Susan's Story
 

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The day of the Space Shuttle Challenger disaster – January 28, 1986 – was the day that my life changed forever.  

While trying to focus on the news, I became increasingly preoccupied with physical symptoms that intensified over the day.  My heart was pounding, my chest was tight, I felt lightheaded and I seemed to be having difficulty breathing.  After several hours of struggling with these symptoms, I decided to go to my doctor’s office.  But after getting in my car, I felt that I could not drive.  I asked a co-worker to take me.  We had not gotten far before I instructed him to skip the doctor’s office and head straight for the emergency room at the nearest hospital.

I felt as though I could not breathe, my blood was pounding in my ears, my heart was racing, my knees were weak, my vision seemed ‘dark’, and I felt as though I was going to pass out.  I thought I must be having a heart attack.

In the ER, a nurse asked if the events of the day had upset me.  I knew instantly what she meant:  that somehow my physical symptoms were connected to ‘upset’ – something psychological.  This was inconceivable to me.  I was certain I was having a heart attack.  But if it had really been a heart attack, I would now be in the Guinness Book of Records for the longest heart attack on record!!

I answered the nurse: “No.”  The Space Shuttle disaster had not upset me.  Of course, my answer was not even remotely true.  But I needed to make it clear that what was going on in my mind had nothing to do with what was happening to my body.  My symptoms were so strong that they couldn’t be psychological!

After six hours and various tests in the ER, a doctor told me I had probably had a panic attack, BUT, I might have a heart problem and I should see a cardiologist.  In the meantime, I should go home, take Valium and stay in bed.

The doctor’s advice to stay in bed was possibly the worst I could have received.  It triggered a reaction of fear and reinforced my idea that something dreadful could happen to me at any moment.  I only had a vague notion of what a panic attack might be and, thus, I focused on the heart attack scenario.

This episode of January 28, 1986 was so powerful, that to this day, when I mean to say “panic attack,” I often say “heart attack” by mistake!

What followed was a nightmare that lasted five years.

I had the “million dollar work-up.”  I saw cardiologists, neurologists, respiratory specialists and gynecologists, each ordering their own medical tests.  At the end of each work-up, all I ever came away with was a prescription for Valium or Xanax.

For the first nine months, the Xanax was actually very helpful.  But then, my symptoms began to reappear.  At this point, I felt very trapped.  The Xanax wasn’t working like it once had, but I was afraid to stop it.  If I stopped it, my symptoms might get even worse. I felt I was in a worse “fix” than when I had started.

I kept trying to get help from doctors.  On two occasions, doctors gave me a new medication with instructions to simply stop the Xanax and start the new drug.  On both occasions, I experienced a huge increase in the symptoms that I was trying to get rid of.  I assumed the new medications were not working and quickly went back to Xanax. I now know that what I experienced was actually withdrawal from the Xanax.  For many people – including myself – changes in anxiety medications are best accomplished gradually.

With all the medical examinations, tests and drugs, I received no help in treating the cause of my symptoms.  The most common explanation I was given was that “it was just nerves.”

Once, after describing my ordeal in detail to a new doctor, he had a simple reply: “It doesn’t sound so horrible to me.”  I felt stunned, shamed and humiliated.  Perhaps, he meant to say that my condition was not life-threatening.  But he failed to understand that it was horrible to me.

I did my best to adjust to my condition.  I became a catalog shopper and a 7-11 shopper, because I could be ‘in and out’ in the shortest possible time.  I avoided  ‘unnecessary’ trips out of the house, and I avoided as many social activities as possible.

My life revolved around two things: avoidance and planning for escape.  I invented excuses I could use to ‘get out of’ any situation where I would feel anxiety. While the successful avoidance would initially bring relief, I soon realized how small my world was becoming.  I became increasingly isolated, lonely and demoralized.  I was not physically housebound – but mentally I certainly was.

During this time, there was one thing I could not avoid: my work.  I was teaching college chemistry – a position that had once been a tremendous joy in my life but had turned into a nightmare. I walked into every lecture believing that I would pass out before the hour was complete. I dreaded seeing students at my office door knowing that this could mean I would be ‘trapped’ in a conversation.

One doctor had recommended a “change of scene” as a cure for my problems.  So, when an opportunity arose for me to move from Washington, DC to Baltimore, I decided to give it a try. The move meant giving up something that I had once loved – teaching.  But I felt that I could no longer live up to my responsibilities to my students. I thought that if I could get away from the anxiety of the teaching commitments for a little while, perhaps I would ‘get better’ and could then return to teaching. 

In Baltimore, I found myself in a new environment with new challenges and expectations – and an escalation of my symptoms.  So much for “change of scene” as a cure!

I found a new gynecologist.  At the end of our first meeting, he was clear and firm in his message to me:  He could not help me, but I had to see a mental health professional.  He gave me the name and phone number of a psychiatrist he recommended.

Other doctors had vaguely suggested that maybe I should “see someone.”  But this was the first time I had been given a referral to a mental health professional.  Also, I was ready.  I had really “hit bottom.”  I felt that I had nowhere else to turn.

I made an appointment with the psychiatrist.  At the end of our first meeting, he said I could continue to see him or I could see an expert.  Thank goodness I still had the presence of mind to make a rational  decision.  I said I wanted the expert.

And that is how my five-year nightmare came to an end.

