Crawling in my skin

My Administrative Law Judge (I refer to her as"Judge Laura") during my Social Security Disability Hearing had one, and only one, question for me during the 40-minute hearing.

“Do you have panic attacks?”

“No,” I quickly responded.

Ever since that day, and especially after getting denied my benefits, I have regretted my answer. I didn’t regret it because I wish I lied. I regret it because I don’t know if I did lie.

I always thought of panic attacks as similar to a person feeling like they are having a heart attack – rapid heartbeat, chest pain, tingling in the arms and fingers, rapid or trouble breathing. Thankfully, as of this writing, I have never experienced anything that I would consider a possible heart attack, hence my quick answer to the judge that day.

I was at a cookout recently. That, in and of itself, was an accomplishment for me. I was having a particularly bad day that day. I had just started a new medication, Vilazodone, a couple of weeks earlier. I have tried numerous antidepressants in recent years and I haven’t felt better with any of them. Two of them, however, I have had awful reactions to. 

The first one was Abilify. I tried Abilify for a month in June 2023. Almost right away I began having problems sleeping. I would wake up gasping for breath a couple of times per night. I know they say it takes two or three weeks for the body to acclimate to a new drug, but this was too scary for me to endure for two or three weeks with no guarantee that it would help. So I told my doctor that I wanted off of it.

The second prescription I had problems with was this one. I have been taking Buproprion for years, but now my doctor wanted me to try this Vilazodone instead. So he had me wean off the Buproprion and started me with 20mg of Vilazodone. Fine. When it came time to up the Vilazodone to the max 40mg dosage and stop taking the Bupropion altogether, that is when the problems began.

It started one day when me and my partner, Erin, were driving the forty minute drive back home after spending a day at Colt State Park – a picturesque state park in Bristol, Rhode Island which overlooks Narragansett Bay. Almost immediately, as I started driving, I started feeling off. My head was foggy. I was getting sleepy. I felt like I was leaving my body. I was also feeling angry. I found myself driving faster, and more aggressively, than I usually do.

Halfway home, I knew I shouldn’t be driving. I wasn’t present in the moment. You know that feeling when you are driving and, without realizing it, you are so caught up in a conversation or daydreaming that you snap out of it and realize you haven’t been watching the road for the last thirty seconds. Well, that is how I was constantly feeling as I was driving.

Erin picked up on it right away and kept asking me if I was okay and if I wanted her to drive. I love driving so I am always reluctant to give up the wheel. Plus, I am scared of her driving. Nothing against her – I just always like being in control. Okay, I guess it does have a little to do with her driving, as well.

I pulled into a gas station and we switched seats. As soon as I sat down in the passenger seat, I reclined it and fell asleep almost instantaneously. Once home, I barely managed to get out of the car and into bed.

The same thing happened the next day and the day after that. At about the same time each day, my mind and body started feeling weird and I needed to lay down and sleep it off. I had to. I could not do anything once this feeling hit.

On about the third or fourth day of feeling this way, I had my weekly appointment with my therapist, Suzy. The appointment was at 11 a.m. so it was a few hours earlier than when these symptoms were hitting me. I figured I'd be safe though, obviously, I was going to discuss this with her.

I felt fine that morning as I drove to my appointment. When I was about halfway there, I started to … panic. It was gradual, but I could feel it building. By the time I pulled into the parking lot of the facility, I couldn’t move. It was just a few minutes before my scheduled appointment, but I couldn’t get the courage to go in. It is odd to say that – couldn’t find the courage to go in. The ordinary person wouldn’t find anything courageous about just walking into a building, but I felt like the Cowardly Lion.

I rubbed my forehead and felt beads of sweat, despite it being a cool, summer day and me sitting in an air-conditioned car. At the same time, I felt my body shivering. It wasn’t a cold type of shivering. It was something different. It was nervousness. I felt dizzy. I just wanted to lay my head back and stare at the roof of the car. My feet were tapping, uncontrollably. My calves were spasming. My thighs were tingling. My upper body was tensing up.

What was happening? I felt like something inside my body was trying to get out. I felt like I, literally, wanted to leave my body. My entire being felt disjointed. My spirit, for lack of a better word, wanted to get out of my corporal body. I felt like I was crawling in my skin and, immediately, the Linkin Park song popped into my head. I now knew what Chester Bennington, the lead singer of Linkin Park, meant when he sang those words.

There's something inside me that pulls beneath the surface

Consuming, confusing

This lack of self-control I fear is never ending

Controlling

I can't seem to find myself again

My walls are closing in

(Without a sense of confidence and I'm convinced that there's just too much pressure to take)

I've felt this way before

So insecure

Crawling in my skin

These wounds they will not heal

Fear is how I fall

Confusing what is real

Bennington would, sadly, succumb to his mental demons and killed himself in July of 2017 at the peak of his band’s popularity. I had tickets to see him in concert just a few weeks later. I was crushed.

