The first time I had a panic attack, I was a young child at the Ohio State Fair. My mother and I were standing in line to attend a circus performance, and the queue had swelled to a throng. I remember looking up to a sea of knees as I stood next to my mother in a surging crowd; at once my excitement at seeing performing tigers, elephants, and trapeze artists was replaced with a single thought: “There’s no air.” The day was hot, and being small I could feel waves of heat emanating from the pavement beneath me. “They’re breathing all the air,” I remember thinking as I peered up at the grown legs that surrounded me like trees. “How can I breath when there is no air?”

I don’t remember getting out of that crowd; perhaps I tugged my mother’s hand and she bustled me away from the throng, alarmed at my reddened face and panicked expression, or perhaps I simply fainted. As I child, I was a finnicky eater, and it wasn’t unusual for me to faint from hunger, as if I were experimenting to see if a small child could live on air alone. Regardless of how I got out of that crowd, the simple fact remained: I never saw the circus that day, and ever since I’ve tended toward claustrophobia in crowds, terrified I might suffocate in a space with no air.

Knowing that air is everywhere does nothing to stem an oncoming panic attack: when you feel the elephantine crush of panic on your chest, there’s nothing rational that can force your lungs to expand. As an infant, I’m told, I was petrified by the car-wash, sandwiched with my sisters in the backseat of my parents’ car. “Mom,” one of my sisters would say, “the baby’s not breathing,” and no cooed words of comfort could cajole me to breathe until our car had returned to the light of day, dripping wet and shiny. Later as a toddler and small child, I remember standing with my mother outside the car-wash while my father drove the car through, a familial accommodation to my peculiar panic.

As an adult, I’ve grown claustrophobic in crowded nightclubs, a surging outdoor concert, and an upper bunk in a mountain cabin filled with sleeping campers. Sleeping in a tent almost always triggers a panic attack; at some point in the night, I’ll awaken feeling too hot, and the stuffiness of stagnant air will inspire the usual panicked palpitations. Whereas the cliched image of “panic” is that of screaming, incoherent irrationality, I tend toward the opposite, shutting down and growing steely with a grim resolution to marshal every last molecule of air. It’s as if I know that scratching and screaming won’t get me outta here any faster than quiet concentration will…so I tend toward the latter, holding my breath as I engineer my escape.

“Where are you going,” my ex-husband used to ask on camping trips when in the middle of the night I’d suddenly unzip sleeping bag then tent door, mosquitoes be damned. “I need some fresh air,” I’d explain, the care I took trying to be quiet belying the inescapable animal urge to escape at any cost. It’s probably no accident that when I divorced, one of the reasons I cited was the “need to breathe”: when even a two-bedroom apartment seems too small for two, a claustrophobe will do anything to escape the sensation of suffocation.

These days, my two-bedroom apartment feels bright and spacious, a quiet and solitary refuge where there’s plenty of air. But even today when I venture into a crowded place, I keep on eye toward the exit, the promise of accessible escape keeping possible panic at bay.