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Over 4 million Americans suffer from panic attacks, which means there are a few hundred million of you who have no idea what it's like. It's not like stage fright, it's not a general feeling of anxiety, it's not even that sense of dread you get when you realize you forgot to edit out the skill "Fartmaster" from your resume before hitting the "send" button.

I've suffered from debilitating panic attacks for half of my life. And now I'm going to tell you about them, because at the very least I deserve to make some money out of this terrible experience.

They Can Start Anytime, Anywhere

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There isn't really any warning that you are going to start getting panic attacks. Sometimes they run in families, but that doesn't mean you are guaranteed to have them. My sister started getting them a few years before I did, and because she was younger than me and in middle school to boot, I just chalked her behavior up to her being a brat.

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Adolescence: just the worst.

My first panic attack came in January of my senior year of high school. Looking back, you can see the obvious triggers, but it was just as likely that I could have gone through the whole day and been fine. Our English class was in the library listening to a special guest speaker: a Holocaust survivor. Obviously, she wasn't doing a stand-up routine. At the same time, my mom was in the hospital going through major surgery. I received a page from my dad telling me that she had just come around. And I think somewhere in my mind I must have realized that one day I would have to tell thousands of people that I was old enough to be a senior in high school when pagers were the hip new thing.

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We mostly used them to let someone know when we'd mailed them dick pics.

About five minutes after I got the page, I started freaking out. I felt like I was floating a foot or two above my body and had this overwhelming feeling that something really bad was happening. It felt like I wouldn't be able to take my next breath, even though I had started hyperventilating. I vaguely remember grabbing the hand of the person sitting next to me and asking them to get the teacher. Or I might have screamed it; I have no idea. The next thing I knew I was in a wheelchair being taken out to an ambulance while everyone stared at me.

For me, life will always be divided into two sections: everything before that day, and everything after.

It's Like Suddenly Owning A Tiger

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For those who have never had a panic attack, here's a really easy way to understand it: Imagine waking up on your average morning. You're thinking about your day, maybe a bit stressed, maybe a bit sleepy, but it's a normal morning. You open up your bathroom door to go brush your teeth and there is a fucking tiger sitting there. Like an actual, 500-pound, big pointy teeth tiger. How would your body react? That's how my body reacts all the fucking time.

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OK, these guys are wizards.

The fight or flight response that kicks in when you are panicking can be anything from a little bit inconvenient to actually requiring medical intervention. You're lucky if all you get are a racing heartbeat, hyperventilation, and a cold sweat. That floating feeling I had during my first one is called derealization. Sometimes your muscles freeze up and you can't move; other times you find yourself in literal flight mode, running down the street. You might suddenly need the bathroom really badly. That's your body trying to shed weight so you can run away from the tiger easier, but in modern life it just adds the fear of shitting yourself in public to this already long list of things to worry about.

"I'll pick up the adult diapers right after I talk to Beth."

The average person might call an ambulance once or twice in their lifetime. I've called them dozens of times. And I don't want you to think I'm some hypochondriac who is taking away life-saving services from people who actually need them. Every single time I have called 911 or gone to the emergency room, I have absolutely 100 percent believed that I was dying. In my case, I always think I am having a heart attack; other people often think they are suffering a stroke or simply going insane. In my mind, I have been on the verge of death many times. It's like being a soldier under constant gunfire. And that's not as dramatic an analogy as you would think, because panic attacks can and do cause PTSD, which in turn makes you more likely to have a panic attack, leading to a vicious and scary-as-hell cycle.

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They Become Your Defining Feature

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While you eventually learn what your triggers are and can work to avoid them, panic attacks often come completely out of the blue. That makes it virtually impossible to hide your occasional freak-outs from the people in your life. This affects them in different ways.

Some people will start walking on eggshells around you. They think that if you are happy all the time then that will keep an attack from happening. In college, a friend's mother died very suddenly, and at the wake that friend seemed more concerned that I would be OK, since death is one of my triggers.

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"You know what would really get this thing going? A Holocaust survivor."

You also get the jackasses who think you are faking. Panic attacks can be hard to understand for people who have never had them, and from an outside perspective, a person screaming that they are dying when it's obvious that there is absolutely nothing physically wrong with them looks like the world's biggest drama queen. Even people who love you and understand that you are seriously ill have a breaking point and can sometimes say the wrong thing or get exasperated when you start screaming for help again.

