No one has any idea as I sit here quietly in the midst of the gathering, passing crowd in front of the triptych, that my calm is my cover. Once when someone asked if I knew anything about panic attacks, I said, "Yes." I told them I heard it was like having your blood replaced by ants. "Must be terrible," he said. "Must be," I replied, as the black-bodied, red-bodied army of ants marched through every vessel in my body.
Terry Tempest Williams, Leap

I first read this passage nearly nine  years ago, sitting on a chair at Elisabeth's house, trying desperately to keep the incipient panic attack at bay. Just reading Wiliams' description of what an episode felt like had caused me to feel the prickle in my arms and legs that so often presaged attacks of fear so horrifying that I would hope to die. To experience a panic attack is to experience the sensation that madness is just around the corner, that the insanity that has stalked you since you were little—the sick feeling in your middle that feels like guilt and shame and it's all my fault—that that sensation is going to swamp you, to drown you, to sting you to death with the prickings of hundreds of red-hot needles.

When I first read that passage, heard it described as having your blood replaced with ants, I felt it so viscerally I damn near lost my breath. I don't remember reading any further. I was afraid that to read about panic would trigger panic. I had developed a reflexive tic, a physical movement away from anything that might push me down the path to losing my shit. I was afraid that I was always on the verge of another attack, and the fear of the fear became this horrible cycle that kept me locked into a hypervigilance that drowned out all other sensations.

I was on the precipice of the recognition that the pain pills that I took to control the seemingly intractable ache of a blown neck disc and nerve damage in my brachial plexus and arms, those pain pills had become the controlling aspect of my life. Just a couple of weeks before, I had unknowingly neglected to take my evening meds and had spent a hellacious night shaking and sweating and shivering and throwing up, convinced that I was losing my mind. It was only the next morning, after I took my regular dose and within 30 minutes felt back to normal that the slow thud of the clumsy epiphany hit me: I was physically dependent on the pain medication. I wasn't yet ready to call it addiction but I was terrified to say that word. Better just to accept that I dare not miss another dose of medicine—ever—or else face the monstrous shapes behind the semaphore that night.

Part of me could not accept that I had become addicted to anything. I knew addiction, had seen what an inability to not drink had done to people I loved. I had felt that searing pain, the frustration that would one minute wish someone dead and the next find myself praying fervently that my words were not that powerful—all in response to watching someone I loved drink and drink and drink and become angry and morose and threatening and scary and making me feel trapped. My job was to listen to long drunken ramblings. My job was to make sure that no one else in the house was threatened by whatever demon took over when there was enough liquor in the body. That job, even now thinking about it, makes me feel ill. My stomach clenches and I feel the restlessness of the jungle cat confined to a zoo cage, pacing back and forth, back and forth, waiting to be released. But it was my job. I was the sentinel.

So, the fear that I had become that which had haunted my childhood, that that demon now inhabited me, became a new source of panic. The only way to keep it at bay was to take the pills. The pills caused my brain to slow down, slow down enough that I could sit for hours with my children on the couch and watch "SpongeBob Squarepants" and "The Wild Thornberries" and even, God forbid, "Rug Rats," and not want to tear my hair out at the colossal waste of time. I thought it was bonding time with my children. I thought that I was showing them how much I loved them. Their father would be in the kitchen fixing dinner, and I would be sitting with them, watching television. I wasn't up in my room writing, or on the internet chatting with friends, or in the kitchen talking to their dad. I was the warm blob on the couch that they could nestle up against, who would laugh at the antics of the Flea-voiced Donnie, or find Mrs. Puff's puffer-fish fear response to SpongeBob's driving a hoot.

