Looking back on my childhood, I realize I had panic attacks a LOT. Like “I missed school on a pretty regular basis from middle school on, freaked out in class, and often stayed up all night sobbing” level. Several notable ones happened after watching a movie or TV show; in particular, Sphere and Contact were really triggering ones. I remember being absolutely, positively, 100% convinced I would die before morning, and would sob for HOURS until daybreak. I would then be able to pass out and rest, but for those few hours, the horror was a tangible thing. I’ve had this in other instances, as well, usually when I’m stressed about something- these days, it’s my constant fear that I’ll be fired. I freaked before going with my boyfriend, his sister and her fiancee to the Renaissance festival in Tennessee somewhere, because I was convinced we wouldn’t make it. (Of course, I’ve had a few harrowing close calls in Tennessee, so I think that one was more justified than the others.) I looked up the symptoms and diagnostic criteria for panic attacks and found this:
DSM IV-TR Criteria for a Panic Attack
A panic attack is a period of intense fear or discomfort, developing abruptly and peaking within 10 minutes, and requiring at least four of the following:
Chest pain or discomfort
Chills or hot flushes
Derealization (feelings of unreality) or depersonalization (being detached from oneself)
Fear of losing control
Feeling dizzy, unsteady, lightheaded, or faint
Feeling of choking
Nausea or abdominal distress
Palpitations or tachycardia
Paresthesias (Had to look this one up, but it’s true for me; my skin feels prickly for hours afterwards and I don’t want to be touched because it hurts)
Sensations of shortness of breath or smothering
Sense of impending doom
Trembling or shaking
Data from American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed, text rev. Washington, DC, American Psychiatric Association, 2000.
Cleveland Clinic link to where I found this.
I bolded the symptoms I have usually, and the impending doom was particularly bad at those nighttime panic attacks when I had no idea what was wrong- and neither did my family, as my mom and brother tried to console me and convince me that I wasn’t going to die before sunrise. At least these days, I have medications and can feel the symptoms long before it becomes that bad, but I do fall victim, especially when stressed or really, really tired. I can go from zero to melancholy in nanoseconds.
But why are these panic attacks so bad? Where did they come from? My research into understanding more about my PTSD looks an awful lot like my anxiety research.
PTSD stands for Post Traumatic Stress Disorder. PTSD is an anxiety disorder that can develop after an individual has experienced or witnessed a major trauma.
There are many different types of symptoms that someone can have after a trauma, but PTSD symptoms fall into 3 categories:
Reliving or re-experiencing the trauma
Attempts to avoid thoughts, situations, or people that are reminders of the trauma
Increased anxiety or arousal, including being constantly on guard for danger, and being easily startled
People with PTSD will have at least one or more symptoms of each of these categories.
(emphasis is, again, mine.) I do have all three on any given day, but the anxiety and avoidance behavior is BAD. I know my panic attacks before work are WAY worse when I’m behind on paperwork (check) or productivity (check) and due to meet with someone for supervision (check). I usually assume and often state that I’m going to get yelled at, when that rarely happens. But I know it will, deep in my heart, and it will be one of my parents’ voices screaming at me.
My downstairs neighbors bellows at odd hours, and this drags me right back to being eight again, and unable to do anything, paralyzed with fear and the need to protect my siblings.. I’ve been woken from a dead, drug-induced slumber by this and have to lay there, trying to ground myself and remember that I’m an adult now. It’s still hard, and I want to give up, but I also want to live. I’ve still got a good 2/3 of my life yet to go.
And wow, looking into paresthesias led me to looking into hypothyroidism, which also went undiagnosed for years. So many warning signs!
Signs and symptoms
Early hypothyroidism is often asymptomatic and can have very mild symptoms. Subclinical hypothyroidism is a state of normal thyroid hormone levels, thyroxine (T4) and triiodothyronine (T3), with mild elevation of thyrotropin, thyroid-stimulating hormone (TSH). With higher TSH levels and low free T4 levels, symptoms become more readily apparent in clinical (or overt) hypothyroidism.
Hypothyroidism can be associated with the following symptoms:
Cold intolerance, increased sensitivity to cold
Weight gain and water retention
Bradycardia (low heart rate – fewer than sixty beats per minute)
Muscle cramps and joint pain
Dry, itchy skin
Thin, brittle fingernails
Poor muscle tone (muscle hypotonia)
Female infertility; any kind of problems with menstrual cycles
Hyperprolactinemia and galactorrhea
Elevated serum cholesterol
Slow speech and a hoarse, breaking voice – deepening of the voice can also be noticed, caused by Reinke’s Edema.
Dry puffy skin, especially on the face
Thinning of the outer third of the eyebrows (sign of Hertoghe)
Abnormal menstrual cycles
Low basal body temperature
Infertility to both men and women
Acute fatigue syndrome
Decreased libido in men
Impaired cognitive function (brain fog) and inattentiveness.
A slow heart rate with ECG changes including low voltage signals. Diminished cardiac output and decreased contractility
Reactive (or post-prandial) hypoglycemia
Anemia caused by impaired haemoglobin synthesis (decreased EPO levels), impaired intestinal iron and folate absorption or B12 deficiency from pernicious anemia
Shortness of breath with a shallow and slow respiratory pattern
Increased need for sleep
Irritability and mood instability
Yellowing of the skin due to impaired conversion of beta-carotene to vitamin A (carotoderma)
Impaired renal function with decreased glomerular filtration rate
Acute psychosis (myxedema madness) (a rare presentation of hypothyroidism)
Decreased libido in men due to impairment of testicular testosterone synthesis
Decreased sense of taste and smell (anosmia)
Puffy face, hands and feet (late, less common symptoms)
It’s insane. So many of my symptoms can be caused my any of my diagnoses; it’s hard to decide where one ends and another begins. But there were SO MANY warning signs for so long. Why did it take until I was 21 to recognize this? Why did I have to suffer for so many years?