Sometimes you feel your world is ending.
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[Daniel Alarcón, host]: Many of you have asked us how you can support Radio Ambulante. There are many ways. If you go to our website —radioambulante.org— you can make a donation, or buy t-shirts or tote bags. And for our listeners in the United States: consider supporting your local public radio station. You can do that by going to donate.npr.org/RadioAmbulante. I repeat: it’s spelled d-o-n-a-t-e, donate.npr.org/RadioAmbulante. And don’t forget to say something about your donation on social media with the hashtag #WhyPublicRadio. Thanks.
Welcome to Radio Ambulante, from NPR. I’m Daniel Alarcón.
If the statistics are correct, many of you have felt something like this:
[Collage of voices]: The worst part of a panic attack is that you lose control…You feel a kind of pressure in your chest that makes it hard to breathe…you can’t breathe… Tachycardia… You start getting these strong palpitations… Your heart goes out of control… I thought I was going into cardiac arrest… A heart attack… Like a freezing sensation… Like a cold feeling…chills… I’m confused… Headache… My legs, my hands my jaw were shaking… You feel like you’re going to die… Like I was about to die at any moment… And I’m going to go crazy… Like I was going crazy, right?… or that I was going insane…
[Daniel]: And I think I’m right when I say that many people are ashamed to admit it, and that is why they wind up feeling like they are the only miserable people on the planet feeling this way.
This is Ana Prieto, an Argentine journalist.
[Ana Prieto]: A panic attack is a kind of internal apocalypse. It’s a kind of internal terrorist that convinces you that the end is near, that you are going to die or that you are on the verge of going insane. Forever. Irreversibly.
[Daniel]: For a period of her life, Ana was having panic attacks up to four times a week. Imagine fighting with that internal terrorist four times a week.
Today, “Panic,” an episode from our archives. Our senior editor Camila Segura continues this story.
[Camila Segura, producer]: It all began one night in 2007, at the Buenos Aires Book Fair.
Ana had gone to cover a talk there and only had about an hour and a half to go to the conversation, take notes and then write something up for the newspaper she was working for
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[Presenter]: Hello everyone. On behalf of the writers: thank you, now let’s have a round of applause for the authors, of course.
[Camila]: That day the speaker arrived 15 minutes late and she was very nervous about not having enough time. She started taking notes.
[Ana]: But my right hand was shaking so much that I couldn’t write out the words very well. I remember very clearly that they looked like spider’s legs, each word looked like a smashed spider.
[Camila]: She tried to concentrate but she couldn’t.
[Ana]: But it was no use, my hand was shaking and that was when I started to get a little scared, you know?
[Camila]: She felt a lot of noise in her head and her own voice -at full force- telling her:
[Ana]: “I need this talk to end so I can write about it”, but I didn’t even know what I had to write because I hadn’t been listening.
[Camila]: At one point, she realized it was eight o’clock and she only had a half hour to write the story. The talk hadn’t ended but she stood up and left the hot cramped press room. Not one of the 5 computers there was free. She ended up waiting and chatting with a colleague who was there.
[Ana]: “Hey there. How are you? How’s it going? Are you already done?” And I said “yes”. I was so nervous, I couldn’t… I remember being jealous of her, I remember being really jealous of how calm she was.
[Camila]: Finally she was able to sit down at one of the computers. She wrote the article with some difficulty, but it was done.
[Ana]: I hit send and said, “Good, great. Alright. It’s finished.” Then my cellphone rang and it was two friends who had just got to the Book Fair.
[Camila]: Ana wanted to leave but she hadn’t seen her friends for a while. They lived in Mendoza and had come to Buenos Aires for the Fair so she felt like she needed to see them. She said, “Fine, we’ll meet up, get out of here and go grab a beer.”
[Ana]: The problem is that when I left the press room, it was at the exact moment they opened the doors to begin what they called the Buenos Aires Book Fair free night.
I was standing there and I remember that soon people were coming in droves.
[Camila]: Her head started to hurt badly but she dealt with it. She walked quickly so that the horde of people wouldn’t catch up with her. Her friends were in the yellow pavilion, an enormous storehouse with thousands of people.
[Mariana]: Everyone just got more crammed together, you know, how it gets in a big crowd.