For at least two years of my pain pill addiction, I continued to work full-time as an assistant editor for a magazine publisher. I conducted interviews, wrote articles, edited other writers' work, drove my car to and from work, shopped, interacted with people, all while taking enough pain medication that I should have been unconscious, if not dead. My tolerance for opiates was gargantuan, but my pain, without the pills was debilitating. I couldn't be crippled. I had children to care for. I had obligations. I had responsibilities to earn money and contribute to my family's income. I could not be some Victorian invalid on the fainting couch who children were warned to whisper around and not make demands. I could not give my body the break it needed. Instead, I asked it to cope by swallowing pain medication. I ignored pain's signal to stop. I told it to shut up, offered it even more potent drugs, all dutifully prescribed by a doctor at a pain clinic who honestly believed that to not give me the medicine for the intractable pain was cruel.

I argued with people about pain. I told them there was nothing ennobling about pain,  that pain was real, suffering was real, and there was no cosmic meaning to be found in its existence. If someone dared to mention that I seemed to be taking a lot of medication, I pointed out to them that every pill I took was prescribed, that I was on the strict schedule given to me by my doctor, that I never cheated and took more medication, never added a dose, never went to another doctor to try to score more pills.
In November of 2000, after virtually every medical and alternative treatment had been tried and had failed—including the insertion of a dorsal column stimulator into my spine with its battery pack subcutaneously hidden in my abdomen—my doctor convinced me to take a six-month disability leave from work. I weighed almost 175 pounds. I had become a termite queen of slothful flesh, swallowing pills as fast as I was allowed, never moving except from desk chair to car seat to couch to bed. I was functioning, and I thought I was functioning well. I was even writing in my journals, and I was convinced that the stuff I was writing was profound. Artful. Worthy of publication.

I discovered that without a job, my life was hell. I was on a four-hour schedule for my pills, and I soon discovered that the pills wore off somewhere between 90 minutes and two hours after I had taken them. That left me two hours before my next dose. I would constantly look at the clock, trying to figure out why those two hours in my head had only moved the second hand 15 minutes. I couldn't take the pills early—to do so would be to admit that I really was an addict. And so I toughed it out. By the third hour, anxiety would set in, and in addition to the pain, I would feel crawly vein spiders in my arms and legs. I would walk into the kitchen, look at the clock, wonder if I could give myself permission to take my pills as much as a half hour early. It became something similar to the way I used to push myself when I ran. I'd get tired when I was running, but I'd tell myself that I couldn't turn around until I reached the fourth street light or the tree I could see ahead of me or the stop sign, some marker of distance that was an objective standard of accomplishment rather than the feeling in my body that I was tired and ready to collapse.
When the clock would blessedly mark the moment that it was medically sanctioned for me to take my pills, I would gulp them down, wait to feel the pain go away, the numbness return. And the whole cycle would begin again.

I'm not sure when I started fantasizing about suicide, but trying to determine a method for killing myself became a great time-killer between doses of medication. I knew that I could not have obviously killed myself. I had two daughters, and I could not imagine the pain of them growing up with a suicide for a mother. Looking back, I'm not sure if I thought they would think it was shameful so much as I thought in some way they would think it was their fault. Just as I had assumed that everything that was wrong growing up in my parents' house was my fault.

No. If I was going to die, it had to happen in such a way that it would appear accidental, unavoidable. And, while I was sure that my girls would miss me, I thought that they would receive enough support from their father, their grandparents, and family friends, that they would come through it. Besides. They had an addict for a mother. How could my not being dead not be better for them? The most logical way to do it seemed a car crash. On a weekday, when their father would be at work and they either at daycare or school, I could take the car out on one of the roads that ran next to the lake. In places, the roads were high enough above the lake that launching the car off a cliff and smashing myself on the rocks below, or better yet, landing in the water and drowning, seemed like a sure bet. But what if I survived? I didn't want to wake up in intensive care, crippled for life and become even more of a burden on my family. What about smashing my car at top speed into a tree? Would that do the trick? But how would I make it appear accidental and not deliberate? Wouldn't accident investigators come out and measure my skid marks, attempt to determine why my car had gone off the road? And if there were no signs that I had hit the brakes, wouldn't that be a dead giveaway?

