The plane waiting to take her family to a vacation in Canada was about to boost its engines when Christina Joanna Suter realized her brother had fled.
Stephen Suter, then 19, suffered from an anxiety disorder that led to his suicide last month, but it was the vacation episode that first alerted his sister. She found the young man on his way out the airport, but talked him back.
Eight years later, Christina Suter and her aunt, Ginny Lee Young,are talking to others with anxiety and panic disorders through a backyard support group.
The patio at Suter and Young's brick ranch house on Geneva Drive is soothing and safe under the shade of a mature maple tree and towering hemlock.
But they know it won't feel safe enough for some of those gathered for the confidential support meetings, so they make it clear that anyone may get up and leave any time during the meeting.
Their pain and loss remains fresh a month afterthe suicide of Stephen Suter, 27. He hanged himself from a bridge June 26 in Frederick, where he was living in a halfway house after being released from the Springfield Hospital Center in Sykesville. He hadbeen diagnosed with schizophrenia and later with severe panic attacks.
Young and Suter decided to found the group in April and ran adsin the personals section of the classifieds. Stephen was still alivethen. He had talked often of suicide and had tried once before, Young said, but their efforts couldn't save him.
"We mainly founded (the support group) because we wanted to educate and help people like Steve," Young said.
Anxiety disorders include severe panic attacks,phobias, post-traumatic stress and obsessive-compulsive disorders, said Francis Schindler, a clinical psychologist who works with the Carroll County Health Department's Mental Health Bureau.
The symptomsof a panic attack can include shortness of breath, dizziness, an increased heart rate, sweating, a feeling of choking, nausea, numbness or a sense of impending death, Schindler said.
The outward signs can be subtle. Although a person may be experiencing many of those symptoms on the inside, he or she might look calm and in control on the outside, Schindler said.
"A lot of panicked people do end up in theemergency room because they think they're having a heart attack," Young said. "Mainly it's a fear of losing control. You could be in the grocery store, and you feel like you're going to die."
The supportgroup, which is independent of the Health Department and any privatetherapists, is not meant as a substitute for professional treatment,said Young.
"The common theme," Young said of those who attended the four meetings so far, "is they didn't know someone else suffered from this."
Knowing they aren't alone helps, she said.
Young, in her 50s, has a milder kind of anxiety disorder called seasonal affliction disorder, or "winter blues."
"I didn't realize it right away, but each year, I wasn't doing very well in the winter," she said.
She later noticed her malaise coincided with the onset of daylightsavings time and a lack of sunlight. She said she has been under a doctor's care, and medication has been helpful.
The most important rule at the meetings is confidentiality, she said. Otherwise, the gatherings are loosely structured, and no one has time limits for speaking. So far, they haven't set a regular time, but are leaning toward Tuesday nights. The group has met four times so far.
Suter said thesupport group also is a way to share books and tapes she and others have collected and to educate the public and family members. Suter herself has spent more than $1,000 on the materials. And when anxiety is the topic of a certain talk show, one of them will tape it and share it with the group.
Schindler said such support groups have led to more awareness of anxiety disorders.
"Fewer than one in four seek treatment," Young said of people with anxiety disorders. "A lot of them are huddled at home, and we don't know they need help. Others were (known as) the town drunks."
She said many people with anxiety disorders use alcohol as an escape, as did her nephew.
Young said she first noticed when Stephen was about 16 that he was drinking too much and seemed out of control.
Suter said her brother had troublecompleting a driver education course at a time when most teens can'twait to get their licenses.
But the first dramatic scene was during the family vacation to Canada when he was 19. Although she and herfather talked him into making the trip, he remained uncomfortable. During one meal at a restaurant, Stephen waited in the car while the family dined.
"Things other people enjoy were just agony to him," Young said. "Panic is agony. You want to escape at all costs. And he did -- by hanging himself. It cost him his life to get away from panic."
The group also welcomes family members of people with the disorders, whether those afflicted attend or not, Young said.
Young said she advises everyone who comes to the group to have a complete physical examination and talk with a doctor about their anxiety. So far, about half of the dozen or so people who have called her previously had been diagnosed with an anxiety disorder.
Psychologists use various criteria to diagnose an anxiety disorder, Schindler said. First, they take an inventory of the patient's symptoms.
Although everyone experiences panic and anxiety sometimes, he said, the difference with a disorder is the intensity and frequency, and the extent to whichit is interfering with the person's life.
The anxiety is usually for no real reason -- an attack can come unexpectedly in the grocery store.
"The person with the anxiety feels very strongly there's a good reason," Schindler said. "Objectively, the normal population maynot feel that way."
Schindler said some disorders, such as phobias -- or fears -- of specific things such as flying or heights can be cured through behavior therapy.
But often, he said, dealing with anxiety disorders means managing them. Although medications can stabilize a person, he said therapists are reluctant to use the mild tranquilizers because they can be addictive.
Treatment usually includes one-on-one psychotherapy, sometimes involving the family or spouse. Stress-management skills such as deep breathing, visualization and biofeedback also can be helpful, he said.
Stephen was not the first in his family to suffer from anxiety. His and Christina's mother -- Young's sister-in-law -- committed suicide in 1969, after years of whatChristina now believes was an undiagnosed anxiety disorder.
Christina was 8 when her mother died of an overdose. But she didn't realize that her mother's death was a suicide until about four years later,when she found the autopsy report in the attic.
Christina remembers her mother as being frail -- less than 90 pounds before she died -- and as never leaving the house.
"My brother and mother are dead,but out of something bad, there is something good that can happen," said Suter, 30.
Schindler said experts still are not sure whether anxiety disorders are caused by biochemical imbalances or whether they are genetically linked.
Suter is participating in a study at Columbia University in New York that is researching the genetic link.
"There's no question anxiety attacks are accompanied by biochemical changes," Schindler said. "The question is are those changes the cause or the effect?"
As for a genetic link, he said he is unconvinced. "I've often seen people with anxiety disorders where there is no family history whatsoever, so it's very up in the air."
To contact Young or Suter to attend a meeting, call 876-3746.