I’m the meltdown master — I panic constantly

Since I can't afford health insurance or therapy, how do I get over my anxiety attacks?

Topics: Since You Asked, psychotherapy, Psychology,

I'm the meltdown master -- I panic constantly (Credit: Zach Trenholm/Salon)

Hey, Cary,

I have a problem with nerves, but no health insurance and very little money to spare for therapy, even on a sliding scale, so maybe you can give me some free insights.

Whenever I end up in any kind of remotely adversarial or stressful situation — and by adversarial, I mean something as minor as having to say no to someone for any reason — I find myself having a strong physical response.  I don’t know if you could quite call it a panic attack, but my heart starts pounding, my hands and voice start shaking, and I start to sweat profusely.

No matter how many breathing exercises I do or how hard I push myself through it or how much I try to coach myself through it mentally, this physical response just keeps happening, and it doesn’t ever seem to weaken.  If anything, the more I push myself, the worse it gets.  It’s like my fear of my own response plus the response itself combine to form this infinite feedback loop of crazy.

You can see how this might be a problem if, every time I try to be assertive or resolve something, I end up a damp, quivering, wreck and have to go sit down for a while and have a drink of water.  And maybe a shower.

It’s not like I’m even trying to do superhuman feats here.  I’m not running into burning buildings and saving lives.  I’m just trying to function like a normal person.  I’m just trying to stand up for myself without caving and resolve the little snags that life throws out at me.

Here’s a recent example, to give you an idea:

I had been sending regular payments on my car loan when I got a nasty-gram accusing me of not paying for a few months.  Turns out they’d gotten the money but someone somewhere had failed to apply it to my account, the fact that I’d paid it online through their system notwithstanding.  

We went back and forth, I tried to climb the levels of customer service to someone who had the power to do something, I faxed copies of my bank statements, they couldn’t find the faxes, I re-sent them, I argued, I refuse to send further payments while they tried to find the others (because being out twice the money for their mistake struck me as a bad thing, and out of my budget besides), and during every phone call I not only had to take an hour or so to do some yoga-breathing and self-coaching to talk myself into getting my papers together and picking up the phone, but I spent every phone call with my forehead resting against the windpane, trying surreptitiously to suck air at every pause in the conversation because I felt like I couldn’t quite breathe.  And then I had to go have a lie-down because I felt dizzy.



These kinds of things should not be such a big, nerve-wracking deal for me.  And yet they are.

Nor is this attention-getting in a “woe is me, I’m so fragile” kind of way.  I’ve never spoken about this to anyone before.  It’s too embarrassing.  I just try to cover it as best I can and truck on.  If somebody notices something and mentions it, I try to bluff and pass it off as too much coffee or too little sleep, or the classic, “I took the stairs and I’m a little winded.”

It probably doesn’t help that I’m the baby of the family, the only daughter, and humiliatingly aware of just how much my parents have sheltered me and tried to take care of things for me all my life.  Of all of my siblings, I was the one who took the longest to get through college (with failures and changes of major along the way), the longest to find a job, the longest to leave home, and I still lean on my parents more than I think I should.  It took me until my mid-20s to realize it, and at 31 I’m still in the process of trying to fix it.

The weird thing is that they don’t even seem to notice or mind.  They’re not controlling, and they unquestioningly allow me space when I take it.  It’s just that their default M.O. seems to be, “Take care of the baby, she needs extra help.”  I appreciate the sentiment, but not necessarily the end result, which is that I have no idea how to deal with things if left on my own.

I’ve been striking out and trying to be a more competent, independent human being, but while I’ve been coping, it’s been slow going and marred with setbacks.  It’s also made my complete lack of organizational or time or life management skills painfully apparent.  My little meltdowns seem to be part and parcel of that.

So far I’ve coped with a combination of (really unhealthy) conflict avoidance and sheer bloody-mindedness.  In other words, I try to force myself to push through it and not to dwell on it.  Sometimes I succeed.  Sometimes I just duck the confrontation because I just can’t face both the confrontation AND my physical response to it.  This happens more often than not, though less often these days, I suppose.  When I do push through successfully, any pride I feel at my success is always secondary to the embarrassment, frustration and exhaustion.  It doesn’t change.  I just get better at pretending to ignore it.

Still, not only does this thing make it so much harder to handle any given situation due to being in a mild panic all the damned time, but I can’t help but think my agitation is obvious, which isn’t great if you’re trying to be firm and stand your ground against someone who’s trying to bully you.  And, yes, I’ve had a lot of trouble with bullies in my time.  Middle school was hell.  I was a shy and awkward kid to start with, and didn’t know how to stand up for myself, and a few years of bullying didn’t make me find my backbone, they just buried it so deeply that I can hardly find it anymore.

I try not to think of myself as neurotic or a fundamentally weak-willed individual, but this whole situation seems to disprove that belief, and it’s disheartening.

Oh, and here’s the funny thing: it stops happening when things get serious.  

Examples:

My grandmother had a major stroke and died after a handful of days in the hospital, and I somehow managed to coordinate family and manage communications so Mom didn’t have to, clean my parents’ house for them, arrange food and find hotels for everyone who visited, and so forth.  Picking up the phone ceased to be a major problem for the duration, to resume being a major problem as soon as the crisis had passed.

I once fished a nephew out of the pool he’d fallen into and did CPR *EVEN THOUGH JUST FORCING MYSELF TO GO THE CPR CLASS WAS A MAJOR EVENT I HAD A MINOR PANIC ATTACK OVER.  You heard that right: I did actual CPR with more serenity and self-possession than I did fake CPR.  And I have no clue how I did that.  No.  Fucking.  Clue.  

