Panic and Despair

Last modified on: 08/08/06

In the depth of winter, I finally learned that there was within me an invincible summer.
-- Albert Camus

Studies Find Link Between Lung Problems and Suicidal Thoughts

People diagnosed with lung disorders such as asthma are more likely to report thoughts of self-harm than those diagnosed with major depression, according to a new study. This link was not seen for people with other physical ailments, such as hypertension, heart conditions, arthritis, diabetes, cancer, liver disease, or kidney disease.

Researchers have offered several possible explanations. The type of physical suffering that accompanies breathing difficulties may create despair, leading to suicidal feelings. For example, lung diseases often result in panic attacks that could create a sense of feeling trapped. Medications for lung diseases, many of which are steroid-based, may also influence emotions.

Sources: Goodwin, R.D., et al. 2003. Major depression, physical illness, and suicidal ideation in primary care. Psychosomatic Medicine 65(July/August):501-505.
Rollman, B.L., and M.K. Shear. 2003. Depression and medical comorbidity: Red flags for current suicidal ideation in primary care. Psychosomatic Medicine 65(July/August):506-507.

What To Do

When I'm in a crisis, the first thing I do is try to postpone any decisions I might make out of panic. Most people call these "impulses." I call them "highly motivated emergency measures." When a crisis is overwhelming, however, these choices are often too drastic and permanent. I wait until after a crisis to, for instance, decide if I'm going to end a relationship or quit a job. Chances are my mind will change when things have returned to normal.

Second, I take care of myself. Give myself the kind of love and care I have given to others. Don't neglect my health or my emotional well-being, as overwhelming as it might be. Find time to eat good meals, sleep as much as I need to, and be good to myself. Sometimes, this is all it takes to get through.

Finally, I try to forgive myself for having faults, making bad decisions, or hurting someone in some way. I might not see it, but everyone has faults, makes bad decisions, and hurts others. This is what being a human entails, but we still deserve love and care. I don't have to be perfect.

No Escape!

Not every problem is kin to those in movies or games. Some problems are unfortunately of those "real life" variety, and their solutions are either insurmountably complex, hidden, or non-existant. Sometimes, eventually, the only apparent solution is walking away (leaving the scene, getting out, splitting, hitting the road). Where is the harm in running away? It sounds cowardly, but sometimes it's the only solution and even the best solution in situations that can't be resolved without getting seriously hurt.

On the other hand, the negative consequences of running away as a matter of habit are psychological and subtle. When running away is impossible, what do you do then? For someone who knows only to run away, the inability to escape leads to panic and despair. Often, running away from something is a good idea or the only thing one can do, but I think if it becomes a habit, it backfires. As a result, I made a change. Even when I can run away, I wait. I procrastinate. I test myself to see how long I can work at a problem. Even if no other solution exists, this new method has taught me that a situation with no escape is not so unbearable.

Questions to Ponder

What can anyone else say that would save you from really terrible emotional pain? What could anyone else do? Can you imagine the words or actions of another person easing your pain? If you can, your journey to peace might benefit from the inclusion of help seeking. However, if you cannot, your journey is a personal one. Think about the power of a hug. How does it work? How much do you really need someone else to save you? Can you save yourself? What does a hug instill in you that is not already there? Extreme emotional pain is very hard to bear, and the need for comfort from others is equally extreme, but often this need leads one to ignore inner resources and personal strength. Never discount your ability to walk alone, especially when you have to.

I'm Not Humpty Dumpty

When I feel like my life is falling apart, I remind myself of all the times I put it back together again. When bad things happen, losses and tragedies, I force myself to remember how I was able to rebuild. And, I hold onto the faith that rebuilding is always possible. I'm not Humpty Dumpty.

Things Can Go Right

As quickly and unexpectedly as things can go horribly wrong is as quickly and unexpectedly as things can go amazingly right.

Push Off From the Bottom

I had a dream that I was floating in a giant pool, hanging onto a raft. The water was dark. There were others there. We started to sink, but I turned to the woman next to me, and I told her, "If you sink too deep, don't try to swim back up. That's doing it the hard way. Instead, let yourself hit the bottom, and then push off with your feet. You'll shoot right to the surface." I swam to the bottom to show her. Suddenly, the pool was shallow and bright, and we had lots of fun.

How Desires Change

Many years ago, one of my deepest desires was to attend Stanford University. This desire was so deep, every other goal and desire grew to depend on it. I lived near the university and worked there briefly and learned everything I could about it. Finally, I submitted my application and held my breath for several months. Everything stood still. I waited very long, but nothing came in the mail, so I called the admissions office. The answer: SORRY.

