Fear vs Panic

I want to clear up another one of the seemingly infinite misconceptions relating to mental illness. Some months ago I was working at a place  -I won’t say where- when my boss saw me in the throes of a panic attack and told me to “quit being so dramatic.” because “we all get scared sometimes” . I’m rather proud of the fact that I resorted to neither interpersonal violence nor the kind of extreme and often bestiality-themed profanity for which I am known in my less serene moments. Instead I rolled my eyes, bit the inside of my cheek and walked away silently wondering how someone so utterly unburdened by any semblance of a functioning intellect had come to be in charge of the two highest visibility stores in the chain.

But that incident got me thinking, an activity I personally doubt my former boss ever engaged in for more than a total of a few minutes in her entire life. And I realized that, for all her insensitivity and apparent willful unwillingness to understand my condition maybe it wasn’t entirely her fault. After all you should never ascribe to malignancy what is more likely the product of simple ignorance. Hence this week’s topic.

Fear is a natural human response to certain stimuli. An inattentive driver on the road as you cross the street or seek to change lanes. A mugger. A fire. Any clown, anywhere, ever. When you get scared your pulse quickens, your breathing speeds up, you become more aware of your surroundings. Your reflexes bump up a notch because your adrenal system is now online. You may sweat because your body is subconsciously trying to make you more slippery and thereby harder to grab hold of. Basically your body is ramping up to either fight back better or run the fuck away. Maybe both. A great many of us are alive today because some ancestor decided to knock the stupid out of a potential threat and then leg it rather than stick around to find out the hard way which of them was better in a scrap. The experience may be somewhat unpleasant but it’s not especially debilitating.

A panic attack is something else entirely. Yes, many of the same physiological process occur in both a fear episode and a panic attack and to the uninformed it may look like a person having one is merely scared of something. This is rather like saying that a flat chunk of ice floating down the river in winter is the same as ship-killing iceberg.

In simplest terms when you have a panic attack you experience all of the things that you experience when you get more generically scared. The problem is that our bodies usually have process in place to moderate the extremity of various processes to keep from destroying itself. In a panic attack these mechanisms get turned off.

Your body does not get enough adrenaline to help you escape the clown or dodge the car. It gets all the adrenaline .  Your pulse does not increase. It hammers in your body so hard it feels like thunder in your ears, like you’re being shaken apart from the inside. Ever get scared and feel like you wanna poop or pee a little? In a panic attack the affect of so much combat hormones at once can give you an almost uncontrollable urge to have the runs or piss yourself.

Your breathing does not increase slightly to better oxygenate your muscles. It either buries the needle to the point where you hyperventilate or it seizes up entirely, like a computer with too many windows open at once. Your brain sends so much “work really hard or we’re DEAD!”  command traffic to your lungs that they just overload and you can’t breathe at all.

There are other ways in which a panic attack can be debilitating. Your body can get overloaded and you can pass out. You can vomit or get the shakes. You might find yourself wanting to cry uncontrollably because you are simply overwhelmed . The human system can only take so much stress before it becomes too much and serious temporary or permanent  malfunctions occur. I have personally experienced all of the things mentioned in the first three sentences of this paragraph. It is scary and, when it happens in public, deeply humiliating.

Understand that I’m not saying I’m embarrassed about having PTSD. I’m not. I survived a Hell that  kills many people and it’s left me some scars. But I’m still here and I’m still fighting. I’m no more ashamed of having PTSD than a breast cancer survivor should be of their experiences.

But when your body fails you it’s embarrassing. We like to think of ourselves as strong, competent, capable people. Blacking out at work or in the checkout lane at Target draws stares and possibly snide remarks. Spontaneously vomiting is gross, messy and draws the aforementioned stares and comments. I’ve had people mutter under their breath about how I must be drunk because well just look at him. This despite the fact that I rarely drink, never do so on the job and, in the twenty-six or so years I’ve been consuming alcohol have been puke-drunk exactly twice.

When these things happen you stop being a person in the eyes of those around you and become a broken bit of wreckage.  It strips away your dignity and feeds the voices whispering that you’re a cripple. It is, in short, a painful, scary, entirely dehumanizing experience.

It may look like  what normal people think of as being scared but only in the same way that a jet fighter at full burn looks looks like a puddle-jumping, prop-driven Piper Cub .They both have wings. They both move through the air. They are both technically examples of aeronautical technology. But that’s where the resemblance stops. One is survivable barring something truly catastrophic happening. The other can fucking kill you.

As I mentioned earlier, the human body is not meant to run full-blast for very long. Having all the stops switched off repeatedly can have serious long-term consequences to your health. You can begin suffering gastrointestinal issues. Your immune system can break down from the stress. The strain on your heart takes its toll, especially as you get older.

I’m 44 years old and in pretty decent shape. I work out several days a week, watch what I eat and have a physically active job. And I’m pretty sure I’ve already had a couple minor heart attacks either in conjunction with or shortly after panic episodes. Like I said, the body can only take so much stress for so long before critical malfunctions occur.

So I hope that clears up the difference between merely afraid and a full-blown anxiety episode. I’m not gonna yell at you. I’m just going to request that the next time you see someone having a moment like that don’t be so quick to dismiss it or compare it to that time you tripped going down the stairs. Please have some understanding and some compassion and understand that what you are witnessing is a potentially life-threatening medical crisis. Offer to help . If it is accepted follow our requests as much as is reasonable. We know what we need because we’ve been dealing with this probably for a long time now. If we say we’d rather manage on our own, respect that and go about your business without judgement or commentary.

That’s all for this week. Please be sure to check out my video blog and support me on Patreon. See you next week everybody.





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