Panic Attacks

I have a psychiatric and medical alert/response service dog who has helped me with tasks that I’m unable to do alone. My service dog is 11 years old and has arthritis in his hips and shoulders, he is on pain medications, and he has stopped wanting to work in public. So I took his lead, and retired him from public access work. My health has declined since I trained him in 2013-2015, and I realize that I don’t have the energy it takes to train another dog on my own, but I definitely need a service dog to maintain my independence. How a service dog has helped me. He nudged me in public every few minutes to keep me grounded, he lay across my chest and lap to help with panic attacks, he guided me to safety if I dissociated out in public, and he stood in lines behind me to make space between me and the person behind me, creating a safer environment. I also have a bunch of medical conditions and he did other tasks for me around those illnesses, like getting help, picking up dropped items, interrupting self destructive behaviors like binging and purging food. He is happy staying home now since I am mostly home, but he is comfortable staying at my condo alone too. He still will perform tasks at home on his own accord, and he is happy, healthy, and oh so loved. When I applied to a new service dog program. I applied to a service dog program that trains a dog for you, and you pay a lot of money for that dog. It seemed like the only option since I would fail a puppy at this point since I don’t have the energy to potty train and socialize the dog properly. Training would be super slow, and I might give up altogether. I was hopeful that paying for a program service dog would achieve my goal without wearing me down. I filled out an extensive application and sent it to the program with the application fee. In the application I let them know I have dissociative identity disorder (see below to learn more about DID). I got an email back from them rejecting my application because my “health far exceeds what a service dog can do,” and that my “DID could overwhelm and stress a dog out.” I have been told far too many times that I am too sick to be helped and this email harped on that wound. It reminded me of when I was at a terrible treatment center for eating disorders and my therapist there, and the clinical director told me I was “too sick to be helped.” And then they kicked me out of the program. When I read the email, I started to wonder if I was overwhelming and stressing my dog out. I started wondering if I’ve hurt him by simply existing. And I’m incredibly angry and defeated because I was brutally honest in my application for this service dog program. I told them everything because I value honesty, and I’m not ashamed of my diagnosis of dissociative identity disorder. But maybe I should be ashamed. My team treats me with the utmost respect and they treat all my parts with respect as well. They love all of my parts and they do not pass judgment. In fact, they go out of their way to make me comfortable and to help me because they know what I’ve survived as a child and as an adult, and they are adamant that they don’t contribute to the violence I’ve lived through. I feel misunderstood by the service dog program. I feel judged without even meeting with them. And it’s really not OK that a service dog program who trains psychiatric service dogs is unwilling to train a dog for someone with dissociative identity disorder based solely on a misconception about this disorder. I could revert back to ignoring my parts. I could apply somewhere else and just not tell them the part about DID. Or I could write this article shedding light on dissociative identity disorder and explain what it really is and what it really is not. Nobody with a history of severe and ongoing trauma should ever be blamed for developing DID. And my family can assure you that my dog is calmer when I’m around. I don’t stress him out. In fact, he pouts if I have to leave him with family for the day. He acts like the world is ending, he ignores people who try to pet him, he sulks, and acts sleepy and unsatisfied. But as soon as he sees me return, he lights up like a Christmas tree. He smiles and squeals as he runs right into my arms. He licks my face until my skin is wet and almost raw. He presses his head into my chest and leans his whole body in to give me a grounding hug. As soon as he hugs me, my anxiety lessens, and I can take a deep breath. He gets so happy he runs in circles and jumps beside me as we walk inside from my car. My diagnosis of dissociative identity disorder does not harmfully impact my dog, nor would it harm another dog. I am not violent (none of my parts are violent), in fact it’s much the opposite — my parts will do anything to keep the peace and resolve conflict. I have never once had an anger outburst, I have never treated my dog with anything but love and respect. It’s true I live alone and go to the hospital often, but my parents live five minutes away and take care of my dog when I am in the hospital or am too tired and symptomatic to take him for a walk. I also have an amazing dog walker who walks my dog every day, and my dog absolutely