Fear Itself
My Struggle With Panic Disorder
By Kara C. Baskin ’00
Photo by Scott Suchman
I’m twenty eight years old, recently married, happily employed and, for two months last fall, I was terrified to leave my house. Things should’ve been peachy, really. I had a book deal in the works. Brian and I had just gotten married. My life was hectic, Type A, and organized just the way I liked it. But suddenly my fancy “happy hours” gave way to TV Land reruns; my posh dinners with media clients were replaced with yogurt and bananas; and my “for better or for worse” marriage vows were being put to the test before my wedding gown even came back from the dry cleaner’s.
I have panic disorder. An acute, debilitating form of anxiety, it affects six million Americans. Women are twice as likely as men to suffer from it, and the attacks usually begin in one’s twenties. Sufferers tend to be overachieving, highly creative, and dare I say it?—a little neurotic. Trembling, sweating, heart palpitations, shortness of breath, choking, chest tightness, and intense nausea are a few of the lovely symptoms that come on like an impromptu acid bath.
Some things are naturally scary: airplane turbulence, public speaking, Courtney Love’s newest facelift. But people with panic disorder feel symptoms for no objective reason, which is the scariest part. Most sufferers eventually dread the unpredictability of the fear. (What if my heart begins to race while I’m driving? What if I’m at a party and suddenly start hyperventilating? How can I go on a blind date what if I throw up on my potential future husband?) Franklin D. Roosevelt famously said, “We have nothing to fear but fear itself.” He could have been talking about panic disorder.
My first attack happened a week before I graduated from Mount Holyoke. I was on my bed, painting my nails bright red, when my heart started to beat erratically. “I’m having a heart attack!” I thought. “Where’s my S.A? Oh, no I am the S.A!” I began to sweat, and my throat tightened. I had the sensation of watching myself from above, like I was the involuntary star of a Quentin Tarantino movie. I’d later learn that this sense of dreamlike unreality is a hallmark of panic disorder. At the time, I thought I was being punished for drinking too much at a party the night before. (What if someone spiked my drink?—They hadn’t. What if I’m dying?—I wasn’t.) This is panic’s flailing logic. You think you’re going to faint, have a heart attack, or die and, guess what? The more you fear, the more your body mimics those feelings. It’s a vicious cycle. Fear feeds off itself; it robs you of oxygen, and it robs you of logic.
Ten minutes later, the feeling vanished. That’s the upside: the attacks usually last just a few minutes. Without missing a beat, I returned to my smug Type-A life. I flaunted hyperactivity like a new BlackBerry, always “complaining” about how much I had to do, when what I was really doing was refusing to sit still with my emotions, my fear.
During my early twenties, I thrived on constant activity and constant vigilance. I thought, if I’m always prepared for something bad to happen to me, it never will. The strong have weapons; the weak have defenses, I believed. My defense was worry. I would obsess about morose absurdities: Is my heart beating strangely? (Sure enough, it would begin beating strangely.) Am I breathing normally? (I’d begin hyperventilating.) I went to the ER twice. Both times, the doctor laughed and suggested I go home and “get a good night’s rest.” Once I called an ambulance, and the EMT, finding nothing remarkable about my condition, looked at me like I’d summoned him for a morning tryst. I also saw an allergist, a gastroenterologist, an internist, and a cardiologist.
Dissatisfied with my doctors—what did they know about how I felt?—I decided to play M.D. I spent countless hours diagnosing myself on the Internet. I’d log off, bleary-eyed at 2 a.m., convinced I had everything from HIV to congestive heart failure. I’d bring this up with my doctors, who would reassure me that nothing was wrong. But reassurance only fuels more panic—what if the doctors are missing something? The panic-prone are a stealthy, aggressive bunch: the average sufferer sees ten doctors before receiving an accurate diagnosis. I almost wanted to have a heart attack in the waiting room, so I could scream, “See! I told you all there was something wrong with me!” Instead, I would sit in the waiting room, monitoring my heart rate while reading Glamour.
