As I sit down to write this article, I am amazed by the things I have been able to do over the last few weeks. Namely, I have done my own grocery shopping, gone to the movies, eaten at restaurants, taken trains and cabs, and even spent a day at an art museum with some friends. Such things may not seem remarkable to most people, but then most people have not lived through panic disorder.

Precisely a year ago, I was writhing on the floor in the grip of a severe panic attack. Like all my severe attacks, I was overwhelmed by stifling sensations, pounding heart, and acute loss of feeling and strength throughout my body. Of course, worst of all was the flood of grotesque horror that almost seemed powerful enough to sweep me away into madness. All I could manage during such attacks was to clutch a pillow or railing with a death-grip and desperately curse away the minutes. My attacks could sometimes last hours and they could sometimes occur more than once a day.

I had been living - if you can call it living - with panic disorder for almost six years. The disorder alone was enough to make anyone miserable, if not severely depressed. However, the attacks themselves were not my only cause of despair during those years. Another cause of despair, which was significant in its own right, was all the losses I had to endure. Since the sudden onset of my panic disorder in 1991, I had lost a promising career, lost virtually all of my savings to doctor and therapy bills, lost my independence, and lost my social life.

A third cause of despair was the fact that the medical community had pretty much given up on me. Panic disorder was not at all well understood in the early 1990s. I had been through exhaustive diagnostics at the Johns Hopkins hospital and the Lahey Clinic. The final judgment of my many doctors was that I was not suffering a medical problem. I didn't know enough about medicine to debate this conclusion, but I did know there was room for doubt. The brain alone was fraught with medical uncertainties. Knowing the degree of my suffering, how could they give up on my case? Yet, the more I pressed the issue, the more I began to look like a hypochondriac. My doctors labored to convince me that I was, indeed, medically healthy and encouraged me to continue psychotherapy. I felt horribly abandoned; as though my case was simply too difficult to be bothered with.

Finally, another cause of despair came surprisingly from those who loved me. Not understanding the seriousness of my condition, people often encouraged me to accept my disorder and find some way to live with it. At first such suggestions seemed to be a form of tough love intended to get me on my feet again. Perhaps such advice might have been helpful if my attacks had been less severe. However, my attacks were horribly overwhelming and the more I considered such advice, the more misguiding it seemed. How could anyone accept a life of daily deathlike horror? How could I possibly accept my condition without somehow diminishing my own self-worth? Did my quality of life mean so little to everyone that it was acceptable for me to live like this?

Altogether, these various causes of despair produced a dangerously severe depression. Not only did I find myself wishing for death, but I even considered suicide as a means of ending the misery. Of course, I never did commit suicide. I guess I simply considered suicide for long enough to realize that I really wanted to live. What I wanted to kill was not myself, but the panic and depression within me.

So, where does "hope" come into all this terrible stuff? This column is called "Faces of Hope," right? Well, I'm not sure that I actually felt hope; as in some wonderfully inspired feeling that I would one day feel like a normal person again. But I did have hope in the sense that I continued to look for answers. Just as you are reading these words now, so did I read the words of many other sufferers and therapists and researchers. I didn't discover something helpful everyday, but month after month I found something useful in publications or the Internet. I had that elusive form of hope that I didn't actually feel, but kept me going anyway.

In time, I learned that there were many other people like myself who also suffered panic disorder. In fact, roughly one percent of the population had shared my fate. Reading on, I slowly learned more about the psychology and biology of anxiety and panic. Eventually, it seemed that my own form of panic disorder was due to an imbalance of neurotransmitters. Fortunately, there existed some medications to treat this imbalance. After several years of searching, I was finally ready to guess that paroxetine (Paxil) might correct my supposed neurotransmitter imbalance. To the delight of both myself and my doctors, my searching paid off. The terrible panic attacks of last year were my last.

Of course, my medications were not a magic bullet nor panacea for panic disorder. Though my horrific panic attacks had ended, I still had significant anxiety problems that required further therapy. Overcoming agoraphobia and various residual avoidance habits has taken allot of emotional effort. I still have problems coping with moderate stress, but otherwise my condition has vastly improved. I can now enjoy many of the mundane activities that most people take for granted.

Knowing first hand how indescribably horrible panic disorder can be, I know how trite and naive words of optimism can sound. All I can say is that myself and many other sufferers have eventually found ways to escape the terror. Our solutions are often different, but we manage to find them even when the world seems to have abandoned us. Hope may not always come in the form of good feelings; sometimes hope is simply an awareness of possibilities.