Panic Disorder Quotes

No amount of me trying to explain myself was doing any good. I didn't even know what was going on inside of me, so how could I have explained it to them?

To stave off the panic associated with the absence of a primary object, borderline patients frequently will impulsively engage in behaviors that numb the panic and establish contact with and control over some new object.

I know how this feels: the tightening of the chest, the panic, the what-have-I-done-wait-I-was-kidding. Eating disorders linger so long undetected, eroding the body in silence, and then they strike. The secret is out. You're dying.

Today I wore a pair of faded old jeans and a plain grey baggy shirt. I hadn't even taken a shower, and I did not put on an ounce of makeup. I grabbed a worn out black oversized jacket to cover myself with even though it is warm outside. I have made conscious decisions lately to look like less of what I felt a male would want to see. I want to disappear.

Certain temperaments respond to anxiety by pulling inward. Their instincts tell them ' Don't go out to meet the world - you'll have a panic attack. Inside is where safety is.

Intimidated, old traumas triggered, and fearing for my safety, I did what I felt I needed to do.

Many women latch onto language from popular psychology, such as "panic attack," when often they are instead experiencing sensory overwhelm.

Fear and anxiety affect decision making in the direction of more caution and risk aversion... Traumatized individuals pay more attention to cues of threat than other experiences, and they interpret ambiguous stimuli and situations as threatening (Eyesenck, 1992), leading to more fear-driven decisions. In people with a dissociative disorder, certain parts are compelled to focus on the perception of danger. Living in trauma-time, these dissociative parts immediately perceive the present as being "just like" the past and "emergency" emotions such as fear, rage, or terror are immediately evoked, which compel impulsive decisions to engage in defensive behaviors (freeze, flight, fight, or collapse). When parts of you are triggered, more rational and grounded parts may be overwhelmed and unable to make effective decisions.

It all made sense — terrible sense. The panic she had experienced in the warehouse district because of not knowing what had happened had been superseded at the newsstand by the even greater panic of partial knowledge. And now the torment of partly knowing had yielded to the infinitely greater terror of knowing precisely

It is not a single crime when a child is photographed while sexually assaulted (raped.) It is a life time crime that should have life time punishments attached to it. If the surviving child is, more often than not, going to suffer for life for the crime(s) committed against them, shouldn't the pedophiles suffer just as long? If it often takes decades for survivors to come to terms with exactly how much damage was caused to them, why are there time limits for prosecution?

Disorder is inherent in stability. Civilized man doesn't understand stability. He's confused it with rigidity. Our political and economic and social leaders drool about stability constantly. It's their favorite word, next to 'power.' 'Gotta stabilize the political situation in Southeast Asia, gotta stabilize oil production and consumption, gotta stabilize student opposition to the government' and so forth. Stabilization to them means order, uniformity, control. And that's a half-witted and potentially genocidal misconception. No matter how thoroughly they control a system, disorder invariably leaks into it. Then the managers panic, rush to plug the leak and endeavor to tighten the controls. Therefore, totalitarianism grows in viciousness and scope. And the blind pity is, rigidity isn't the same as stability at all. True stability results when presumed order and presumed disorder are balanced. A truly stable system expects the unexpected, is prepared to be disrupted, waits to be transformed.

Carla's description was typical of survivors of chronic childhood abuse. Almost always, they deny or minimize the abusive memories. They have to: it's too painful to believe that their parents would do such a thing. So they fragment the memories into hundreds of shards, leaving only acceptable traces in their conscious minds. Rationalizations like "my childhood was rough," "he only did it to me once or twice," and "it wasn't so bad" are common, masking the fact that the abuse was devastating and chronic. But while the knowledge, body sensations, and feelings are shattered, they are not forgotten. They intrude in unexpected ways: through panic attacks and insomnia, through dreams and artwork, through seemingly inexplicable compulsions, and through the shadowy dread of the abusive parent. They live just outside of consciousness like noisy neighbors who bang on the pipes and occasionally show up at the door.

Misinformation about the Bible's answers to these issues has led to much wrong teaching about boundaries. Not only that, but many clinical psychological symptoms, such as depression, anxiety disorders, guilt problems, shame issues, panic disorders, and marital and relational struggles, find their root in conflicts with boundaries.

He told me that if I hung up, he'd do it. He would commit suicide. He told me that if I called the cops he would kill every single one of them and I knew that he had the potential and the means to do it

The story of my birth that my mother told me went like this: "When you were coming out I wasn't ready yet and neither was the nurse. The nurse tried to push you back in, but I shit on the table and when you came out, you landed in my shit." If there ever was a way to sum things up, the story of my birth was it.

John was still making comments regarding violent things that he shouldn't, but I hoped he was just being a big mouth. Nobody was going to listen to me anyway.

Trigger warnings are antithetical to a fundamental principle of exposure therapy, a well-researched therapeutic approach for combatting generalized anxiety disorder, social anxiety disorder, phobias (like arachnophobia), panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.

The vision I see in the mirror is me, who I am, supposedly, but that vision does not express the way my mind works or the way I feel inside. A realization creeps over me, the words tumbling into my head quietly like falling leaves. I. Am. Crazy. This is my new shameful truth. Something changed yesterday. A door has been opened that I can never close again. I touch my reflection, the glass smooth and cold, not really believing that the girl I see is me.

The worst part about anxiety attacks, is that you’re aware it’s irrational and sometimes unexplainable, but knowing that gives no aid what so ever. In most cases, it deepens the anxiety as you realise “if I know it’s irrational, why can’t I stop it… Oh god I can’t stop it” you begin to believe you are no longer in control of your mind. That. That is fear.

One aspect of DID is the PTSD suffered by some of the alters. PTSD is similar to Panic Attacks in that once turned on, the anxiety is fed into a vicious cycle.

panic disorder with agoraphobia (DSM-V code 300.22): the condition, as Hippocrates described it, “usually attacks abroad, if a person is travelling a lonely road somewhere, and fear seizes him.

I wanted to go to a few therapy sessions and be back to normal. As I saw it, the panic attacks were the problem. What I really wanted was to stop having them. I genuinely thought I could do that. I didn't want to think about the past.

I'm afraid of everything and nothing.

It's okay to panic. It's okay to be scared and to have no clue what you're doing. As long as you keep going. As long as you keep fighting.

YOU NEVER HAVE TO APOLOGIZE FOR HAVING HIGH ANXIETY.

The intent is to shatter cohesion, produce paralysis, and bring about collapse of the adversary by generating confusion, disorder, panic, and chaos.

I found my way home, stripped naked, and lay on the bathroom floor, the cool tiles pushing up. Keeping me from falling. I didn't know how long the floor would hold me. I prayed Ellen would come home...

