I still don’t know what triggers panic attacks. They start slowly, from nowhere and then arrive in an unstoppable wave. Like watching an oncoming headlight which appears to be far in the distance, a tiny spark, far away, no threat. Until it suddenly runs you over.

Or a wave that starts as a ripple on the horizon and then crashes over you, a roaring face of white and green, a cold Atlantic punch in the face pulling you beneath, tumbling you over, roaring in your ears, demonstrating its power and your vulnerability, weakness, fragility.

It should have been the sort of day when my anxiety levels should be low. I was cycling with friends, who knew and understood that I might go quiet and withdrawn at times and would generally intervene if they saw that happening. Engaging me distracts from whatever catastrophe I have begun to fixate on. Make me talk. Make me focus on other things.

We even had a retired GP in the group who would surely be able to deal with any medical emergency I might contrive to believe that I was experiencing.

The day was sunny, warm for February with an open sky and fresh shades of green stirring in the hedgerows. I hadn’t had a panic attack for some weeks. It should have just been another group ride, stopping to discuss ‘important matters’, an opportunity to halt and gaze at the view and participate in a series of overlocking, meandering conversations. Looking forward to a coffee stop in a cafe overlooking the Atlantic surf on the north coast. No threats, no risks, no dangers.

My chest hurts. Left side. I can feel a pain radiating up my neck. My breath is choppy, unable to open my lungs and forced to breathe quicker and quicker. I am still at the front of the group on every hill which makes no sense to me as I feel worse and worse. I scan again – chest still hurts. I move my hands on the bars to see if it’s a muscular pain, maybe gripping the bars too tight. The pain remains. My breathing becomes worse – each breath sucked in from a great depth.

I suddenly remember reading that 95% of people experiencing a cardiac arrest outside a hospital will die. Unless someone is there for CPR. My retired GP friend is here but I am not sure it will be enough. The ambulance will take too long.

I know what is happening but cannot control it. It rises up from deep within. Why now. There seems to be no reason for it.

The feeling takes over.

I begin to tremble. I know what’s coming and I just fall deeper and deeper into fear. I ride on, trying to ignore the feelings, to rationalise them, to try and regulate my breath, to reassure myself that my chest hurts because the air is cold. My breathing is poor because I have tensed up, am taking shallow breaths. This usually works.

But not today. Over the next half hour it gets worse until I can’t focus on anything else. I just know I am going to die today. On this road. I want to escape from it but there is nowhere to go. Riding faster doesn’t help although every molecule of me wants to out run the panic, find a safe place, leave it behind me.

The group stop for another chat and I ride on ahead to find a quiet place where I can dig out some Lorazepan tablets. I am ashamed of feeling this way – so I seek to hide it, to maintain the facade of being normal, in control.

One mg is swallowed with a check on the time. My hands are shaking badly with the adrenaline.

I know the drug will take thirty minutes to work. I have a trick where I will count the minutes in my head. Or will do mental maths, counting down from 1000 in thirteens. Or sevens. Anything to block out the voice in my head, my personal Cassandra on a permanent loop. ‘You are going to die today’.

I just need to get to that bend in the lane. Just think that far ahead, Ignore the feelings, the phantom pains and anxieties, the sense of impending doom. That this time it is really happening, not just a panic attack. This time it’s real.

Just get to that to that tree.

To the top of this hill.

Waiting for the minutes to pass, hoping it will pass soon. Drowning in fear.

I force myself not to look at my heart rate monitor for whatever it tells me will be unhelpful. Heart rate low – it must be broken or perhaps my heart is giving up. Heart rate high – it must be about to explode. I can feel my heart beating, shaking my chest, pulse thumping in my throat, in my ears, arms trembling, fingers locked around the bars.

Twenty five minutes.

We arrive at the cafe.

I focus on the next ten seconds, the next ten seconds. I can’t talk. Don’t know what to order. Can’t eat or drink.

Suddenly, really very suddenly, it begins to clear. A curtain opens. Clouds vanish. The drug has reached my brain, soothed the fears, washed away the negativity, allowed me to breathe again.

I can hear the conversations around me now.

The noise of the cafe is suddenly very loud. My ears have unblocked, the speech of my friends is unmuffled.

I can join in.

I know that now I will become euphoric, excitable, gregarious in a way that I am usually not. I know my pupils will have shrunk, that my smile will be broader. I have to force myself to be quiet, to listen, to remember this euphoria is as false as the panic that preceded it. It is a drug high.

It’s an addictive feeling though. I have to ration the times I resort to taking these tablets. Never more than twice a week, never more than two weeks in a row.

The panic has evaporated leaving nothing more than a vague sense of disquiet, an echo, a faint snail trail of fear. Now I can laugh at myself, at the stupidity of my reactions, at the lack of necessity to have had to put myself through such a painful experience. It has gone like a departing summer storm, leaving a few puddles and a musty smell. I feel exhausted.

It is better than it used to be. There are long periods when I feel fine, have no panic, just a mild anxiety from time to time. I have lots of strategies for day to day anxiety. I do not fear anxiety, I fear panic.

I will not allow the fear to control what I do, where I go. At least I think that I will do these things, but perhaps I have subtle avoidance strategies, quiet changes of heart over plans, an ability to rationalise my choices as pragmatic, rather than cowardly.

I know now that I will never be free of this thing but at least I understand it better. That there will be bad times and better times. That I am not alone. That I am in my own small way sometimes actually quite brave.

Not a scaredy cat frightened of my own mind. Except when I am.