My first panic attack happened in a grocery store. Aisle seven, canned goods, a Tuesday afternoon in March. Nothing was wrong. Nobody was chasing me. There was no fire, no threat, no reason for my heart to decide it was going to try to exit through my sternum. But there it was. My vision narrowed. My hands went numb. I was suddenly, completely certain I was dying, in the specific, absolute way that only panic can produce. Not afraid I might be dying. Certain. I sat down on the floor next to the kidney beans and waited for it to pass, and when it did, I drove home and did not go back to that grocery store for two months. That was nine years ago. I have had maybe two hundred panic attacks since then. And somewhere around attack number fifty, I started to understand something that I could not have heard during attack number one: the panic attack was not the problem. The panic attack was the first honest thing my body had done in years.

The Body's Version of the Truth

I had spent a long time being fine. I was professionally fine. I was relationally fine. I was a person who handled things, who managed, who did not make a fuss. And underneath that fineness, my body was keeping a tally. Every swallowed argument, every performative okay, every time I said I am good when I was not, my nervous system logged it. Filed it. Stored it in my shoulders and my chest and apparently my relationship with aisle seven of the grocery store. Bessel van der Kolk's research has shown that the body stores unprocessed emotional experience as physiological tension and that this stored material will eventually find expression, often through symptoms that appear disproportionate to their immediate trigger. A panic attack in a grocery store looks random. It is not random. It is the body's accumulated truth arriving all at once because it was never allowed to arrive gradually. There is a way of understanding panic attacks that I think is more useful than the standard clinical framing. The standard framing treats them as malfunctions. Your fight-or-flight system misfired. Your amygdala overreacted. Here is a breathing exercise. And that framing is not wrong, exactly, but it misses something. It misses the possibility that the alarm was accurate. Not accurate about the grocery store. Accurate about everything else. Accurate about the years of compression, the accumulated dishonesty, the long project of pretending to be fine when fine was never really what you were.

What Honesty Sounds Like When You Have Been Lying to Yourself

The Surgeon General's 2023 advisory on loneliness and isolation talked about the health consequences of disconnection. But there is a kind of disconnection that does not show up in social surveys because it is not about other people. It is about you. It is the disconnection between what you feel and what you permit yourself to feel. Between the signal and the response you allow yourself to have to the signal. I spent years disconnected from myself. I do not say that in a mystical way. I say it clinically, diagnostically, the way you would say someone is disconnected from a smoke detector. The alarm was going off and I had removed the batteries. And when you remove the batteries from enough alarms for long enough, the fire does not stop. It just reaches you later, bigger, and all at once. Kristin Neff's 2023 research on self-compassion suggests that the act of reframing distress signals, moving from what is wrong with me to what is this trying to tell me, fundamentally alters the stress response. It shifts the nervous system from adversarial to collaborative. The panic is not your enemy. The panic is your body's last remaining strategy for getting your attention after every quieter strategy failed. I think about all the quieter strategies that came before aisle seven. The tight chest I attributed to caffeine. The insomnia I attributed to screen time. The vague dread I attributed to the news. Each one was a knock on the door. Each one was my body saying something is wrong and here is a small, manageable signal to let you know. And each time, I turned the volume down. So eventually my body turned it up. All the way up. On a Tuesday afternoon in March, next to the kidney beans, it screamed.

Listening After the Scream

I still get panic attacks. Fewer now, and less severe, but they have not stopped entirely. The difference is that I have changed my relationship with them. When one arrives, I do not treat it as a malfunction. I treat it as information. Urgent, graceless, overwhelming information delivered by a body that has learned that I will not listen to whispers. The work now is learning to hear the whispers. To notice the tightness before it becomes a vice. To register the unease before it becomes terror. To let myself not be fine in small, real-time increments instead of storing it all up for one catastrophic disclosure in a grocery store. I am not grateful for the panic attacks. That would be dishonest, and the whole point is to stop being dishonest. But I understand them now. They were my body's attempt to tell the truth after years of being asked to lie. And I cannot fault the messenger just because the message arrived louder than I would have liked.