[Camila]: This is Mariana, one of Ana’s friends. Finally they found each other.
[Mariana]: But I have to say my friend and I were completely happy. We were on vacation at a book fair so it didn’t even bother us.
[Camila]: Remember they came from Mendoza where they don’t have such big events like this. And Ana arrived just as a show was starting in the middle of all the people that had gathered in the pavilion.
[Mariana]: This sort of carriage appears with some poets who were in some kind of poetic trance, like they were destined to perform.
[Ana]: There was a poet wearing a fairy mask or something with a big, bright, yellow dress with a hoopskirt. It was nonsense, it was absurd, it was… For me it was a frightening show.
[Mariana]: I was fascinated. I said, “Why isn’t this happening all the time where I’m from?” It seemed great to me.
[Ana]: For me she was a kind of monster, she was a monstrous woman. I wasn’t feeling well. Everything was really horrible.
[Camila]: There was a large number of people around her, not to mention the thousands that were in the pavilion.
[Ana]: And I could see on the faces of those 300 people that they thought the poem was beautiful. Even my friends, who I was really starting to hate, were watching: how wonderful are the poetry and lyrics from this girl in a yellow dress.
And I started to say: “Let’s go, let’s go, let’s go please, let’s go. I don’t feel well”, and that was when I started to feel really, really bad.
[Mariana]: She started really insisting: “I want to go, I want to go, I want to go…”
[Ana]: Let’s go, let’s go, let’s go please, let’s go.
[Mariana]: And we couldn’t leave because we were fascinated by what we were seeing.
[Ana]: Let’s go, let’s go, let’s go please, let’s go.
[Mariana]: Besides, imagine, we had traveled something like 1,100 kilometers, and something that seemed interesting to us was happening and then our friend was saying “I want to go! I want to go!” –”Cut it out!”
[Ana]: Let’s go, let’s go, let’s go please, let’s go.
[Camila]: That need to flee, that sense of urgency, that is the start of a panic attack.
[Ana]: I remember seeing everyone around me and it was like I was looking at them through a sheet of glass, as if they were close to me but far away. And something started to happen with the sound, it started to get really, really loud. Everything started to overwhelm me.
[Camila]: All the sounds started mixing together.
[Ana]: From my friends telling me: “Wait a minute, Ana, then we’ll go, it’s finishing up now, it’s finishing up now”. To the poet speaking, to the people eating as they walked by, to the people who were turning the pages in the books they had just bought. All of it was like “boom”. Like the sounds were bursting in my head. And that was when I really went into a serious panic.
[Camila]: Ana couldn’t wait anymore.
[Mariana]: But she said “I’m leaving. I’m leaving”. And one moment I looked over and she had been swept away by the crowd and she disappeared. Little Ana, who is really small, had gone through the crowd quickly and I lost sight of her and that was the last I knew of her.
[Camila]: She knew that in order to make it to the exit she would have to go through the horde of people.
[Ana]: I walked through the crowd staring at the ground, staring at the ground, staring at the ground. And the situation was so distressing, I felt so bad, I felt like I was going to die at any minute, that I was going to die at the Buenos Aires Book Fair that night. I was so certain I was going to collapse and I did not want to, I didn’t want that to happen at all.
[Camila]: Finally she made it out and decided to take the subway since it was the fastest way to get home.
[Ana]: When I went down to the subway there were some people on the platform. I kept going, feeling flustered, like everything was sped up. My hands were shaking. And I remember that I needed to say something in order to feel like I was in the world because I still felt separated.
[Camila]: She kept feeling like she was looking at the world through a sheet of glass and that all of the sound on the planet was distorted.
[Ana]: And then I felt my blood pressure going down and I said, “I need something with sugar.” I didn’t have anything sugary in my purse. There was a woman there with her daughter and I asked her “Do you have a piece of candy?”. The poor woman looked at me terrified and gave me a piece of sugar-free gum. And I put it in my mouth and started chewing it and I remember that I was chewing really, really hard.
[Camila]: Then the train arrived. She got in and sat down…
[Ana]: And at the moment something really strange happened because this guy got in and was doing magic tricks with a deck of cards. I started looking at him with absolutely no interest, and then he started to do really incredible tricks. And he was really funny. He was so funny that at one point I started to laugh.
