Rosario’s Panic Attacks and Hypochondria

When I went to see my next appointment, I was concerned to see Rosario leaning against and for all intents, being carried into my office by a young lady.

“I’m sorry, but I’m having an anxiety attack right now!”

Rosario was the first person, among hundreds of cases that I have helped, that showed up at my office with an extremely high level of anxiety.

I quickly responded, “I’m glad that you are having an anxiety attack right here and right now because this way I can observe you with my own eyes. It will be very useful for my work. So please go ahead and feel free to hyperventilate, get nervous and have a pounding heart. Don’t worry about passing out because right next door my office there are several doctors, and there is a health clinic right across the street. I also see that someone is with you.”

“I’m her daughter-in-law”, said the accompanying young woman.

Rosario’s symptoms had already started to diminish. But I insisted that she should not calm down so quickly because it was a great opportunity for me to observe her. After all, my objective observation would give me more information than her subjective narration of her symptoms. But Rosario became calmer and relaxed and finally asked her daughter-in-law to wait outside.

She explained that it all started 7 years ago at her place of work. An argument with her boss caused her to have her first anxiety attack. She left her job and in the following months she lost 40 pounds due to anxiety-related digestive problems. Moreover, 20 years ago, her husband had several affairs with other women. This infidelity had brought on a depression. Although she wanted to forgive him, she couldn’t but help feel bitter resentment.

Six months prior to her coming to see me she had had four anxiety attacks in a single day. As a result, Rosario was hospitalized and given larger doses of tranquilizers. From the beginning of her ordeal, about 7 years ago, she had changed four different psychiatrists. They had all prescribed anti-anxiety and anti-depression drugs. However she wasn’t happy with the therapy because they couldn’t really find out what was wrong with her. She had also changed three psychologists who had given her the same advice: ‘Don’t take your life too seriously’. The end result of many years of psychotherapy was that she should be more positive.

Rosario stayed home most of the time and avoided going out unless she accompanied. She used to keep the house very clean, cook and then sit on the sofa most of the time and cry. Her husband worked late and would come home at around 10 PM at night. At home she was alone most of the time and understandably, she felt very lonely. Her husband had the habit of calling her three to four times a day to ask how she was feeling. During these short phone conversations he reassured her that he loved her and cared for her. At night she would tell her husband about her sad and anxious feelings. Her son also visited her every day asking her how she felt and would console her.

On top of her feelings of resentment due to her husband’s infidelity, her depression, her anxiety attacks and her constant worry about her own health, she also had unresolved issues related to the death of her infant granddaughter. Her eyes filled with tears as she told me how she missed the little baby, and how it pained her that her son and her daughter-in-law lost their first infant child.

After listening to her account I asked her about her spiritual beliefs. She said that she was a firm Catholic and believed in God and in life after death. I recounted the following analogy:

“A kind gardener knows what’s good for his flowers. He takes good care of his garden and makes sure that all the flowers and plants receive proper water and light. For example, one day the gardener may uproot a tender rose and take it away. For the plants and the other flowers who were used to enjoy the beauty and the company of the tender rose, this act may seem cruel. They stare at the hole in the ground where their loving friend used to be. However, the gardener is not cruel. He is kind and loving. The reason for his action might have been that, in another location of the garden, the tender rose would flourish better and develop fully. After all the rose was still in the same garden but his companions couldn’t see him.”

Rosario’s eyes filled with tears as she listened to me.

“You are a believer in God. You know that the Almighty is kind and knows best. Like the gardener, He loves your niece and decided to allow her flourish in another realm. But he is not gone. She is still your niece and you are her grandmother. And as a grandmother you can carry out your responsibilities as such because your relationship is not severed. He is at another level. You as her grandmother can continue cherishing her memory. You can pray for her soul, and if you wish, also donate money to the poor in her name.”

I then gave her the phone number of an organization that helps single mothers by providing food and clothing for their children.

“Now about your anxiety and depression. You tell me that your husband calls you four times a day to reassure you. You also cry and complain to him about your sadness and anxiety. You also have your son coming to visit you every day listening to you about how sad your life is. I want to ask you a question: with their attention, support, care and loving ears, do you feel better or worse?”

“Well, I really don’t feel better.”

“So you don’t feel better. Is their attention and support really helping you to overcome your anxiety and depression or is it maybe keeping you dependent on them?” Rosario nodded in silence.

“Of course”, I added, “they want to help you because they love you. But at the same time, whenever they offer you care and support, in the way they are offering them to you, they are saying ‘You are incapable and you cannot take care of yourself’. So their help keeps you from getting well. I know that you are not ready to change everything quickly. And you shouldn’t. All I’m asking you to do is to become aware that whenever your son visits you every day, he is making a statement, without knowing it of course, and that statement is ‘Mom you are an invalid.’ An emotional invalid – emotionally crippled. He is not aware of the result of his action because love is blind. He loves you. However, when he comes to see you every day to hear his mother complaining about her depression and anxiety, he is telling you indirectly that you are an invalid because you cannot live and enjoy your life like others can. Your husband’s phone calls also are having the same negative effect. And on top of all this you are also making a similar statement to yourself: whenever you avoid going places on your own, you are saying to yourself ‘I’m not capable. I cannot do it on my own. I’m a powerless and inept person’.”

Rosario was listening with rapt attention as if in a trance.

“So for the next seven days whenever you avoid doing things or going places on your own and whenever they rush to your aid, think about the negative effects of all this. It would be as if you water a foul tree with bitter fruits. If you want to get rid of the bitterness in your life, you ought to stop watering this foul tree. I know that you are not ready to do everything on your own just yet. I only want you to realize that when you avoid or when you ask for help, you water the foul tree that bears bitter fruits.”

One week later Rosario came back with a slight angry expression on her face. She said that she became angry at her son and at her husband because she felt that they pitied her. “I don’t want anyone pity me”, she said with a harsh tome of voice.

Rosario had asked her husband and her son not to call her or visit her. If she needed help, she had explained to them, she would ask them. Even though she was still crying, her depression was not as intense as before because now she was mostly angry at them!

“I’m always nervous and worried”, she added, “I’m also a hypochondriac!”

I said that I would help her with her hypochondria as well. And I congratulated her for taking action right away in stopping to water ‘the bitter tree’. I also cautioned her on making life changes too quickly. Things will fall into place. There is no need to rush. I gave her two new tasks for the next two weeks.

In our third session Rosario walked in with a beaming smile that filled the room. She said that she was happier and this change had intrigued her family. She asked me if she should stop taking her medications for anxiety and depression. I told her that she can make this decision in consultation with her psychiatrist. I explained to her that someone that has been taking any medication that alters brain chemistry must cut down in a very gradual way. Sudden changes in your dose may cause you to have anxiety attacks. She said she had an appointment with her doctor in few days and that would consult with him.

In the course of other four sessions I helped Rosario overcome her problems related to anxiety and depression. She had talked to her doctor who had seen her improvement and started to reduce the dosage of her anti-anxiety and anti-depressant medications. Finally she was able to forgive her husband and let go of ’20 years of anger and hatred’.