When Panic Attacks by Karen Tang

“I’m dying.” “Why can’t I breathe?” “What is happening to me?”

These are the thoughts that were running through my head as I gasped for oxygen. It happened so fast, it was a blur. One moment I had been actively listening to my client telling me about their issues and then when I had asked what brought them here, their answer, “Oh, I don’t want to be here.” sent my body into overdrive. It hit like a ton of bricks. My hands were shaking and clammy, my heart rate was racing, tears flowed uncontrollably, and my vision blurred. It was so, so hard to breathe, as if I had an elephant sitting on my chest. And it was almost twice as humiliating as we were in the middle of our role-playing clinical interviews class, where I was the therapist and one of my cohort was the patient, with our professor watching from the next room. I was playing the role of the therapist, that means I’m supposed to be in control, right? But I wasn’t. Not even close.

I felt so helpless as I continued to gasp for breath like a fish out of water. And then everything slowed down; it was all surreal.

All my brain could process was the erratic pounding of my heart. One heartbeat later, I remember a tissue box appeared in my hands as tears streamed down my cheeks. In the next heartbeat, I remember trying to verbally express that I was having difficulty breathing, but I was unable to form a coherent sentence. And the next, my professor came in and asked if I needed a break, and I gratefully nodded. Suddenly, I was hobbling to the bathroom, in an attempt to get away from all the kind but concerned eyes of my colleagues. As I was splashing water on my face, I recall thinking, “Did I just have a nervous breakdown? In the middle of class in my first year of graduate school? Was I finally losing it?

My cohort member came to check on me and I plastered on a brave face. My breathing was no longer coming in short gasps, and the tears had stopped. I was fine, or so I thought. (Rally the psych majors! I am surely the case study they dream of?)

I went back to our session and attempted to continue. But that same wave of fear and impending doom hit again. I don’t remember what happened next, but I recall being exhausted while stumbling back home, after my compassionate professor dismissed me early. I know I frantically called my brother, then my best friend, who are both my best support systems that I needed right then, in my time of personal need. Just hearing their voices and genuine concern for my personal well-being allowed my racing thoughts to calm down and for me to slow my breathing down again. It honestly wasn’t until 2-3 hours after the incident that I was able to sit down, and further reflect what had happened. Was it a breakdown from the major stresses of graduate school? Or the move across the country to a city where I knew no one? Perhaps it was due to a major program requirement coming up?

Reflecting on my experience now, I have learned a few things.

First off, those symptoms I had resembled what is a panic attack. That sense of impending doom? Check. Loss of control? Yep. Rapid heartbeat? You name it, I felt it. And oh yeah, can’t forget shortness of breath or tightness of the throat, or feeling like you are unable to breathe. Okay, great. Well, not great clearly, but at least now there is a label, some validity to how I felt, a common enemy I can face down. I spent a long time trying to determine what triggered my panic attack.

Plot twist: panic attacks are often unprovoked and unpredictable.

I honestly still can’t pinpoint what elicited my panic attack to this day. At the time of writing this, it’s been almost two months since the incident and I still have no clue. Zero, zip, zilch, nada. Was it a fear of making a mistake in the middle of class? Or was it just the stresses of graduate school life finally getting to me? Perhaps I will never find out. Maybe there was no specific trigger and it just happened. A sign from the universe, if you will.

I wish I could tell you that months later, I know how to manage my panic attacks. I wish I could say with complete certainty that I will never experience those debilitating symptoms ever again, that I will never feel like there is an anvil on my chest and a vice grip around my throat. I want to say I have things under control. But I don’t. And that is perfectly fine too.

I have come to accept that panic attacks will mostly likely reoccur at least once in my lifetime. Probably at another one of my lowest of lows moments in life if my luck would have it. But I know that if I can beat it once, I can overcome it again. Because I am resilient. Because I am human.

