I had my first-ever panic attack late at night on a couch in Tatarstan. I had gone to Russia that summer of 2010, after my sophomore year of college, for a State Department Russian-language program in Kazan. My hosts were a young couple who appeared to hate their concrete-walled, un-air-conditioned apartment nearly as much as they hated each other. All night I could hear their whispered fights, hissing like a choking gas through their bedroom door to the couch where I slept a few feet away. At first I thought they might have been whispering sweet nothings. Then my Russian improved.
The night it happened I had been drinking — a little — and had indulged in a habit I was just then developing, smoking strawberry-flavored, ultra-thin cigarettes that sold for fifty cents a pack. It was around midnight, and I lay on the couch in my sweaty nest of sheets, feeling my heart beat rapidly against my breast. I breathed in and breathed out and stared at the cracks in the ceiling, but my heartbeat didn’t slow; it rabbited as if I were climbing an invisible staircase, though I was lying flat on my back, my palms pressed to my sternum. I began to feel a star-shaped pain radiating through my hands, and it was accompanied by a wave of such pure fear that I bolted to my feet, gasping so profoundly I must have looked like a silent-movie star enacting surprise, and dashed to the balcony. I stared at the onion-domed cathedral opposite, whose bells woke me at 6 a.m. every Sunday, felt the wind curve off the metal and dry up the sweat that drenched my face. I dialed my mother, a doctor, and confessed: I had been smoking. I had been drinking. Now I was convinced some retribution — divine or simply physical — had fallen on me. My heart hammered like a handyman gone mad, leaping in my chest, and I knew I would die there, on that balcony in Kazan, punishment for how far I had strayed. I was so dizzy I grasped at my host parents’ clothesline for a hold, dislodging several pairs of socks; I felt my gorge rise and choke me.
My mother’s sleepy reassurances — you’re fine, it’s probably nothing — did little to dispel my certitude that the end had arrived for me. I was twenty and not quite ready to give up on the idea of having a future. So I balled my hands into fists and knocked urgently on the bedroom door of my hosts, explaining in my elementary Russian that I was dying, that I needed help immediately. “My heart has gone out of its mind,” I said. “My heart, something’s wrong. I can’t breathe.”
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“That happens to me really often,” my host “mother,” Asya, told me. She must have been in her late twenties, prone to wearing tiny miniskirts and velour; earlier that week, I had watched her husband, Seryozha, smash her laptop because he had seen a photo of her with another man on it. I couldn’t believe that she had looked death repeatedly in the face and survived: She was so thin her hip bones jutted out. I panted like a dog, caught in the grips of my whirring heart and ragged breath, and asked her to call emergency services. After she dialed the number she put on a full face of makeup before the paramedics arrived.
I wound up getting an impromptu electrocardiogram on that saggy couch in the center of a living room that had seen more than its share of despair. The electrodes were cold against my overheated chest; the line they spat out on graph paper made a series of perfectly regular peaks. I don’t remember the medics’ faces, only their hands, and their murmured reassurance. They gave me a drink they said was “herbs.” I hadn’t died, somehow. As dawn broke over the cathedral I finally fell asleep.
The happy part of this story is that I learned what panic was, eventually, and that it isn’t a fatal condition. The unhappy part — the untidy part — is that it’s never left me.
In the eight years since that night, the rhythm of a panic attack has become far more familiar to me, if no more pleasant. I don’t know what caused that first attack, although my family history is rife with anxiety — from the inherited trauma of Holocaust survival to more garden-variety Ashkenazi nerves. Panic has become a looming presence in my life, filling my throat with bile at the most inopportune moments: a job interview or a simple meeting; in the dark crowd of a rush-hour subway; on planes, at my desk, in the middle of the night, when my pulse blares in my ears and I know my body is about to burst all over my sheets like a punctured water balloon.
More than simply the blaze of fear and pain of a panic attack, panic disorder, which I have since come to know with terrible intimacy, is about how panic and escaping panic warp life. In the hopes of staying clear of panic’s terrible sequence of sensations, I bend my life away from its triggers, walking circuitous routes through my days. The ways my phobias control my behaviors are profound, and I keep them secret from most people, evading questions about my own evasions. Panic has its own logic separate from earth-logic; it’s not fear, but another plane, an Upside Down of the mind, in which everyday things (a two-block walk to the bodega in the dark; a ride on the J train; a plate of fish that might have bones) become limned with electric terror. To nerves primed to sing with fear, everything is a monster. Sometimes, after panic recedes, there’s a grim humor to it all: like a shape, menacing in the dark, that turns out to be a blender, or a shirt on a hanger. My life is full of this black and secret comedy.
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Once, just after I graduated college, I could not leave my parents’ house for a week; the thought of stepping out even onto the suburban sidewalk convulsed me with fear. In the end I broke that seal by climbing into the very back of my mother’s SUV, behind the seats, and staying there in the fetal position as she drove across the George Washington Bridge, to her profound bemusement.
There are other times when I wear my terrors lightly. I cling to routine — what’s familiar feels safe. When I push myself, sometimes I am pleasantly surprised; other times, I regret such excursions profoundly.
I have no tidy end to this story — no “it gets better” tale, except that I’m on medication now, and the full, flushed eruption of panic is a comparatively rare occurrence. Flashes of panic singe me enough; my relationship to sleep is not a happy one. I am not the person I was when I got on that plane to Kazan at twenty: fearless, thrilled to taste new phonemes on my tongue. These days my phone is full of notes to myself, written in moments of psychic agony: You aren’t dying. You haven’t died any of the times this has happened before. You are going to be OK. You are going to be OK. You are going to be OK. Please, please let me be OK. Oh god let me be OK. In the sweat and pain of my brain’s misfired fear, I can smell and hear and feel everything — the hyperarousal of terror, they call it. Perhaps it helps me write, feeling so keenly. I admit that in the grips of this condition my life is smaller than I could have imagined. But still, I live. I am going to be OK.