His death came only two months after his close friend and talented, former lead singer of Soundgarden, Chris Cornell, took his life. It was a sad couple of months for rock music lovers and, really, opened my eyes for one of the first times to the dangers of mental illness.

With Bennington's angst voice blasting in my head, there was no way I could go in for my session. I was panicking. I hate being late. I needed a cigarette, but I knew I had no time.

I texted my therapist saying that I was in the parking lot, but that I couldn’t move. I then began to worry that she was going to come outside to talk me down. I didn’t want that. I didn’t want to talk or see anyone. I just wanted her to know I was okay, but I wasn't okay.

I was slightly relieved when she texted me, “OK. Come in when you are ready.”

Thank God. She wasn’t going to come out or call me. The last thing I needed at this moment was to be smothered.

I bought myself some time. I could get out of the car and have a cigarette – which I did. As I puffed away, I couldn’t help but take inventory of my body from top to bottom. If I had ever wondered if I had suffered a panic attack before, there was no doubting I was in the throes of one now. 

Crawling in my skin was the best way to describe what I was experiencing. My skin and my being were at battle. I was twitching all over now. I was shaking. It was like an alien was trying to get out. I could barely hold my cigarette – my hand was shaking so much, sprinkling ashes constantly.

The more I worried about what I was feeling, the worse it got. I would later find out that is the fuel that feeds panic attacks. You worry about you worrying so much and then your panic attack snowballs.

I was determined to make my appointment – even if it was only for a few minutes. I wanted my therapist to see this. I wanted this documented. I wanted an explanation. I wanted it to end.

I began to think back to the last couple of months when I was working. I was never one to leave my restaurant on my breaks. As the general manager, I shouldn’t leave my store in case something happens. As a general manager, I was always “on.” I was never on break or even “off duty.” It was a 24/7 job.

My whole career I always took cigarette breaks, periodically. It wasn’t, really, because I need a nicotine fix. I never did consider myself addicted to smoking. It was more so I could just go outside and get away for a couple of minutes without having to hear, “Tony ….,” every thirty seconds. It didn’t matter if it was a blizzard outside, a torrential downpour, or 100 degrees. I would go out there every couple of hours. I just needed those moments of being alone for a couple of minutes.

But in those last few months at work, just going outside to the enclosed, smelly, bumble bee-infested dumpster area wasn’t enough. I need to get away… far away. When the stress got too much (and it didn’t take too long – three hours, at most – into my shift) I started getting in my car and leaving the store. I would take drives to find a vacant parking lot belonging to a bank, a hardware store, or a hotel. I would just sit in my car and tremble and worry about what I was going to be going back to.

Some days, like I was experiencing this day at the therapist, there was just no way I could go back to work. I couldn’t deal with people. The rest of the day felt like an eternity. I couldn't do it. The journey seemed too long.

These were the times I would text or call my supervisor and say I wasn’t feeling well and I needed to go home. They, obviously, were not happy, but they had no choice.

I now realize that those were panic attacks. I didn’t have to feel chest pains like I was having a heart attack for it to be a panic attack. That is what I had always believed from watching movies or TV shows.

I just had to be paralyzed and stuck. I had been wrong when I replied to Judge Laura that I had never had panic attacks. I had.

Somehow, having realized that I had experienced this feeling before – maybe not to this extent, but possibly so – I was determined to go inside to see my therapist. I was now thirty minutes late, but I put out my second cigarette and walked across the parking lot, crossed the road, and walked towards the door of the building. I still felt like I wasn't really there, that I didn't belong here – like I was a tourist in a foreign country.

Does that person that just walked by me sense there was something wrong with me? Did they even notice me? Did they know I even exist? Am I really here?

Once inside, I decided to go to the restroom before walking down the long hall to my therapist’s office. I needed to regroup one last time and splash some cold water on my face. What I saw in the mirror was someone I didn’t recognize. It was the face of a scared and defeated little child, ill-equipped to deal with the changes he was going through. My eyes were dead, sorrowful, and without soul. My shoulders were slumped. My lower lip protruded in somewhat of a pout. My skin was pasty, yet blotchy. I looked tired and drained. I looked like I had just run a marathon. The creature crawling inside my skin was winning.

When I got to my therapist’s office, her door was slightly ajar – letting me know I could come in when I got there without knocking. As soon as my therapist saw me stumble into the room, she jumped out of her chair and into action. As I got ready to collapse onto the couch, she told me not to sit down.

Stay on your feet and walk around. Burn off your energy.

She told me to focus on something – a plant, a painting, a lamp. She asked me to describe that object in detail.

Tell me more about it. What else?

She was trying to bring my mind back to the present – to where I was right now. She was trying to reel me back in.