My first meeting with Dr. Sally Winston was the turning point in my life.  Within a few minutes, she was describing the symptoms I had been experiencing for five years!  She was the first to explain the physiological basis of my symptoms – the effects of hyperventilation and adrenalin surges.  She was the first to acknowledge that my symptoms were real, and there was a cause.  She explained that my symptoms were horrible, but not dangerous.  And, Dr. Winston was the first to give me a plan – a plan for recovery – and a reason to hope. 

(Note: Dr. Winston is the Co-Director of the Anxiety and Stress Disorders Institute of Maryland.  She has an outstanding website at: http://www.anxietyandstress.com)

The foundation of Dr. Winston’s plan was education.  The first book she suggested was Claire Weeke’s “Hope and Help for Your Nerves.”  It was amazing to see my fears, thoughts and actions described in print – it made me feel less alone.

Learning coping skills – life skills, really – were also part of the education process.  Dr. Winston taught me specific skills that addressed both the mental and physical aspects of anxiety disorder.  Here are some of the skills that were key in my recovery process.  (I’ve included links to some helpful pages on paniccure.com.)

1)  Learning to use an “anxiety scale” of “0” to “10”.  All levels of anxiety are not the same.  For example, being in a restaurant might be a “10”, but being in a grocery store might be a “6”.  Discovering this means you can start your recovery work by going to grocery stores, before you go to restaurants.  Using the anxiety scale is a lot more helpful than saying “I can’t do anything – everything is hard”!

2)  Learning to do slow, abdominal breathing.  See this page for a similar breathing technique: http://www.paniccure.com/Approaches/Meditation/Belly_Breathing.htm

3)  Learning to stay “in the now”:  focusing on the present instead of worrying about the future.

4)  Learning to accept feelings of anxiety.  This attitude of acceptance actually lowers anxiety.  See this page for a good explanation of this idea: http://www.paniccure.com/Short_Essays/Allowing.htm

5)  Learning to correctly identify my emotions.  (For example, “I am angry, not anxious.”)

6)  Learning to correctly estimate the risk that a scary event might happen.  (See this page: http://www.paniccure.com/Approaches/CBT/Mastering_Panic/Pizza-7.htm)

As I became more confident and knowledgable, I began to take on more aspects of Dr. Winston’s plan for recovery. I participated in ‘in vivo’ or ‘exposure’ therapy, which means going to places and putting yourself in situations that actually provoke anxiety.  This is all about facing your fears and it is not easy! You really have to be willing to experience the discomfort – to be willing to suffer!

Initially, my in vivo experiences were guided by a therapist.  She planned the sessions and the degree of difficulty and helped me through each outing. In a grocery store, for example, she would have me go down every aisle, read labels and select the longest check-out line.  Many of these sessions were about learning how to slow down, how to focus on the moment and how to wait – whether it be in a checkout line, in a traffic jam or in a conversation.

Doing these outings on a regular basis is called “practicing.”  As I continued to do my outings, it was essential for me to learn to accept my feelings and go on.  I could see my progress, and I learned that the key to recovery is practice, practice, practice!  (See this page: http://www.paniccure.com/Overcoming_Agoraphobia/Practice_key.htm)

Dr. Winston suggested that I have both individual and group therapy sessions.  The group therapy was difficult for me, as it was hard for me to express my personal thoughts and feelings in a group setting.  But I learned to do better – and this was extremely important in breaking the isolation I had felt.

My favorite therapy experiences were my individual sessions with Dr. Winston.  Here, I had the opportunity to explore the underlying causes of my anxiety, as well as strengthen my new skills.

So, Dr. Winston’s plan for recovery included both “behavioral” and “cognitive” therapy – practicing specific tasks as well as changing my attitudes.  Through this approach, the tasks are transformed into a meaningful exploration of self.

For me, the concept  of 'recovery' involves an on-going process of understanding, coping and succeeding.  I still can experience uncomfortable levels of anxiety and sometimes this anxiety leads to a panic attack.  But today, as compared with my 'pre-treatment' days, there is a big difference in how I feel and how I respond.  I know what is happening and I know how to deal with it.  I have already had my worst panic attacks – the ones that occurred when I had no concept of what was happening to me. That level of extended fear and incapacitation can never happen again.  I know too much now.

When I first met Dr Winston, I told her I wanted my old life back.  But what happened, through learning to deal with my anxiety, was something different.  I found a new life – a better life – one with greater self-confidence and self-awareness.

There are two stories that I like to tell.  I always liked ‘dangling earrings,’ but I never thought I was mature enough or ‘cool’ enough to wear them.  Now, as a result of learning how to deal with my anxiety, I wear them.  And every time I put them on, I get a charge out of it!  It is a powerful symbol to me of how much I have grown.

The second story is from my experience at an Anxiety Disorders Association of America conference I attended in 2001.  One night, there was to be a dance.  My first thought was “I will NEVER go.” But I did go – and I danced!  It was the first time in 30 years that I danced while sober!!  And I so enjoyed it that, when I went home, I took dancing lessons – because I intended to dance again!
 

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Panic – and learning to deal with it and its causes – has opened new and wonderful facets of my life that I never imagined possible. 

I started with the grocery store, but it has become so much more.  I could not have done this alone – I had support from my family, from others with anxiety disorders and, most importantly, from Dr. Sally Winston.  In Dr. Winston, I had a therapist who made me believe I could get better and have a better life.  I trusted her and it has made all the difference.

I hope that you too can find that belief, that support, that hope.  And I hope that you will go out and buy the ‘dangling earrings’ and, in the words of a popular song, “when you have the choice to sit it out or dance, I hope you dance!”


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