That left the pills. What if I accidentally took an overdose of pain medication? I had had an experience earlier on where the new level of opiate I had been prescribed had made it difficult for me to breathe one night, so what if I simply took several times my prescribed dose and made myself unconscious? Again, I had too much trepidation that it would be obvious what I had done. And again, what if I fucked it up? When I was in college, a friend of mine had attempted to kill himself by running a hose from his exhaust pipe into the interior of his car. All he had succeeded in doing was giving himself brain damage and winding up in the state mental hospital. What if I simply turned myself into a vegetable?

It was amazing how much brain power I could devote to trying to figure out how to exit the world. I refused to consider actually getting off the pills. I had seen the movies and heard the stories about opiate withdrawal. I had visions of myself lying on some concrete bathroom floor somewhere, throwing up repeatedly, shaking and sweating and wanting to die. Worse, in my imagination, opiate withdrawal would be one long drawn-out panic attack. The fear of what withdrawal would entail kept me putting off making any decisions for that day.

I both dreaded and looked forward to the moments when my family would come home from their days at 5:30 pm. Looked forward to them, because it meant that I wouldn't be alone, and there would be company in the house to partially distract me from what had become one continuous hamster wheel rotation of fear and death and shame about my addiction. But I dreaded their coming home because I felt as if I had to hide my despair from my children. Mommy had to be happy to see her kids. Mommy had to be attentive, and loving, and do the things that parents do. And what I really wanted to do at times was just spend more time staring at the clock, trying to figure out how to get myself out of the mess that I had landed in.

The worst days happened when my ex-husband would be traveling out of town on business. On those days, I would get the kids off to school in the morning, and then spend the day panicking that I would not be able to properly care for them when I went to pick them up. The thought of cooking dinner was overwhelming. So, we ate out. And I can still remember sitting in restaurants, barely able to function, forcing myself to eat whatever I had ordered, even though it felt like everything  below my neck was dead.

I wanted to beg my husband not to leave town. I wanted him to stay home and take care of me, but I was terrified to ask him. I didn't want him to know just how bad things were, just how out of control I felt. And I knew that I could not, would not, absolutely must not let my kids see that I had become a pill junkie. Jesus. That was the worst thing I could do. And I spiraled deeper into depression and a twitchy angst as it hit me that my children were now the daughters of an addict, just as I had been the daughter of an alcoholic. How had this happened? And what was I going to do about it?

Elisabeth worked as a nurse. On the days when she was off, she would come sit with me, and the two of us would sit with our cups of coffee and Diet Cokes and watch TV and be sad about how our lives were not what we wanted them to be. Elisabeth was in love with another woman. She was in a horrible relationship with a woman we referred to as the "barnacle." She was in love with a beautiful, gracious, kind, strawberry-blonde woman who had two college-age children and a painful divorce behind her. She was, as far as both Elisabeth and I knew, straight. So our mornings were the most poignant—or pathetic, depending on our moods—discussions about unrequited desire for her and my overwhelming fear of what it would be to get off the medication.

Truth was, I was writing. Since I had left school, left my job, I was working on a novel, and each day. I was getting a little work done. I thought, somewhere in the deep recesses of my head, that the opiates were the fuel for my creativity, and in addition to my fear of withdrawal was my fear that without the drugs, I would return to ordinary, to no-talent, to a life that I could barely face and which I spent so much time fantasizing about leaving.

I can't tell you the exact sequence of events of what happened next. It is all fuzzy, as sometimes it feels as if I simply spent November 2000 to February 2001 in a drug and panic haze. But in early February, my mother flew out from Seattle to come see us. She hadn't seen her grandchildren in a while, and I knew that I needed her. I wasn't going to be able to talk to her about what was going on, but I needed someone to help me with the children if I was going to do what it was I had resolved to do.

I took my mom with me to the my next appointment at the pain clinic. And I told. I told them that I was ready to stop using the painkillers, that I wanted to get off them and I was terrified. Could they help me? Could they please help me figure out a way to stop taking all these pills? In a word, I surrendered. And in that moment of turning the problem over to the professionals, of asking them to help me out of the mess I was in, I felt relieved of a shame that was killing me.