Learning Not to Attack Panic

Last week I had what I quickly realized was a panic attack.
Even more astonishing was the realization that I have had them before, once every other month or so - that in fact, they punctuate the PMDD I take anti-depressants for - but I had never recognized them as being panic attacks.

I spent a couple of hours frozen, unable to act, feeling pressure from even the tiniest inclinations, desires, much less obligations. Luckily, Dylan was coming home early, and as soon as I was able to cry, I was able to release enough of the anxiety to see more clearly. That's when I asked him, since he gets panic attacks, what they feel like.

It felt good to have a name for the frozen feeling, the state of total alarm, edginess, and shock that accompanied my life every few weeks, along with large bouts of grief, until a year and a half or so. Funny that no one ever called them that before, not me, not my therapists.

This week in class, there seems to be an ongoing lesson we are all learning. It's not relevant to the topic I am assigning this week - not directly - so I am not sure why it keeps coming up. I'm not bringing it up. And yet, there it is. It started early in the week with someone writing about how even a car mechanic doesn't know for sure what is working or not working in a car - they can only tell what is *not* wrong. This is the nature of diagnostics - process of elimination, guesswork. This is true for science, medicine - and now that I say it out loud, it makes perfect sense. No one really knows anything. There's constant guesswork, is all.

But at the time it really hit all of us in the class how many "experts" we rely on to get through our lives and how angry we can get at them (especially doctors) when they are wrong. Various conversations like this cropped up in EVERY class of the four out of five so far this week - one woman brought up her anger at the federal level doctors who now claim maybe the H1N1 vaccines won't work, for instance. Someone else pointed out (her father is a doctor) that doctors don't know everything - that especially with a mysterious illness like a major flu, it's more a set of games around what this flu isn't - which strain it isn't, which origin it didn't come from - than what it is. Sometimes it takes releasing a vaccination, a gamble, to realize that the guess was off.

So it is with psychiatry, too. I came home and took a nap - still recovering from the cold which began the day after the panic attack, as if to cap it off - and when I woke I realized that this wisdom passing in and out of all of my classes is true as well for my panic attacks. The doctors, even me, no matter how many words or books or data entries we make, it's all a matter of guessing.

And why? Because the world is a really rich place, with quite a few pitfalls and many many hot spots. More mystery than anyone can shake a stick at. And truth is, I'd rather it be that way. So I'll trade in the expertise - today, at least - for some mystery, and try not to attack the panic next time it comes.