Anatomy of a Panic Attack


Right now, we are seeing a lot of very smart and passionate people writing and talking about both wellness and mental illness in the legal profession. It is amazing to see the level of awareness grow almost daily. But there is an area of discussion where much more can be said. I continue to hear people suggest that anxiety attacks either “aren’t a thing” or not severe enough to require professional help. The perception that anxiety attacks are just stage fright or a little about something ignores the reality that people who suffer from them feel real pain. Speaking from experience, I can assure you that they are real; they can be debilitating, and you cannot simply “muscle” through them. Indeed, you often need to address them in a multiplicity of medication, exercise, and therapy.

For people that have been fortunate enough to go through life without experiencing one here is what an anxiety or panic might feel like for your friend, family and colleagues who suffer from them.

You might wake up at night soaked in sweat, with your whole body violently shaking in terror because of something you can’t see or understand. You try to go back to sleep, but by that time your heart rate is so elevated that you cannot control your breath. When you get up in the morning, you feel like someone dropped a weight your chest. As the day progresses, you feel better, but the fatigue from the depths of the night still lingers.

On another day as you try to navigate the interpersonal dynamics of your work and family life, you begin to feel your heart race and you notice that your hands are shaking. You fight to type every word you need to type, to get through every conversation you need to have and to salvage the day so that you don’t feel unproductive and lazy in addition to feeling that underlying sense of terror. You might have to give a speech or make a presentation that day. You might self-medicate with caffeine to raise your energy levels and bring you out of that stupor, but that just makes it worse because it makes your heart race even faster. You try to catch your breath but you can’t. When you go into your presentation, you manage to push down the terror and the panic until it’s over. Yeah! You do a great job, but as a result of your panic or anxiety, the chemicals in your body revolt when you are done, and the terror returns with a vengeance.

For me, the most frightening panic attacks are what I call the compression room. It is when you feel like you are in a room where the walls, the floor and the ceiling are coming toward you—and you will inevitably be crushed. Your breathing isn’t fast anymore; it’s labored. You feel like you are actually being squeezed to death, and every breath requires enormous energy. You feel endless waves of sheer terror. When those types of attacks come in the night, it’s worse. When you wake up, you actually wiggle your toes to see if your body still works, and it takes time to convince your brain that you were never actually in that horrible room.

I share this perspective for two reasons: When someone tells you they suffer from panic attacks, do not make a joke of it. It is a very real thing and people that suffer from them need your support. Do not tell them that they need to muscle through or just learn to breath. Those responses are flippant and demeaning. Ask them how you can help, take them to lunch, drag them to a meditation or Yoga class and ask them if they need help finding help. Most of all remind them that you are there as a friend and that your friendship is unconditional. Having friends that you can trust and that will help you without judgement mean more than you can ever know.

Conversely, if you suffer from panic attacks, get help. What help looks like is different for everyone, but starting with healthcare providers and others in the therapeutic community is a good jumping off point. Don’t fool yourself that you can face the problem alone. You need to honor your family and friend by sharing who you are and trust them to help you. You need to find a peer group that understands your pain and can help guide you through the process of finding the tools and strategies that will help you manage the problem. You also need to take some steps to care for yourself in other ways. Walking and breathing are a good way to start. Finding communities that share your hobbies or passion for fitness are also good ways to begin building a support system. Belonging to a community and knowing you are cared for really help.

People with panic attacks are everywhere. They are your supervisor, your peer, your assistant—and they might be you. With help and a supportive community, people who suffer from anxiety attacks can find relief. They can also function at a high-level, do inspired work and be great team members. All the great work that is being done to address mental health issues and erase the stigma associated with them in our profession leads to a culture of recovery. For those suffering, continue to reach out and ask for help. For those advocates out there, keep your voices strong. And, for those who are fortunate enough not to suffer from anxiety attacks or other mental health issues, be kind and be aware.



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