Still, things didn’t get truly out of control until after I was married. Adrenaline saw me through the wedding. Then came the Hawaiian honeymoon—a time of bliss, fruity drinks, and gorgeous sunsets? Not for me. Separated from my hectic life, it was just Brian, me, and my neuroses. We went to Maui, where I refused to leave our suite for fear of another attack. Note to travelers: A tropical paradise filled with giggling honeymooners is not the ideal place to descend into nuttiness. I was so jealous of the other women, tanned and smiley in their bikinis. Their hearts beat normally. Their lungs inhaled deep, healthy breaths. They were immortal, and I was about to die. The only thing that comforted me was Roseanne reruns. The cadence of the dialogue and the tinny laugh track soothed me to sleep. (I believe I am the only person ever to be lulled into blissful oblivion by Roseanne Barr’s voice.) When awake, I mapped routes to the nearest hospital, just in case. My poor husband stood by helplessly, wondering if he should go play golf or check me into a mental hospital.
Determined to tell coworkers I had a dreamy honeymoon, I hopped on the DC Metro for my first day back at work. And it stalled. My heart raced, and I needed to get off that train—now. One of the characteristics of panic disorder is the compulsion to flee. But to where? Panic’s cruel riddle: You can’t run, literally. Running makes the heart quicken, the breath shallow. And you can’t hide because the enemy’s inside you. For whatever reason, my mind was getting the message that I was in danger—and my flight-or-fight response kicked into gear.
When the train finally crept to Dupont Circle, I maneuvered up the escalator and hailed a cab home. It was the last time I was in public for more than a month. How could I go out into the world when it felt so dangerous? Days took on a devastating sameness. I clung to Brian each morning. He would disentangle himself and bring me cinnamon applesauce, which I would promptly throw up. Then I’d turn on the television and will my couch into a womb. Occasionally, I’d open my door to get a whiff of fresh air, but I couldn’t go outside. I’d become agoraphobic (not uncommon among panic sufferers), terrified of “triggers”: the Metro, the taxi, the world.
I should have challenged myself. The longer I avoided the world, the more terrifying the very idea of it became. “By staying in the situation and allowing yourself to be with the feelings rather than leave, you’ll desensitize yourself,” says Dr. Jerilyn Ross, president of the Anxiety Disorders Association of America. “Every time you leave a [panic-inducing] situation, you think, phew, thank god. [But] the fear builds. To break it, keep yourself in the situation.”
It was too late; I was already marooned in my house and petrified to the point of irrationality. I’d been prescribed Zoloft, but refused to swallow one pill. (What if I died? Worse—what if I lived?) Brian pleaded with me. My parents pleaded with me. Finally, my aunt intervened. She knew of a psychiatrist, an eccentric European. I went to his office in ratty pajamas. He looked me in the eye and said in a thick accent, “You’re sick. You have panic disorder. Either you take medication or you enter a hospital.” Brian and my aunt began to cry. “Please do this,” he urged. Something in his appeal touched me. I agreed to take Zoloft and Valium. The next morning, I woke up alive. Brian drove me to the psychiatrist. “See, you lived!” the doctor cheered.
I lived. And I wasn’t weak, I realized. I was strong—after all, it takes endurance to die so many false deaths. Now I want to use that strength to help other sufferers, instead of channeling it into locating a brilliant cardiologist.
The treatment for panic disorder is a combination of SSRIs [Selective Serotonin Reuptake Inhibitors] like Zoloft, which blunt its symptoms; anti-anxiety medications like Xanax for quick relief; and, over the long term, cognitive behavioral therapy, to understand what triggers those frightening feelings. In therapy, I’ve learned that panic symptoms are scary, but completely manageable. Today, I speak to groups about panic disorder. (I love public speaking, most people’s worst fear. Go figure!) My husband and I even talked on the Today show about living with anxiety. I’m beginning to branch out and conquer my old fears. First, the Metro. Then, the world; maybe even Maui.
Learn More: For a panic disorder self-test, visit: http://www.rosscenter.com/. For additional resources, go to http://www.adaa.org.
Kara C. Baskin ’00, until recently an assistant editor at The New Republic, is working on her first book.
Photo by Scott Suchman
