A few months ago, I arrived home from a drinks meeting and out of nowhere, had a panic attack.
During the attack and immediately afterwards, I tried to unpick and analyse what had caused that sudden wave of intense fear. I thought about all the standard possible causes of existential dread; where I was living, work, my relationship, meeting new people earlier that day, doing too much, whatever.
To be clear: this was altogether unexpected. It was the first time in months I’d had a panic attack and the first time ever where I felt fine beforehand.
Only when I woke up the next morning did I realise what had caused it. Like any sane person, I don’t drink much or any caffeine after about 2 pm — and I try to only stick to 1–2 coffees in the morning. I also almost never drink alcohol because it doesn’t agree with me.
But for whatever reason, on that particular evening, I’d met someone for coffee at 6 pm and had a couple of cups. Then I’d been for drinks and had an espresso martini and two Diet Colas. It was far more caffeine than my body was used to consuming so late in the day, accompanied by alcohol. Caffeine is a known cause of anxiety. Alcohol always fills me with a low-level sense of despair, one reason I avoid it. No wonder I’d felt so terrible.
I tell this anecdote because it hit home for me how hard it is to understand or even read our own emotions. Let alone the emotions of others.
Emotions are not discrete states.
We are never in one box or the other. We all put different labels on what might be the same feelings. Unable to experience the world as anyone other than ourselves, we have to guess at the right words for what we feel.
I get hung up on the inadequacy of language and the unknowability of people and their motivations a lot. Nowhere is all that truer than when it comes to emotions. Language is as useless as it ever can be.
Science has yet to establish any scale for measuring or classifying emotions. We rely on subjective measures. On guesswork and ambiguities. Or simplified metrics like facial expressions.
The basic emotions — happiness, sadness, anger , surprise, fear, and disgust — are universal. They’re present in all people, even among isolated groups with no exposure to modern culture. But they are only the basic building blocks.
Plus, emotions are not purely mental states. They exist in a confused, intermingled intersection of the mental and physical.
Most emotions, particularly strong ones, are accompanied by physical sensations. It goes both ways. We somatize stress, frustration, depression and other strong emotions. We turn them into a physical experience. Somatisation is defined as:
‘… the tendency to experience psychological distress in the form of somatic symptoms and to seek medical help for these symptoms, which may be initiated and/or perpetuated by emotional responses such as anxiety and depression. Multiple or unexplained physical symptoms cause substantial disability in patients, excess use of medical services, disappointment for therapists, and frustration for physicians.’
Nor is it a rare problem:
‘Patients with somatisation account for about 20% of the work load in general practice.’
On the flip side, we can experience physical sensations as emotional ones.
Anxiety, for example, has numerous physical components. The churning stomach, clenched jaw and subsequent jackhammer tension headache. The pounding heart and shaky hands. The overwhelming sense of physical fragility and vulnerability.
The physical side of anxiety can be the result of caffeine, especially in large amounts or any amount for people who are sensitive to it (although this is confused by the fact that people who are already stressed due to overwork tend to intake more caffeine.)
As Wikipedia puts it:
‘The effects of caffeine and the symptoms of anxiety both increase activity within the sympathetic nervous system. Caffeine has been linked to the aggravation and maintenance of anxiety disorders, and the initiation of panic or anxiety attacks in those who are already predisposed to such phenomena.’
As still happens to me from time to time, when caffeine produces the same physical effects as anxiety, we can start finding justifications for it. We start inventing reasons to be anxious that weren’t present before.
An acupuncturist I saw said he had a consultation with a patient who reported severe anxiety, chest pains, insomnia, and emotional instability. When he asked how much caffeine they consumed, they admitted to drinking 20–30 black coffees per day.
There’s a reason why so many people head to the emergency room when they have a panic attack for the first time. It’s very much a physical experience. It becomes impossible to disentangle what part of the panic comes from the terrifying physical sensations and what is causing it.
During the aforementioned panic attack, I assumed there had to be a psychological cause — something in my life that I was anxious about even if I wasn’t aware of it at the forefront of my mind. There wasn’t.
Anxiety and caffeine are just one example. There are plenty of other physical experiences we can mistake for emotional ones.
When we struggle to read how we’re feeling, we can so easily mislabel emotions and set off a vicious feedback loop. I think I feel angry therefore let me think of things I could be angry about, and now I’m genuinely angry. Or I think I feel anxious so let me think of all the things I could be anxious about and goodness, there’s a lot of them, and now I can’t breathe.
Plus, not everyone experiences emotions in the same way. Psychopaths struggle to experience emotions other than anger in more than a mild way. People with alexithymia are mostly unable to label their own or others’ emotions.
Some of us disassociate in times of stress and feel nothing. Some of us get too used to suppressing what we feel or become determined not to engage with certain emotions.
We are all surely familiar with the experience of feeling bad for no discernible reason. You wake up one day and the world is shrouded in a grey mist.
People ask what’s up and you say you don’t know. They press you and you get annoyed or defensive. They back off. Then the annoyance fades, but the lingering off-ness resurfaces. The next day, it’s gone. You still don’t know what was up.
There isn’t always a clear cut answer. Sometimes it is just physical. Sometimes we feel more than one thing at once and it all intermingles.
Sometimes when we snap “I’m fine!” the reality is that we just don’t know. I’ve learned lately to first consider possible physical causes before assuming unforeseen feelings have a purely emotional basis. When I get anxious, I don’t jump to making lists of everything I could justifiably worry about, I try to focus on the physical sensations.
The hidden advantage of this is that learning to recognise the physical effects of strong emotions and focus on that robs them of some of their power. You can dismantle them. Look at them from all angles. Consider where they’re coming from.
[And, yes, I am aware that this is a mindfulness practice which I did not invent, I just ended up discovering its value through a circuitous route.]
We don’t always know why we feel what we feel. Sometimes we need to dig a little deeper to understand that.
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