DSM (Defeating Stigma Mindfully)
Helping you reach a slightly higher State of Mind 😎 by Dr. Alexander
Millions of people all over the world experience panic attacks. These occur out of the blue and involve a great sense of doom, fear and sometimes even physical symptoms. Panic attacks can be treated with Cognitive Behavioral Therapy and/or antidepressants. Don’t be afraid to seek therapy. Would you rather take a chance with therapy and medications or continue to suffer from panic attacks while in public?
Millions of people all over the world experience panic attack symptoms. These occur out of the blue and involve a great sense of doom, fear and sometimes even physical symptoms. Panic attacks can be treated with cognitive behavioral therapy and/or antidepressants. Don’t be afraid to seek therapy. Would you rather take a chance with therapy and medications or continue to suffer from panic attacks while in public?
The most obvious is fear. I still remember my first panic attack because the fear was insane. It was a Saturday night in Redlands, California the day after I drank a lot; typical freshman college weekend. I went to a Chinese store to order some food with a friend and while standing in line, started to experience fear. I had never just randomly experienced fear before. This time was different because there was nothing to fear besides fear itself. But then the fear started to make more sense. I was afraid of standing in line and being in the store.
Then there are the physical symptoms such as sweaty palms, lightheadedness, dizziness, tachycardia and shortness of breath. Some people also tremble. My physical symptoms weren’t as bad. I would only experience sweaty palms thankfully. But I can imagine how more intense physical symptoms can worsen the panic attacks, worrying the person into thinking that others are aware of their symptoms. For me, sweaty palms were a sign that I was getting anxious and that a panic attack was looming around the corner.
Then there are the symptoms of overthinking, a general feeling of anxiety, heightened vigilance for danger and wanting to escape your environment. Some people also get depersonalization and/or derealization. Depersonalization is when you don’t appear real in your surroundings while derealization is when your surroundings don’t appear real to you. I experienced some derealization but it wasn’t until in my late 20s. My panic attacks started when I was 20.
The worst part of the entire experience is definitely the fear. It’s like experiencing a sense of doom like something really bad is doing to happen to you. This is accompanied by the thought that others around you could be noticing you having a panic attack. This further motivates you to leave the vicinity. I don’t believe that I ever walked out of a classroom or mall (the majority of my panic attacks occurred in college lecture halls or in the mall). However, I do remember being in an Italian restaurant in Pittsburgh with my mother once, and I had to get up from the table and go outside because the panic attack was too unbearable.
Lastly, the most important feature that distinguishes isolated panic attacks from panic disorder is the worrying about future panic attacks. People with isolated panic attacks have them too randomly to worry about future ones. But people with panic disorder constantly worry about future panic attacks; it becomes part of their daily thought content. This is another worrisome symptom because it can prevent you from going to places where you previously experienced panic attacks. For me, I was worried to go to the mall thinking that I would have another one. This symptom can get tricky because it can easily lead to agoraphobia, which will be discussed elsewhere.
If you keep experiencing them, than what should you do? Honestly, what worked for me was an antidepressant called Prozac. I took about 20 mg once in the morning. Probably within six months of consistent use, my panic attacks significantly went down. The medication was like a miracle. How did I improve so much just from taking one pill every morning? The dose was low too. Prozac goes up to 80 mg. But I can’t complain. I started the medication when I was 20 and continued it until 28. I know, eight years is so long! But the problem was that I stopped taking it a few times and my panic attacks had returned.
The reason I tried to stop again at 28 was because I was ending medical school and had matched into a residency training program. I was in a good place mentally, free of panic attacks for many years and was ready to try going off the medication again. My recommendation is that you need to be in a good place in your life to try to go off an antidepressant for panic attacks. Panic attacks can be induced by drugs, alcohol, stress and genetics, so it’s important that you’re in the right state of mind when discontinuing an antidepressant. Overall, panic attack symptoms are brutal.
Have you had an experience with panic attacks?
Are you Ready? (This is Defeating Stigma Mindfully)
“I am free of marijuana because I realize that it’s not necessary for me to use it in order to be happy and find joy in life. Even though marijuana may be fun, I find pleasure in socializing in a sober state of mind, enjoying my senses without having the munchies and watching movies and listening to music without experiencing an altered perception of my reality. I also enjoy to not cough up a lung or experience mini panic attacks when I am getting high. I also prefer to have a clear conscience and not feel guilty when I am high. I am free of marijuana!”
Are you Ready? (This is Defeating Stigma Mindfully)
“I am free of marijuana because I realize that it’s not necessary for me to use it to be happy and find joy in life. Even though marijuana is fun, I find pleasure in socializing in a sober state of mind. I enjoy my senses without having the munchies or watching movies and listening to music in an altered state of reality. I also enjoy not coughing up a lung or experiencing panic attacks when I am getting high. I prefer to have a clear conscience and not feel guilty when I am high. Smoking marijuana is an act of my past.
