I will never forget it. In the middle of the night, on a rickety bus on the Thai-Burma border, I thought I stopped breathing. No matter how I tried, I just couldn’t catch my breath. As the bus swerved through unlit curvy jungle roads, I struggled not to pass out. I grabbed someone’s inhaler and tried to stabilize myself for the next six hours until the next village.
The next evening, I woke up with my heart pounding like I had just run a marathon, and I had to flee my room. I ran through the guest house and into the street, flagged down the first motorcycle I saw, and said, “Hospital!” The driver repeated “Hospital” in Burmese, we sped towards the hospital entrance, and he dropped me literally in the lobby. The doctors ran a bunch of tests, and then in a gentle way, as if not to disappoint, told me there was nothing wrong.
It was only later, when I talked to a doctor friend, that I understood exactly what happened. I had just had a panic attack—which means a quick, intense attack that makes you feel like you’re in a dire situation or dying and causes your “flight or fight mode” to kick in. As my aunt once told me, “You only know how scary it feels if you’ve been through it.” Symptoms include a pounding heart, struggling to catch your breath (or hyperventilation), tingling of your extremities, a feeling of losing control, and chest pain. Causes can be a number of things, but attacks are usually due to a buildup of stress of some sort. As I dug further into what had happened to me, I realized that, in my young career, I had seen a lot of human rights violations and difficult conditions that I never allowed myself to fully process—and that stress manifested during my trip in the form of panic.
After that, I learned a lot about panic attacks, including that some sort of anxiety affects over 40 million Americans, and that women are more likely to experience panic attacks than men. So if you do, know that you’re not alone. If you’re traveling abroad, or just journeying out of your comfort zone, here are a few ways to cope when the panic kicks in.
Trust Yourself and Breathe
One of the best coping techniques I learned was, at the onset of anxiety or panic, to create an intervention in your mind. Remind yourself that this is only anxiety—a normal process of your brain and body—and try to detatch yourself from the physiological symptoms by counting down and breathing slowly. Breathing will enable you to put your mind back into focus, interrupt the panic cycle, and slow your heart rate. It can be terrifying, but try to trust yourself that you’ll be OK and give the symptoms some time to pass.
Know the Butterfly Effect
While working at a refugee camp in Thailand, I often met with people who experienced tremendous trauma, including crossing borders during war, losing loved ones, and surviving landmine explosions. The psychologist who worked with them would often tell them when the fear or worry hits, you must imagine it is in the air, and let it pass like a fluttering butterfly. For many of the people at the camp, connecting with nature was important to staying grounded in reality. While this metaphor may sound soft, I have found that it’s a positive way to focus on something outside of yourself.
Seek Professional Help
If you’re experiencing repeated panic attacks or are having trouble dealing with your anxiety, it can be immensely helpful to see a doctor or mental health professional. But when you’re traveling, it’s important to understand that different cultures have different views about anxiety and panic. For example, in Chinese medicine, you may receive a root or an herb to take instead of a pill, and it is expected to work over the long term instead of be a quick fix, as we often seek in the United States.
Be sure to identify if you would like an expat doctor or a local one, and understand the different cultural frameworks that come with that. Set expectations for what you want out of your visit—whether it’s just to talk to someone or to ensure that there is no other medical condition, and be clear about your symptoms and experiences. Also make sure that language is not an issue, and you have a proper translation of what the doctor tells you. While some hospitals have translators, it is not always guaranteed, so it's a good idea to bring someone who speaks both languages and can communicate effectively.
Seek Support From Locals and at Home
Anxiety is hard to talk about, and living in a foreign country and being out of your comfort zone might make it even more difficult to cope. You may feel like you don’t want to stress anyone out back home, or have the people you’re traveling with think you’re losing it, or let your travel partners down, but it’s important to talk to people about what’s going on. Know that many people have experienced this, even if they aren’t talking about it, and that you aren’t alone, even in a foreign country.
Talk to your friends and family about your condition, or seek out local expat support groups and medical practitioners. And make sure you identify a place that is a comfort zone, whether it’s a friend’s home, your hotel, or even a support network via Skype. It can make you feel tremendously better to have that safe space.
Finally, know that you are going to be OK. A friend of mine reminded me that, “this, too, shall pass” and she was right. Over time, I learned to manage stress and anxiety, and I went on to continue my journey at home and abroad.