... adults with SM are significantly more likely than the general population to develop other mood- and anxiety-related conditions, most notably depression, generalised anxiety, panic disorder, social anxiety and PTSD. For some, chronic mental health conditions are a factor in their lives. Most indicated that they felt their long-term mental health conditions could have been avoided with appropriate support at the appropriate time in childhood.

People with depression can't just snap out of it or "turn that frown upside down." Depression can be a painful and overwhelming state that makes one unable to function, to think clearly or reasonably, or to want to simply face another day. Many people suffer alone and in silence because they are scared or ashamed. They feel weak…or pitiful. How can a person be incapable of having joy? “Why can’t I just have a good time? Why can’t I get on with it?

The attachment disorder made us unable to trust close relationships because the first thing we ever learned is that people leave you. Then it also made us panic at the prospect of being alone. It’s slow, difficult, excruciating work.

I'm afraid people will see me pretending to be normal.

Don’t ignore the life that is happening now because you are too focused on getting to the finish line of some ambiguous societal destination.

Panic disorder? I don't have panic disorder. Panic disorder was a thing that came up in my psychology elective last year. I read like half a paragraph on it.

A disability that is not apparent in the person’s appearance is no less intrusive, no less painful, no less disturbing than one that can be spotted across the room. And, yet, many people fail to respect the tremendous impact that the invisible disability has on the human enduring it.

Boyd, borrowing from Sun Tzu, said the best commander is the one who wins while avoiding battle. The intent is to shatter cohesion, produce paralysis, and bring about collapse of the adversary by generating confusion, disorder, panic, and chaos. Boyd said war is organic and compared his technique to clipping the nerves, muscles, and tendons of an enemy, thus reducing him to jelly. As Boyd

First documented in the late 1800s, then “codified as an independent diagnostic entity” a century later, though largely comorbid with panic disorder. You can read all about it, if you like, in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. DSM-5 for short. It’s always amused me, that title; it sounds like a movie franchise. Liked Mental Disorders 4? You’ll love the sequel!

The criteria of agency and ownership distinguish structural dissociation from other manifestations of insufficient integration such as intruding panic attacks in panic disorder or intrusions of negative cognitions in major depression.

While dragging herself up she had to hang onto the rail. Her twisted progress was that of a cripple. Once on the open deck she felt the solid impact of the black night, and the mobility of the accidental home she was about to leave. Although Lucette had never died before—no, dived before, Violet—from such a height, in such a disorder of shadows and snaking reflections, she went with hardly a splash through the wave that humped to welcome her. That perfect end was spoiled by her instinctively surfacing in an immediate sweep — instead of surrendering under water to her drugged lassitude as she had planned to do on her last night ashore if it ever did come to this. The silly girl had not rehearsed the technique of suicide as, say, free-fall parachutists do every day in the element of another chapter. Owing to the tumultuous swell and her not being sure which way to peer through the spray and the darkness and her own tentaclinging hair—t,a,c,l—she could not make out the lights of the liner, an easily imagined many-eyed bulk mightily receding in heartless triumph. Now I’ve lost my next note. Got it. The sky was also heartless and dark, and her body, her head,and particularly those damned thirsty trousers, felt clogged with Oceanus Nox, n,o,x. At every slap and splash of cold wild salt, she heaved with anise-flavored nausea and there was an increasing number, okay, or numbness, in her neck and arms. As she began losing track of herself, she thought it proper to inform a series of receding Lucettes—telling them to pass it on and on in a trick-crystal regression—that what death amounted to was only a more complete assortment of the infinite fractions of solitude. She did not see her whole life flash before her as we all were afraid she might have done; the red rubber of a favorite doll remained safely decomposed among the myosotes of an un-analyzable brook; but she did see a few odds and ends as she swam like a dilettante Tobakoff in a circle of brief panic and merciful torpor. She saw a pair of new vairfurred bedroom slippers, which Brigitte had forgotten to pack; she saw Van wiping his mouth before answering, and then, still withholding the answer, throwing his napkin on the table as they both got up; and she saw a girl with long black hair quickly bend in passing to clap her hands over a dackel in a half-tom wreath. A brilliantly illumined motorboat was launched from the not-too-distant ship with Van and the swimming coach and the oilskin-hooded Toby among the would-be saviors; but by that time a lot of sea had rolled by and Lucette was too tired to wait. Then the night was filled with the rattle of an old but still strong helicopter. Its diligent beam could spot only the dark head of Van, who, having been propelled out of the boat when it shied from its own sudden shadow, kept bobbing and bawling the drowned girl’s name in the black, foam-veined, complicated waters.

Although panic attacks can be scary and overwhelming, they can also be a powerful teacher, showing us the depths of our inner strength and resilience. We may develop more self-awareness, self-compassion, and a stronger feeling of connection with others by addressing our anxieties and finding ways to control our anxiety.

Bipolar disorder is the impact of the memory loss, ADHD, dread, anxiety, racing thoughts, depression, mania, panic attacks, and more. Bipolar disorder is suffering in silence and mourning the lost years. Bipolar disorder is misreading situations and people and constantly checking to see if things are as they seem to be.

We know you sometimes have a tricky time adjusting to stress.

In my practice I use neurofeedback primarily to help with the hyperarousal, confusion, and concentration problems of people who suffer from developmental trauma. However, it has also shown good results for numerous issues and conditions that go beyond the scope of this book, including relieving tension headaches, improving cognitive functioning following a traumatic brain injury, reducing anxiety and panic attacks, learning to deepen meditation states, treating autism, improving seizure control, self-regulation in mood disorders, and more.

An evolutionary perspective also contributes to explain the higher female prevalence of panic disorder and agoraphobia. On average, women are more physically vulnerable than men and less able to defend themselves against attacks. Accordingly, it is adaptive for them to be more sensitive to potential cues of vulnerability and entrapment, and display a lower threshold for the activation of escape behaviors.

Everything was numbered: the lenses, the painterly sky, the milligrams of my panic pills. I had prescription eyes that allowed me to see better, and prescription panic pills that allowed me to play blind.

Kevin was right, Karena thinks, there is grotesquerie here, but it's not Karena and Charles. It's Charles's disorder, the way it reduces a grown man to sobbing panic on the floor. The way it renders Karena unable to feel. The way it takes you by the hand, nodding and smiling slyly, and leads you back to the same old place every time, so just when you think everything might be all right after all, you come home and open a door to a room full of blood.

If fear is like a storm wave striking you, then a panic attack is a tsunami that batters your soul. Drinking to overcome panic attacks is like smoking cigarettes to overcome asthma. You start with one problem, then you have two.

Instead of showing visibly distinct alternate identities, the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stressdisorder (PTSD) symptoms that are embedded in a matrix of ostensibly non-trauma-related symptoms (e.g., depression, panic attacks, substance abuse,somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions. - Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p5

The daughter may have been criticized to the point of developing panic attacks, eating disorders, and migraines. When we don’t learn to identify our emotions and have them validated by caregivers, our emotional development is hindered.