Even when faced with adversity, I always try to approach life by walking away from major hurdles and setbacks by taking at least one life lesson with me. As an aspiring clinical psychologist, having experienced a mental health crisis in my first year of graduate school was downright frightening, and I feared that my high-achieving colleagues would think lesser of me. Who am I, a clinical psychology student who suffers from panic attacks, to treat patients with diagnosed mental health disorders? Well, it actually seems that psychologists who deal with their own mental health problems may actually be better at their job because they have been through it; they have what we call in the academic realm “lived experience”. Lived experience is defined as, “Personal knowledge about the world gained through direct, first-hand involvement in everyday events rather than through representations constructed by other people.” Essentially, we all have unique lived experiences that shape our identities and perspectives. Research has found that 61% of psychologists have suffered at least one episode of clinical depression. Because of this lived experience with mental health, that’s why a lot of psychologists pursue the work they do. It is this passion that drives them, and now, myself included.

And it’s not just psychologists; it’s also individuals working in medicine, social work, nursing, psychiatry, and the clergy. It’s also these helping professions that have its fair share of wounded healers. We are all wounded, it’s simply a part of the human condition. But it is those who are able to disclose and accept their woundedness, their humanity, that can go on to effectively and empathetically heal others. After all, we are only humans too.

Mental health is a continuous and lifelong journey, and is idiosyncratic to each of us, just like our fingerprints.

And akin to our physical well-being, our mental well-being must be cherished and nourished. In academia, we are no stranger to mental health problems. Often dubbed a mental health “crisis” in higher education, we as a whole need to learn how to take care of ourselves better—physically and mentally. This panic attack was the wake-up call I needed. It is why I have begun to slowly adopt specific self-care strategies to strengthen and enhance my mental health, that I can employ in my day-to-day life and during moments of intense panic. One of my favorite strategies thus far is self-compassion and it has become part of my daily routine.

We’ve all heard of mindfulness, that is, the basic human ability to be fully aware and present in the current moment. However, not many have heard of or implemented self-compassion into our daily lives, which includes aspects of mindfulness. The foremost research on self-compassion is by Dr. Kristen Neff, who defines it as comprising of three main components: (1) self-kindness (i.e., being kind and understanding to oneself when one is suffering or in pain, as opposed to being self-critical), (2) common humanity (i.e., perceiving one’s experiences as part of the human condition shared by all rather than isolating and separating), and (3) mindfulness (i.e., having a balanced awareness on painful thoughts and emotions, rather than over-identifying with them). Perhaps one of my favorite self-compassion exercises to practice on a daily basis is the Self-Compassion Break. It helps evoke all three elements of self-compassion when you need it the most, and I certainly used this after my panic attack to ground myself.

If you’re not fully convinced, perhaps one of the best pieces of advice I have ever received from a mentor is to embrace self-compassion during the graduate school journey—and am I ever grateful for this tidbit.

Graduate school can be lonely, isolating, and can leave you with crippling self-doubt and harsh self-criticism. Practicing self-compassion allows you to acknowledge the pain and suffering that is the manifestation of grad school, while also gaining an understanding that you are not alone in this journey. Be kind to yourself during this time, be compassionate.  

All in all, I am a clinical psychology student who is trained to diagnose and treat patients with mental health disorders and conditions, but I am also on my own idiosyncratic mental health journey that has its own unique concerns and challenges. I am wounded, which is an aspect of the human condition. Because I am human too. And just like any other human, we learn to adapt because we are resilient. In the end, be proud of all the highs and lows you have. Be compassionate to yourself. Wholeheartedly embrace your unique mental health journey because we all have a story to tell. So, give it a try. I dare you.

Karen Tang

Karen Tang completed her BA (Hons.) in Psychology degree at the University of Calgary and is currently in the PhD Clinical Psychology program at Dalhousie University. In her research on addiction, Karen is primarily interested in examining co-morbid disorders, specifically behavioral addictions and mental health correlates (e.g., gambling disorder and depression). In the realm of health psychology, Karen is actively involved in research on chronic health conditions and the role of mindfulness and self-compassion. She hopes to combine both research interests in an upcoming study on addiction, mental health, and self-compassion. In her spare time, Karen enjoys volunteering and traveling.