Nick Wong for Reader's Digest International
It’s six o’clock on a September evening in 2001, and I’m driving our minivan on a Toronto highway, heading to dinner at my parents’ house. My husband is in Bermuda, where he has landed a two-year contract; he’s looking for an apartment so I can join him. Now it’s just me and my little black poodle, making the half-hour drive I’ve made hundreds of times.
The news is on the radio—top story, the recent 9/11 terrorist attack. It seems I can’t get away from the shocking stories and images. As I approach a bridge, my heart suddenly starts beating rapidly. Then my legs turn to jelly.
You’re going to drive off the bridge, a voice in my head warns. Now my arms are numb. You’re about to lose control and die. I’m terrified. My hands grip the wheel; I just want to make it over the bridge and to an exit. I do; then I pull into a parking lot and start to cry. What is happening to me? Watch out for these clear signs you’re having a panic attack.
I tried driving on the highway a week later—and again, panic drove me to the first exit. After that, I took only smaller, slower roads. Weeks later, I moved to Bermuda, where we did not have a car. I was so relieved. I hadn’t told my husband about the episodes; I knew he loved my independence and strength, and I felt ashamed of being so weak.
To get around, we had a motor scooter that I rode on the back of, or I’d take the bus when I went somewhere on my own. I did this often over the first couple of months, but one day as I rode the bus into town to do some Christmas shopping, my heart started racing. Sure enough, next came the sweating, my legs turning to jelly, and the feeling that somehow I’d lose control or “go crazy.”
I hadn’t reached my destination, but I rang the bell to exit and, in tears, walked home, where I felt safer. A few days later, I tried the bus again, and the same thing happened. The thing that had forced me to avoid highway driving was now forcing me to avoid public transit.
It was time to come clean. That evening, I told my husband what had been going on. He was sympathetic; I shouldn’t have kept it bottled up, because it felt good to let it out. But he was as mystified as I was. We searched online for “fear of highways” and “fear of public transportation” and got lots of hits, which is when we learned that the episodes were actually classic panic attacks.
Unlike fear, which is a reaction to an actual threat, panic is intense fear in the absence of real danger. Sufferers often report recent stresses, such as getting married or divorced, changing jobs, or financial or health problems. For me, the stressor was my upcoming move. Plus, I’d not been sleeping well.
Sleeping poorly can make us more sensitive to anxiety-related events, such as rapid heartbeat; panic attacks occur when the brain identifies those events as signals of extreme peril.
“Humans are hardwired to survive,” explains Eilenna Denisoff, a clinical psychologist and director of CBT Associates in Toronto. “The fight-or-flight response allows us to run faster, jump higher, if we’re being chased. Physiologically, then, the brain’s reaction to the rapid heartbeat ‘danger signal’ is to move blood from the limbs to protect the core.” (This explains the feeling of limbs turning to jelly.) The person isn’t actually in danger, but the brain misreads the signs as indicating a need to flee.
Because the symptoms make you feel like you’ll die, the first attack can lead to panic disorder, says Denisoff. “Your brain looks for situations when you should be fearful or feel trapped.” You begin to fear the fear. Watch out for these everyday habits that can trigger a panic attack.
It was time to tackle this; I wasn’t about to let something in my mind terrorize my life without trying to fight back. I’d read that it helped to talk about it. So when I was back in Toronto for a visit, I told my best friend and her husband about the panic attacks.
Lindsay looked at Todd with wide eyes, then said to me, “Todd went through that a few years ago!”
When Todd was 28, he’d just taken over the family business and was feeling very stressed. One evening when he was at a restaurant, his heart started pounding fast; he thought he was having a heart attack and went to his doctor.
The doctor said, “It sounds like you had a panic attack.” He referred Todd to a psychiatrist, who gave him a prescription for Ativan, an antianxiety drug taken when panic symptoms start. Todd took the medication and avoided restaurants, but then a panic attack hit when he was in an airport lounge.
He learned relaxation techniques, including deep breathing. Eventually, the frequency of the attacks lessened, then disappeared, so he stopped the medication. Todd told me, “The drug was key, and reading up on panic attacks really helped.” He gave me his copy of Living with Fear: Understanding and Coping with Anxiety by Dr. Isaac M. Marks.
Back in Bermuda, I dared to get back on the bus—with the book in my handbag. When my heart started racing a few minutes into the journey, I opened the book to the dog-eared pages advising that panic wouldn’t kill me. That really did calm me.
Nick Wong for Reader's Digest International
For the next two years, I kept panic at bay this way. Even after we moved back to Canada, the land of highways, I treated myself not with therapy or medication but by altering my behavior.
For nine years after moving home, I relied on my husband to do all the highway driving. Then we bought a cabin. My husband would fix it up for weeks at a time while I worked in the city. The house was three hours away and it wasn’t on a bus route, so if I wanted to go on weekends, I would need to drive. Finally, it was time to find a psychologist.
Panic disorder can be treated with antidepressants long-term and with beta-blockers for immediate relief of symptoms. But experts recognize cognitive behavioral therapy, or CBT, as the best treatment. It resolves anxiety by changing the underlying beliefs that tell you the panicky feeling is itself dangerous.
In my first therapy session, I practiced deep breathing—a long, slow inhale through the nose, a long, slow exhale through the mouth. “This will be your tool to calm yourself when you feel panicky,” the psychologist explained.
A week later, we started imaginal therapy, a form of exposure therapy. The doctor asked me to imagine driving the least scary highway route near my home, rating my anxiety level from one to ten with each step.
“One,” I said, mentally backing out of the driveway, then “two” as I turned onto the next street.
It jumped to eight when I reached the road leading to the on-ramp. My heart was pounding; I was starting to sweat. “Do your breathing,” she said.
She asked whether I’d ever kept something in my purse for when I felt unwell. In fact, I had peppermint gum for stomach upsets. “Good,” she said.
“Imagine you’re chewing a piece of gum.”
Now the moment of truth: In my imagination, I accelerated and merged into highway traffic. “Ten.”
My legs turned to jelly, and I had that awful feeling that I’d lose control. “It’s OK. Keep breathing,” my therapist advised. “It’s only about half a mile to the first exit.” Moments later, I saw the exit ramp in my mind, and I began to calm down when I reached it.
My relief turned back to fear when my therapist said, “Your homework is to do that for real this week. Remember your breathing. Bring your gum. It won’t be much different than doing it in your mind.”
So one Tuesday after dinner, I took a deep breath and grabbed the keys. Just like in therapy, my heart pounded as I got on the highway. But, using my new tools, I made it to the exit without my physical symptoms escalating. I was overjoyed.
We did imaginal therapy over four more sessions, each time taking a tougher or longer route. Each week I was able to do it for real, though I always returned home on regular roads.
But finally, on a homework session that involved the scariest route yet, I exited the highway panic-free, then said to myself, “What the heck—let’s give it a go.” I looped around and got back on the highway toward home. I haven’t had a panic attack since. Next, read about these tips for understanding and managing panic disorder.