She gave me an eraser and told me to erase what was written on the dry eraser board on the wall.

Do it slowly, but thoroughly. Get every corner.

OK, now she was taking advantage of me, I thought, What next? Is she going to want me to vacuum the room? Dust the shelves?

No, she was trying to focus my mind on a task. She wanted my mind to stop wandering.

I told her that I had tried taking deep breaths outside and tried focusing on my breathing, but it didn’t help. She shocked me by telling me that was the worst thing I could do during a panic attack.

What? I thought deep breaths and focusing on your breathing was the answer to everything. She explained that if you only take deep breaths when you are stressed, you are only reaffirming to your mind that you are in a bad situation if you start deep breathing. Makes sense.

I walked around the room for the remaining fifteen minutes of my session. I didn’t feel any better. I was still sweating – even more so now because I was continuously walking around in the small, warm room with no windows. I could now add claustrophobic to my symptoms.

She insisted I looked better than when I first walked in. I was less pale and I looked a little more relaxed, she said. I felt like she was seeing what she wanted to see. She wanted to see that her techniques were working. I didn’t feel any better, but I felt like I would feel better once this session was over. I knew I would, in fact, and that helped my panic attack subside. I reassured my therapist I was good to drive home.

By the time I got back to my car, I did feel better. I still had “an aftershock” or two – a slight twitch or momentary flash of light in my vision as I sat in my car for a few moments making sure I was good to drive home. But I knew I had nothing else to do today – nobody else to meet, nowhere else to go. That was the way I liked it. My mind was at peace.

Ever since that episode, I have had the same trepidations about going to my most recent appointments, but nowhere near that extreme.

Two days after that incident, however, I did change an in-person visit with my nurse practitioner to a telehealth visit. I was sitting at a park that morning, as usual. I was trying to kill some time before I had to leave for the appointment. When the time came to pack my chair and go, I couldn’t, or I didn’t want to. It is hard to differentiate.

I was happy where I was – sitting alone in the shade under a tree on a nice, cool day. Why would I want to drive thirty minutes to sit in a stuffy, windowless room five feet away from a complete stranger who would be asking me uncomfortable questions?

So I called the office and asked if "Dr. Mike", as his secretaries refer to him as, – despite Suzy, with contempt, pointing out to me that he is a nurse practitioner, not a doctor – could call me instead. When he called, I told him about the panic attacks and we agreed to wean me off the Vilazodone.

We revisited the topic of TMS treatment – transcranial magnetic stimulation. He has been pushing this treatment on me in recent visits as an alternative to the medication which hasn’t been helping me. My therapist, Suzy, agrees TMS would be a good idea which is surprising, because she doesn’t like "Dr. Mike" (he is not a doctor!) very much based on what I have told her. 

I will discuss TMS in a future article, but for the purpose of this one, I will just say that I decided to pass on it for now. I will, probably, decide to do it, but I am not ready right now.

When I first heard Dr. Mike say it, I immediately thought electroshock treatment and Jack Nicholson in the movie One Flew Over the Cuckoo's Nest. I was reassured that it is nothing like that, but it does involve many visits over several weeks – something like five thirty-minute visits weekly for six weeks for a total of thirty treatments. I've always had issues with commitment, and that is a lot of commitment.

The next time I saw Suzy, we had more of a rational discussion about panic attacks. I had done my research on YouTube, of course. She warned me that there is a lot of misinformation out there about panic attacks – such as the deep breathing technique. 

She also explained to me (or tried to, anyway) about the difference between a panic attack and an anxiety attack. I told her how I had heard that, according to medical handbooks, there appears to be no clinical definition of anxiety attacks. There are only panic attacks, according to the medical Bible.

She explained to me that panic attacks are more severe than anxiety attacks. Panic attacks happen when you start having anxiety over having anxiety attacks – or having anxiety over having anxiety of having anxiety attacks. It seemed all very multi-layered and too much like the movie, Inception, for me. I've had to have her explain the difference a few more times since and am still not sure if I explained it right.

What is important is that you realize when you are in one to accept it for what it is and not to fight it. Fighting it only makes it worse. It is important to remember you are safe. Nothing bad is going to happen to you. And that it will end,

It helps to focus on something and observe every little detail of it you can. Vocalize it. Get your mind back on track. Mock the panic attack if you have to. Play with it. Toy with it. Take its power away.

Oh, is it you again? How have you been?

I came across a video of an anchorman that had a panic attack on air. His name is Dan Harris. He has since written a book called Ten Percent Happier and he also has a podcast by the same name in which he interviews celebrities with experience with anxiety and panic attacks.

Just this week, I watched one of his podcasts where he interviewed actor and Saturday Night Live alum, Bill Hader. I encourage you to watch it as well, even though it looks like they caught Hader just getting out of bed with a hangover, but it is fitting for a discussion about depression and anxiety.