Solomon had good days and he had bad days, but the good had far outnumbered the bad since Lisa and Clark had started coming around. Sometimes, though, they'd show up and he's look completely exhausted, drained of all his charm and moving in slow motion. They could do that to him—the attacks. Something about the physical response to panic can drain all the energy out of a person, and it doesn't matter what causes it or how long it lasts. What Solomon had was unforgiving and sneaky and as smart as any other illness. It was like a virus or cancer that would hide just long enough to fool him into thinking it was gone. And because it showed up when it damn well pleased, he'd learned to be honest about it, knowing that embarrassment only made it worse.

The sense of growing panic, the feeling that gibberish is being passed off as coherent conversation, the fear that the world is engaged in meaningless discourse masquerading as meaningful exchange—these are the blurry states individuals with ADD negotiate each day.

About half of patients with pure anxiety disorders develop major depression within five years. Insofar as depression and anxiety are genetically determined, they share a single set of genes (which are tied to the genes for alcoholism). Depression exacerbated by anxiety has a much higher suicide rate than depression alone, and it is much harder to recover from. “If you’re having several panic attacks every day,” says Ballenger, “it’s gonna bring Hannibal to his knees. People are beaten into a pulp, into a fetal position in bed.

To change that thought process, state the obvious: “I was/am terribly depressed.” Now for the different thought. Say to yourself, “So how depressed am I?” Now go for the less obvious. “I am so depressed…” Now think of something not obvious. How about, “I’m so depressed I sleep under my mattress”?

What is panic? We are told that psychiatrists recently discovered and named a new kind of disorder—they call it “Panic Disorder.” It seems that it’s something quite recent in the psychological self-perception of human beings. But what does panic mean? “Panic” used to be a nice word, and this is the sense in which the Swiss-American psychoanalyst James Hillman remembers it in his book on Pan. Pan was the god of nature and totality. In Greek mythology, Pan was the symbol of the relationship between man and nature. Nature is the overwhelming flow of reality, things, and information that surrounds us.

It was your mind. The way you were wired. That was the only thing all the theories had in common. You were manic. You were depressive. You were schizophrenic. You were on drugs. You were on the wrong medication. You needed medication. You heard voices. You'd lost the will to speak. Anxiety. Disorder. Nobody knew for sure, at least nobody who was saying anything. After you left, all the remained were guesses. I would go over everything. Every detail. Every panic. Every sigh. But they never added up to anything but you. I only saw the person. I couldn't see the wiring. I couldn't fix the wiring. I tried I tried I

MOOD DISORDERS BY THE NUMBERS If you’re overwhelmed with anxiety, depression, anger, or other emotions, you’re certainly not alone. Among adults in the United States: •Nearly 29 percent will have an anxiety disorder at some point in their life, including phobias (12 percent), social anxiety disorder (12 percent), generalized anxiety disorder (6 percent), and panic disorder (5 percent). •As many as 25 percent will experience major depressive disorder during their lifetime. •In a given year, more than 44 million will experience an anxiety disorder and more than 16 million will experience major depressive disorder.

If your boundaries have been injured, you may find that when you are in conflict with someone, you shut down without even being aware of it. This isolates us from love, and keeps us from taking in safe people. Kate had been quite controlled by her overprotective mother. She’d always been warned that she was sickly, would get hit by cars, and didn’t know how to care for herself well. So she fulfilled all those prophecies. Having no sense of strong boundaries, Kate had great difficulty taking risks and connecting with people. The only safe people were at her home. Finally, however, with a supportive church group, Kate set limits on her time with her mom, made friends in her singles’ group, and stayed connected to her new spiritual family. People who have trouble with boundaries may exhibit the following symptoms: blaming others, codependency, depression, difficulties with being alone, disorganization and lack of direction, extreme dependency, feelings of being let down, feelings of obligation, generalized anxiety, identity confusion, impulsiveness, inability to say no, isolation, masochism, overresponsibility and guilt, panic, passive-aggressive behavior, procrastination and inability to follow through, resentment, substance abuse and eating disorders, thought problems and obsessive-compulsive problems, underresponsibility, and victim mentality.

Let’s try discrimination. “I have been discriminated against.” State the obvious. “People treat me differently when they find out I have bipolar disorder.” Now state the not so obvious. “As someone with a mental illness, I see discrimination where others don’t. Take happy hour, for instance. I think that is being discriminatory. There should also be a crappy hour for depressed people. And people with bipolar disorder could go to both.” So where do you see discrimination? At work? At school? With family? Now think of the unexpected. How about the bathtub? Or the local restaurant? Let’s take the restaurant. What would be a menu item that is discriminatory? Scrambled eggs? Take your time. Let your mind

Anxiety and worrying can cause heart palpitations. Worrying about the palpitations causes anxiety. With increased anxiety come more frequent palpitations, which are perceived as being 'worse', or more intense due to the extreme focus that's placed on them. You can summarise it as a two-way process. Anxiety causes palpitations. Palpitations cause anxiety.

Yet an anxiety disorder is simply an experience that a person moves through, just like a period of grief or sadness. Would we give a person with a broken heart or someone suffering from grief a label for life? No, yet people who go through a period of anxiety sometimes end up believing that this diagnosis, this label, is now a part of who they are.   “HOW

Something similar often happens to people who develop an anxiety disorder, such as agoraphobia. People with agoraphobia can become so overwhelmed with fear that they will no longer leave their homes. Agoraphobia is the consequence of a positive feedback loop. The first event that precipitates the disorder is often a panic attack. The sufferer is typically a middle-aged woman who has been too dependent on other people. Perhaps she went immediately from over-reliance on her father to a relationship with an older and comparatively dominant boyfriend or husband, with little or no break for independent existence. In the weeks leading up to the emergence of her agoraphobia, such a woman typically experiences something unexpected and anomalous.

Because now mental health disorders have gone “mainstream”. And for all the good it’s brought people like me who have been given therapy and stuff, there’s a lot of bad it’s brought too. Because now people use the phrase OCD to describe minor personality quirks. “Oooh, I like my pens in a line, I’m so OCD.” NO YOU’RE FUCKING NOT. “Oh my God, I was so nervous about that presentation, I literally had a panic attack.” NO YOU FUCKING DIDN’T. “I’m so hormonal today. I just feel totally bipolar.” SHUT UP, YOU IGNORANT BUMFACE. Told you I got angry. These words – words like OCD and bipolar – are not words to use lightly. And yet now they’re everywhere. There are TV programmes that actually pun on them. People smile and use them, proud of themselves for learning them, like they should get a sticker or something. Not realizing that if those words are said to you by a medical health professional, as a diagnosis of something you’ll probably have for ever, they’re words you don’t appreciate being misused every single day by someone who likes to keep their house quite clean. People actually die of bipolar, you know? They jump in front of trains and tip down bottles of paracetamol and leave letters behind to their devastated families because their bullying brains just won’t let them be for five minutes and they can’t bear to live with that any more. People also die of cancer. You don’t hear people going around saying: “Oh my God, my headache is so, like, tumoury today.” Yet it’s apparently okay to make light of the language of people’s internal hell

Some of the parts inside me were ready to come up and tell what had happened, but others didn't want me to know they even existed, I learned that when parts were in conflict with each other or didn't like what I was doing, I felt pain and panic, Dr. Summer encouraged me to pay attention to the parts and address the issues they raised, but to also challenge them and keep doing as many of my normal activities as I could.

