woman up at night

When 2 A.M. Becomes My Panic Hour


It’s 2 a.m.

I went to bed at 8 p.m. because I was exhausted. Again. I’m always exhausted.

I slept for maybe two hours but was awake by midnight. I lay still. Listening to the sound of the wind blowing around the house. My husband is away again. My 7-year-old fills his space in the bed. I listen to him breathing.

Around 1 a.m. I switch on my phone. Check Facebook and Twitter. Then the worry sets in. Like a fog coming in from the ocean it creeps slowly over me. Firstly I worry about the wind. Will it blow down a tree? Then it’s about work. I glance across at my sleeping baby and realize he’s all grown up now. He’s pulling away from me. Won’t kiss me at school. Doesn’t need me nearly as much as he used to. I yearn for the babies we didn’t get to meet. I grieve again for the babies my infertility has taken from us.

By 2 a.m. my hands are sweating, my heart is racing and I can’t steady my breathing. I would cry if I had the energy. I recognize the panic attack, but I can do nothing to abate it. A million thoughts run through my head. Doubts and fears at first. Self-loathing next. Then a deep loneliness and sadness.

The dialog in my head is constant. Backwards and forwards I go, trying desperately to steady myself all the while falling further into the darkness.

“You need to go to sleep. You will be exhausted in the morning.” “What’s the point in sleeping now. It’s already nearly 3 a.m. Why don’t you get up and do some of the things you are worried about?” “What’s the point in working? You’re rubbish at everything.” And so it goes further and further down the pit of despair.

I pull my son into my arms, and finally the tears flow. He struggles free, and I can barely catch my breath. I would run away, but my body weighs a thousand tons. I feel detached from it. It’s not who I am. My head is dizzy, like it’s stuck on the Waltzer at the fair. Spinning out of control. Colors, pictures, sounds, memories rush by but nothing stays. Nothing sticks. My head is speeding, but my body can’t move. I lay in bed watching the minutes tick by. 3 a.m. 4 a.m. 5 a.m. Finally I drift off to sleep and wake to the sound of my alarm. Exhausted and puffy eyed.

I try to push away the memories of last night and busy myself with the daily chores. “Today I will be productive,” I tell myself. “Today I will get things done.” But my eyes are slightly glassier than they were yesterday, my body more sluggish, my mind is hazier. Everything is harder today. Everything takes longer than it should. My concentration dwindles. Trying desperately to reconnect my body and my brain.

Panic attacks at 2 a.m. are more common than I would like. The recovery seems to take longer and longer — 2 a.m. used to be mean night time feeds and sleep-deprived baby cuddles. Now 2 a.m. is my panic hour.

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Thinkstock photo by gpointstudio




Why I'm Opening Up About Being a Therapist With a Panic Disorder


Last weekend, I cried.

I don’t cry much. When I do, it’s often because I’m hearing someone else’s pure pain and sorrow. That happens a fair amount when you’re a therapist. I may not allow the tears to break from behind my eyelids, but they’re there.

I cry when I feel loss or grief. I’ve wept openly when loved ones have died. I cried buckets over a friendship ending years ago. I cried trying to get used to my son being gone to college and still tear up a little when I leave his world, and reenter my own.

But last weekend, my tears were unexpected, and in front of a handful of people. I wasn’t embarrassed — that’s not true, I was a tad embarrassed — but I was mainly surprised at the need to get back in control and breathe.

What was the circumstance?

I was at a rehearsal of the “This Is My Brave” show, telling the tale of my own panic disorder.

Now, if you’ve been reading my blogs for a while, you know I’ve already talked about having panic. I’ve told the story about being accosted by my psychiatrist’s receptionist, as her curiosity got the best of her. She asked what exactly was wrong with me. I’ve written about my panic emerging, and how I fought off the realization I had a mental illness. I’ve revealed panic can cause me to tremble and shake at unexpected times. It happened at my mom’s funeral, for example, as I followed her casket down the middle aisle of the church.

