The first time I had a problem I was earning very little, had never been in therapy, certainly wasn't on any kind of insurance plan, and had to fork over the money from my own pocket. I was lucky enough to find a therapist at a public clinic who had a sliding scale. My sessions with her were $10 an hour; I know she charged $90 regularly, and that was back in 1984. She arranged for me to get my medication fairly inexpensively, and I didn't have to actually see anyone else for that.

The second bout of panic attacks happened in 1993. By then I had insurance, but our plan didn't include mental health benefits. I found a psychologist through the Yellow Pages, and paid for my therapy and periodic visits to a psychiatrist who oversaw the medication end of things. It was a lot more than $10 a visit, I'll tell you that. It was worth it, though, because I still had a lot of things to work out in therapy and the medication was just part of the deal.

In both cases the physical problems were the outward manifestation of long-term, unbearably intense psychological strain. I coped, and coped, and compartmentalized, and strategized, and kept a stiff upper lip, and when my body couldn't handle it any more I developed panic attacks. Some people get ulcers, some people take up drinking, and some people have a predisposition to panic attacks. The predisposition is thought to be genetic. Lucky me.

Panic attacks are classified as anxiety disorders, as far as I know, and thus a patient will typically receive some kind of seratonin re-uptake inhibitor to stop the physical problem while seeing a therapist to resolve the anxiety and behavioral problems. What happens is the adrenal gland gets a constant series of neurological signals to fire off adrenaline: the body thinks it's constantly under attack. The build up is horrible. You believe you are about to die, that you're having a heart attack or something else catastrophic, that if you pass out you will never wake up. It's intensely frightening, and wholly recognisable once you've been through it. Therapy can help, biofeedback can help, and calming rituals can help, but only once you've stopped the physical cycle with medication. Thus, I spent all of last week tracking down a doctor who could help me.

It was quite an experience. The first day I called 12 psychiatrists. It had to be a psychiatrist as they're the only ones who are licensed to prescribe. I struck out, though. Every single one was either on vacation until August, not taking new patients, or no longer on my health plan. The next day I called 20 doctors from a different provider list, some psychiatrists, some psychologists. Each time I left a message stating my situation and begging someone to call me back if they could see me soon. I heard from one doctor that day. One out of 20. Nice, huh? He wasn't taking new patients.

The third day I heard back from five of the 20. Two were not taking new patients, one said he didn't have any connections with a psychiatrist to get me on medication, one said he could see me in three weeks, and one said, and I quote, "Lucy? I can't see you. Goodbye." Like, what, he didn't have room, or he didn't see people with my problem, or maybe he thought it was a date? It was so weird.

Finally on Thursday I found a psychiatrist who could see me on Monday, and was on my health plan. "I don't do therapy," he said, "but if you're having panic attacks I can get you on medication right away. We'll have one follow-up session, otherwise I don't need to see you." Meanwhile, my regular doctor said he'd prescribe something non-addictive to help with the anxiety. I think this is all going as fast as it possibly can considering I'm dealing with an HMO.

The main thing is I don't think I need therapy this time. There aren't any long term stresses that are undermining my health and happiness. There are some short term ones, though, so I guess I'd better sort myself out. I'm still deeply upset about Dixie's death, for one thing. I never did have a service or a ritual for saying goodbye to her. I need to do that, not that that is all I need to do on that issue. For another, I've been rushing around on a much busier schedule than I'm used to and I've definitely felt stressed out by it. Trying to juggle work, school, household chores, gardening, social life and gym time has meant thinking ahead constantly, always having the right clothes or books with me, always being on a tight schedule, never missing a train, and having little time to just be spontaneous. I can make it work, but the personal cost is too high.

I think I know how I've gotten myself into this fix and I think I know what needs to change. I have an unreasonable fear of being thought lazy. I sincerely don't know why I fixate on that, I can't remember being yelled at for being lazy or anything, but I've seen it crop up again and again in my life. Sometimes it's for the good, but clearly it can be a method of tormenting myself. For a long time I've been convinced that I'd be a better, more successful person if I could learn to handle being busy. This year I took on more projects, more commitments, more appointments. But it hasn't worked that way. One too many stressors and all of a sudden I'm having to wade through the morass of provider lists and co-payments. Obviously, I have it backwards.

I need to stop kidding myself that being busy equals moral goodness. I must stop thinking of myself as lazy and bad just because I don't like planning ahead or having a full schedule. It is not wrong to enjoy lying around reading mysteries or talking to my friends online or going shopping. I do not have to be engaged in intellectual pursuits every minute of the day in order to justify my existence. Naps are not a waste of time. Reserving weekends for myself is not anti-social and self-indulgent. I am not a complacent, stupid, selfish cow just because I don't have every minute of my day planned. This critical, puritanical mindset is inappropriate, and it's literally making me sick.

I'm going to cure myself inside and out with a little help from the medical establishment. Meanwhile, I'm going to post this online as a reminder to myself that it's okay to be different from everyone else. I operate best at a mellow pace with lots of unstructured time. Normal is not narrowly defined, nor is happiness or success. My path is right for me. I'm going to do my best not to forget that again.

I am taking the month of July off from Aries Moon. See you in August.

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