And then it was like…I came back to…I came back, I came back, I came back. I reconnected to the world I was looking at…looking at this guy doing amazing things. And then I was myself again.
[Camila]: When she got home she no longer felt any physical symptoms but she felt very anxious about what had just happened to her. Her friends called.
[Mariana]: And that was when she told me for the first time, “I left because if I hadn’t I was going to die”. And that phrase was what got me to understand the state she was in.
[Camila]: At that time, Ana lived with her boyfriend of 3 years. He was working and got home a little later. When he arrived, Ana tried to explain to him what had happened but not even she knew it was a panic attack. They didn’t talk about it much more. She ate something and went to bed. She thought that she would feel better the next day. But she didn’t. That day was the start of a period of constant panic.
[Ana]: Not just because I started having panic attacks 2,3,4 times a week, but also because I was always afraid that I was going to have one soon. That was biggest problem. That I was afraid of fear.
[Camila]: Nothing changed for days, She started to think that that state of intense anxiety would become her new normal. She was always worried, anxious. Her face started to change.
[Ana]: I had a furrowed brow and a bothered look, like I was always thinking about something very important and serious. I didn’t relax, it was a constant state of extreme anxiety.
[Camila]: But she was also good at hiding it when it happened, especially when she was talking to the people who were important to her. But in her case, there was also the fact that her boyfriend didn’t seem to understand her. She tried to explain it to him any way she could.
[Ana]: From trying to explain to him that it wasn’t intentional, that I couldn’t control it, to explaining to him in great detail what a panic attack felt like, there was just no way for him to understand and it’s not his fault. It’s hard for people who don’t have panic attacks, whoever they may be, to understand that state of mind and empathize. And well, it hurt because at times I felt like an object of pity or that people were treating me like a poor crazy person, it was painful and really frustrating for me.
And you become a little convinced. You start to believe it, that you really are unbalanced, that the problem probably doesn’t have a solution and that if you had a little force of will you could fix it.
[Camila]: And as someone who feels like part of them is broken…
[Ana]: It’s obvious that the other person is going to be right, the one who is whole.
[Camila]:: And then, even though her partner didn’t understand her, she justified it.
[Ana]: I was thinking: How is he going to empathize with someone who is as messed up as me?
[Daniel]: We’ll be back after a short break…
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[Daniel]: Many of you have asked us how you can support Radio Ambulante. There are many ways. If you go to our website —radioambulante.org— you can make a donation, or buy t-shirts or tote bags. And for our listeners in the United States: consider supporting your local public radio station. You can do that by going to donate.npr.org/RadioAmbulante. I repeat: it’s spelled d-o-n-a-t-e, donate.npr.org/RadioAmbulante. And don’t forget to say something about your donation on social media with the hashtag #WhyPublicRadio. Thanks.
Ana works as a freelance journalist, so she normally works from home. Staying home made her feel safer. But from time to time she had to go out, and every outing was a small torture,
[Camila]: One night, her boyfriend made plans to go to the theatre with some friends. The theatre was downtown and it was the weekend. There were going to be a lot of people on the street. And of course in the theatre as well. She didn’t like any of that.
[Ana]: But, well, let’s say I gathered up my courage and I said “Great, let’s go”.
[Camila]: Ana wanted to go in a taxi. She hated the idea of taking the subway, packed like a sardine underground. But her boyfriend didn’t want to.
[Ana]: Sadly, there was no way to explain it to my partner, or if I explained it he still wouldn’t understand; that is to say, you’re with me, you’re taking the train, nothing is going to happen. But what I was feeling was a deep sense of loneliness and a deep sense of terror.
[Camila]: The trip was even worse than she had imagined.
[Ana]: It was only 20 minutes but I remember that I started crying. I didn’t sob or cause a scene, but I remember that my eyes were completely full of tears and some fell from my eyes and I wiped them away quickly and I was completely terrified. The feeling was: I’m going to burst, I’m going to burst, I have to get off, I have to get off.
[Camila]: But she didn’t get off and she managed to get there. In terrible shape. Hiding the fact that her body was shaking. She realized the room they were going to be sitting in was in the lower level so she would have to go back underground.