Some encouraging studies suggest that the answer may be yes. Dr. Isaac Marks, from the Institute of Psychiatry at the University of London, has shown that many individuals can overcome anxiety disorders using CBT techniques without face-to-face psychotherapy or medications. I’m hopeful that this book will prove just as effective for people with anxiety as Feeling Good has been for people struggling with depression. However, no

Many people suffer alone and in silence because they are scared or ashamed. They feel weak…or pitiful. How can a person be incapable of having joy? “Why can’t I just have a good time? Why can’t I get on with it?” And for those in the spotlight who live under the microscope of public scrutiny fear being discovered, ridiculed, and shunned should their illness be discovered. So they wear a mask for the public, and sometimes even for themselves.

The key difference, of course, is that non-HSPs with anxiety disorders can approach their anxiety as a mental illness that can be eliminated entirely with the right treatment. On the other hand, an HSP will never fully eliminate their sensitivity and susceptibility to anxiety and panic. If you are a particularly anxious HSP, aim to get your tendency to worry under control rather than to overcome it completely. You can help yourself cope with high levels of intense stimuli, but you will always have a lower stress threshold than a non-HSP.

because studies also show that we women often hold anger in our bodies. Unacknowledged or actively repressed, anger takes its toll on us. Numerous psychological studies have unequivocally shown that women who mask, externalize, or project their anger are at greater risk for anxiety, nervousness, tension, panic attacks, and depression. A growing number of clinical studies have linked suppressed anger to serious medical conditions such as high blood pressure, heart disease, gastrointestinal disorders, and the development of certain cancers.

It was torture to be starving and not being able to eat. All I could think about was my face and my chewing and how much food was on my fork when I brought it to my mouth. Eating in front of people was like stripping and standing there naked for everyone to judge. My mind was in a constant state of panic wondering if I looked like a pig when I was eating, or if I was chewing too loud. Or worse, what if I ate too much and everyone saw what my mom always saw: a fat sob that could do with losing a few meals? The thought always left me in cold chills.

I was in doubt, and then everything took a hue of unreality, and I did not know what to trust, even the evidence of my own senses. Not knowing what to trust, I did not know what to do; and so had only to keep on working in what had hitherto been the groove of my life. The groove ceased to avail me, and I mistrusted myself... You don't know what it is to doubt everything, even yourself... It was the doubt as to the reality of the whole thing that knocked me over. I felt impotent, and in the dark, and distrustful. But now that I know, I am not afraid...

The answer was, we weren’t at all ready. Annual flu shots didn’t provide protection against H1N1, it turned out, and because vaccines generally weren’t a moneymaker for drug companies, the few U.S. vaccine makers that existed had a limited capacity to ramp up production of a new one. Then we faced questions of how to distribute antiviral medicines, what guidelines hospitals used in treating cases of the flu, and even how we’d handle the possibility of closing schools and imposing quarantines if things got significantly worse. Several veterans of the Ford administration’s 1976 swine flu response team warned us of the difficulties involved in getting out in front of an outbreak without overreacting or triggering a panic: Apparently President Ford, wanting to act decisively in the middle of a reelection campaign, had fast-tracked mandatory vaccinations before the severity of the pandemic had been determined, with the result that more Americans developed a neurological disorder connected to the vaccine than died from the flu. “You need to be involved, Mr. President,” one of Ford’s staffers advised, “but you need to let the experts run the process.

Getting into fights with people makes my heart race. Not getting into fights with people makes my heart race. Even sleeping makes my heart race! I'm lying in bed when the thumping arrives, like a foreign invader. It's a horrible dark mass, like the monolith in 2001, self-organized but completely unknowable, and it enters my body and releases adrenaline. Like a black hole, it sucks in any benign thoughts that might be scrolling across my brain and attaches visceral panic to them. For instance, during the day I might have mused, Hey, I should pack more fresh fruit in Bee's lunch. That night, with the arrival of The Thumper, it becomes, I'VE GOT TO PACK MORE FRESH FRUIT IN BEE'S LUNCH!!! I can feel the irrationality and anxiety draining my store of energy like a battery-operated racecar grinding away in the corner. This is energy I will need to get through the next day. But I just lie in bed and watch it burn, and with it any hope for a productive tomorrow. There go the dishes, there goes the grocery store, there goes exercise, there goes bringing in the garbage cans. There goes basic human kindness. I wake up in a sweat so through I sleep with a pitcher of water by the bed or I might die of dehydration.

But Shunt, he thirsted for understanding with obsessive perseverance. It was a pathology in this way, and pathologies aren't hobbies to be entertained through the inclination of the willing. With some assertion, you certainly can't direct a pathology: it directs, contorts, warps, wears you. Shunt walked through school, down his bedroom corridor, high-ceiling'd and close-panelled, over asphalt as hot as holiday sex, in his head, always relegated to a realm of internal mystery, a sphere of indecipherable symbols that were filtered in, held fast to, but never understood. He saw things or deduced things, and they were there for eternity. Once Shunt had them inside, it was impossible to divorce or expunge them, and so there they remained, infecting his peace and placidity of mind, thoughts like foreign bodies entering a gaping, unquenched wound, and after that Shunt's life devolved into the gangrene set in by these unpurged foreign bodies. Shunt suffered from epilepsy and a panic disorder. He didn't know who he was. He was not a funny person, a wise person, a valorous person, a soft person. Shunt was epilepsy and a panic disorder, and that's as encompassing as his personality had ever been. When you suffer a pathology it directs, contorts, warps, wears you.