Then of course there is the issue of how we talk about mental health in this country. When people find out you have panic attacks, either from you telling them or if they witness one in its full glory, they start questioning your sanity. You can imagine how well that goes down at your job. I once had a really bad episode while I was working in retail, and they shut down the whole store while the ambulance came. Obviously, this is bad for business, and while I wasn't fired, the boss called me in the next time I was there to have a serious conversation about if I could do the job or not. That was just to sell jewelry; now imagine if I guarded nuclear missiles or was president of the United States. We'd all be fucked.

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If I think I'm dying, you are all coming with me.

There Is No Guaranteed Way To Control Them

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To try to keep my panic in check, I take four different kinds of pills twice a day, with a fifth "as needed." I also see a shrink. But I still have attacks, just not as often and they are usually not as intense.

One of the reasons it is so hard to make them go away forever is that almost everything that is supposed to help can also trigger them. Read the pamphlet that comes with any anti-anxiety medication and you'll see "panic attacks" listed as a side effect. If you went to buy medication for, say, a sinus infection, and the pharmacist told you that it had a pretty good chance of actually causing another sinus infection, you'd probably think twice about taking it. But those of us with panic attacks have no choice but to chance it.

Even James Bond's gambling manages to be less dramatic.

If you don't want to take medication, you can try cognitive behavioral therapy. CBT involves repeating mantras about how you are OK, but it also concentrates a lot on breathing techniques. Since breathing "correctly" can cause lightheadedness, a symptom of panic attacks, you can find yourself freaking out instead of feeling better. The same goes for exercise. Daily workouts can do wonders for anxiety, but since sufferers mentally associate a pounding heart and sweating with having a panic attack, a lot of people avoid it. The doctor might as well be prescribing you "screaming" and "having a panic attack" as a means of controlling it.

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The rest of you can feel free to use that excuse in solidarity.

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They Can Lead To Much Bigger Problems

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Since the medications and techniques to "fix" panic attacks have so many issues, people often end up self-medicating. I've known people who could barely function if they weren't smoking weed, because it was the only thing that calmed them down (of course, a side effect of pot is increased anxiety, so don't assume that will work for you either). I went with a much more common and much more destructive drug: alcohol.

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Maybe you've heard of it?

Let me tell you, it worked like a charm. When I was boozing I never had to worry about freaking out, so I started drinking more often. Panic attacks don't just come at night, so I started drinking in the morning. As my system got used to it, I had to drink larger amounts to get the calming effect I was desperate for. Then once my body got addicted I could basically never be sober, since anxiety is a side effect of withdrawal. This is the "just the tip" method of nature trying to fuck you ... and succeeding.

I spent almost 10 years self-medicating with alcohol. In order to keep my brain from thinking it was dying all the time, I ended up bringing myself actually close to death twice. I went to rehab here and there and managed to stay sober for short periods of time, but every time I relapsed it was because I had a panic attack. This is nature convincing you it doesn't need a condom because, "You're my first, so I don't have any diseases. I promise I'll pull out way before it's time."

Of course, when you are that drunk all the time it is hard to hold down a traditional job and you certainly can't drive anywhere. So I started spending more and more time in my house. My husband ran all the errands. As I spent less time outside, I started to actually fear it. Soon, leaving the house meant a guaranteed panic attack, so I just stopped going anywhere. For the better part of a year my panic-induced agoraphobia meant I was under self-imposed house arrest. When you have that much in common with Lindsay Lohan, it's time to make a change.

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Puppy dog eyes be damned.

Thankfully, I am now four months sober, and at the very least I leave the house every day to take my dog for a walk. So for everyone out there who also suffers from what can be such a debilitating condition, know that it can get better. And if you are lucky enough to have no idea what I've been talking about this whole time, at least don't call us crazy, or we might be tempted to prove you right.

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Despite being terrified of death, Kathy wrote a very funny book called FUNERALS TO DIE FOR, and you can buy it here. Or follow her on Facebook, Tumblr, and Twitter.

Many people smoke pot to treat their anxiety, but it turns out that can actually worsen panic attacks. See why in 5 Pro-Marijuana Arguments That Aren't Helping, and if you have social anxiety, see why one potential way to turn it around is to convince people you're outgoing. Check out the science in 6 Scientific Solutions To Your Crippling Social Anxiety.

Subscribe to our YouTube channel to see Daniel O'Brien (a guy who knows a thing or two about anxiety) break down the worst movie concept ever in Officially The Worst Movie Idea Anyone's Ever Had - Obsessive Pop Culture Disorder, and watch other videos you won't see on the site!

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