To appropriate a quote of Kirsten Dunst’s in Elizabethtown, “I don’t know a lot of everything, but I do know a lot about the part that I know about, and that’s anxiety.” I’ll talk about two aspects of that here.

First, there is what mental health professionals call, in a most unglamorous way, “Generalized Anxiety Disorder.” This is when, basically, you walk around all day in a state of unrepentant, unremitting, unglorious fear. Note the graph at the right:

Imagine being “me” for about fifteen hours out of any given day. Not so nice. It gets old pretty fast, let me tell you.

However, that is not as interesting as a panic attack. Ah, that frontier of the paranoid, that haven for the irrational, that instigator of white knuckles and hyperventilation!

If that’s what a bout of anxiety looks like, well, a panic attack is off the charts. It is overwhelming, in the most literal sense of the word. Fear is all there is, rationality takes a flying leap, and there you are. Here is what a panic attack sounds like from inside the head of someone who knows it well: “CRAPCRAPCRAPCRAPCRAPCRAPCRAPCRAPAAAHHHHHCRAAAAAAAPCRAPCRAPCRAPHOSH**OHS*

HOSH**F***************************************************************************……….”

Well, you get the idea. I’m not making that up. See, here’s the deal with a panic attack: You are going to die. That’s right, you, and not in the all-too-distant future, either. Who wouldn’t respond with an incoherent string of obscenities? Who wouldn’t go all Ray Bones on that s***? And, see, you  know you’re going to die. Because your heart is beating weird, and all of a sudden for no reason you’re dizzy, then there’s a pain in your chest.And you just know, this is it. This is no bonfire of the vanities, with all going up in smoke piece by piece, this is a straight-up firestorm, and you are goin’ to die.

Because. see, the deal is, you’re in a car. The driver is pretty good, but maaaan that last turn was sharp, and that semi, OHGOSH it’s coming this way, we’re going to go right over the edge, ARE WE ON A BRIDGE? ohnoohnoohnoohno we’re not going to make it, this is going to be it, wait – I just felt a little vibration – are the wheels flying off? I think they are going to fall off, or maybe the whole floor is going to fall, and me with it, this is it, hold on tight, no, tighter, close your eyes, (hyperventilate hyperventilate hyperventilate) this is it, the crash is coming, I just know it, this is bad, this is bad, this is SOO BAD because really, this time it’s going to happen, this time I just know it’s going to be bad, what if we hit that curb? Wait – what was that sound? Is that an earthquake? I think the ground is going to swallow us up, I just know it, I really do, this time it’s going to be bad…

Or maybe you’re on a plane, white-knuckling it, grimacing, sweating tears of anguish, as the flight attendant gaily ignores your misery – “would you like something to drink?” You give her one, pained, glorious look, and your steely glare says it all: “CRAPCRAPCRAPCRAPHOWINTHEHECKISDIETCOKEGOINGTOSTOPTHEPLANEFROMCRASHING

HUHHUHHUH???DAAAMMMMNNNAAAGGHHH.”

Yup. Because the plane is lilting a little – was that a dip?  – there was a noise in the engine and WE ARE ALL GOING TO DIE. How can all the other passengers be so oblivious? How can you read the newspaper at a time like this? I’d get on my knees and pray, except even if I could unlock my fingers from this armrest, well, I really wouldn’t because that’s all that’s holding me steady….

Yes. What? A plane is the safest way to travel? Those are all psychosomatic symptoms of someone who is having a panic attack, as delineated somewhere in that wonderful tome, the DSMIV? Well, see, you just don’t get it – I just know I’m dying. I AM DYING. Right now. If you felt like I did, you’d understand, and you would also be huddled under the covers calling your mother…

“Mom…mom….this is bad….I think this is it….”

“….what time is it?”

“I think I have cancer.”

“Cancer.”

“Yes, see, there’s this mole, and it got a little darker today, and ohcrap I just know it’s cancer and I’m going to die, and now I have this pain in my chest, maybe I’m going to die of a heart attack before the cancer gets me, it just won’t go away, and I can’t breath, and the room is getting small…”

“Tonia.”

“No, mom, it’s real this time I just know it, I AM GOING TO DIE. Tonight. See, I had this thought, ‘you are going to die’ and then, what do you know, I started feeling all this stuff, and I found that mole…”

“Tonia.”

“..And now ohgosh now I think my hand is going numb what do you think that means? I’m pretty sure – no really I’M DYING….(starts to hyperventilate)…”

“Tonia?”

“….(rapid breathing)…yes?”

“Take some Xanax.”