This week is a series of posts about depression, anxiety, family issues, and other brainweasels, for the people who have come on over from CaptainAwkward.com's various open threads. Hello, welcome, and feel free to comment here.

I have an anxiety disorder. My medical records say "anxiety disorder, NOS". NOS is for Not Otherwise Specified, and translated from doctor-speak, that means, "You obviously have a thing, but you don't fit precisely into any of the insurance company's boxes, so we've pasted together parts of two or three different checklists and then also written some things in the margins."

My anxiety disorder presents weirdly sometimes. If you've read more than two or three of these blog entries, you probably could have guessed that. The thinky parts of my brain work even when nothing else does; so I tend to go in and talk to people looking like a paranoid insomniac basket case, but sounding like I've just escaped my classes at the local medical school. Very few people have any idea what to do with someone who can sit in a chair and calmly ask to be kept away from all of the TVs in the waiting room that are tuned to CNN because international politics terrifies her, while registering a resting heart rate of 140bpm. Pretty much the only medical person I've ever met who wasn't flummoxed by this was a psych nurse in Flagstaff who I suspect was a veteran, but never got the chance to ask.

One of the most difficult things I have to explain over and over and fucking over again is that I don't talk myself into panicking. I gather most people do. They seize upon something bad that might happen and then catastrophize for a while, make plans, catastrophize the possible failure of those plans, make more plans... and so on and so forth, ad infinitum. I don't do that. I talk myself out of this stuff more often than not. When it doesn't work, it does't work because the panic response is faster than the speed of conscious thought. 

Time for an example. I keep myself on about an 85% world news blackout, because that shit scares me to death. I've gotten quite good at it. I happened to be in an Airbus over the Rockies when the Second Iraqi War started, and the bastard pilot decided to break my streak of pleasant ignorance by announcing this over the cabin loudspeakers. My family picked me up from the airport, and my mother helpfully informed me on the way back to their house that my sister had spent the past couple of hours terrified that someone would shoot my plane out of the sky. Because routine flights on a cheaply-outfitted A330 from O'Hare to Sky Harbor are such a juicy target for terrorists, I guess?

Spending time with my family has never been good for me, my government was yammering about Weapons of Mass Destruction, I had classes with loads of homework going on at the time, and these things sent me into a death spiral. I started jumping at absolutely everything. I lived in Flagstaff then, and there's a small airport outside of town that's used mostly as a refueling depot for the medivac choppers and as a landing strip for the NOAA planes; the place is jammed into a fairly small valley in the mountains, so one of the common takeoff paths for light aircraft goes right over the town. The NYYEEERRRRRROOO noise of planes going overhead started setting me off.

What would happen was this: 
  1. A NYYEEERRRRRRROOO noise would happen overhead.
  2. I would get that bucket of ice water across the back of my neck that heralded a panic attack.
  3. The following things would go through my head, in no real order:
    • That is an airplane.
    • Sometimes airplanes carry bombs.
    • Thermonuclear war is a bad idea, and we shouldn't have one.
    • We're not currently engaged in a thermonuclear war.
    • Nobody would waste any kind of bombs on Flagstaff, Arizona, much less the expensive kind.
    • Nuclear warheads are attached to ICBMs these days anyway.
    • That thing is going right overhead.
    • That particular NYYEEERRRROO noise only goes with propeller-driven aircraft.
    • No one has made a propeller-driven bomber since at least the Korean War. Even places where you're more likely to find loose chickens inside a house than indoor plumbing have scraped together enough for a couple of jets by now.
    • The only reason I associate that sound with danger is that I have watched too many Errol Flynn movies.
    • I'm going to die.
    • Well, yes, everyone dies someday, but it's unlikely you're going to die right now.
    • What the fuck brain, can you not at least stick to panicking over things that are actually going on, like exams?
Please note the order in which these things occur. The panic response comes way before the thinking part -- aeons, by the standards of brain impulses. By the time I'm aware of having thought anything, I'm also aware that it's irrational or way out of proportion to whatever's going on, and I'm also aware that it doesn't make a damn bit of difference, because I'm already at Defcon 5. Changing my thinking has done exactly fuck-all to stop the panic attacks, because the thinking is not what triggers them.

It's even more obvious when the panic wakes me up. My brain is not good at booting up all at the same time, which makes me prone to hypnopompic hallucinations -- essentially where you keep dreaming for a few seconds after you open your eyes until everything syncs back up again. If something fairly innocuous (car door outside, roommate drops something in the kitchen, rat falls off his hammock) wakes me from a sound sleep, the processing-things part of my brain doesn't come online until the running-away-from-things part has already gotten all the alarms sounding. I finish coming to after I'm already across the room with the lights on. A favorite waking-dream is 'fuck-off huge spider on the wall right by my head', which I actually find kind of funny when not in media res, because I'm so not scared of spiders when I'm awake that I'm asked to chase them down and squash them for the arachnophobes.

I know that "anecdote" is not the singular of "data", but judging from the stories I see elsewhere, I'm not unique -- just in an unacknowledged minority. The only medical people I've ever gotten to grasp this on the first or second try are ER and urgent care staff. "Oh, I see, you have an immediate physical problem that needs solving. All righty then! Here are some low-dose sedatives, please don't hesitate to come back if you have further issues." The only 'further issues' I've ever had with this approach were 'medication doing something disruptively weird' (stop taking that one) and 'medication bottle is empty' (here is another Rx slip), so I'd call it a success.

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