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Submitted by Shikha Aleya on 11 January 2020

Shikha Aleya candidly and meticulously describes her first panic attack, the ensuing anxiety, how she dealt with her anxiety and depression reflects on her support system and the professional team. Her advice for persons in similar situations and their caregivers. 

Can you describe your first incidence of a Panic Attack? What was your initial reaction? What made you eventually seek help? 

I was in my mid to late twenties, on my way to a meeting along with my (then) husband and work partner, when out of the blue, I felt a sensation of pins and needles in my hands and feet and my arms and shoulders began to stiffen. I thought I was about to have a heart attack, my ears began to buzz and I found it difficult to breathe. We stopped the jeep we were traveling in and I got out and flopped to the ground, because I thought I was dying. The usual happened, a crowd began to gather. Not helpful, just curious and ready for drama. I found myself leaping up, the panic increasing and lay in the back of the jeep.

I was raced to our family doc, a very good cardiologist. When we reached his clinic I walked in thumping my chest with my fist because for some reason that appeared to help, and I think perhaps I thought I was giving myself CPR! Funny now, looking back, but oh you should have seen the look on the faces of the other patients in the clinic. They leapt up in fright and cleared a path for me. I still remember the face of a middle aged woman as she stared at me and backed away against a wall. She looked terrified as I strode past her thumping my chest!

So anyway, the doc checked me out and sat me down to tell me it wasn’t a heart attack, I wasn’t dying and he believed I’d had a panic attack. I had no clue what this was and I have no memory of what he explained to me then. The only thing I remember is him telling me I may want to go and see a shrink. All I heard was ‘shrink’ and immediately figured he’d got it wrong.  I figured it was a one-of thing and possibly triggered by some ongoing work stress. I said bye and left, determined not to go to any shrink, and to not have another attack.

I had a few more. Each one ambushed me unexpectedly. I had no control over it, no understanding of it and was reduced to a reasonably fear filled person, unlike the self that I have always known myself to be, and continue to know myself to be today. Going to a psychiatrist is unfortunately a lot like going to see a dentist. You don’t go till it’s unbearable. That’s how I first visited the shrink. I still don’t visit dentists till its unbearable though.

What was your first consultation with the psychiatrist like? Did he say you will be on meds for life? Did he suggest therapy as well? 

It was easy once I’d decided. I went with my husband, who was basically one of the best friends I’ve ever had, so my strongest support system of that time was with me. I want to emphasize many aspects of this because they are all important. This support I had was not due to the perceived relationship of marriage that we were in, but due to the truth, love and care that was essential to our being together. He is a person of enormous optimism and great good humour. At no point in time, before then, during any of this, or in the decades that followed, did he ever let me feel I was less myself in any way, of strength, ability, intelligence, knowledge or dependability. If I forgot or lost confidence in myself, he just wouldn’t let me stay there long. It’s like picking up your friends when they’re down and carrying them along, not leaving them behind. I’ve had friends like that as well, the kind that leave you behind. I know the difference. Friendships like those reduce you to the basics of survival. I guess many readers will understand this, not necessarily just in the context of panic, anxiety or mental health issues.

I had another huge advantage. A person dear to me also happens to be a clinical psychologist. She has never done any counselling or therapy with me, we know each other too well and too personally, and her presence in my life reduced the sense of fear and stigma around visiting a psychiatrist. I have no recollection of anything we spoke of at the time, but knowing her as a friend meant that, to me, the fact of some people being mental health professionals was not an unfamiliar thing. 

The psychiatrist himself was, and is, fantastic. I wept when I met him, I couldn’t help it, I was so scared. That was over twenty years ago. I met him recently, and wept again and he laughed a little and I laughed as I wept, and he reminded me I’d done the same thing the first time we met. I consider myself both blessed and lucky, because I do know that not all shrinks are great. But then, that’s true of all professionals isn’t it? I suppose, the difference is, not all professionals are working with your mind, your spirit, the core part of a person.

So this doc explained things to me in the way that he thought best, at the time. His explanation simplified things for me, because he spoke of brain chemicals and imbalance, and made the whole thing sound manageable, and quite normal. A malfunction of some aspect of the body no different from any other that requires medication. He told me I would need to stick to the medication schedule but that it would be for a while, not for ever. That I may feel some side effects and he may need to reconfigure dosage etc.. accordingly.  All of it was as he had said. The initial month wasn’t easy but only because for a person who had not needed long term medication for anything prior to this, just the idea of being on meds for months is both embarrassing and irritating. Looking back I know this doc walked me through my panic about panic step by step. There was no mention of therapy. 

