Content note: This post graphically discusses panic attacks.
Mental health conditions in general seem to be something that many people have difficulty understanding. For people who don’t experience mental illness, wrapping your head around something that is not obviously physical is challenging, even when presented with evidence that mental health conditions can have associated physiological effects; mental illness is something ‘all in your head’ and that makes it hard for people to comprehend. A broken leg is something you can see, assess, and fix. A brain that functions differently may manifest symptoms, may even appear different on brain scans, but it isn’t something as clearcut and obvious as a leg at an angle that shouldn’t be seen in nature, or as an injured spinal cord that makes it difficult to walk.
People tend to discount mental illness, and one case where this really comes up is with anxiety disorders, which are often written off as being, well, all in the patient’s head. The seriousness of anxiety disorders isn’t understood, and they’re viewed as something that people get over or are capable of suppressing; observers don’t understand what it’s like to have severe phobias, social anxiety, or other conditions associated with severe anxiety. They don’t accept the fact that for some people, these conditions can cause severe impairment.
For almost ten years, ranging more than 20 miles from home was almost impossible for me. Not in the sense that I would get extremely anxious and worried (my house will catch fire while I’m gone, there will be an earthquake, someone will break in, did I leave the stove on, did I lock the doors, will my bookshelves fall over and crush one of the cats, will the person feeding the cats accidentally let them out…), although both of these things did happen, but that I would become physically ill. I’d get tremors and cold sweats. My vision would blur, my heart would pound, I’d have trouble walking, sometimes I’d even become incontinent. I’d vomit almost continually—for years, people thought I got horribly carsick, and I did nothing to dispel that notion because I was ashamed of the fact that the sickness was rooted in my brain.
Just writing loosely about the surface of what my panic attacks were like is making me clench my jaw and shiver. I get nauseous thinking about it. It got to the point that I would get so anxious thinking about taking any sort of trip that I had to hurriedly head off any conversations leading in that direction at the pass. When I absolutely had to go on a trip for some reason, I would be anxious for days or sometimes weeks beforehand. For several nights before, I wouldn’t be able to sleep at all, and I’d be lying in my bed covered in cold sweat, shivering, periodically getting up to vomit. On aircraft, I’d huddle hollow-eyed in my seat.
Leaving home was a torment for me. And it was a physical torment as well as an emotional one. I was having panic attacks so severe that they limited my ability to engage with society, to go out with friends, to visit people; a friend moved to a distant city and I didn’t go to see him for years because I knew that I couldn’t physically withstand the trip. I’d have to drive all the way to the city, and then get on an airplane, and then be in a strange place. I would have been a quivering, shivering, horrific wreck the whole time I was there.
I had a serious mental health condition. And I was ashamed of it. I tried to cover it up as best I could; I was always ready with a perfectly reasonable explanation for why I couldn’t take a trip, why I hadn’t visited, why I’d gotten so ill on a car ride, why I was so quiet and inwardly focused when I went to the City with people. There was always a good reason. I fronted. People had no idea what I endured because I didn’t want to be mocked for it, and because I felt ridiculous, felt like I shouldn’t be ‘allowing’ my brain to control me this much, because I didn’t understand how anxiety disorders work, and I didn’t understand panic attacks. I didn’t understand that this wasn’t something within my control.
And then I got treatment, and went on medication. And I started going on trips. I was excited instead of terrified. I came up with excuses to go to the City, I enjoyed plane rides to new cities like I used to when I was a kid. I still get panic attacks, that’s something that is never going to go away, but they’re rooted in other things, and I’m better at managing them effectively now, with treatment and help, and with being open about them to the people around me. They’re still serious, and an environment can still turn from totally fine to radically unsafe for me on the turn of a dime, but now I’m not alone.
The thing is, though, that many people act like anxiety disorders are no big deal, and like the severity of panic attacks is overstated. Those people have clearly never experienced either of those things, and are picking up specific social messaging about mental illnesses. Some of that sadly comes from those of us who experience these disorders, because we’re socialised to be ashamed of our conditions and to put a front on it rather than subjecting people to the reality, so we reinforce that messaging. ‘I used to have panic attacks and I got over it/they were no big deal.’ Consequently, people think a panic attack is something you can just ‘push through,’ and they don’t understand how debilitating they can be.
Just writing this piece is hard for me; I’m sweating, my jaw is locked, I feel a little sick to my stomach. Talking about panic attacks is, for some people, a great way to bring one on. That’s how illogical and frustrating they are. Do you think this is something we choose for ourselves? Do you think we enjoy it? Do you think we want or like the attention? Do you think we think it’s awesome that we can’t ‘just’ engage with society like everyone else?
Believe me, if there was a pill I could take to never have a panic attack ever again, I would down it in a heartbeat, but one doesn’t exist. So, for the time being, I need the world to take panic attacks seriously, and to understand that anxiety disorders are a real thing with serious consequences, and that people who have them may need accommodations.
Some of those accommodations might seem bizarre to you, but that doesn’t make them invalid.