My Panic Disorder Kinda Sorta Helped Me Quit Coffee (for Now)
In the worst of my recent spiral, I imagined that if I poured coffee into my mouth, it would burn my esophagus, leach through my skin, and spill out onto the hotel room carpet, staining it with my invisible sickness. I live with a panic disorder and generalized anxiety that on most days manifests in shaking hands as I prepare to leave my home. Flashbulbs fire at the edge of my consciousness when I navigate past people on the sidewalk, staircases, and subways cars, and there’s heart-pounding terror if the phone should happen to ring. Many days, it is much worse than that, but a lifetime of living with a brain and body prone to this level of self-generated terror has conditioned me to accept it as my baseline. This is just what I'm working with. It will never be fully fixed or cured, so I cope as best I can. I have learned to weather these seas.
But every year or two, usually in the summer for reasons I don't understand, the boat capsizes and I am left drowning, grasping, sick, and mad for air and solid ground for a week, two, three—this time a full month. If you've had a panic attack, you know too well the horror, the utter certainty of the death that your brain tells you will certainly be coming soon. Mercifully, this subsides, sometimes with lingering exhaustion and shakiness, but still there is an end. If you have a disorder like mine, there is no respite for hours, days, sometimes weeks on end. My body is in a constant state of heart-thudding, muscle-twitching, jaw-clenching panic with seemingly no end in sight. There's never one aha! reason for it; this is just what my brain's chemistry does.
As it happened, I'd been on the road for weeks both before and after Anthony Bourdain's suicide, gathering groups of chefs and restaurant professionals in closed rooms to talk about mental health issues in the industry. This is work that sustains me, and I am loath to admit it takes a toll. It does, though, mainly because while I'm out of town talking about trauma with people in the midst of it, I am far away from the failsafes I've put in place to keep the panic from pulling me under: routine, colleagues, husband reassuringly breathing in the night next to me even if I can’t sleep myself, regular meals, therapy (she was on vacation), my own time zone, my own bed, dogs. With none of these things around to slow the spiral, I figured the only thing I could do was try not to impel it any further.
Quitting—or scaling back on—coffee seemed like the most obvious solution, and one of the least pleasant. I am by no means a connoisseur of the stuff, though I can appreciate a well-sourced and crafted cup. For me, it's fuel. I pour it in several times a day and it makes my body go. I'm not picky; it can come from the machine at work, iced from a chain store, in a vat from the gas station, from the pot in my kitchen well after it has cooled. I used to take it with a glug of half-and-half, but a gut condition cropped up and now I take it black. You get used to things. After years of drinking this much coffee and so constantly I’ve stopped feeling its effects, but I definitely notice its absence. The sluggishness I could deal with, and it would in fact be welcome since genuine rest was so scarce. But the headaches stop just short of blinding and are painful enough to rouse me from my fitful sleep with a jolt behind my eyes and and insistent throb across the bridge of my nose, radiating over my cheekbones. I couldn't just go cold turkey in the middle of my maelstrom, I figured, so I'd taper.
Hotels are an ideal place to modify your behavior. Without your usual creature comforts, you make do with what's around you. So in Portland—a city steeped in coffee culture—I brewed a single cup in the pod machine in my room, winced as I sipped it, and threw half of it down the drain. Over the course of a week in New Orleans, my intake from the Keurig slowly decreased from a half cup down to a maintenance sip or two to keep the headaches at bay. Still, the panic roared around me, but at the very least I was not clawing holes in the wreckage of me that was still afloat.
I eventually signaled for help. After weeks under constant attack from my own brain, I made an appointment with my physician who suggested that we explore ADHD as a possible accelerant for my panic. The thought had fluttered across my mind before and then went away because, y'know, ADHD. I agreed to try something I hadn't for a while: medication. This terrified me both because I'd had a godawful experience with one a decade ago, and because the one he was suggesting was a stimulant—a pretty intense one. We don't know the exact science, he said, and it seems counterintuitive, but if your brain works the way I think it does, the drug will actually calm it, and if it doesn't, believe me, we will know quickly.
The next day, my hand shook as I maneuvered the first pill toward my mouth, and I fumbled it onto the bathroom floor. Desperately, quickly, and disgusted with myself, I shoved it past my tongue and gulped a glass of water. Forty-five minutes later, for the first time in recent memory, my brain was still—like a pond with fronds bending gently into still water. It was like this the next day, too. In the week since, of course some things have bobbed up from the surface, disturbing the calm, but the effects have rippled outward, softening, rather than becoming a whirlpool that drags me to the bottom and beyond.
I've had a little coffee from time to time because I am a deeply imperfect creature and this medication comes with headaches, but it's infinitely less than before. I miss it—the ritual, the smell, the taste, the rush, the something to do with my hands—but I will find another comfort. For once, I'm not too worried about it.
