Thursday, May 5, 2016

Timeline of an Anxiety Attack

***Trigger warning

I’ve mentioned anxiety attacks & PTSD trigger, before, but many people don’t know what they really looks like. A couple months ago, I began talking my way through them by messaging my friend a play by play, of sorts. It helps me to stay more self-aware & feel more in control while I work through the anxiety attack. She has suggested to me that I might share one of these episodes so that others can have a better understanding of what happens. 

 Today, while at work, I was triggered. At first, I thought I could manage & pull it together, if I took a few minutes alone. This normally works but, not this time. Once I realized that I wasn’t going to be able to, I decided to take sick leave or the remainder of the day, so that I could get home, where I could fall apart without people staring at me.

12:43: Triggered. Find quiet place to focus & deep breath. 

12:45: Feelings of uncontrollable panic rising. Heart rate is increasing. Recognize that my breaths are shallow, so start focusing on breath control. 

12:58: Chest pains begin. Realize that anxiety attack is inevitable. Must hold it together long enough to get permission to leave work. Compartmentalization still working, but is very laborious. Physically shaking, trying to hide the signs of emotions & stay in control so I can speak.

1:04: As I’m shutting down my workstation, the Director comes to check on me. She’s worried. I compartmentalize well enough that no one ever really knows when I’m struggling with anxiety. In my two years there, I’ve never had an attack bad enough that I had to leave work. My voice cracks while I talk to her. I tell myself: “NO…hold it together. No tears. You’re a professional. No breaking down until you’re out of here.”

1:11: Drive out of parking lot.

1:14: Tears involuntarily fall. Not the type of crying like when you’re sad. It feels more like the tears of frustration. They’re from having to work so hard to keep it together until a more appropriate time. Only a few falls, then my body starts shaking.

1:19: Depersonalization/disassociation begins. It feels like being detached from yourself. I don’t actively feel the panic anymore. My body still has the physical reaction, so the process is still happening, on some level, but I’m no longer consciously aware of it. I always describe it as being in a mental fog. Everything feels a bit 1 dimensional, and not quite real. So, I consciously focus on breathing & making sure I’m extra careful in my driving, because my reflexes will be slower than usual.

1:24: Still consistently telling myself to stay clear headed and drive safely. Mentally talking myself through where other cars are on the road, my speed, every maneuver, etc. because the fog makes reaction times slower. Plus, talking myself through that helps me focus on something other than the anxiety attack that is causing horrendous chest pains, shortness of breath, etc.

1:33: Pull into my driveway. My neighbor is outside & wants to say “hi”. I wave, as I rush into the house. There is no way I can speak to anyone right now.

1:34: Lock the doors, not just to the house, but also my bedroom, so that I have somewhere I can feel safe.

1:35: Set alarm for time for after school kid arrival.

1:36: Turn off lights & lay in fetal position.

1:37: Concentrate on controlling breathing. Must not hyperventilate.

2:02: Breathing is more under control. Chest pains persist. Text a friend who deals with same struggle, to help refocus.

2:12: Order pizza, to be delivered later, because I know I won’t feel like cooking dinner. Thank god that can be done quickly, from a phone app.

2:37: Lying in the dark. TV is on, to drown out all outside sounds. Chest pains are gone, but heart rate remains elevated. Muscles at base of neck are so tense it’s painful. Somatic symptoms, also called body memories, begin. I won’t go into what mine are, specifically, but it’s painful & triggering. Lie in fetal position, focused on breathing.

2:43: Having to focus so intently on controlling breath, to keep from hyperventilating, is starting to feel like work. Feeling twinges of anger that I cannot fully control PTSD, or make it go away, just manage symptoms.

2:46: Body memories seem to have subsided, mostly. Still lots of overall tension. Still focusing on breath control but getting easier. Mild chest tightness. Tension headache starting. Taking ibuprofen.

2:50: Breathing not yet normal, but no longer having to consciously control. Heart rate still elevated but returning to normal. Fog clearing. Starting to really become more consciously aware of the muscle tension & stressed feeling. Going to close my eyes.

2:57: Throat feels like it’s trying to close up. It’s like a crushing feeling, from the tension. Head hurts. Chest tightness gone. Base of neck still in spasm but rest of body starting to relax. Muscles are aching from being tense for so long.

3:03: Feel completely drained. Eyes feel heavy. Lethargic. Like my body wants to shut down. Going to try to take a nap.

3:04: Text from a coworker, about work. Really don’t feel like I can do this right now. I need to take care of me. Don’t people know how hard this is? When you’re in the middle of this, your brain tells you that you may very well be dying, so asking me to answer questions about anything that isn’t life or death seems rather…well, I don’t have words right now. The worst part: I answered, because I feel obligated to help people, even when I should prioritize self-care.

3:07 Almost dozed off. Child’s voice startles me through the bedroom door, asking for a cookie. Heart rate elevated, again, from the startle reflex.

3:10: Adrenaline rush has passed. Eyes heavy, again. Want to shut down for a while.

3:11: Another text from coworker. Answer quickly & back to nap.

3:17: Startled awake by text message. Work again. Quick answer, eyes back closed.

3:47: Once again awakened by text about work, but notice that, this time, it woke but did not startle me. Heart rate normal. Anxiety attack officially over, just emotional frustration left from not being able to stop it. Headache is still quite painful and I still feel drained of all energy.

4:19: Pizza delivered. First time lights have been on. Sign receipt quickly so delivery man will go away.

4:20: Give pizza to kids (only one kid at home for a few days) & tell her I’ going to lie back down because I don’t feel well.

4:22: Normal energy level has resumed & attack is over. Mild headache remains. Proceed to eat my feelings.