Cannabis helps me think outside the box but I can also do that without using it. I enjoy meditating and thinking which help me harness new creative ideas. Cannabis intoxicates my mind and makes me want to use more. The high gets my dopamine to act funny, making me psychologically crave more of it. I’ve tried stopping cannabis in the past; the worst part are the first few weeks after stopping. I end up craving more and have to struggle to stop myself from using. Why put myself through this mental obstacle? I rather just be free and at peace, regardless of its legality.
Everyone says it’s not a gateway drug but they are wrong. Marijuana convinces the mind that there is more next door. This leads to either consuming more of it or seeking other substances never previously experienced. Classically, the next class of substances to make an appearance are the hallucinogens; can you say shrooms without thinking of its magical effects? And after that comes cocaine and what not. This does not apply to everyone but certainly applies to enough. Why do I need more drugs in my life? I can find mental satisfaction without consuming mind-altering chemicals.
How do I prevent myself from consuming? I stop smoking marijuana and put away the substance without seeking it. Sometimes it helps to completely discard it. I stop seeking the munchies, fun experiences and thought-provoking moments; I can find those naturally. I am not here to judge others on their partaking. In this case, I don’t want to use marijuana anymore. I find happiness by being sober and enjoying what life has to offer me. While smoking marijuana may be fun, I create my life circumstances and breath fun into existence without the THC binding to my cannabinoid receptors.
Are you Ready? (This is Defeating Stigma Mindfully)
“I am free of panic attacks because they no longer control my life, my emotions, my presence in public and they no longer make me experience fear, uncertainty, doubt and sadness!”
Some people remember when their mental illness started while others are completely oblivious to when they first began experiencing symptoms. Some don’t even know that they have a mental illness; these are the cases with zero insight. Suffering from a mental illness is not easy and many are ashamed to even recognize their newfound reality. Many are afraid of their mental illness because they do not know how to deal with it.
Fear is a natural emotion that should be extinguished as soon as possible. The longer you allow fear to marinate within your mind, the more complicated things will get in terms of your mental illness. By being afraid of your mental illness, you are preventing yourself from taking the necessary steps required to defeat the disorder at play. That’s because fear paralyzes you, preventing you from thinking clearly and getting a grip on your mental state of mind.
It can be difficult to accept your mental illness because it can truly feel like a stranger has entered your head. Your reality may start to take a different shape because you previously never experienced any symptoms. For instance, I remember the day that I experienced my first panic attack: I was in college the day after partying and standing in line at a Chinese restaurant ready to order food.
I suddenly felt a great feeling of unease while standing in line, as if fear had engulfed my entire presence. I wasn’t sure what I was experiencing because I never thought for one second that it was something mental; a panic attack didn’t even cross my mind. But in fact, that’s exactly what I was experiencing: a full-blown panic attack at the age of 19. But rather than running out, I uncomfortably stood in that line suffering while afraid of my existence. That was the longest Chinese order I ever placed.
I eventually learned that I was in fact suffering from panic disorder: I would worry about future panic attacks after experiencing a handful in public. I was afraid of my mental illness because it seemed to rock my world (in a bad way) whenever it felt like it! I felt like I was just a bystander, observing a stranger in my mind controlling my reality. I had to go on a psychiatric medication and eventually felt much better on it. Today, I no longer take any medications and I feel great because I’ve learned to take back control of my mind.
The point is that you may be afraid of your mental illness, but you have to eventually conquer your fear and take back control of your life. You cannot allow a mental illness to push you aside like a bully controlling your mind; these bullies have to be pushed aside with therapy, medication or willpower. But sometimes willpower is not enough; therefore, you need to seek psychiatric treatment and there is no shame in that!
Are you afraid of your mental illness?
Are you Ready? (This is Defeating Stigma Mindfully)
Anyone who has ever experienced a panic attack will tell you that it’s one of the worst feelings in the world. The impending sense of doom that many experience when a panic attack comes into being, is a feeling and thought that your life is about to end; everything to come down to this very moment. That’s why being open about panic attacks is important and can prove to be very beneficial.
Sometimes it helps to tell someone around you that you might have a panic attack in the next couple of minutes. It takes a lot of confidence to divulge such information, so that’s why it’s better to tell someone who you feel comfortable with. But if you have the courage to tell anyone, it can still help prevent you from experiencing a panic attack.
When you share with others around you your fear of an impending panic attack, you are basically incorporating another person into your experience: when this happens, there’s a greater chance that the panic attack will not start in the first place, or diminish right away. This is because you’ll feel more comfortable about your situation if someone knows about it.
Part of the battle with panic attacks is that you want to avoid any detection. If anyone notices your symptoms, you start to freak out even more, thinking to yourself, “I probably look like a fool right now. This is so embarrassing!” This worsens the symptoms. But when you tell someone that you’re about to have a panic attack, that person can now help you calm down.
