(CW: panic attack, hospitals, general mental illness etc.)

I’m on extended sick leave from work at the moment, diagnosed with Panic Disorder and severe depression/Bipolar 2. I decided when I took sick leave that I would be open about my mental illness on twitter, but I haven’t written anywhere how it came about or why I’m open about it.

Let’s start with the latter first. As a sociologist I have taught students about various forms of disability, including teaching the social model of disability, and have discussed with them about stigma and mental health. When I had to take a break from working I decided that it would be hypocritical of me to have taught about these things while hiding my mental illness from people. It is clearly important to many living with various disorders and conditions to know that mental illness can affect anyone, and that there should be no shame in ‘admitting’ to it. Since writing on twitter about my struggles I’ve received many messages to thank me for being open about it which I appreciate very much. More than that though, I’ve discovered that talking frankly about your mental health is like a weight being lifted from your shoulders. The shame that is instilled into us is heavy—and it’s particularly the case that men suffer in silence. I will talk about suicide and suicidal ideation in another post, but clearly it would help reduce the number of suicides if we were ‘allowed’ to talk more openly about our mental health. So, I am open about my Panic Disorder and depression, the treatments I am receiving and the ups and downs of living with it.

As for how I ended up in this situation—off work, on medication with regular appointments with a psychiatrist—I can say this: mental illness often sneaks up on you and you don’t know how bad it is until there’s a crisis point. This is what happened to me.

I have always been a nervous person, shy as a child and filled with worry. I have no idea where that comes from but I’m sure a psychoanalyst would have a field day working it out. As I mentioned in a previous post, I had a breakdown when I was around twenty and recovered from agoraphobia. I say ‘recovered’ because I think it’s important to state that it is possible to overcome anxiety disorders enough to live a fulfilling life filled with ‘successes’ (depression warps your view of the past so that you only see failures). I recovered enough to successfully attain university degrees, move to Japan and have a career that led to tenure as an associate professor. But, despite outwardly appearing to be pretty laid back and confident, I am still that shy person who worries a lot.

So how did this general and ‘normal’ anxiety turn into a disorder? This will be different for everyone, but with me it first appeared in the form of digestive troubles. I found myself frequently feeling nauseous, having intestinal pain and after visiting a stomach doctor was diagnosed with IBS and prescribed medication for that. I struggled with this almost constant nausea for several years and it reached a peak during a business trip to the US. Something really didn’t feel right; I basically felt like throwing up a lot of the time. Now of course, with hindsight, I can put a lot of this down to anxiety, nausea being a common symptom, but at the time I was convinced it was a disorder of my digestive system. I returned from my US trip (feeling awful on the flight) and back to my teaching and research in Japan. The nausea never really went away fully, though some days were better than others.

And then, in a Chinese restaurant in Yokohama’s Chinatown, I had an episode that I now mark as the beginning of my current troubles. I’d met a friend there and we visited the temples as usual and then found a restaurant to have dinner in. I felt overly hungry, a bit nauseous, but otherwise OK. And after ordering just as the first dishes arrived I felt very very sick. Went to the bathroom, can’t remember actually going inside but woke up collapsed slumped on the lid of the toilet. I’d fainted. I stumbled back to the table, white as a sheet, and my friend asked if I needed an ambulance. I had no idea what was going on and was scared. An ambulance came and took me to hospital. I was shivering and delirious. And then I threw up. A lot. They gave me antiemetic medicine, my partner came down from Tokyo to get me and after lots of throwing up we made it back home via train.

Convinced it was food poisoning of some kind at the time, now I have no idea. But I am sure that even if it was food poisoning, there was also panic. I’m convinced of this because a few weeks (I think) later, I had very similar symptoms in a restaurant with my partner. I felt faint, the room spun, I thought (actually utterly convinced) that I was going to throw up, collapse, probably die, And so I quickly left the restaurant to find the bathroom. While in the bathroom the symptoms eased (the nausea subsided).

A classic panic attack.

Now while panic attacks are different for everyone there are often common sensations. Rapid breathing, nausea, shaking limbs, weak feeling in the legs, vertigo, but most of all is dread. You often hear people say they’re having an ‘anxiety attack’ when what they mean is that they’re very anxious about something, perhaps have spinning thoughts, but to me this is very different to a panic attack. A panic attack is where you have sensations and an utter feeling of dread. People often think they’re going to die or that some horrific situation will befall them. It’s really really scary.

So I worked out subsequently that what happened in that second restaurant was a panic attack. Perhaps the incident in Chinatown was also a panic attack or food poisoning or a combination of the two, but whatever, the trigger was now set: eating in public could cause me to have panic attacks. Not so long after that second one I had another (ironically, or perhaps not, in another Chinese restaurant).

And then I started having them in all sorts of unrelated situations. Seemingly anything could trigger one:

• Eating/drinking
• a cold breeze
• sweating
• a rise in heart rate if exercising
• thinking of any of the above
• and…

… meetings and classes. Yep, I found myself increasingly having panic attacks during work meetings. I would be sitting there attempting to follow proceedings while the room spun, I felt sick, I was certain that I would collapse/look crazy/throw up over the table/die…

I would have panic attacks during classes. Fortunately this usually happened while students were doing group work so I could quietly ‘die’ while not being watched.

The number of panic attacks increased with each day until, when I eventually sought help with a psychiatrist, I was having on average five or six a day. You can imagine how exhausting that is, both physically and mentally. It’s no wonder that I then started having thoughts of suicide; each day was filled with trepidation of the hours ahead, with fear of the sensations, with utter, utter dread. I still managed to work, but it was becoming increasingly difficult. All future plans seemed impossible to me. Something had to give and eventually I would take sick leave, find a suitable psychiatrist and begin taking various medications along with counseling.

But more on that in a future post.

If you’re in Japan and experiencing suicidal thoughts, you can call the lifeline at TELL: https://telljp.com/lifeline/