It’s all in your Head

This may come across as ranty. That’s because it is. A few weeks ago, as many of you know, I had a brief trip to the hospital. As many others of you know, I was diagnosed with severe panic disorder in 2000.

Based on the responses I often hear about panic attacks, it means, it must mean, that people are misinformed. Or, they’re assholes. As Hanlon said, “Never attribute to malice that which is adequately explained by stupidity.” So I’ve opted to write this in the form of a PSA, and swap out “stupidity” for “ignorance”.

It’s a Tuesday night. I’ve gotten home from work at a reasonable hour, and am sitting on the couch with a glass of wine, a couple of sips in. I’m relaxed, and my husband has just gotten home and is starting dinner. Life is good. I got enough sleep the night before, ate two regular meals that day. Suddenly, the corners of my vision start to go black, and it feels like my brain is pulling away from the inside of my skull; not pain, just dizzying disconnection. I go to move, but my arms feel insanely, insanely heavy, like I can’t move them at all. I decide to go to the bathroom and have a glass of water. Because I am pretty sure I can’t stand up without fainting, I crawl to the bathroom, and ask my husband to talk to me the entire time through the door, to ensure that I haven’t passed out. My limbs feel like dead branches. When it doesn’t get better after a few minutes, I call an advice nurse while my husband drives me to the hospital. I pick up the cat and cuddle him and say goodbye before I leave. I am not convinced I’m going to see him again. The advice nurse tells me to get to an emergency room and, when my husband drops me off so that he can go park, they take one look at me and let me immediately in without going through the metal detector. When I check in and tell the receptionist my symptoms, I’m triaged first.

(It’s all in your head.)

The medical tech immediately calls an ER doc and, within minutes, my husband is there, trying to remain calm, and I’m being hooked up to an EKG. My blood pressure is 146/110. I’m normally 100/70. Check out this informative link.

My bloodwork is good. Great. I think I’m the only person who ever came into an ER who said they had a half glass of wine who… actually had a half glass of wine. I’m in very good physical shape; I work out constantly. I had to explain the rope burns on my legs to a confused-looking ER team.

So, what does it mean?

(it’s all in your head.)

As with so many things, I think the first issue can be attributed to a language problem. The word “panic” invokes visions of hysterics, waterworks, deeply emotional responses. I’ve come to refer to this as an anxiety attack. Those are easy…simple. There’s usually an obvious trigger; a stressful day at work, not enough sleep, being hungry, anticipation of a stressful event, any number of things. These can often also be mitigated with a few easy… Well, a few simple, tricks. Get enough sleep. Eat. Don’t eat a lot of preservatives and crap. Eliminate drama in your life. When you see something stressful, take a step back, and take a deep breath. Easy. Well, simple. This is not meant to minimize the seriousness of anxiety attacks – just an effort to highlight the differences. Knowing that you’re having an anxiety attack can make it better. Being unsure whether it’s a panic attack or heart attack makes a panic attack worse, without the victim knowing why.

When I mentioned that there is a good chance what I experienced may have been a panic attack (we’re still checking it out), the first question I get is “what triggered it?” My snarky response is often “having panic disorder.” This blog is basically a long and (slightly) less snarky version of that same sentiment. For panic attacks, there is rarely one trigger. If there were an obvious trigger, I could point it out, freak out, call it anxiety, take a Xanax and be done with it. No, a panic attack is something much more sinister. For reference, please check out the link above.

(It’s all in your head.)

But numbers don’t lie. So, you’re sitting on the couch. You’re relaxing. You feel the need to respond to every email you get from every acquaintance that you have, asking for a small favor or response, you feel obliged to do it or risk people not liking you, or calling you a flake. There is nothing in this world worse than being called a flake. Every week, 15 to 20 requests flow in that have nothing to do with your day job, or singing, or even with your work for Thunderdome. And why do these requests keep flowing? Because I have always, always said yes. I have always responded, regardless of the nature of the request, without a lot of thought about the minutes/hours it might take to respond properly and thoughtfully. I never just say no. I have always figured, it doesn’t cost me anything to help people out. I could not have been more wrong.

