Most descriptions of a panic attack read like a checklist. Racing heart. Shortness of breath. Dizziness. Chest tightness. Trembling. Sweating. Numbness. They are accurate, as far as they go. But they miss the thing that makes a panic attack unlike anything else — the thing I could never find the right words for until I sat down to write this.
The symptoms are not the panic.
The symptoms are what happens after the panic arrives. The panic itself is something else — a feeling, one of the most primal feelings a human being can have. The absolute, unshakeable certainty that something is catastrophically, irreversibly wrong.
Not that something might be wrong. Not that you're worried something is wrong. That something is wrong, right now, and that you are powerless to stop it.
I've been in rooms where people were dying. I've watched patients code. I've delivered bad news more times than I can count. None of that felt like a panic attack. In the emergency department, fear was appropriate — it was information, and I knew what to do with it. A panic attack is different. A panic attack is fear without cause, without target, without any rational basis whatsoever. And that is exactly what makes it so disorienting.
The first time it happened to me
I was nineteen years old, at a campsite in Canada, when my body launched its first attack on itself. I was walking through the dark to wake our camping companions — our tent had flooded — and then, without any warning at all, I wasn't okay.
My chest locked. My vision tunneled. The ground seemed to tilt. And then came the terror — a mushroom cloud of it, spreading through my body from some point I couldn't locate. I ended up on my knees in the mud, shaking, yelling for help, unable to explain to the people who came running what had happened because I had no idea myself.
It ended as suddenly as it began. My lungs released. My pulse came down. I could think again. And in its place came something almost worse than the panic itself — the question that would follow me for the next forty years.
Will it happen again?
What people don't tell you
There are things about panic disorder that I wish someone had told me early on. Things that took me decades to understand — partly because I was too proud to ask, and partly because the people around me didn't know either.
The first is that a panic attack is not a sign of weakness, and it is not something you can simply decide your way out of. The physical response is real — the body genuinely believes it is in danger, and it responds accordingly. Telling yourself to calm down is about as useful as telling yourself not to bleed.
The second is that the anticipation of a panic attack is often worse than the attack itself. Once you've had one, a part of your brain files it away and starts watching for signs of another. That watchfulness becomes its own form of anxiety. You start scanning for the first flutter of symptoms, and the scanning itself can trigger what you're scanning for.
The third — and this one took me the longest to understand — is that the things that seemed to make me safer often made things worse. Avoidance. Staying close to exits. Never going far from a hospital. These felt like reasonable precautions, but they were quiet agreements with the fear. They told my nervous system that the fear was justified. And the fear grew accordingly.
What helped — eventually
I'm not going to pretend I figured this out quickly or gracefully. I managed panic disorder for most of my adult life before I found something that actually worked. That something was EMDR — Eye Movement Desensitization and Reprocessing — a form of therapy I approached with considerable skepticism and left with considerable respect.
I'll write more about EMDR in a future post. For now I'll just say this: the panic attacks didn't stop because I got better at managing them. They stopped because, for the first time, I actually addressed where they came from.
That's a longer story. It's the one in the memoir.
But if you're reading this because you recognize yourself in any of what I've described — the sudden terror, the physical symptoms, the years of quietly managing something you've never quite named — I want you to know that what you're experiencing is real, it is treatable, and you do not have to carry it alone.
That's why I'm writing here.