Did the meds work in terms of stopping panic attacks?  Do you still have panic attacks?  Are they different now? Have they transformed into other forms of anxiety?

The panic attacks didn’t stop suddenly, and they didn’t stop fast enough. I wanted it all to go away, the way an antibiotic course gets rid of strep-toe-cock-eye! It didn’t happen like that. I remember it being really bad and debilitating for a few months. Terribly embarrassing. You think you’re going to go out there and negotiate a work deal and you cry sitting across the table instead. Did you see the Robert de Niro film ‘Analyze This?’ Comic when he bawls. It really is when you do. It’s okay to see that. I understand gender operates strongly here. I clearly inhabit a female body and despite gender bending it is easier for people to see me cry than it would be to see a person inhabiting a male body who did the same, under similar circumstances. 

Your question is interesting because looking back I am clear the shrink and his medicine was a troubleshooting thing. The long term healing and recovery came with therapy. A few months down the line – I think the panic attacks may have become a little easier to deal with, some episodes were less severe, some continued to be troublesome. One day I sat and wrote many personal things, events from my life, in a diary, which I took to show shrink. Shrink barely read the first para, when he shut the diary and told me he felt it was time to ease the medication to its end and that I should start therapy. Honestly, I didn’t like this. I thought telling him personal stuff would be enough, maybe he’d get his medicine right. I’d finally be done with this panic crap. It wasn’t so.

Again, after much resistance, I decided to see a therapist he recommended. That was one of the best decisions of my life. I think for a short while, the end of medication period overlapped with the start of therapy. It may be scary for readers to know this, but it is my truth and important to this business I’m writing about, I was in and out of therapy for over a decade. This was what worked for me in the long term. This is how I finally got a handle on the panic, how things changed in my life and how anxiety, as opposed to the more severe panic, became the simpler presence in my life.

It’s not black and white. I don’t have panic attacks any more. I deal with some kinds of anxiety and very occasionally I have episodes of anxiety which I deal with using simple tools - breathing, phone-a-friend, that sort of thing. There are certain situations I stay away from because I do not wish to invite the stress they will put me through. These decisions are mine.  I am very firm today about my boundaries, emotional, spiritual, psychological, personal, physical, professional, all of it. My life is my own, its not a party. I decide what stresses me and I decide if I want any of it. I decide what keeps me content, well and happy. I trust myself, something that I have been able to wrestle away from the grip of panic and anxiety, with the help of good professionals and supportive friends and colleagues.

Are you still on meds for anxiety? Are you able to anticipate and prepare better for a flare up?

I am not on any medication for anxiety and haven’t been for over two decades. I did not stop the medication myself, I did not play with it, I followed the doctor’s orders. He is a good doc and my gut told me to keep faith in his process. I was right. As I progressed to feeling better and better, I found proof that he was right and this strengthened my faith.

About anticipating and preparing, these are two different things. Anticipating an attack is something I have had to consciously learn not to do. You see, it’s easy to believe that because you had a panic attack in one situation, you will always have one in a similar or a repeat of that situation. This is not true. I do not recommend anticipating distress. Anticipate that you are well and all is well. Those around you need to do the same. If those around you anticipate the worst for you, healing and recovery are an uphill job. Stay away from those who anticipate the worst for you.

Preparation is a completely different thing. It’s a life long and life altering process. It’s what athletes, actors, students, dancers, astronauts, mountaineers, ultra runners, and those planning a trip to Ladakh do! It’s what someone diagnosed with BP, heart trouble, cholesterol, diabetes needs to do. Preparation is the foundation for achieving intent. A big part of preparation is practice. So yes, I prepared better and I continue to practice every day, - some old tools and some new ones that help me fulfil my intent to live anxiety free. I am clear about what the word anxiety connotes to me. To be anxiety free does not mean that I am careless and it does mean that I am cautious. I prepare and practice breathing, inner quiet, strong dependable relationships, a daily connection with my-tribe, my family-of-choice, emotional health, spiritual seeking and always an optimism. 