Melancholy isn’t, of course, a disorder that needs to be cured. It’s a species of intelligent grief which arises when we come face to face with the certainty that disappointment is written into the script from the start. We have not been singled out. Marrying anyone, even the most suitable of beings, comes down to a case of identifying which variety of suffering we would most like to sacrifice ourselves for. In an ideal world, marriage vows would be entirely rewritten. At the altar, a couple would speak thus: “We accept not to panic when, some years from now, what we are doing today will seem like the worst decision of our lives. Yet we promise not to look around, either, for we accept that there cannot be better options out there. Everyone is always impossible. We are a demented species.” After the solemn repetition of the last sentence by the congregation, the couple would continue: “We will endeavor to be faithful. At the same time, we are certain that never being allowed to sleep with anyone else is one of the tragedies of existence. We apologize that our jealousies have made this peculiar but sound and non-negotiable restriction very necessary. We promise to make each other the sole repository of our regrets rather than distribute them through a life of sexual Don Juanism. We have surveyed the different options for unhappiness, and it is to each other we have chosen to bind ourselves.” Spouses who had been cheated upon would no longer be at liberty furiously to complain that they had expected their partner to be content with them alone. Instead they could more poignantly and justly cry, “I was relying on you to be loyal to the specific variety of compromise and unhappiness which our hard-won marriage represents.” Thereafter, an affair would be a betrayal not of intimate joy but of a reciprocal pledge to endure the disappointments of marriage with bravery and stoic reserve.

The flat tire that threw Julio into a temporary panic and the divorce that almost killed Jim don’t act directly as physical causes producing a physical effect—as, for instance, one billiard ball hitting another and making it carom in a predictable direction. The outside event appears in consciousness purely as information, without necessarily having a positive or negative value attached to it. It is the self that interprets that raw information in the context of its own interests, and determines whether it is harmful or not. For instance, if Julio had had more money or some credit, his problem would have been perfectly innocuous. If in the past he had invested more psychic energy in making friends on the job, the flat tire would not have created panic, because he could have always asked one of his co-workers to give him a ride for a few days. And if he had had a stronger sense of self-confidence, the temporary setback would not have affected him as much because he would have trusted his ability to overcome it eventually. Similarly, if Jim had been more independent, the divorce would not have affected him as deeply. But at his age his goals must have still been bound up too closely with those of his mother and father, so that the split between them also split his sense of self. Had he had closer friends or a longer record of goals successfully achieved, his self would have had the strength to maintain its integrity. He was lucky that after the breakdown his parents realized the predicament and sought help for themselves and their son, reestablishing a stable enough relationship with Jim to allow him to go on with the task of building a sturdy self. Every piece of information we process gets evaluated for its bearing on the self. Does it threaten our goals, does it support them, or is it neutral? News of the fall of the stock market will upset the banker, but it might reinforce the sense of self of the political activist. A new piece of information will either create disorder in consciousness, by getting us all worked up to face the threat, or it will reinforce our goals, thereby freeing up psychic energy.

Once you pay attention to those feelings, you can turn them around and begin to improve your overall outlook. Knowing what causes your negative feelings can work a great deal towards ending the cycle of Generalized Anxiety Disorder and panic attacks. What drove me to the ER were one of the two different kinds of anxiety symptoms I experienced throughout a day―there were the lingering kind such as a lump in the throat feeling, more commonly known as Globus Hystericus, or the dizzy feeling of literally feeling like you’re walking in a dream and no one can really see or hear you. Or there were the sudden symptoms in the form of a heart palpitation that seemed to rise from nowhere and scared the life out of me, or the numbness/tingling in my arms that led me to always think a stroke was right around the corner, but as always I was wrong again...thankfully.

Virtually every version of CBT for anxiety disorders involves working through what’s called an exposure hierarchy. The concept is simple. You make a list of all the situations and behaviors you avoid due to anxiety. You then assign a number to each item on your list based on how anxiety provoking you expect doing the avoided behavior would be. Use numbers from 0 (= not anxiety provoking at all) to 100 (= you would fear having an instant panic attack). For example, attempting to talk to a famous person in your field at a conference might be an 80 on the 0-100 scale. Sort your list in order, from least to most anxiety provoking. Aim to construct a list that has several avoided actions in each 10-point range. For example, several that fall between 20 and 30, between 30 and 40, and so on, on your anxiety scale. That way, you won’t have any jumps that are too big. Omit things that are anxiety-provoking but wouldn’t actually benefit you (such as eating a fried insect). Make a plan for how you can work through your hierarchy, starting at the bottom of the list. Where possible, repeat an avoided behavior several times before you move up to the next level. For example, if one of your items is talking to a colleague you find intimidating, do this several times (with the same or different colleagues) before moving on. When you start doing things you’d usually avoid that are low on your hierarchy, you’ll gain the confidence you need to do the things that are higher up on your list. It’s important you don’t use what are called safety behaviors. Safety behaviors are things people do as an anxiety crutch—for example, wearing their lucky undies when they approach that famous person or excessively rehearsing what they plan to say. There is a general consensus within psychology that exposure techniques like the one just described are among the most effective ways to reduce problems with anxiety. In clinical settings, people who do exposures get the most out of treatment. Some studies have even shown that just doing exposure can be as effective as therapies that also include extensive work on thoughts. If you want to turbocharge your results, try exposure. If you find it too difficult to do alone, consider working with a therapist.

Nothing fires the warrior’s heart more with courage than to find himself and his comrades at the point of annihilation, at the brink of being routed and overrun, and then to dredge not merely from one’s own bowels or guts but from one’s own discipline and training the presence of mind not to panic, not to yield to the possession of despair, but instead to complete those homely acts of order which Dienekes had ever declared the supreme accomplishment of the warrior: to perform the commonplace under far-from-commonplace conditions. Not only to achieve this for oneself alone, as Achilles or the solo champions of yore, but to do it as part of a unit, to feel about oneself one’s brothers-in-arms, in an instance like this of chaos and disorder, comrades whom one doesn’t even know, with whom one has never trained; to feel them filling the spaces alongside him, from spear side and shield side, fore and rear, to behold one’s comrades likewise rallying, not in a frenzy of mad possession-driven abandon, but with order and self-composure, each man knowing his role and rising to it, drawing strength from him as he draws it from them; the warrior in these moments finds himself lifted as if by the hand of a god. He cannot tell where his being leaves off and that of the comrade beside him begins. In that moment the phalanx forms a unity so dense and all-divining that it performs not merely at the level of a machine or engine of war but, surpassing that, to the state of a single organism, a beast of one blood and heart.

