Swapan Seth, who runs an advertising firm called Equus with his brother, is a focused, intelligent man who gives off a kind of coiled energy. He describes himself as hyper and anxious. “Oddly enough, though, people see me as calm and collected,” he says. “So the panic attacks felt like a bit of a chink in the armour.”
The terms “anxiety attack” and “panic attack” are not metaphors. Clinical panic sweeps through the body with such acute physicality that it’s difficult for the sufferer to believe that the symptoms are psychosomatic. What starts with mildly jangly nerves can spiral swiftly, and out of nowhere, into a devastating flood of adrenaline: chest pains, a racing pulse, trembling clammy hands, cold sweats, pain or numbness in the limbs. It feels like a serious medical emergency — a sudden, disastrous lunge towards death. It’s terrifying.
Mr Seth’s panic attacks started 10 years ago, in his mid-30s, though they can strike anyone at any age, including in childhood. A variety of things triggered them for him — someone yelling, a missed meal, overcrowded lifts, some sounds and smells. Convinced that he was experiencing a heart attack or a stroke, he kept checking into hospitals for emergency medical attention. It got so bad that he wouldn’t go anywhere without strips of alprazolam and sorbitrate in his wallet, but often, knowing he had medication wasn’t enough.
After each episode of cataclysmic fear, you spend your time understandably fearing and defending against the next onslaught. People who experience regular panic attacks go to great lengths to avoid panic-inducing situations, even if it means shrinking their lives. Mr Seth became terrified of flying and of not being able to access medical help. “I’d say, let’s just Skype — why spend so much money? On an aircraft I’d always ask if there was a doctor on board. I have stopped an aircraft that was taxiing for takeoff, and told the pilot that I needed to get off because I was having a heart attack.” He stopped visiting his Bombay office, insisted on thorough medical checks every few months, and would only stay at places that had hospitals nearby.
Like many successful people in a competitive environment, he didn’t tell anyone about his debilitating condition, but panic disorder can savage your professional life. For almost a year, he says, “I would leave for work at 9 a m, turn the car around at 9.30 a m and come home and lie down. When I was at work, I’d keep running out of the office to Max Diagnostic Centre next door.” It also affects your personal life; Mr Seth’s constant fearfulness was hard on his wife too, and his young son began to complain about chest pains.
The full-blown panic attacks more or less stopped in 2008, but like many people, Mr Seth is still wary. He is still occasionally anxious, carries medication, and likes to know that medical facilities are available. It’s a testimony to the powerful effect of panic attacks that even after his stopped, though he knew nothing would happen if he didn’t take his prescribed tranquilliser, he would panic if he forgot to take it. He gave it up only a month ago. Now, when he’s feeling panicky, his wife can talk him out of it.
Mr Seth is unusually frank and open about what he has been through. One of the things that encouraged him to talk about it was the discovery that lots of his friends – extremely high-powered, well-known people living and working in the public eye – also experience panic attacks, silently and alone. The other is the feeling that he has conquered the worst of it. “The more we talk about it, the more people will realise that it’s perfectly normal to have panic attacks, that many, many people have them. I don’t think of it as a chink in the armour any more. If you’ve got it, you’ve got it. I’ve come to terms with it.” In hindsight, Mr Seth feels he should have read more about anxiety and panic. Many sufferers do, compulsively, to reassure themselves that what is happening to them is not going to kill them.
India doesn’t exactly lead the world in handling mental health without prejudice. The silence from those who endure panic attacks reflects both a general attitude towards perceived weakness, and a lack of information about what is a surprisingly prevalent condition. Many people with panic disorder are dismissed as hypochondriacs, especially by long-suffering family members and impatient doctors who don’t know enough to point them to Cognitive Behavioural Therapy (CBT) or other kinds of counselling.
Some people find relief in CBT, which helps realign anxiety-generating situations with calmer, more positive feelings; others in meditation, yoga, and breathing control. Many more people never find relief. It says nothing complimentary about our society that an issue that affects a large number of the general population is still largely incarcerated in silence, especially in the high-stress conditions that typically surround success.