Can you describe the experience and benefits of therapy - what was the type of therapy, how did you deal with the reflection and homework required, the opening of the pandora's box sometimes?  Was therapy similar to what popular media shows in terms of talk therapy? How did you select the therapist or the approach of therapy that would work?

Type of therapy? I have no clue. I talked and reflected a lot with a therapist who walked me through a long journey of what a friend of mine calls selfing. The benefits of therapy depend on therapist and client, on that particular relationship and the will and capacity of both. Despite having had such a long experience with therapy as a client, I have never bothered to find out the text book explanations and descriptions of therapy. I’m not interested. I neither selected the therapist nor the approach. I took the recommendation made by my shrink, I liked the person that I met and decided to give her a chance to prove herself. With every session, my confidence in her grew, my appreciation of her also grew. It helped that she had a sense of humour. As she still does. While I had this this one, long-running therapist, I did meet a couple of others in the middle. I didn’t like them. I felt that one of them was nervous around me and I felt the other had a bad attitude, she was aggressive and insensitive. I did not return to those therapists. 

In the therapy room I spoke about many things, discussed many things, with my therapist. I did not discuss these things with too many people outside the therapy room. Just perhaps three people close to me that I trusted. Everyone in life is not a therapist and due to their particular roles and relationships and established patterns of behaviour with you, may not be able to be very supportive of your issues, your fragilities and specific vulnerabilities. Also not everyone is supportive. Period. I read somewhere on a Facebook post recently, would you go to get milk from a hardware store? That’s so apt. When you accept that you need support, you must also choose who to go to and speak to for support. It’s not just your capacity to seek support, but the capacity of another to be supportive about certain things. This is a trial and error thing, no easy answers.

What was the role of therapy vis-a-vis medicines?

I think I’ve answered this earlier. I do want to add, that about ten years into this process, I shifted cities and a new shrink was recommended by my old shrink as a back up support person. The new shrink, who is also very capable and good, continued to maintain a no medication schedule with me and our sessions were also therapy sessions. Very effective. I need to make one thing very clear here. I speak for myself, my experience and my requirements. Its different for each person and not all health issues, physical or psychosocial, are the same. 

There is another important aspect of my life experiences related to therapy and medicine which is very recent. Definitely worth sharing. I have grown up as a very cut and dry kind of person. No room for anything but boot camp methods of getting on with it. Got a cut? Stick a bandaid on. Got a fever, caught a chill, swallow a pill. Somebody punches you? Punch them back with interest and make sure they don’t try it again. Stay tough, get on with it. I do not know if other readers will identify with any of this, but if even one does, I want to ring a small bell here. These methods are of use under certain circumstances and in extreme states of survival, but perhaps they require a re-think when the extreme states are over. 

I’m saying, fix it in a quick-fix-and-keep-moving way does not do a deep clean job. We know what happens when dirt clogs the drain or germs clog your throat. They’re visible, or the effects are visible, they’re known agents of harm. We do what is needed to clean them up. We don’t ignore them and get on with it.

Feelings for example, are felt, ignored if inconvenient, and rarely reflected upon. Specially the toxic stuff, anger, frustration, pain, fear, helplessness, humiliation. We don’t identify them, they don’t go anywhere while we get on with it. Then they pile up in layers and grow heavier. We don’t see it, we don’t name them. We grow heavier. Something will give. There’s your mind-body connection. Stress related illnesses or a sudden out of the blue episode of anxiety. 

In connection with this - I have had the opportunity recently to explore other ways of cleaning up the system, other forms of healing that include energy therapy modalities. I began by helping out a friend who was studying these and needed some hands on practice to complete a course and become a certified practitioner of one such modality. I laughed at her and expecting nothing but to help her out, I played guinea pig. That was two years ago. Today she’s one of my go-to people for a vast variety of things I want to sort out, from sudden physical aches and pains to emotional and spiritual aches and pains around complex life situations. 

What I’m trying to say here is, I opened the door to practices and teachings that I earlier dismissed as esoteric, new-age’y stuff. I’d never have opened that door for myself, I only did so because I was being supportive. It changed many more things in my life in the best possible ways. If something attracts you about a healing practice, after conventional medicine and conventional therapies have done their job to whatever degree, then explore it. Study it. Sometimes some of these practices have their roots going back across time, space and culture and at other times there are aspects of new learning, new findings and explorations into the working of mind, body, brain, relationships and connections that are not yet in the text books. Different things work for different people. I found things that really work for me.