It’s all about distraction with panic attacks. Whenever you become distracted from the train of thoughts surrounding a panic attack, it tends to either never come into play or go away much faster. Because what is a panic attack? It’s a set of uncomfortable anxious symptoms based on thoughts that have gone haywire in the present moment.
Panic attacks are also based on patterns: if you previously had a panic attack in the middle of the mall, then the thought of having a future one, again in that setting, starts to occur even before you arrive at the mall. But if you tell someone who is with you at the mall, “Hey I think it’s about to happen. Can we sit down and relax for a bit?”, there’s a good chance that you’ll feel better, rather than dealing with it on your own.
So don’t let panic attacks corner you. Always tell someone about it, especially if you have a good opportunity to do so. Don’t be embarrassed.
Are you Ready? (This is Defeating Stigma Mindfully)
There are many forms of anxiety: panic attacks, generalized anxiety, social anxiety, substance-induced anxiety, agoraphobia, etc. Anxiety is prevalent in all cultures and nobody is immune to it. The Existential School of Thought actually believes that the source of anxiety is existence itself.
Not all anxiety is bad however; it is normal to have anxiety if you are being threatened. That means that your sympathetic system is warning you that potential danger lies ahead. On the other hand, other forms of anxiety can be very debilitating and paralyze people.
What are panic attacks? A panic attack is a sudden feeling of acute and disabling anxiety: a fear of the world coming to an end, sweating, palpitations (heart beating fast), a fear of being “doomed”, a fear of loss of control of oneself, trembling and shaking, shortness of breath or chest tightness, chills or even hot flashes.
Multiple recurrent panic attacks over a month with a future fear of having more panic attacks results in a diagnosis of Panic Disorder; this can be caused by genetics or substances such as excessive alcohol use.
If anyone has even experienced a panic attack, they know that it is extremely unpleasant. I have experienced panic attacks and I can attest that the feeling of “derealization” is very real: an alteration of the experience of your surroundings. For example, you may lose track of time or you may feel a sense of disconnection with your surroundings. On a positive note, panic attacks can be treated with medication and CBT.
What is generalized anxiety disorder? This is 6 months or more of excessive and exaggerated worrying and tension about everyday things, that other people would normally not worry about. For instance, a mother may excessively worry about: going to work, paying the bills, picking her son up from soccer practice, putting food on the table, doing the laundry, not making enough money, not exercising enough, not having enough friends, etc.
These are all normal things to worry about, but patients with GAD take it to the extreme where the worrying becomes debilitating: it interferes with their sleep and relationships and they may even experience feeling lightheaded or shortness of breath. Thankfully, GAD can be treated with medication and therapy.
What is social anxiety? This is the intense fear of being judged, negatively evaluated or rejected in a social situation. For instance, you go out with your friend to a bar on a Friday night and he suddenly storms out within 20 minutes of being there. When you find him outside on a bench down the street from the bar, his reasoning may be “I thought everyone was staring at me and judging me” when in fact, nobody was.
This disorder can be very debilitating because it prevents people from having a normal social life; some may not even go to work or school anymore due to a fear of being humiliated. The solution is medication, therapy and encouraging the person to socialize despite having the irrational fear.
What is substance-induced anxiety? As you can guess, it involves anxiety that has been brought upon by a drug, such as alcohol, marijuana, cocaine, K2, methamphetamine, etc. The anxiety usually occurs while the person is under the influence of the drug. They may feel panic, worried, have shortness of breath and sweating and feel like they are going to die.
The anxiety usually subsides after they come out of their high. Some drugs such as alcohol can cause panic disorder, which persists after the intoxication from alcohol goes away. This is treated with medication, therapy and sobriety.
And lastly, what is agoraphobia? This is an extreme fear of being in open places, such as a mall or college classroom, and results in the person not wanting to leave their home, in order to avoid the anxiety that comes upon them when they are in the open place. They interpret these open places as “being difficult to escape from.”
A lot of times, agoraphobia is associated with panic disorder, because the person may have had a panic attack in an open place (a mall, a college classroom, a gym, etc.) and therefore, has developed a fear of being in that open place; they try to avoid having a future panic attack by not going to that open place again.
Agoraphobia can be very serious as it can paralyze people and prevent them from leaving their home. It is a very depressing condition to have. This is treated with medication, therapy and encouraging the person to go into open places and live a normal life, despite their fear.
There are more anxiety disorders that haven’t been covered here, but I hope you are able to understand the serious nature of these disorders and their impact on humanity. The DSM movement encourages everyone to come together and share their experiences, so we can unify and tackle these problems together.
Are you Ready? (This is Defeating Stigma Mindfully)
DSM (Defeating Stigma Mindfully) 