loves her and her dog. I feed my dog re-hydrated raw meat and a veggie and fruit mixture. He gets his favorite kind of chew/bone after dinner, and I give him his pills in cream cheese because he’s not a fan of peanut butter. He gets a puppuccino when we go to Starbucks, and he gets snackin’ bacon or munchkins when we go to Dunkin Donuts. He has his own twin bed in the guest room that he naps on, he has a king sized bed in his playroom with blankets so he can dig and make a nest at night. He has a zillion toys, multiple dog beds, and is allowed on all the furniture in my house and my parents’ houses. He won’t get on furniture in another person’s house unless I give him the OK. And he has only experienced positive reinforcement as a training tool. I do use the word “No” but never harshly. When he’s doing something he shouldn’t be doing, I remove him from the situation calmly and gently. I’m sad the service dog program didn’t even offer me an interview to hear how my dog lives his best life. I didn’t get to explain to them that I have a lot of help. I wish they had talked with me in person to tell me that my tasks are too complex for them to train. I wish they hadn’t said that my dissociative identity disorder is the reason they don’t want to even entertain me getting one of their dogs, so that I could educate them on what DID really is, and what it is not. Surely some people with DID can be violent, but that’s true of someone without DID as well. I know I’ll find a way to train a service dog after my current retired service dog passes the rainbow bridge, but I’ll have to hire my own help. I’ll have to train someone to help me. But if that’s the only way I can have a service dog, I’ll make it work, because that’s what I do when life knocks me down; I get up and get creative. At least this way I’ll get to adopt another pit bull mix as a service dog prospect, and I won’t have to accept a dog breed I don’t care for. And so be it if people judge me even more because of the breed of my future dog. My current dog is part pit bull/part vizsla, and he is the gentlest, calmest dog I know, even when really tested by nipping, barking puppies and toddlers who pull his tail and toes. If you take anything away from this article, I want you to hear that dissociative identity disorder doesn’t necessarily make a person “crazy” or violent, and unsafe for dogs. All that DID means is that your memory is not linear and you have times of amnesia, and there are a lot of conflicting opinions and feelings inside. But personally, my dog has been my saving grace. I would never harm a canine — I believe them to be saints sent to Earth to help ease the pain of life. This is just one tiny example of the misunderstandings of mental health conditions. I’m saddened to know that a service dog program who trains psychiatric service dogs will not train a dog for someone with dissociative identity disorder. The stigma associated with this illness complicates an already complicated life for the struggling person. I hope we can do better someday as a culture to accept those who are diagnosed with disorders that are highly stigmatized.   What does it mean to have dissociative identity disorder, and what does it not mean? What does having dissociative identity disorder look like in real life? Dissociative identity disorder (DID), formerly multiple personality disorder (MPD), is a direct result of unimaginable trauma that occurs early in a child’s life, and usually the abuse is ongoing. Everyone has parts of themselves, trauma or not. We say “a part of me wants to go swimming, but another part doesn’t want to get wet and cold.” Just like everyone else, those with dissociative identity disorder also have parts of ourselves, but in the case of a patient with DID, these parts have taken extreme roles in our system to try to keep us safe. We are not automatically more dangerous or unpredictable than anyone else. The other aspect of dissociative identity disorder that is different from any other human, is that we experience amnesia when certain parts take the reins. In therapy, I work to integrate these parts so that they are all communicating and agreeing on decisions I have to make throughout the day. Dissociative identity disorder is a protective mechanism to keep a child from the horrific trauma they experience, to keep it locked away so that the child can keep living life as normally as possible. Most people wouldn’t be able to tell I have DID. It is often secretive and all parts try to pass as a singular being because if people knew about my parts they could hurt me again. Dissociative identity disorder is usually not covert, unless the person with DID is with super safe people who are knowledgeable about DID. The person struggling has to go through a ton of therapy, and test the waters to know it’s safe to be who we are. Personally, I am only able to allow my dissociative identity disorder to be witnessed when I’m in a therapy session with my team of providers who I trust completely. Needless to say, we aren’t all violent, impulsive and dangerous. We have been shattered at the hands of an abuser, we need help, and mostly we need safety, love, and acceptance.

