PANIC IN THE GROCERY STORE

I witnessed something this past week that I’ve read about, and have heard patients share many times, but have never seen happen in real time.

I was standing in line in a grocery store behind a woman, probably in her late twenties, casually dressed in shorts, a colorful shirt, hair swept back, with a cart brimming over with groceries.  She appeared no different than every other shopper checking out.  She suddenly began to shift back and forth on her feet, furtively looking left and right, acting fidgety.  Anyway, she began pulling at the top of her blouse, taking deep breaths, visibly uncomfortable and appearing clammy.  Her skin color changed to an ashen hue.  Suddenly, she pulled her cart backwards, out from the checkout aisle.  Then, shoving the woman in front of her against the counter, bolted in a slow trot out the front door into
the parking lot.

It was apparent she was having a panic attack.  I suppose she could’ve been having an emergency of another kind, so I watched as she continued out the store and, without breaking stride, made it to her car which was parked directly out front.

It so happened I was parked beyond her and as I approached her vehicle while walking to mine, I noticed she was still sitting in the driver’s seat of a small red truck, the window rolled down, appearing to be taking deep breaths.  I walked up, and asked her if she was okay.  She looked up, somewhat startled, and said, “Yes, I think so.  I just need to catch my breath.”  I didn’t see an inhaler but asked anyway if she had asthma or was having chest pains.  "No, I think I’ll be okay.  I have these attacks so often and they come over me without warning.  I get dizzy and my vision goes blurry.  I just have to get away.  They always pass over.”  I asked, “Are you able to drive home?  Do you need to call someone to come get you?”  “No, thanks.  I’ll be alright.  I need to go back in
if I can and get my groceries.”  I asked her if she was sure, and she said she was.

I walked to my truck, backed out and looked back once more to see she was still sitting there.  Waiting for a break in the traffic, I pulled out into slow traffic, behind several cars waiting at the intersection.  Just a minute later, I looked to my right to see her pull up beside me, seemingly oblivious to everything around her but she seemed to be composed.  The light changed, I drove on ahead and she took a right and I could see her driving was unimpaired.

Obviously she had a panic anxiety attack, usually characterized by a sudden onset of shortness of breath, chest pain, fast heart beats, dizziness, and according to many who have them, the feeling as if you might die on the spot.  I call them “Pearl Harbor Attacks.”  They come out of the blue, without warning, exploding uncontrollably in the moment.  Attempts to ward it off or break the attack are usually unsuccessful and the helpless feeling of being able to modify the attack is, for most people, the most alarming thing.  I’ve heard many women lament that their husbands and family members, apparently lacking an appreciation of the subjective and physical effects of the affliction, more or
less tell the sufferer to “just straighten up and get a hold of yourself; just get over it!”

The drug of choice for treating panic disorder is Xanax®.  Although not the only medication that can treat the condition, it works far better than most others.  The sad thing these days, from a doctor’s viewpoint in being able to help people with panic disorder, which primarily afflicts women, is a couple of things.  One is the abuse of Xanax by people of all ages and socioeconomic status; the other is with people feigning the condition in order to get a “legitimate” prescription of Xanax that, I’m told, can be sold on the street for $6-10 a pill.  This social behavior, the seemingly widespread practice of wanting to alter one’s consciousness with almost any chemical (meth, marijuana,
cocaine, spice, ivory soap beads, energy drinks), coupled with the street market value of the drug, has jaded physicians’ opinions regarding the use of Xanax in treating panic disorder or anxiety in general.  Physicians and clinics around the country are reporting they have stopped writing new Xanax prescriptions and  are switching patients to other medications with less abuse potential instead.  Physicians are developing a better appreciation of unwittingly becoming enablers to those with veiled addiction issues.  

As we all know, the actions of others, of course, can and do come to bear upon each one us personally, at some point, at some time.  In one way or another we are all connected.