In that one small conversation, everything I was running for (living for) vanished. All my plans and aspirations fell flat on the ground. I thought I would spend the rest of my life regretting my failure.

In a recent conversation, I was talking about all those events, and it occurred to me that I could not care less. I COULD NOT CARE LESS! How could I go from centering my entire life around a desire to losing it altogether? The realization was a powerful lesson: The next time I feel like everything is lost, I will not be so quick to conclude it.

The Serenity Prayer
Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. Grant me patience with the changes that take time, appreciation of all that I have, tolerance of those with different struggles, and strength to get up and try again, one day at a time.

Monitoring Emotions

Keeping a record of my feelings has a positive effect on how those feelings influence me. Monitoring my emotions helps me to be objective about them. I draw a line through the middle of a piece of graph paper, which comes with both horizontal and vertical lines, making a nice sheet of squares. The space above the line represents happiness. Ten lines up represents total bliss. The space below the line represents emotional pain. Ten lines down represents the greatest despair I could ever feel. Whenever my mood changes, I place a big dot on the intersection of two lines representing the time or date and my feelings. Later I connect the dots so that I have a single line illustrating the rise and fall of my mood. It sounds dry and perhaps overly analytical, but this activity has produced two effects in me. First, when I inspect my emotion enough to judge its intensity, I essentially take a step back. My perspective is more objective, and I can feel my emotion without drowning in it or becoming overly involved in it. Second, I witness concrete evidence that for every valley there follows a peak, increasing my faith in the eventual cessation of anguish.

A Reason

There are times in life when it's hard to press forward and the temptation to give up is strong. You need a reason to keep going but can't find one in the circumstances. You can keep going for this one: A good reason will come along eventually. When you can't see the light at the end of the tunnel, it won't be a motivating factor. But, you can trust that it's there, enough to move ahead. With that trust, you then have the power to create meaning rather than waiting to find it.

Hope

With hope, you can endure anything, but it doesn't take something huge to create hope. Small things offer big hope. You might even try making a list of things in life that make you feel inspired, that encourage you to face the day, and warm your heart. For example, when I see flowers planted on the side of the highway, I feel more positive about society. When I visit the park on a sunny day, the trees, grass, and birds make me feel so serene that no crisis seems to matter as much. As bad as you might feel, simple things may give you hope in life, in others and in yourself.

Patience

Nothing will be solved overnight. Pain takes time to dissipate. With patience, you can make it through any crisis. Trusting that a crisis will eventually pass helps me to have patience. Also, it helps me to pretend that I am old and wise, someone who has seen it all. This role helps me to brush worries aside and have confidence in my ability to withstand troubled times.

Occupy Yourself

This sounds like a weak suggestion, but it works very well (sometimes too well). In a crisis, you may, like me, have the tendency to confront your problems and unpleasant feelings straight on and attack with vigilance. Unfortunately, this attack cannot always solve things immediately or relieve your pain. In those situations, vigilance only seems to magnify the discomfort. It might go against your instinct, but I've found that temporary distraction is beneficial for coping with a crisis. Don't think of distraction as a way of ignoring or repressing your pain. Instead, think of it is a hiatus, a period of rest, and a means of refreshing your perspective on life. Try shifting your focus away from the crisis. Try recalling a time when you did this naturally.
Here are some ideas for occupying yourself. Novelty is key.
- Think of an unusual, creative project that interests you, such as making a greeting card or building a bird feeder.
- Find a new recipe and spend some time in the kitchen.
- Read a short, adventurous story. I enjoy the Star Trek novels and the jokes from the Reader's Digest.
- Take a walk on a new route.

Meditation

Meditation, I've found, is like pushing your reset button. This simple exercise might help:

1. Sit in a comfortable position and remain unmoving (unless you have an itch or become uncomfortable). Relax your muscles into that position.

2. Turn your attention to your breath. Notice how it feels when you inhale and exhale. Take a few moments to simply watch your breath without analyzing it or judging how well you are watching it.

3. When your mind wanders, simply watch your thoughts and allow them to return to your breath. If you hear a sound, simply hear the sound and allow your attention to return to your breath. If you start to worry or panic, simply watch your feelings without judgement and allow your attention to return to your breath.
Note: You don't need to force your attention to your breath. The breath is merely an anchor. The idea is to be aware without judgement, without getting carried away by your perceptions and thoughts.

4. Remain aware of your breath in this comfortable position for as long as you like. I have found that even one moment of pure non-analytical awareness is enough to break free of panic and see things from a totally different perspective.