I’m lying on the couch listening to the icy February rain slide down my living room window. Dizzy, nauseated, and experiencing severe migraine, I can’t concentrate on anything other than my excruciating pain. It feels like ice picks are digging behind my eye sockets and my entire head is being squeezed in an unrelenting vice grip. The only thoughts that penetrate the fog of illness are half-formed and terrifying. Maybe I should go to the emergency room. Will that make the migraine worse? Will they believe me, or will think I’m seeking drugs? Should I go alone or make my partner come with me? What if we both get COVID-19 at the hospital? Do I already have COVID-19? Am I dying? Would it be better if I died? Will this last forever? It’s definitely a tumor. I’m just being a baby. Should I call my mom? Take another pill? It’s definitely an inoperable brain tumor. I don’t want to die, but I’m not sure I want to live. I turn my head and for a split second, I focus on the view of our tiny Brooklyn backyard. Suddenly, I catch a flash of scarlet under the dripping trees. It’s a single cardinal with his unmistakable crimson crown and wings — seeking respite from the storm under our mulberry tree. I’d seen cardinals in our yard before — but only in summer. In 2020, during the height of pandemic isolation, I thought the cardinals were good omens. Messengers of hope from a benevolent universe, perhaps signs of better times ahead. My mom uses the phrase “a perfect storm” to describe those moments in life when multiple unexpected traumatic events occur in seemingly spontaneous succession. I don’t know how this term came to be. Perhaps it exists because we rarely see storms as bringing anything but chaos and pain. We can’t think of a storm as “perfect” in a good way. We rarely greet an oncoming storm with excitement or delight. We are primed for devastation, attuned to catastrophe. I recently read a piece in which one of my favorite contemporary writers, Anne Helen Petersen, interviewed Karla Vermeulen about her book, “Generation Disaster.” The book describes the unique collective trauma experienced by Americans born between 1989 and 2001. Our adolescence and young adulthood was punctuated by 9/11, mass shootings, increasingly terrifying reports about climate change, the war in Afghanistan, an economic recession that just about destroyed the economy, and deep, perpetual political strife and social upheaval. In other words, we grew up at the mouth of the volcano — with waves of molten lava lapping at our feet. I’ve seen this instability manifest in my own life in various ways. When my older sister was a freshman in high school, the news of a mass shooting at nearby Columbine High School rocked my hometown. Two years later, we watched the Twin Towers fall. Suddenly, we were all but strip-searched in order to board a plane. It became clear that most of us would never live as safe or as well as our parents did. And yet, in all my youthful naivete, I started my higher education career at a private college in Los Angeles with a price tag so shocking that the financial aid I received barely made a dent. I had undiagnosed attention-deficit hyperactivity disorder (ADHD) and no idea that I wasn’t ready for college — let alone in a huge, unnavigable city far from my close-knit family. I arrived to find that — despite the astounding tuition — my freshman class was overenrolled, and several of the 1970s-era dorms were closed for remodeling. So my entire cohort was housed in forced triples — double rooms with an extra bed and desk squeezed into eight-foot by 10-foot rooms. To add insult to injury, the administration also decided to deliver us three sets of furniture — three desks, three impractically large, heavy dressers with granite tops, and the requisite mini-fridge. One of my first nights on campus, the air conditioning in our dorm broke. I had attended an all-girls high school and barely dated — I had never even gone beyond a peck on the lips with a boy. Suddenly, boys and girls were walking around half-naked and sleeping on the floor of the library next to total strangers. I was unprepared to make my own decisions about whether or not to attend class, what to eat, which romantic encounters would end in heartbreak. A few months into that first year, I started having severe panic attacks and experienced my first major depressive episode. My dad had to rescue me from Los Angeles, packing my things as I lay on the floor, convinced my racing heart and shortness of breath indicated some grave medical condition. On the plane home, I heard voices telling me I was going to die. Without my family’s quick response — finding me a therapist and getting me the treatment I needed — I’m fairly sure I would have. Six months later, after moving back home and attending community college, I was finally stable enough to start again at a public university 30 minutes from home. And yet, stability was not on the horizon. Though I graduated in four years, earned honors for my academics, held down a part-time job, and enjoyed a few friendships, I also struggled deeply with depression and anxiety that I now know was partially a result of my undiagnosed ADHD. I now recognize the impulsive behavior — experimenting with the wrong boys, drinking too much, dropping classes, lying to my parents — and the struggles with executive functioning that still affect me as an adult. There were fender benders, detonated friendships, roommates furious with my lack of cleanliness, drunken declarations of love to undeserving boys. But more difficult than all of this was the sense that I didn’t quite fit anywhere — that maybe I was irreversibly and fundamentally “broken.” Between graduating college with honors in 2011 and moving to New York in 2019, I had at least 11 jobs — including serving in Americorps, teaching middle school English, and bagging groceries at Whole Foods. I had a series of bad roommates and moved back in with my parents for the second and third times. I had complicated romantic relationships with men who were patently unsuited for me. I excelled in a master’s program in media studies but became bored and decided not to go for a doctorate, essentially cutting off a career path in academia. Just before I decided to move to New York and just after my ADHD diagnosis, I finally confessed to my parents that I had over $10,000 in credit card debt on top of my $70,000 in student loans. At age 29, after working without a break for almost a decade, I had no partner, no friends, no career, and no savings. I was — in the most literal sense — worthless. And yet, I plunged ahead like the cardinal, seeking shelter and a place to nest. I used the money my parents had set aside for my future wedding to pay off credit card debt, sold my car, and moved to Brooklyn with a part-time job, an offer to crash with a friend, and an incredibly risky belief that things would get better. They did and they have. I fell in love. I moved in with my boyfriend. I worked through some core issues in therapy. I secured a series of higher-paying jobs in my field. But then, COVID-19 hit. It was the perfect storm. Isolation, fear, the relentless drumbeat of capitalism undaunted. The reasons I moved to New York vanished overnight as restaurants shuttered, theaters went dark, and ambulances wailed. The pandemic stretched on for months. Months turned into years. Armed terrorists stormed our nation’s capital. States passed and courts affirmed more and more bills attacking abortion rights, voting rights, and the right to gender-affirming care. My partner and I had very few friends nearby, no family, and no “pandemic pod” with whom to weather the storm. We were an island unto ourselves — huddling together as the rain lashed at our windows and the waves crashed. We worked. We stared at screens. We drank. We missed family Christmases and baby showers. We stood in line for COVID-19 tests and vaccines and masks and groceries. We found pockets of joy and laughter and peace. The world opened again, then shuttered, then reopened again — a dizzying dance of changing guidelines and social expectations. I started having five migraines a month, then 10, then more. I had finally established myself in a life I loved — only to find out at sea once again. It’s not that no other generation in history has grown up during dark times. I appreciated the Apple TV series “Dickinson” — a fictionalized dramedy about the poet Emily Dickinson — for the way it gently pokes fun at how young people whine about living in “unprecedented times.” In one episode, Emily’s sister, Lavinia, whines, “The Civil War ruins everything!” Today, she would no doubt post her frustration as a snarky Instagram meme. But the outrage is the same. The systems that were meant to help us have failed, the promise of a good job and home ownership with a college degree have been rendered meaningless, and young people full of promise have been lost to racial violence, mass shootings, a pandemic, endless war, and environmental ruin. But as Vermeulen remarked in “Generation Disaster,” the point isn’t that no past generation has had it harder than millennials. The difference, perhaps, is that millennials have never seen the world as safe or believed on a deeper level that we’d be rewarded in the same way as our parents have been for pursuing the things they pursued — marriage, a stable career, higher education, home ownership, or