[Ana]: And to make matters even worse, our seats were the farthest from the emergency exit.
[Camila]: If she wanted to get up in the middle of the performance, she would have to bother a lot of people, which also worried her. But there was nothing else to do.
[Ana]: I’m quiet. I sit down. To suffer in silence, count to 10 and count back down to 1, from 10 to 1 and 1 to 10, until the show started, while everyone was chatting away as happy as can be, everyone else was outside having a good time.
[Camila]: Aside from the worry, she felt furious: furious that everyone was able to enjoy themselves but not her.
Finally the show started. It was a monologue. And it happened to be about a castaway who was alone on an island, and he had a lot of phobias which constantly gave him panic attacks.
[Ana]: I think I was the person who laughed the most during the show because I was the one who identified most with the actor.
[Camila]: And so, the night was saved. But once she was at home, Ana’s reasoning was this: taking the metro was shit; waiting for the play to start was shit. And of course, she wasn’t going to end up watching a play about panic that made her laugh every time she went out.
What followed was the period of her life in which her social life diminished considerably.
But the anxiety continued. One afternoon she went to a convenience store near her house, a place where she went several times a week to buy whatever she needed. She didn’t know the name of the store clerk but after so many visits they recognized each other. And that day Ana showed up…
[Ana]: With that constantly horrified look on my face, and the woman said something like, “it’s alright, everything is going to be alright.” It was a totally unexpected positive message because of course I didn’t have to hide my state from her at all. It was rather motivating that out of nowhere she would say something like that.
[Camila]: Motivating because for Ana, the store clerk’s gesture was a red flag. There were people who realized how bad off she was and had to give her some kind of encouragement.
She started trying to force herself to go out more often because she felt that if she was broken she had to fix herself and one of the ways to do that was going out.
But no matter how she tried to force herself to “be alright” the panic attacks continued. One day she started experiencing one but this time she started to feel her chest and left arm hurting.
She thought it was her heart.
There was a hospital nearby and she decided to go.
[Ana]: And what’s the fastest way to get to the hospital? Because I considered all of the possibilities: walking, taking a cab, riding a bike.
[Camila]: That’s the logic of someone having a panic attack.
[Ana]: And the fastest way really was riding a bike, because to take a cab you have to call it and that was going to take time and I was about to have a heart attack. So I couldn’t wait for a taxi. But on the other hand, my problem was if I rode a bike that would get me worked up and if I got worked up I would have a heart attack. So, there was no way out, but I decided to go the fastest way and I left on my bike.
[Camila]: When she got there there were a lot of people ahead of her, but since she said her chest hurt they gave her priority. They ordered her an EKG and a doctor saw her.
[Ana]: And the doctor told me: “Your EKG is perfect. Tell me what’s going on with you.” And I told her: “Well, nothing” And I started explaining to her what I just explained about what was the most practical way of getting there and she let me throw out all that nonsense and she said: “It seems to me that you have anxiety and that you should really see a psychologist”. And then I started to cry, “buahhh”
[Camila]: She cried a lot during that period, but also:
[Ana]: That someone was looking me in the eyes and telling me “you have anxiety, do something about your anxiety, you aren’t having a heart attack”, was also a relief.
[Camila]: This event was very important. What the doctor told her completely reinforced the idea that she had to do something, that she could do something. That she wasn’t doomed to live like that forever. And that made her feel a little better. Moreover, when she left the hospital it was the first time in a long time she was able to think about something other than her physical symptoms, her panic.
[Ana]: And once I left, I remember that all of a sudden I got distracted by something. “Oh what a nice day”, ‘Oh, I’ve never walked down this street”. Some nonsense like that, but it was like leaving that state of permanent introspection and horror for a while.
[Camila]: Aside from what she had said to her boyfriend, she had said little to nothing about this to other people. Not even her parents. But that very night she called them and told them everything that was happening to her. Her mom told her not to worry and the next day she got her an appointment with a psychiatrist.
[Ana]: I got there, I filled out a questionnaire, she told me “You have panic attacks. Well, I have panic attacks all the time. I swear it’s not serious. You’re having a very hard time but it’s not serious. You’re going to make it out.” And she made me laugh a little and I said, “Wow, there are people who understand, I’m not alone in the universe”.