I’d imagined talking about it in a speech would be a breeze.

Yet, last weekend, as these words started to come out of my mouth, my voice was suddenly jerky and I stopped breathing.

“Perhaps if you’ve ever talked with me one on one, you may notice I often lean against the wall, or steady myself with a chair. That’s my anxiety.”

I felt exposed. I was letting out a secret. I was choosing to allow people into my real world, the world behind the persona I create. I was handing over the keys to my hiding place, to anyone who might be interested enough to go in and take a peek.

But it wasn’t over yet.

“Anxiety was invading my life. I didn’t mind so much the panic itself. It was the shaking. I hated that my anxiety — my vulnerability — showed.”

That was it. Now I was being totally honest. It’s not that I have a problem or a mental health issue, that was, or is uncomfortable and even painful. It’s that others can see it. I can’t hide it — at least not all of the time.

I felt incredibly vulnerable. And tears were there to remind me of that fear.

I did everything I could to shut up the voice yelling at me inside my head. You’re a psychologist. It’s your job to help others achieve change they need and want. Now you’re choosing to let people know not only that you struggle, but you’re going to tell them how they can tell you are? You’re “nuts.”

I may feel “nuts.” But my choice is clear.

I’m not ashamed of my vulnerability. If I can help one person who hides their struggle, then reveal, I will.

It’s me, being real. It’s me, being totally honest.

If I cry as I do it, then so be it.

You can hear more about panic and many other topics by listening to Dr. Margaret’s new podcast, SelfWork with Dr. Margaret Rutherford.

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Thinkstock photo via Pimonova.


The Experience That Reaffirmed Panic Attack Recovery Is Not Linear


When we talk about anxiety, we tend to say the same sorts of things.

“You will learn to manage your anxiety.”

“You will learn tools to ease in and out of panic attacks.”

“You will figure out what works and what doesn’t.”

“In the end, you will come out a wiser, more balanced person.”

We like this version of things because it’s full of hope and light and for the most part, it’s true. Sometimes, though, the line is a little curvier than that.

Yesterday, I went to a presentation on domestic violence. I sat in the second row in the seat closest to the wall and turned my chair slightly sideways, because it makes me feel safer to have my back to a wall. A row in front of me on the opposite side of the room, a boy mirrored my position. He wore a baggy sweatshirt, a backpack and a noticeable frown. One of his hands rested on the table and the other, in the pocket of his sweatshirt. There was no danger, no reason, but I panicked. I convinced myself the bulge in his pocket wasn’t just his fist, but a gun, and at the end of the presentation he was going to take it out and do something unspeakable. My heart rate spiked, my breathing became shallow and the rest of my body quickly followed into a full panic attack.

This isn’t the first time this has happened. Last month, I had to leave class because I had a panic attack while we watched a documentary on masculine violence in American cinema. That same week, I went to the park to call my parents and saw a fight instead. Teenage boys, shoving and punching and yelling at each other. On the phone, I asked my dad what I should do. Intervene? Call the police? He told me to leave before I got shot. My friends said the same thing later that night. They weren’t wrong to be worried because the month before that, one of my classmates did a local news presentation with security camera footage of a fight that ended up with one of the people being shot at a gas station near our college.

This thing, this violence trigger, has been a long time coming, but that doesn’t make it any easier to accept. I never thought here, years later, I would develop a new trigger for panic attacks. I thought I could identify the triggers I had, learn the tools I needed to learn and will myself to a more manageable level of anxiety — but here we are. Dealing with anxiety is not a straight shot towards a balanced, happy life. There are curves in the road — new triggers, new roadblocks and maybe old, unhealthy coping mechanisms. But with effort and hope, it can still be part of your upward trend. Instead of succumbing to these panic attacks, I am identifying the trigger and I’m working through it. You can, too. Don’t give up hope.