SENSORY AVOIDERS – SENSORY DEFENSIVENESS “And have I not told you that what you mistake for madness is but over-acuteness of the senses?” -Edgar Allen Poe, The Tell-Tale Heart (1843) Imagine a day inside Jenny’s skin. The morning alarm goes off and she startles, her heart races, her body tightens, her breathing quickens.  Her husband turns to get out of bed, grazing her foot, and she cringes, her bodily rhythms speed up another notch and her body tightens further. He sees that she seems annoyed about something and affectionately strokes her cheek. She bristles and, when he turns around, rubs where he touched her. She slowly arises to get out of bed, as she feels a bit dizzy, and quickly puts on her soft cotton house slippers, as the feel of the carpet makes her recoil, and walks into the bathroom. The bright lights her husband has left turned on assault her. Her eyes squint painfully. She quickly turns off the lights and turns on a small lamp on the sink counter. Her already overloaded system gets further destabilized. She starts to brush her teeth but the toothbrush is new and the bristles tickle her uncomfortably. She leans over to spit out the toothpaste and feels a sudden loss of balance and a surge of panic engulfs her. She steadies herself and turns on the shower. The soft spray of water from the showerhead feels like pelts of hail hitting her body. Her already stressed system is accelerating fast into overload. And her morning has only just begun!  She still has to figure out what clothes to put on, as most textures annoy her and feel uncomfortable on her body. She has to figure out what to eat for breakfast, as anything soft, mushy, or creamy repulses her. Worst of all, she has to figure out how to face the world outside that, for her, is like maneuvering through a sensory minefield. Jenny is an avoider or what is commonly known as sensory defensive (SD), a common mimicker of anxiety and panic. The sensory defensive feel too much, too soon and for too long, and experience the world as too loud, too bright, too fast and too tight, becoming easily distressed by everyday sensation

A phobia is an excessive or unreasonable fear of an object, situation or place. Phobias are quite common and often take root in childhood for no apparent reason. Other times they spring from traumatic events or develop from an attempt to make sense of unexpected and intense feelings of anxiety or panic. Simple phobias are fears of specific things such as insects, infections, or even flying. Agoraphobia is a fear of being in places where one feels trapped or unable to get help, such as in crowds, on a bus or in a car, or standing in a line. It is basically an anxiety that ignites from being in places or situations from which escape might be difficult (or embarrassing). A social phobia is a marked fear of social or performance situations. When the phobic person actually encounters, or even anticipates, being in the presence of the feared object or situation, immediate anxiety can be triggered. The physical symptoms of anxiety may include shortness of breath, sweating, a racing heart, chest or abdominal discomfort, trembling, and similar reactions. The emotional component involves an intense fear and may include feelings of losing control, embarrassing oneself, or passing out. Most people who experience phobias try to escape or avoid the feared situation wherever possible. This may be fairly easy if the feared object is rarely encountered (such as snakes) and avoidance will not greatly restrict the person’s life. At other times, avoiding the feared situation (in the case of agoraphobia, social phobia) is not easily done. After all, we live in a world filled with people and places. Having a fear of such things can limit anyone’s life significantly, and trying to escape or avoid a feared object or situation because of feelings of fear about that object or situation can escalate and make the feelings of dread and terror even more pronounced. In some situations of phobias, the person may have specific thoughts that contribute some threat to the feared situation. This is particularly true for social phobia, in which there is often a fear of being negatively evaluated by others, and for agoraphobia, in which there may be a fear of passing out or dying with no one around to help, and of having a panic attack where one fears making a fool of oneself in the presence of other people. Upon recognizing their problem for what it is, men should take heart in knowing that eighty percent of people who seek help can experience improvement of symptoms or, in male-speak, the illness can be “fixed.

Treating Abuse Today (Tat), 3(4), pp. 26-33 Freyd: You were also looking for some operational criteria for false memory syndrome: what a clinician could look for or test for, and so on. I spoke with several of our scientific advisory board members and I have some information for you that isn't really in writing at this point but I think it's a direction you want us to go in. So if I can read some of these notes . . . TAT: Please do. Freyd: One would look for false memory syndrome: 1. If a patient reports having been sexually abused by a parent, relative or someone in very early childhood, but then claims that she or he had complete amnesia about it for a decade or more; 2. If the patient attributes his or her current reason for being in therapy to delayed-memories. And this is where one would want to look for evidence suggesting that the abuse did not occur as demonstrated by a list of things, including firm, confident denials by the alleged perpetrators; 3. If there is denial by the entire family; 4. In the absence of evidence of familial disturbances or psychiatric illnesses. For example, if there's no evidence that the perpetrator had alcohol dependency or bipolar disorder or tendencies to pedophilia; 5. If some of the accusations are preposterous or impossible or they contain impossible or implausible elements such as a person being made pregnant prior to menarche, being forced to engage in sex with animals, or participating in the ritual killing of animals, and; 6. In the absence of evidence of distress surrounding the putative abuse. That is, despite alleged abuse going from age two to 27 or from three to 16, the child displayed normal social and academic functioning and that there was no evidence of any kind of psychopathology. Are these the kind of things you were asking for? TAT: Yeah, it's a little bit more specific. I take issue with several, but at least it gives us more of a sense of what you all mean when you say "false memory syndrome." Freyd: Right. Well, you know I think that things are moving in that direction since that seems to be what people are requesting. Nobody's denying that people are abused and there's no one denying that someone who was abused a decade ago or two decades ago probably would not have talked about it to anybody. I think I mentioned to you that somebody who works in this office had that very experience of having been abused when she was a young teenager-not extremely abused, but made very uncomfortable by an uncle who was older-and she dealt with it for about three days at the time and then it got pushed to the back of her mind and she completely forgot about it until she was in therapy. TAT: There you go. That's how dissociation works! Freyd: That's how it worked. And after this came up and she had discussed and dealt with it in therapy, she could again put it to one side and go on with her life. Certainly confronting her uncle and doing all these other things was not a part of what she had to do. Interestingly, though, at the same time, she has a daughter who went into therapy and came up with memories of having been abused by her parents. This daughter ran away and is cutoff from the family-hasn't spoken to anyone for three years. And there has never been any meeting between the therapist and the whole family to try to find out what was involved. TAT: If we take the first example -- that of her own abuse -- and follow the criteria you gave, we would have a very strong disbelief in the truth of what she told.

counselors, often confuses stages, states, and lines. He mentioned that clients could move through all four stages (sensorimotor to formal operations) in a single counseling session. People do not actually develop through four (or even two) stages in a day. Rather, different lines of development may be differentially developed, so that a client may appear to exhibit very rudimentary development in one aspect (for example, morality) and advanced development in another (scientific or mathematical thinking). Similar phenomena (clients’ appearing to exhibit the qualities of different stages of development) can be accounted for by distinguishing between stages and states of consciousness. For example, a client may have a developmental center of gravity that hovers around the formal-reflexive mind but experience a state of panic or intense depression during which he resorts to the type of illogical and contrary-to-evidence thinking that characterize preoperational thinking. There are a few places where Ivey seems to distinguish between stages and states, as when he is describing a concrete operational client with whom the counselor finds various deletions, distortions, overgeneralizations, and other errors of thinking or behaving that “represent preoperational states” (1986, p. 163, italics added). This is an important point. The basic structures are not completely stable; otherwise, they would endure even under extreme stress. Hence, developmental waves are conceived of as relatively stable and enduring—far more stable and enduring than states of consciousness, but also far from rigidly permanent structures. Levels and Lines of Development Ivey also wrote of how clients cycle through Piaget’s stages of cognitive development: Each person who continues on to higher levels of development is also, paradoxically, forced to return to basic sensori-motor and pre-operational experience… . the skilled individual who decides to learn a foreign language … must enter language training at the lowest level and work through sensori-motor, preoperational, and concrete experience before being able to engage in formal operations with the new language. (Ivey, 1986, p. 161) People do not revert from the capacity for formal operational thinking to sensorimotor, except perhaps because of a brain injury or organic disorders of the nervous system. Piaget was very emphatic that cognitive development occurs in invariant stages, meaning that everyone progresses through the stages in the same order. At the same time, it is true that just because an individual exhibits formal operational thinking (a stage or level of cognitive development) in chemistry and mathematics does not mean that she automatically can perform at mastery levels in any domain, such as, in this case, a foreign language. This is another example of the utility of Wilber’s (2000e) distinguishing the sundry lines

