WHAT’S IT LIKE TO FEEL CRAZY? by Art Smukler, author & psychiatrist

A number of years ago, I was post surgery for a sports related injury. Woozy, they rolled me back to my hospital room and hooked me up to an IV drip, an EKG monitor, and a machine to give me morphine if the pain got too bad. As soon as the nurse left the room I needed to get up.

“What are you doing?” my wife said, startled that I was trying to stand.

“I have to get up,” I said.

“Stop it you’re being crazy. You’re going to pull the IV out.”

I ignored her, pulled off the EKG wires, pulled out the morphine drip, and started rolling the IV bottle towards the bathroom. I knew I was being crazy, but couldn’t stop it.

“Going to the bathroom,” I said, lying because I knew she was right, but I just had to get up and move around .

I stood in the bathroom and looked at my diaphoretic, unshaven face. I couldn’t just lay there. Something weird was happening to me. I waited 5 maybe 10 minutes and got back in bed.

“Are you okay?” my wife asked’

“I’m fine.”

Ten minutes later the same thing happened again, and ten minutes after that again, and again… It was a nightmare. It felt like I had lost my mind, and like a dog with a ball on the other side of a very high fence would never retrieve it. I begged my wife to go home. She wouldn’t leave. I didn’t want her to see me this way. The nurses didn’t know what was happening and kept suggesting that I take more morphine. Four long hours later, when the surgeon finally finished his next two operations and came in to see me, I was finally back to normal.

The next day I figured out what happened. The anesthetic, Droperidol, triggered an akithesia,  an abnormal, uncontrollable movement disorder that originated in the extrapyramidal part of my brain. Droperidol is from the same family as Haloperidol, a major tranquilizer to treat schizophrenia, bipolar disorders etc. Haloperidol can cause the same symptoms that I experienced. Until this happened, I never imagined the hell my poor patients were going through when they had side effects from the medication I was giving them.

Not being able to control oneself is a horrible experience. Imagine having voices that try to control you, or a delusion that people are trying to kill you, or panic attacks so bad that you’re sweating, your heart’s pounding, you can’t think straight, and you’ll do almost ANYTHING to get it to stop.

For anyone to ever minimize the pain of mental illness is a travesty, yet insurance companies almost always separate treatment for “medical” problems with treatment for “psychological” problems. For the millionth time, let me remind them that the brain is connected to the rest of our bodies.

Any thoughts about being out of control or how our medical care system works or doesn’t work?

PANIC ATTACK? WE’RE NOT CRAZY by Art Smukler MD

About fifteen years ago, on a return flight from Japan, I started to have this very strange sensation that the roof of the plane was too low, and that the walls of the plane seemed to be closing in. I took a deep breath, looked out the window at the night sky, and tried to relax. Maybe I was just overtired?

“What’s wrong?” my wife asked. “You’re sweating.”

“Nothing. Maybe just a little warm.” I got up out of my seat, and as I walked towards the bathroom I mopped my forehead and pulled my shirt away from my chest. I was drenched! What is going on? I wondered. This is ridiculous. I was bathed in sweat! In addition,  I couldn’t catch my breath. With ten hours left to go in the flight, I wondered how I could possibly make it.

I washed my face and forced myself to take deep breaths. This was absolutely insane. Was I having a silent heart attack? How could that be? I was healthy and strong. There was no pain anywhere. Was I going crazy?

I left the bathroom and spent the next hour walking up and down the narrow aisle. There was no way I was getting back in that tiny, claustrophobic seat! No way! Ever!

I walked and walked and told my wife and friends that I needed to stretch. They looked at me quizzically. I looked back at them and shrugged.

Nothing made any sense. Why was I acting this way? What was happening to me? I walked and I thought and I walked and thought and finally it hit me. I WAS HAVING A PANIC ATTACK. The psychiatrist was falling apart and going crazy himself.

Crazy? Was this really happening? Was I going crazy? No! That’s ridiculous. I knew that wasn’t the case. But why, why now have these symptoms? I’d flown all over the world and it never happened before. Maybe too much coffee? Too little sleep? Going back to the stress of everyday life after a wonderful vacation?

It could be… But I still couldn’t go back to that disgusting seat! Not yet. I wandered to the back of the plane and stood in the area where the flight attendants served meals. Eventually, I asked a young woman for a glass of water. “You okay?” she asked.

“Actually I’m feeling somewhat claustrophobic. It never happened before.”

She smiled kindly. “That happens a lot. It’s more common than people know.”

“Really?”

“I haven’t been doing this for all that long, and I’ve seen it happen at least a dozen times.”

I nodded.

She smiled and squeezed my arm. “You’ll be fine. It goes away.”

I walked the aisle for another twenty minutes and finally sat down. The panicky feeling was still there, but not so bad. What had just happened? Why would the reassurance of a young woman less than half my age be so comforting?  As I thought about it, the whirring of the engines, and the gentle rocking lulled me to sleep. The last thing I remembered thinking was how she said, “You’ll be fine. It goes away.”

That’s a lot of what happens in our lives. Something triggers our autonomic nervous system and we are clueless as to what’s happened. When someone can legitimately reassure us, all the hormones and excited neurons can go back to normal and we can relax again.