parenting. Though I may be generationally primed for disaster — especially on a national or global scale — it’s always the personal catastrophes that take me by surprise. I’m someone who lives with ADHD, anxiety, depression, and chronic migraine. These are storms I know — biological forces with which I’m intimately familiar. Though they can be dormant for weeks or months, they’re never far from the horizon. And yet, they sometimes take me by surprise — leaving me breathless and gasping in the wreckage. This February, migraine was a storm I didn’t expect. The pain, the fear, the sense of residing in a space somewhere between life and death, between illness and health, completely cut off from the world. I eventually ended up in the emergency room after a night spent weeping in pain and asking my partner to tell me stories to distract me from the sense of impending doom — the certainty that my life was about to end. I wasn’t sure I minded. The ER doctors drew my blood, gave me various medications and fluids, and ran a series of tests. A scan of my brain came back clear. No tumor. I didn’t have COVID-19 either. It was “just migraine.” As the treatment started to work and the pain receded, I lay on my back with an IV in my arm, and I was overcome by a sudden sense of peace. I realized immediately and forcefully that this moment, this imperfect storm, would abate. I would live. I would hold my nephews’ small hands and stroke my dog’s fur. I would stand by the ocean and marvel at it. I would be a part of the world again — for as long as luck and grace decreed. But just as deeply as I knew I would again experience great love and joy, I also knew that sorrow, pain, and terror were not finished with me. The world was still broken. This moment of respite was the cardinal in the storm — a flash of crimson on a gray winter day. A little over a month later, I stood with my toes in the sand looking out at the ocean. I was visiting Sanibel Island, Florida with a dear friend and her family. It was the most beautiful place I’d ever seen: pristine beaches with white sand and teal waters, a wildlife refuge where we watched great blue herons and egrets soar over a bay where dolphins and manatees played. We kayaked through clusters of mangroves, combed the beach for seashells, and watched the sun set in blazes of orange and peach. But looming in the background was disaster. My friend’s grandfather was glued to the rental home’s television for hours each day — watching the coverage of the invasion of Ukraine. Just before we set out for a bike ride through the nature preserve where we’d see roseate spoonbills, sea turtles and an alligator, we watched Ukraine’s president, Volodymyr Zelenskyy, address Congress. He played a video that depicted daily life in Ukraine before and during the Russian invasion. Much like the American disasters he referenced in his speech — Pearl Harbor and 9/11 — the video showed ordinary days with blue skies and laughing children turned to horrific blood and rubble. It was strange for me to be in such a beautiful place while other parts of the world were burning. Or maybe it wasn’t strange at all. And so I thought again of the cardinal. The one I saw when I was sick was different. It was a quick flash of light in the darkness — transient and ephemeral. It represented the single hour or week or month or year that happens to be free from pain, fear, and grief. It was the brief calm after the storm — not its permanent cessation. As part of “Generation Disaster,” I realized that these moments between storms were the times when joy and peace can enter a life and take root. After all, every life has two surfaces: one shiny and unbroken, the other troubled and crumbling. Generation Disaster. Generation Resilience. The eye of the storm — and its apex. I wanted to tell the sick, exhausted, broken version of myself staring out at the rain and hoping to die to hang on just a little longer. Things don’t always get better, but they always, always change. And with change comes promise. The cardinal was a reminder that we don’t stay alive because we’re guaranteed endless sunny days. We stay alive — we choose to keep living — because if we don’t, we may miss those moments when our very cells sing with gratitude for every breath, every kiss, every heartbeat. We often endure because we hope that when the storm returns — and it will return — we will be wiser, stronger, and better equipped. We may hope we’ll have deeper roots and sturdier branches. We may hope that when the final storm comes for us, we can say that we did the best we could — despite the gale-force winds and raging waters. We hope to say that in the storms, we were broken and alive and perfect.