Most of us are visually oriented and tend to believe what we see rather than considering the less obvious story behind the pleasant smile or cheery demeanor of another. But what happens when the person who appears happy and at peace to family, friends, and co-workers is quietly suffering from debilitating depression, a panic disorder or a phobia, severe anxiety, or obsessive-compulsive disorder? What if he is experiencing dread or disturbing images behind that fragile smile? What if every minute of his day is filled with fear, worry and the brutal weight of what feels like never-ending depression? Looks can be decieving, and they frequently are.

According to National Institute of Mental Health (NIMH), the following anxiety disorders exist within adults with Asperger’s:     1.   Panic Disorder     2.   Obsessive Compulsive Disorder (OCD)     3.   Social Anxiety Disorder / Social Phobia     4.   Generalized Anxiety Disorder (GAD)

ANXIOUS CONTRACTIONS Life is movement. It’s dynamic and pulsating like a swift moving river. To be in a contented and happy state is to be in a state of flow where your thoughts and feelings follow a natural current and there is no inner friction or need to check in on your anxiety every five minutes. When you feel in flow, your body feels light and your mind becomes spontaneous and joyful. Anxiety and fear are the total opposite. They’re the contractions of life. When we get scared, we contract in fear. Our bodies become stiff and our minds become fearful and rigid. If we hold that contracted state, we eventually cut ourselves off from life. We lose flexibility. We lose our flow. We can think of this a bit like pulling a muscle. When a muscle is overused and tired, its cells run out of energy and fluid. This can lead to a sudden and forceful contraction, such as a cramp. This contraction is painful and scary as it comes without warning. In the same way, we can be living our lives with a lot of stress and exhaustion, similar to holding a muscle in an unusual position for too long. If we fail to notice and take care of this situation, we can experience an intense and sudden moment of anxiety or even panic. I call this an “anxious contraction,” and it can feel quite painful. Learning how to respond correctly to this anxious contraction is crucial and determines how quickly we release it. Anxious contractions happen to almost everyone at some point in their lives. We suddenly feel overwhelmed with anxiety as our body experiences all manner of intense sensations, such as a pounding heart or a tight chest or a dizzy sensation. Our anxiety level then is maybe an 8 or 9 out of 10. We recoil in fear and spiral into a downward loop of more fear and anxiety. Some might say they had a spontaneous panic attack while others might describe the feeling as being very “on edge.”   THE ANXIETY LOOP It’s at this point in time where people get split into those that develop an anxiety disorder and those that don’t. The real deciding factor is whether a person gets caught in the “anxiety loop” or not. The anxiety loop is a mental trap, a vicious cycle of fearing fear. Instead of ignoring anxious thoughts or bodily sensations, the person becomes acutely aware and paranoid of them. “What if I lose control and do something crazy?” “What if those sensations come back again while I’m in a meeting?” “What if it’s a sign of a serious health problem?” This trap is akin to quicksand. Our immediate response is to struggle hard to free ourselves, but it’s the wrong response. The more we struggle, the deeper we sink. Anxiety is such a simple but costly trap to fall into. All your additional worry and stress make the problem worse, fueling more anxiety and creating a vicious cycle or loop. It’s like spilling gasoline onto a bonfire: the more you fear the bodily sensations, the more intense they feel. I’ve seen so many carefree people go from feeling fine one day to becoming fearful of everyday situations simply because they had one bad panic attack and then got stuck in this anxious loop of fearing fear. But there is great hope. As strange as it sounds, the greatest obstacle to healing your anxiety is you. You’re the cure. Your body wants to heal your anxiety as much as you do.

When you look at the impossibly long list of symptoms and maladies for which antidepressants can be prescribed, it’s practically farcical. These drugs are indicated for classic signs of depression as well as all of the following: premenstrual syndrome, anxiety, obsessive-compulsive disorder (OCD), bipolar disorder, anorexia and binge eating, pain, irritable bowel, and explosive disorders fit for anger management class. Some doctors prescribe them for arthritis, hot flashes, migraine, irritable bowel syndrome, and panic disorder. The

My anxiety keeps spiraling and I feel like I'm losing it.

Apocalypse has already begun, but it seems that we still prefer to die than to allow the apocalyptic threat to scare us to death.”175 Moments of doom and resigned expectation of the end are interchanged with pseudo-courageous endurance (“we’ll somehow get through it, just don’t lose your nerve and fall into panic”).

People tend to overidentify with clinical labels once they have been given one by their doctor or mental health professional. Yet an anxiety disorder is simply an experience that a person moves through, just like a period of grief or sadness. Would we give a person with a broken heart or someone suffering from grief a label for life? No, yet people who go through a period of anxiety sometimes end up believing that this diagnosis, this label, is now a part of who they are.