Another time I found my then-boyfriend cornered in the backyard by a neighbor’s very aggressive dog, and it’s like a sane person took over my body, grabbed a stick, ran up, and managed to scare it off.  It left.  I closed the gate behind it and called the police.  HE was more freaked out about the whole event than I was.  I was just like, “Meh.  You OK?  OK.  Let’s go have a beer.  You look a little pale.”  

And my hands, my traitorous hands that shake like leaves in just about any other situation, were steady the whole time.

It’s like, in a crisis, the usual me unfolds, in some bizarre kind of reverse mental origami, into Super Me.

But the rest of the time I can’t even balance my budget, apply for a job, go out in a crowd, or say boo to a goose without feeling like I need a sedative.

It’s like my own brain is playing some twisted joke on me, and I can’t figure out how to make it stop.

Help me.  This feels a lot like insanity.

Meltdown Master

Dear Meltdown Master,

I’m going to do something I don’t usually do. I’m not going to try to dazzle you with prose. I’m going to write at some length, not editing myself too much, but not going for anything poetic-sounding. I’m going to write more in a talking style, and just give you some information and ideas. I hope that will be OK with you and the rest of the readers.

I have to say right off that I have no clinical training in psychology so when I say maybe you have this or maybe you have that, it’s like somebody who lives up the street saying it. Except I’ve done some reading. That’s all. Oh, and I have had some of these things myself. That too.

I do suggest you see a professional. But since you say you can’t see a professional, the next best thing is to learn as much as you can and then take steps to help yourself.

Here is the crucial thing. Gathering information will not create behavior change. Only doing things works. I have survived alcoholism, drug addiction, cancer, depression and panic attacks. How I got better was I found out what worked and then I did as suggested. I used cognitive behavioral therapy to get out of my depression back in the 1990s by finding a therapist and doing what he suggested — which was to read “Feeling Good” by Dr. David Burns and do the exercises in the book. It worked. Likewise, to stop  drinking I had to find a group of people who had been able to stop drinking, and learn how they had done it, and do what they had done.

So learning about your condition is important. But it is only part of the cure. You must take the necessary actions.

The Anxiety Disorders Association of America website is very informative. Read what they have to say about panic attacks. Also read what the Mayo Clinic says about generalized anxiety disorder.

Since the Dr. Burns book “Feeling Good” was so useful, I figure his book “When Panic Attacks” is probably good, too, for people with panic disorders and anxiety. So read that book and do what it says. Cognitive behavioral therapy worked for me and it has worked for a lot of other people. The thing is, you have to do these things, not just read about them. So you may need the encouragement of others. Consider joining the Mayo Clinic’s online community. The Anxiety Forum might be pretty useful, too. Try them out. If they’re not for you, fine. Find other ways to motivate yourself to do the exercises.

In looking for answers for you, I went to my local San Francisco branch library, which just happened to be closed on a Wednesday morning. I wanted to put my hands on a copy of that “When Panic Attacks” book, just so I could say I’d really taken a look at it. So then I went to the Bookshop West Portal, and they had some interesting books on psychology, including the latest edition of the “Feeling Good” book, but not “When Panic Attacks.” Then I went to the Booksmith on Haight Street, and they didn’t have it on the shelves either. That’s not surprising, nor is it a bad thing. Bookstores cannot afford to stock every book; they’re not libraries, and it’s not cost effective. It is still useful to browse bookstores to see what catches your eye. They did have the “Anxiety and Phobia Workbook,” which might be useful to you, especially as it emphasizes doing the exercises, which is key.

Here is one other interesting thing that happened. In searching the Web I ran across something called the Panic Puzzle, which provided a look at what appears to be an extremely clever and successful Internet marketing operation the likes of which I have rarely seen. I didn’t actually buy the Panic Puzzle because I wasn’t able to get an accurate feel for what it is and how it works. Everywhere I looked, all I found were what appeared to be thinly disguised sales pitches, masterfully orchestrated to appear as independent evaluations. It was bizarre and fascinating.

Take a look at this document headlined “Posts Tagged ‘panic puzzle review’” that Google turned up for me with the subject heading “Tag Archive for ‘panic puzzle review’ – - Free Design Resources.” Isn’t that an amazing and interesting bit of SEO-driven word agglomeration? Look at this lead sentence: “Millions panic puzzle review Americans day after day stop stress and anxiety with over-the-counter medicine.” Fascinating, no? Something very interesting is going on here, in the gaming of search engines. It is beyond my understanding but I just thought it was interesting. I couldn’t come to any conclusion about the “Panic Puzzle,” though.

There was no easy and convenient way to locate a trustworthy independent source that might have evaluated the Panic Puzzle. It’s  possible that no reputable psychologist has shown any interest in the Panic Puzzle. Or I suppose it’s possible that the Google search engine has been gamed. I don’t know. I felt surrounded by ersatz “reviews” and “text.” Much more could be said were there time. I just found it interesting. Perhaps someone with more time to explore will shed some light on this phenomenon.

So anyway, since you have no health insurance and cannot afford a therapist, I suggest you learn all you can about anxiety disorders and panic attacks. Fearlessly investigate. Do the exercises. Try stuff even if it doesn’t sound like it will work. You have no idea what will work. Anything that will work is good, even if it sounds crazy.

What interests me is the possibility that you might actually get better results taking your recovery into your own hands, on the advice of proven experts, than you would going to a therapist who might not be as expert in the field as these authors.

It will be interesting to hear how you do. Please let me know.

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