-normal rope for the rest of the night, and ask for extra hugs and cuddles from my family.

I don’t often talk about living with mental illness, partly because I feel like I don’t have it so bad. I don’t get panic attacks that feel like heart attacks much anymore. I had them during and after my divorce- debilitating, major instances where I couldn’t function normally and felt like I might never be normal again. I used to carry a just-in-case bottle of Xanax in my purse, but they’re long gone and the prescription’s run out.

So many people have more serious, more crippling conditions and it makes me wonder if I have the right to use the label of mental illness. I can handle it, it’s not easy when it happens, but I am always okay in the end. When I imagine how I would cope if I didn’t have the friends and family I do, the support system I’ve built… I just can’t. It’s unimaginable.

I live with generalized anxiety and depression, and I take medication for it daily. I’m not sure how long I’ve had panic attacks. It was only in the last year of my marriage and the years of self-discovery and nurturing afterwards that I recognized them. If I ever miss a few days of my medication it becomes blatantly obvious why I take it and why I will continue to do so for the rest of my life. I’m okay with that. Something doesn’t work quite right inside my brain, and the medication I take improves my quality of life.

My attacks can be set off by so many different things, the severity and length depends on how I’m feeling before it starts, what triggers it, and what physical state my mind and body are in. This one is set off by receiving news of a close family member’s medical situation on top of an already stressful week. That one is triggered by my boyfriend being difficult to wake one Sunday when bad feelings from the past swirl to the surface and suddenly I’m drowning in them. The next one may be set off by another mass shooting, or a phone call from my child’s school, or one of a hundred other things.

To my coworkers, it may seem like I have just suddenly gotten quiet or stopped talking. To my family, I may appear irritable, bitchy, or overemotional. I might snap at my kid for closing the cabinet too loud before I stand up and retreat to my bedroom, walking away from my family. I’m grateful that I have gotten better at recognizing these mini panics and can remove myself and take 15 or 20 minutes for my heartbeat to slow down and the noise to recede from my brain.

These are not just bad moods or me being angry or snappy. These are all common ways that anxiety and panic attacks manifest for me. It took me a long time to recognize that irritability and a short rope were symptoms of anxiety, and that I wasn’t just in a rotten mood.

Being human is hard enough without unkindness and judgement. So many of us live with conditions, mental illness, anxiety, depression, bipolar disorder, panic attacks and other invisible illnesses. You won’t always be able to tell when you run into one of us in the midst of something like what happened to me that afternoon at work.

I share my experiences and stories because I can, and because not everybody who goes through this is able to. Even writing about my symptoms here brought some of them to the surface and my skin began to crawl.

It is easy to judge someone as a jerk for perceived behaviors. It’s easy to assume someone is ignoring you or acting conceited. It is harder to recognize that some illnesses are invisible and that someone may be giving everything they have just to keep going in that moment. I try to always give people the benefit of the doubt, and remember that if someone is giving you a hard time, it might really be because they are having a hard time. That’s what I would like for people to do for me.

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