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Thinkstock photo via Pimonova.


How I Understand My 'Panic Process' as a Therapist With a Panic Disorder


Although it’s been three years since my last full blown panic attack, my mind remains littered by debris. When I make plans to go out with my wife or plan an activity with my children, fear of an attack tries to jail me. These days I am a bit more able to barrel through fear and allow reality to stomp the lies my brain tells me. However, because healing from panic disorder is a process, hurdles remain. I sometimes feel flurries, but they are usually rebuffed by a combination of my medication and deep breathing. I still carry a safety pack of snacks and water whenever I travel by car and public transportation remains out of the question, although it won’t be this way forever. Because panic disorder plants doubt grenades in my brain, my pride related to remission of attacks is sullied by internal accusations I am not pushing myself out of my safety zones fast enough. Sometimes my inner critic refuses to give me a break.

I have recently started examining triggers and although mine are singular to me, I imagine others experience them. My attacks have all begun with a physical sensation in my digestive tract. My attacks usually happen while driving. I’ve been blessed to never have been hindered by attacks in my home, nor have I ever been woken up by panic’s grip. Still, my third panic attack of approximately ten full-blown ones scarred me and the world I used to explore with reckless abandon has gotten somewhat smaller.

For reasons known only to my disorder, subtle changes in bodily sensation sets off my alarm. I have never felt chest pain or shortness of breath, nor have I experienced depersonalization or derealization. My symptom is overwhelming nausea, followed by intense fear I will be publicly humiliated by spilling the contents of my stomach or colon for all the world to see.

Panic attack is the ignition of our body’s fight, flight or freeze response. I imagine if my attacks are triggered by sensations in my digestive tract, followed by mortification as a result of the world pointing its finger and laughing, therein lives my perceived danger. The moment panic strikes, I am compelled to flee until I reach bed or bowl where I am confined for days. Panic is never pretty. Once confined, my process of establishing safe distances from home begins.

My experiences have led me to question my perceptions of humanity and myself. It seems clear I lack faith no one will offer to help me if I am in distress. My mind has convinced me the masses will run, be disgusted or stare as if I am a freak. It seems unreasonable to think no one will help, but my roots grew in toxic soil. My mother spent years hospitalized with major depressive disorder and my father struggled to keep my home from unraveling. Constant turmoil left no room for hugs, affirmations or support. I believe my adult self believes if my own family was unavailable, strangers won’t be either.

Introspection also revealed my stringent use of intellectualization as a defense mechanism. I have a history of being afraid to be wrong. I loathe the phrase, “I don’t know” and I hyper-focus on self-image. I am also deathly afraid to be made fun of and I am sensitive to criticism. It seems if panic is going to thrive anywhere, it is going to thrive in a person wound too tightly. Recently, I have focused on letting myself be the butt of a friendly joke. I admit flaw and I am liberated by admitting I don’t know everything. Admitting weakness is how I outed myself as a therapist with panic disorder in the first place and it is a decision that is freeing me from the inside of my own mind.

In recent weeks, I have begun the practice of acknowledging physical sensations and trying my best to let them be what they are. If I feel a rumble in my gut, I note the change and it goes away. If anxiety brings about slight nausea, I note it, remind myself I am not in danger and it helps. Whatever glitches I feel in my body, I am certain millions of others are experiencing the same thing. I have seen people vomit in public and while the thought terrifies me, I have ever pointed a finger and laughed, nor I have seen anyone else engage in such mockery either. My wife always reminds me bodily functions happen to everyone and it is a thought that helps keep me centered. When I think about ways to counter fear of humiliation, I imagine myself  announcing to everyone I might have a panic attack and my insides might explode. I suspect should I just put it out there and destroy the stigma, fear will recede. It is a strategy I am moving closer to employing as I unravel the mystery of my illness. As more and more people hear about my experiences, my shame recedes and I move forward.

