Dear Ruth,

I believe I am very ill, though my doctor reassures me that I am not. He has conducted numerous tests and can find nothing wrong. He tells me I am having panic attacks, but I am sure it is a medical condition.

My heart starts pounding and racing without any warning. I get a pain in my chest and pins and needles in my hands. I find that I can't breathe, and I feel as if I am going to die, that I don't have another ten minutes in this world.

I cannot even begin to describe the feelings of fear and terror that come with all this. I have to lie down, because my head is spinning and I feel I will fall if I remain standing. Can this in any way be psychological rather than medical?

I don't suppose you will be able to help me in any way. This condition is dominating my life. I am afraid that I will have a heart attack at the worst time, perhaps when I am driving.

Rick

Dear Rick,

Your doctor is right. You are describing classic panic attack symptoms. More specifically, you are having hyperventilation attacks. This seems especially certain whereas your doctor says that there is nothing physically wrong with you.

If you pay attention, you will notice that during an attack you breathe faster and more deeply than you do normally. This kind of breathing leads to a chemical chain reaction called respiratory alkalosis. This reaction comes with all the feelings you describe, and can be terrifying because it is often accompanied by a terrible feeling that one is going to die. Rest assured that no matter what you may feel like, you will not die in a panic attack.

During the attack the person feels giddy, thinks he is not getting enough air, and feels he is trembling out of control. Numbness and tingling or pins and needles in the mouth, fingers, and toes are also common symptoms. Probably the best way to control this is by breathing for some minutes into a paper bag. (Do not use a plastic bag!) This restores the balance between oxygen and carbon dioxide.

However, over the years I have found that few people use the paper bag, especially if they tend to have these attacks in public places. They are too embarrassed. Instead, you can breathe into your hand or blow onto a feather or a square of paper for several minutes.

Once you see that you have control of the situation, you will feel considerably better.

Dear Ruth,

I have been married for just over two years, and in most respects we have been very happy. However, a problem has arisen that I feel has to be addressed.

My husband is an architect by profession and works very hard. I accept this, because it is necessary for him to provide for the needs of our family and to make sure we keep up the standard of living to which we are accustomed. However, he spends four nights a week attending Torah classes or learning with his chavrusa (study partner), and he comes home quite late.

I am beginning to feel very neglected. He is home for an hour before minchah to be with the baby and myself, and then for forty minutes after ma'ariv. After that I often do not see him until late at night. I know that learning is important, but this is somewhat excessive. He is no longer a yeshivah bachur, and he is not in kollel.

I was tolerant of his schedule at first, but now I find myself becoming quite bad-tempered about it. My husband should realize that he is not facing up to his responsibilities at home. He has a wife and family to consider. I feel very angry about this, but at the same time quite guilty at the thought of limiting his learning.

Shira

Dear Shira,

No matter what is going on in your marriage, it is not a good thing for either of you to become nasty and spoil the atmosphere in the home. That tends to push the other partner away, whether or not you are aware of it.

You say that you understand the importance of your husband's work and that he is providing well for the family. But he must also provide in the spiritual sense. His learning and his davening are providing well for the family in ways far beyond what we can comprehend.

Nonetheless, I understand that you feel neglected, and I believe that a better schedule can be devised. For one thing, perhaps his chavrusa could learn with him in your home one or two nights out of the week. In this way he would be home and studying Torah at the same time.

I suggest you both go together to your rav and tell him how you feel about your husband being at so many shiurim. Then trust the rav's decision in the matter.

Remember, in all things try to have open, frank discussions, and try to keep a good atmosphere in the home.

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Dr. Ruth Benjamin
The Jewish Homemaker
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Brooklyn, NY 11213