The First Panic Attack Showed Me Something I Had Been Managing for Years

I was at a work conference in Lucknow, in the middle of a networking dinner, when the specific and unmistakable physical experience of a panic attack arrived. My heart rate elevated with the abruptness of something being switched. The room acquired a specific quality of unreality that I could not reason my way out of.

I spent about eight minutes in the venue's bathroom bringing myself back to a state I could return to the dinner from, which I did, and then I drove home in a state of shaken calm that lasted through the evening and became, by the following morning, a fixed intention to understand what had happened.

I had been managing, for several years, a level of cumulative stress that I had successfully kept below the threshold of crisis. Below the threshold of crisis is not below the threshold of physiological impact, and the panic attack was my nervous system using the conference dinner as the moment to discharge what a gradual accumulation had made too much to hold.

The doctor I saw the following week asked me to describe a typical week. I described it and she listened carefully and said that what I was describing was not a person who was occasionally stressed. It was a person whose baseline was significantly above what a nervous system can sustain without event.

The panic attack had not come from nowhere. It had come from everywhere I had been not looking. The treatment I undertook was partly about the panic attacks, which have not recurred, and partly about the baseline state that had made them possible. That baseline required more significant change than any single intervention could produce.

I changed where I lived, how I worked, and what I said no to with a comprehensiveness that I would not have managed without the specific alarm of the conference dinner.