I don’t suspect these strategies will work for everyone, but I hope there are some out there who will relate to lack of trust and use of defense mechanisms to compensate for insecurities as root causes. Gaining our freedom from panic disorder is a process that begins with a look inside. As with any enemy, in order to vanquish it, we must get to know the process of our disorder intimately. Although it is not who we are, it is part of us and with most any part of us, there is hope of gaining understanding and mastery.

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Thinkstock photo via Victor_Tongdee.


How Getting a Panic Disorder Diagnosis Changed My Life


One year ago today, I had wires protruding from my body and trailing out of my shirt to connect to a machine on my hip. Due to my symptoms of heart palpitations, chest pain and vertigo, the cardiologist I visited recommended I wear a 24 hour EKG machine to map my heart patterns. I remember the hope that accompanied wearing the machine. Maybe, finally, they will discover what is wrong with me so I can get the help I need.

I also remember the shame, embarrassment and fear at having to wear this obvious machine to work. I put on the bravest face I could and tried to stand confidently at my cashier post. It was barely an hour into my shift when I began feeling the chest pain and racing heart that had been plaguing me for months.

Over the next several hours, the left side of my arm and face went numb. I was confused and did not know what I was doing or why I was standing with cash in my hand. Electric shocks ran up and down the left side of my spine, ending with bright bursts at the back of my head. I felt the blood drain from my face and my body felt like it was in an ice chest. My arms and the left side of my face twitched, seemingly controlled by an invisible finger that was poking the left side of my head with force.

My thoughts were on loop. I must be dying. What is happening to me? Is the monitor getting all of this? I’m dying and nobody is noticing.

One year ago today, I was still a month away from being diagnosed with a panic disorder. It took hundreds of dollars, an obscene amount of doctors and countless desperate moments to get to the diagnosis.

I never want to forget the darkness and hopelessness that occupied my day last March 29th. A year out, the difference between then and now is like night and day. I need people to know if they are in a place of desperation and fear I was in last year, there is healing for them.

The journey of therapy and medication that led me to where I am now was, not by any means, easy. The path is rough—a parabola of hills rather than a straight incline toward health. Between then and now, I had to get a leave of absence from work. There were days when I was too dizzy or too nauseas to leave my bathroom floor. There was a month when I simply could not eat. My throat constricted at the introduction of food and I lost weight that left me feeling frail and breakable.

But today, this March 29th is a day I am celebrating with depths of joy. I no longer experience panic attacks. I no longer loathe my body for its confusing and debilitating physical symptoms. If I do experience anxiety, therapy has taught me to locate my triggers and how I can healthily respond to my physical reactions.

Today I am celebrating because I have been given a new life. My chains of anxiety and fear are broken and I have the privilege of looking back on last year with a completely new perspective. I have learned to love my body and what it teaches me about my internal emotional state. There is healing for you. The path is hard and you may get discouraged, but there is a possibility of a life without panic attacks.

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Thinkstock photo via Olarty.


When Panic Attacks Attack


I am standing in the grocery store on an ordinary Tuesday in October, list in one hand, phone in the other. Like most people, I do not enjoy grocery shopping, especially since my son is usually with me jumping up and down, begging for every single shrink wrapped toy dangling within his reach. But, today, I am alone and for once I am Ed-McMahon-just-rang-my-doorbell-with-a-giant-check thrilled.

I knock items off my list like whacking moles at an arcade:

Cucumbers. Mostly water, good for bloating. Check.

Zucchini for “zoodles,” which my kid will probably hate. Check.

Dark chocolate Dove squares to hide from family in box of tampons. Check.

Cottage cheese — No, hell no. If shame had a flavor it would be this shit.

As I stare down at my “Eat Me” board on Pinterest trying to figure out what to make for dinner I steer my cart full of good intentions into the cereal aisle.