(It’s all in your head.)

I have a career about which I care a great deal. A flourishing and rewarding singing career. A madcap working vacation in the desert and an endless stream of requests from people who apparently can’t read meeting notes. (I love you guys.) These things are a constant, pervasive pressure. I am well equipped to handle these things, and they fulfill me. But the nagging trickle of everything else? The inability to say no, or even just to delete? Impossible. My inbox, on Tuesday, March 4, was full of “this will just take a second” requests. In reality, full of requests whose responses will take anywhere from 5 to 20 minutes, most of them from acquaintances. Nothing against acquaintances but, when you have a lot of them, there will naturally be more requests. And so it was, but on the evening of Tuesday, March 4, my head decided it was time to rebel against me. Being Marisa was a trigger.

(It’s all in your head.)

The second response I get is “I’m glad it wasn’t more serious”.
They haven’t done the research, they haven’t looked at the numbers, they haven’t seen what an incredible killer this is. The symptoms have a lot in common with those of a woman’s heart attack. That’s why they send you to the hospital.

Then there’s the “It’s all in your head.” You know what else is on your head? Schizophrenia. Every thing you have ever learned. Every feeling you have ever felt. Migraines. Love. Pain. So, the next time you get the urge to tell someone that panic is in their head, go ahead and take a mallet and slam it into your foot as hard as you possibly can. I work out a lot, so I can do it if you’re worried you’re not strong enough. Then, as your nerves are sending screaming messages back to your brain, begging you to stop, remind yourself:

(It’s all in your head.)
Better yet, tell a woman in labor that the pain is all in her head. See how that goes for you. Or, if you’re diagnosed with really, crazy, life-threateningly-high blood pressure, just know that it’s all in your head – you can just think your way out of that stuff.

My solution? It seems to be working well. I’m telling people that it’s like I’ve been in a car accident. My body’s in shock, and recovery is slow, and foggy. And that’s after Wednesday the 5th’s weepy ativan hangover wore off. First of all, this whole seven hours of sleep thing is pretty amazing. My body responded to this experience by practically insisting on seven hours of sleep a night at a minimum, and it is fantastic. Of course, I think this detracts from my catlike state of readiness, but I can do this for now. I’m not making plans, I’m not saying yes, and I’m not allowing myself to feel even the smallest bit of pressure based on other people’s expectations. This is the biggest one. When you spend decades saying yes, accommodating every tiny request that comes your way, you set certain expectations of your behavior. That ship has sailed, my friends. And my acquaintances, especially. If someone thinks it’s personal, well… that’s all in THEIR head.

Not allowing myself to feel pressured by other people’s expectations has yielded amazing things. It’s given me vast insight into my amazing friends; the people who are jealously guarding my time and my health. The people who have not seen this as an antisocial act, but a changing of the guard, openness for more spontaneity. I’m not deciding in advance when I don’t have to. And so I find myself doing amazing things on the weekend, or when I don’t have rehearsal. Free, uplifting, amazing interactions that could never have happened in an overly scheduled life. I am free to let go of interactions that were largely one-sided. The Friends I’m gaining through this process, the friendships I get to nurture, are so incredible and fulfilling, that I fear what would have happened had I not ended up in the hospital, had I just kept going on this path, filling every moment with the lowest common denominator responses for the lowest common denominator interactions, never making room for the amazing ones with which I am now rewarded.

I’m a silver lining person. I have found the good in the worst of situations; it’s my combination of snark and optimism that has kept me good-natured through nasty terrain. Maintaining this new world order (now with slightly less order(tm)) will take vigilance and attention; no more setting and forgetting. It will take some re-setting of expectations. I will be ok. I will. It will just take time, it will look different. I will be different. I’ve spent a lot of time taking care of my body; in addition, I’m going to be taking care of my head.