Neurodivergent Checklist Time Blindness: Many neurodivergent people have trouble properly perceiving time as it passes. It either goes by too quickly or slowly. The perception of time depends on the level of stimulation the neurodivergent person is dealing with. It also can vary depending on what you’re focused on. If you’ve ever found yourself unable to account for time, you may be neurodivergent. Executive Dysfunction: This is what you experience when you want to accomplish a task, but despite how hard you try, you cannot see it through. Executive dysfunction happens for various reasons, depending on the type of neurodivergence in question. Still, the point is that this is a common occurrence in neurodivergent people. Task Multiplication: What is task multiplication? It happens when you set off to accomplish one thing but have to do a million other things, even though that wasn’t your original plan. For instance, you may want to sit down to finish some writing, only to notice water on the floor. You get up to grab a mop, and on the way, you notice the laundry you were supposed to drop off at the dry cleaners. Stooping to pick up the bag, you find yourself at eye level with your journal and remember you were supposed to make an entry the previous day, so you’re going to do that now. On and on it goes. Inconsistent Sleep Habits: This depends on what sort of neurodivergence you’re dealing with and if you’ve got comorbid disorders. Most importantly, neurodivergent people sleep more or less than “regular” people. You may also notice that your sleep habits fluctuate a lot. Sometimes you may sleep for eight hours at a stretch for a week, only to suddenly start running on just three hours of sleep. Emotional Dysregulation: With many neurodivergent people, it’s hard to keep emotions in check. Emotional dysregulation occurs in extreme emotions, sudden mood swings, or inappropriate emotional reactions (either not responding to the degree they should or overreacting). Hyperfixation: This also plays out differently depending on the brand of neurodivergence in question. Often, neurodivergent people get very involved in topics or hobbies to the point of what others may think of as obsession. Picking Up on Subtleties but Missing the Obvious: Neurodivergent people may struggle with picking up on things neurotypical people can see easily. At the same time, they are incredibly adept at noticing the subtle things everyone else misses. Sensory Sensitivities: If you’re neurodivergent, you may be unable to ignore your clothes tag scratching your back, have trouble hearing certain sounds, and can’t quite deal with certain textures of clothing, food, and so on. Rejection Sensitivity: Neurodivergent people are often more sensitive to rejection than others due to neurological differences and life experiences. For instance, children with ADHD get much more negative feedback than their peers without ADHD. Neurodivergent people are often rejected to the point where they notice rejection even when it’s not there.

Your internal dialogue and what you keep telling yourself plays a major role as we’ve seen. It is what makes the difference between feeling anxious for less than a minute, developing generalized anxiety disorder, having panic attacks, or suffering from phobias.

In March, I read parts of the book Complex PTSD: From Surviving to Thriving. Author and psychotherapist Pete Walker wrote: "When the obsessive/compulsive flight type is not doing, she is worrying and planning about doing... These types are also susceptible to stimulating substance addictions: workaholism and busyholism. Severely traumatized flight types may devolve into severe anxiety and panic disorders." Maybe work was not salvation. Maybe it was a symptom.

The voyage of the Beagle, four years and nine months long, was a pivotal experience, enabling Darwin to develop his scientific work.k The months in port prior to the launch of the Beagle were, as Darwin would write in his old age, “the most miserable which I ever spent”—and that’s saying something, given the terrible physical suffering he would later endure. “I was out of spirits at the thought of leaving all my family and friends for so long a time, and the weather seemed to me inexpressibly gloomy,” he recalled. “I was also troubled with palpitations and pain about the heart, and like many a young ignorant man, especially one with a smattering of medical knowledge, was convinced I had heart disease.” He also suffered from faintness and tingling in his fingers. These are all symptoms of anxiety—and in particular of the hyperventilation associated with panic disorder.

This is consistent with a trait called anxiety sensitivity, which research has shown to be strongly correlated with panic disorder. Individuals who rate high on the so-called Anxiety Sensitivity Index, or ASI, have a high degree of what’s known as interoceptive awareness, meaning they are highly attuned to the inner workings of their bodies, to the beepings and bleatings, the blips and burps, of their physiologies; they are more conscious of their heart rate, blood pressure, body temperature, breathing rates, digestive burblings, and so forth than other people are. This hyperawareness of physiological activity makes such people more prone to “internally cued panic attacks”: the individual with a high ASI rating picks up on a subtle increase in heart rate or a slight sensation of dizziness or a vague, unidentifiable fluttering in the chest; this perception, in turn, produces a frisson of conscious anxiety (Am I having a heart attack?), which causes those physical sensations to intensify. The individual immediately perceives this intensification of sensation—which in turn generates more anxiety, which produces still more intensified sensations, and before long the individual is in the throes of panic.

A number of recent studies published in periodicals like the Journal of Psychosomatic Research have found a powerful interrelationship among anxiety sensitivity, irritable bowel syndrome, worry, and a personality trait known as neuroticism, which psychologists define as you would expect—a tendency to dwell on the negative; a high susceptibility to excessive feelings of anxiety, guilt, and depression; and a predisposition to overreact to minor stress. Unsurprisingly, people who score high on cognitive measures of neuroticism are disproportionately prone to developing phobias, panic disorder, and depression. (People who score low on the neuroticism scale are disproportionately resistant to those disorders.)

Even when anxiety really is a problem, embracing it helps. [...] Although people who have an anxiety disorder perceive their physiology as out of control, it actually isn’t. [P]eople with anxiety self-report higher physical reactivity than those without anxiety. [...] But objectively, their cardiovascular and autonomic responses look just like those of the non-anxious. Everyone experiences an increase in heart rate and adrenaline. People with anxiety disorders perceive those changes differently. [...] And they make more negative assumptions about those sensations, fearing a panic attack. But their physical response is not fundamentally different.

Jobs: Who can work and try to cope with the vagaries of bipolar disorder? Only a robot. I counted back the other day and discovered I have had 22 jobs in my lifetime, many of them really desirable, lucrative jobs. However, anybody with this illness will gladly tell you that it is nigh impossible to try to work while you are shaking from head to toe with anxiety, running in the restroom five times a day with panic attacks, sitting almost comatose at your desk because your head is full of cotton wool when you’re depressed, skipping around the office singing stupid songs, or thumping your fist on your boss’s desk, screaming bloody murder in his startled face when you are manic. It is out the door with you, Sally Alter. Bring the company car back tomorrow.

A few days after I left UConn my mom took me to a psychiatrist in Stamford. After talking with me for an hour, smiling kindly and calmly asking me questions, he diagnosed me. “You have an anxiety disorder,” he said. “It’s a rare and very unpleasant type called ‘plateau panic disorder.’ Basically you’re having panic attacks that don’t ever end.

Silence is another barometer of timidity. A timid silence in the face of novelty or a perceived threat is a sign of the activity of a neural circuit running between the forebrain, the amygdala, and nearby limbic structures that control the ability to vocalize. These same circuits make us "choke up" under stress. These sensitive children are at high risk for developing an anxiety disorder such as panic attacks, starting as early as sixth or seventh grade.

In depression, no amount of cheerleading, self-help books, or inspirational sticky notes on our bathroom mirror can overcome the power of the illness.

Instead of a clear agent addressing demands to the state and thereby offering itself as a partner in dialogue, we get a polymorphous popular pressure, and what puts those in power in a panic is precisely that this pressure cannot be localized in a clear opponent but remains a version of what Antonio Negri calls “multitude.” If such a pressure expresses itself in concrete demands, these demands are not what the protest is really about . . . However, at some point, hysterical demands have to translate themselves into a political program (or they disappear).

In contrast, if you are harboring the deep fear that you are going insane and are experiencing episodes of panic in which you sense you are losing control or going over the deep end, it is a near certainty that you are not. These are typical symptoms of ordinary anxiety, a much less serious disorder.