Standing there next to my friends Tony, Snap, Crackle, Pop and the Cap’n a strange feeling comes over me, slowly at first. It starts in my ears where I can hear my heart beating at about the tempo of a Souza march. I shove my phone and list in my pocket and grip the plastic bar of my cart.

Then, the skin on my chest and neck starts to feel warm and itchy. I unzip my jacket.

Sweat, fulsome and sticky seeps like lava from my brow, my pits, between Lucy and Ethel and, worst of all, in and around my, uh, box of Trix.

I know I need to move; I’m sure I’m in the way standing there in the middle of the aisle or I will be, but I can’t.

Am I having a heart attack?

I have no arm pain, jaw pain, chest pain.

Am I having a stroke?

What’s the acronym for that? S.M.I.L.E? F.A.C.E?

I know it has something to do with smiling or talking or smelling burnt toast — Fuck, I have no idea.  

I contemplate sitting down right there mid-aisle, but my pride won’t let me. It would be just my luck for someone to snap a viral-worthy photo of me  — “Moist Lady Needs Cleanup on Aisle Three.”

I try to accept the discomfort. Be in the moment. You know, “The Power of Now” and all that. But that only makes me more aware of fresh sensations I can’t control — the feeling I’m being strangled by some super villain bent on revenge, for example.

Nope, nope. Fuck Eckhart Tolle. He wouldn’t last a half a second standing in my sensible shoes right now.

Finally, I try to take a few deep breaths:

In for four, out for eight.

In for four, out for eight.

In for four . . .

I close my eyes for a minute or two or 10 or I don’t even know.

When I open them, something inside me has unlocked just enough to have what feels like an epiphany: I need to eat. I need to eat RIGHT NOW.

I begin pulling boxes of cereal off the shelf like a contestant on “The Price is Right.”

I skip the rest of the items on my list, go through the do-it-yourself checkout line, come home, leave the groceries in the car, except the cereal – Oatmeal Crisp, (AKA “Crack in the Box”) – and pour myself a bowl. And not one of those delicate Crate and Barrel cereal bowls designed for sensible portions.

Fuck that shit.

I got the biggest, the deepest, the most sinful vessel I could find – The Popcorn Bowl. I don’t even sit down. I stand there at my kitchen counter dumping back more sweet flakey love than I’ve had in a very long time. Years, actually.

Later that night (and well into the next day) I was reminded why I gave up cereal. Let’s just say I had a lot of time to sit in my fortress of porcelain solitude and reflect on (and Google) what happened to me in the grocery store.

I had my first panic attack. I spent an obsessive amount of time trying to figure out why it happened — Why then? Why there? Why me? — but what I’ve come to realize is they are called panic “attacks,” not panic “Hey you might wanna not schedule anything important for 9 a.m. next Tuesday,” for a reason. For me, sometimes there are known triggers, but mostly there aren’t.

Many years later as I reflect on what it’s like to live with anxiety, I’d like to say I have found a quick and easy cure like the perfect yoga practice or breathing exercise or self-help book, essential oil or a combination of medications that don’t eventually stop working, chamomile-ashwagandha-kava-kava super herb or something. But I haven’t. I mean, all of those things have worked for me at one time or another – well, the kava kava gave me the trots – but nothing took the anxiety away completely.

I’ve come to (mostly) accept my anxious nature, like that quirk you discover your partner has after the honeymoon period. The one that makes you want to scream, “Why the hell are you like that!?” at first but then you decide to love them right past it.

Right now, as I write, I am anxious about how to end this. I am anxious that my tale might seem flippant or trite or miss the mark. I feel the weight of responsible storytelling, the weight of getting it “right,” and so I contemplate leaving this one in my drafts folder, like so many tubs of cottage cheese left to rot in the back of my fridge.

Instead, I think I’ll love myself right past this feeling and put it out there, in the hopes that someone, somewhere will feel what I want to feel — less alone.

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Thinkstock photo via Weedezign


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