Can you share your experience of the co-existence of anxiety and depression?

For this I need to go back to the first couple of years when all this started. The panic attacks and their debilitating effect on me caused me to feel depressed to the point of not wanting to leave a corner of my room. The anger that such a thing should happen to me was also converted into depression. The combination of therapy, support, work, love and friendships was all necessary to deal with depression. 

This is nowhere near the all of it. It’s not as simple as your question sounds. The depression may have been hidden and may have led to the first panic attack. I don’t know. I do know there’s more to it than chemicals. When life gets to you and you don’t realise it’s got to you, a panic attack is just one of the distressful consequences. You don’t realise these things till you’ve experienced them and worked your way through some of it. 

I have heard people speak dismissively of someone going through a crisis or responding badly to life and relationships. I feel that in doing this, people are dismissive of their own deeper selves, perhaps because a mental health issue or crisis is so scary for the witness, the person-who’s-there, seeing it happen to someone else. 

It’s time to stop reducing core aspects of what it means to be human in a world with great damage potential, to the word ‘mental’. That puts the onus of an issue on the individual. It is rarely, if ever, that. An individual engages with and experiences multiple aspects of life and relationships, at home, in school and college, in the neighbourhood, at work, in the streets, on social media, WhatsApp and TV news channels. This has positive and negative impacts on the person, just as the individual impacts their environment in different ways. It is often these interactions that contribute to wellbeing or disability and disorders. Pretty much the way pollution can cause asthma, it’s not put down to the individual’s lungs. So. Not simple.

Did you have to make life changes (changing jobs, roles, cities, etc..) 

I made life changes because I changed. They were all positive changes along a personal journey of self, identity, healing and recovery. They included changing jobs, roles, cities, relationships, over the past two decades. I continue to make life changes and am pleased and proud to do so. 

How did you build a support network at your workplace and at home?

I didn’t build anything. The friends who supported me did so unstintingly, the ones who didn’t are no longer in my life. My workplace depended on me, I have always been self-employed working with people I know very well. Again, I have had a lot of support. I understand that many people do not have this. But I also understand that many, many more people are in a position to provide this support! At work, at home, in friends circles. That’s something to think about.

What is your advice to family members of persons with mental health issues?

If you cannot help make things better, do not hinder and make things worse. Do remember that the person dealing with their issues is the hero of their own story, you are only the hero of your story, not of theirs. A person with mental health issues may need your support, they don’t need you to take over their life and they don’t need you to tell them what they’re doing right or wrong. You have your own issues as a caregiver? Identify and deal with those. Don’t make assumptions, don’t patronise and infantilise a person dealing with psychosocial issues. This is disempowering and insulting. 

Your advice to persons dealing with a mental health issue.

Phew. I don’t have too much advice. I’ve shared aspects of my story here with the intention of building a pool of experience and learning about these issues from someone on this side of the fence. Trust yourself, ask for help of those that you feel will and can help you. Breathe. Find professionals you are comfortable with and then give them a chance to do their stuff. This is not overnight work. It’s life work.

5 simple tips to get through a difficult day:

First prepare and practice knowing that there will be difficult days and you may need to lead yourself by the nose through them. If necessary, write down what to do and practice it so that when you need to do any of it, it’s not new.

  • Sip cool or cold water.
  • Practice a method of breathing that calms you.
  • Phone-in-your-support, preferably someone tried and tested, and tell them you’re having a difficult day. If you cannot speak, message. But connect. If you know what you want from them, tell them. Have two or three people on your phone as back up for each other because everyone is not always free. I have some WhatsApp groups that are a part of my daily life and a part of my not-daily, but regular relationships.  
  • Take a pause and identify what is possible for you to do that will make you immediately feel better. (This is personal and oddly enough needs reflection, as part of the preparation.)
  • Oh. And don’t drink alcoholic beverages when you’re feeling distressed!

I love my life. I regret nothing. I wouldn’t be who I am and where I am if I hadn’t lived each of these experiences. I thank each person who has walked with me, and helped me walk through it my way.

Shikha Aleya is a free spirit with a strict bedtime, fascinated by explorations of worlds within and without, loves her tribe of animals, birds and people. Works on issues of justice, equality, rights, and understanding gender, sexuality, health and ability. A post-graduate from XLRI, graduated from Hindu college, Delhi University

 

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