adrenaline injections and miracle berries
JUL 12, 2026
take
I had a panic attack at during a dental procedure the other day. It was the whole package: can't breathe, I'm crying uncontrollably, heart's racing, what's happening, am I going to die?
…which was weird, given how accustomed I am to medical settings and how many procedures I've had done to date. I'm at some sort of medical appointment every other week, and I've never had a reaction like this.
What gives?
It turns out that for certain procedures, dentists will use that big scary syringe to inject adrenaline (a.k.a. epinephrine) in addition to a local anesthetic like lidocaine or articaine. The adrenaline makes nearby blood vessels constrict, which reduces bleeding and makes the local anesthetic last longer.
This is not the only thing adrenaline does. You probably know it as the "fight-or-flight" hormone, the one that tells your body "oh sh*t, that's a bear!".
Hence the panic.
Obviously, the whole experience sucked. I was reduced to some animal state with a stupid purple rubber thing in my mouth, while the dentist and his assistant sat there all awkward because you can't really do dental work on someone who's hyperventilating.1
But I think this experience was useful for me to have, because it helped me internalize that I could have a panic response without actually being in a panic-inducing situation, and that it was possible to realize this mid-panic. I couldn't un-panic myself, but my "I am good at medical situations" prior was so strong that I realized mid-attack that there was no bear; all I needed to do was wait for the adrenaline to leave my system. I am much more confident that if something similar were to happen again, I could recognize the panic feeling and wait for it to pass without doing anything stupid.
In mathematics, there is a notion of "seeing behind" the notation — the symbol 5 is not the number we call "five", it is simply a shorthand used to make reasoning about the concept easier. The number we call "five" is the same whether we write it as five, 5, V, 五, or 正 (as in the East Asian tally system). Taking it further: there's no need to use decimal place value system to represent numbers — we could use whatever system the Romans were using or something even crazier, and in the end, we'd still be talking about the same numbers.
In other words, as Alfred Korzybski said, the map is not the territory. We use representations of objects to be able to reason about them, but we should be careful not to confuse the representation with reality.
This is true in real life, too. We interface with reality through our experience of reality, which is an amalgamation of all different forms of information: obvious senses like sight or smell, nebulous emotions, current physical state, etc. But crucially, our perception cannot capture all of reality in its infinite fractal detail — for example, we cannot sense magnetic fields.2 Our experience of reality is the map, and reality is the territory.
This is a broader version of what I learned from the adrenaline injection panic attack. In my experience, "adrenaline in my system" was represented as "this procedure is freaking me out". But despite sitting in the dentist's chair, feeling panicked about the procedure, it would have been wrong to assume I was actually feeling panicked about the procedure…because the reality was that I had just been injected with adrenaline. The panic feeling was a useful signal, but it was not necessarily accurate.
There is huge alpha to be gained from really understanding that your experience is only a map of reality, not reality itself. In addition to the advantage of being better at dealing with stressful situations, it helps you form better models of yourself and the world. You can adjust for the ways in which your personal experience is unrepresentative and skewed, and give yourself space between instinct and action.
For example, I recently realized a dreadfully obvious thing: when I am in physical pain, I am much more pessimistic about everything, and I often think that people are out to get me. This was bad — for example, I would lash out at my partner for no reason — and also, it was simply untrue. Now that I understand that the experience of "people are out to get me" can be a signal for something else, I just run a naive check that says "hey, am I in pain right now?" and if I am, I try to read feelings of "all people are terrible" as "I'm in pain".
It's like flying a plane with miscalibrated instruments — the altimeter tells you you're below sea level all the time, maybe the compass is pointing at something magnetic in the cabin instead of pointing north. Luckily, the instruments are miscalibrated, not faulty; they're wrong in a consistent fashion, and you can slowly figure out which ones are wrong and in what ways. In the same way, you can watch how your experience diverges from reality, and use that to calibrate what specific experiences mean. You can learn to interpret signals differently to give you a better sense of what is true, so that you can make decisions that are grounded in reality.
You just have to remember that your experience is only a representation of reality, and try to see past it.
Practically, the best way to internalize this fact is to try lots of things that alter your experience of reality, observing the difference between what you experience and what you know to be true. I cannot bring myself to recommend having an adrenaline-induced panic attack (it is really Not Very Fun), but there are plently of other perception-altering things you can try.
It's best to start with something that has a localized, low-stakes effect on a well-defined sense. My favorite recommendation is eating miracle berries.3 Miracle berries contain the (aptly named) glycoprotein miraculin, which makes your body interpret sour foods as sweet. You can eat a whole lemon without cringing, noticing that you experience sweetness on your tongue but acidic prickles on your lips. You might have the unmooring realization that if you didn't know you had eaten a miracle berry and you had no idea what a lemon was, you would totally think that lemons were sweet. (I know I did!)
Some other things that might work include bone conduction headphones, the rubber hand illusion, virtual reality, and regular local anesthesia.
Eventually you would like to learn that emotions are also a part of your experience of reality. This is a little harder: emotions are always affecting how you see the world, of course, but it is near-impossible to induce experiences that are as clear-cut as my adrenaline injection.4 Because of this, it's probably better to observe the way you feel as you live your life, paying attention to how emotions color your experience of reality. Metacognition isn't easy, but trying to think about emotions in the same way you thought about senses in the simpler, sense-oriented experiences should help.
(Note of warning: this won't work if you are angry at yourself for what you feel. You will not be able to think yourself out of what your body is experiencing — recall that I still had the panic attack despite having formed a model of what was happening; no amount of telling myself "this feeling is simply adrenaline in my blood" was going to stop it. You need to accept that you are a meatbag and some things are hard-coded, because your job is to observe, not to make your perception line up with reality.)
I think this is one of the truths of being a human person that everyone figures out eventually. Some people, like my partner, seem to have figured it out a long time ago, while some people (me) are still trying to figure it out by writing long blog posts.
For those who are still figuring it out: good luck, and I hope this helped.
For those of you who have already figured it out: you should still try the miracle berries. They are the coolest thing ever.
footnotes
- 1
To their credit, they were very sweet and reassuring, telling me that they were going to take good care of me. The assistant even gave me a stress ball!
- 2
Well, unless you put magnets in your fingertips.
- 3
Thanks to MLL for introducing me to miracle berries!
- 4
The closest thing I can think of is drinking alcohol, though it is hard to observe yourself when your cognitive function is impaired.