[Camila]: She prescribed an anxiolytic drug that Ana had to start taking that same day. She also referred her to a psychologist. Ana bought the anxiolytic and went home.
[Ana]: And I remember that really well. I took the anxiolytic and I remember that I had to work, right? And I sat down to do it. And all of a sudden, in about a half hour, I felt completely different. It was like I was missing something, something was absent from my surroundings. Something wasn’t with me. It was that fierce anxiety, that gigantic monstrous shadow that had been cast over me for a month and a half, all of a sudden it disappeared, it wasn’t there anymore.
[Camila]: She didn’t understand how she had survived that month and a half without taking that little pill. But it wasn’t just the pill. Four days later she started therapy with a psychologist.
A kind of therapy that is very common for these cases is called cognitive behavioral therapy, and the first thing the therapist did was ask what her fears were.
[Ana]: I was afraid my heart was going to explode like a grenade, that a vein would rupture in my brain and I would die of a brain hemorrhage. I was afraid of going crazy. Those were my three most obvious fears.
[Camila]: They took each of those fears and rationalized them. She made a diagram of a heart, explaining where the blood entered and left, getting her to understand that the heart isn’t something that can explode. She ordered medical exams to show Ana that she didn’t have high cholesterol or clogged arteries and her fear that her heart would stop wasn’t rational either. And they did that with all her fears. But the thought that she was going to die continued, no matter what she did.
[Ana]: Then she asked me to imagine that I died in the middle of the street. Because I was also afraid that I would die in the middle of the street and no one would help me. So she made me close my eyes and imagine that happening.
[Camila]: Then she was walking along a major street in Buenos Aires, one that was full of people.
[Ana]: And poof I collapsed, it didn’t matter why. She made my close my eyes and tell her about it in detail. She asked me how I was dressed, who was walking by, what I was feeling.
[Camila]: And so on, until the ambulance arrived. But it was too late. Ana was already dead. And she described every detail of the scene.
[Ana]: And then my parents found out and my sisters, and I had to organize a funeral and make a whole scene. Even what kinds of flowers I would have and who would be invited to see me in the casket. And I did this exercise over and over again. Until I had told it so many times it started to be absurd because I kept going out in the street without that ever happening.
[Camila]: And finally Ana could just laugh about everything.
[Ana]: About the guests and I said, “Damn, what is this girl from the sixth grade who I never liked doing at my funeral? Why is she at my funeral.” and then I started to laugh and it all came apart and I lost my fear.
[Camila]: It took her more than a year to get better, to be herself again. During the course of her therapy she started writing a book about panic and certainly this process helped her greatly. And now, she has gone 8 years without having a panic attack.
And it’s not that she’s stopped feeling anxious entirely, but today when she starts to feel the symptoms, she doesn’t get scared anymore.
[Ana]: It’s as simple as that. If I don’t get scared, it doesn’t happen. When I start to get scared I say: “Relax”. And the process doesn’t even take me a minute. It’s like it’s already out of the equation.
[Camila]: That is to say, Ana isn’t afraid of fear anymore.
[Daniel]: Ana Prieto’s book is called “Panic: 10 Minutes With Death”. She lives in Buenos Aires and is a fact-checker at Radio Ambulante.
Thanks to Camilo Montilla from Sónica studio in Bogotá.
Camila Segura is the senior editor at Radio Ambulante and lives in Bogotá. This story was edited by Silvia Viñas and me, Daniel Alarcón. The sound design is by Martina Castro and Andrés Azpiri.
The rest of the Radio Ambulante team includes Jorge Caraballo, Patrick Moseley, Laura Pérez, Barbara Sawhill, Ryan Sweikert, Luis Trelles, David Trujillo, Elsa Liliana Ulloa, and Luis Fernando Vargas. Maytik Avirama is our editorial intern. Andrea Betanzos is our program coordinator. Carolina Guerrero is the CEO.
Radio Ambulante is produced and mixed on Hindenburg PRO.
Learn more about Radio Ambulante and this story on our website: radioambulante.org. There you can also send us your questions at radioambulante.org/pregunta. Your question could be the starting point for a new episode.
Radio Ambulante tells the stories of Latin American I’m Daniel Alarcón. Thanks for listening.