I wouldn't wish them on anyone. That feeling of "I'm trapped, this is forever, I'm going to die, this is overwhelming, I need to escape" is genuinely the worst thing I've ever experienced. The brain misfiring the trigger that gets pulled when you're in a life or death situation is terrifying.
Fortunately recognizing that it's just a chemical response and I don't have an infinite supply of those chemicals and it will all be ok in a moment is one of the most calming thoughts and one that I always turn to when I'm panicking. Also remembering that I've felt amazing between panic attacks reminds me that soon I will feel that way again.
Just a few thoughts I turn to when I need to white knuckle that wave of panic that might be able to help someone else out.
A favorite passage from Pema’s book:
An article about morning pages:
The anxiety itself is still unpleasant, and sometimes it can take novel forms, symptomatically, which is cute (and a good way to jade you to legitimate medical issues). Fortunately, though, I've had nothing as intense as my first or second panic attacks to date.
Honestly I don't mind it as much as I used to, and maybe that was due to the sheer frequency of it earlier in my life, but in a way it makes even the most mundane calm feeling truly special, and I like that, a lot.
There are many techniques out there (such as the 7-11 pattern, etc). I'd recommend practicing with any wristwatch or clock that has a ticking second hand. Breathe through the nose and not the mouth. In for five, out slowly for ten, repeat until comfortable. If you're not immediately able to do that, try holding your breath until you can begin. It's a great trick and general mental clarity hack to have in reserve.
Here's my epiphany though: When I got to the emergency room, they just laid me down in a bed for monitoring, and after a few minutes (and about $1k) it went away. Since then, in the couple of times I've felt it coming on again I've just told myself that if it happens I'll find a place to lie down and relax until it passes. I haven't had to actually do that, because just the idea that I can is enough to make it go away. (YMMV, but it works for me.)
I can easily shallow breathe into my chest all day long. That doesn't fix anxiety.
You need to breathe into your belly. Watch your belly rise and fall with each breath.
It works, but in my case it only works while I'm actively focusing on breathing, which isn't super helpful. As soon as I want to start thinking about the core problem again, my autonomic systems revert to the original problematic breathing pattern.
Instead, you have to address the core problem. The only long-term solutions seem to be:
1. Rationalizing away the core problem that's making you scared. If you're anxious that you're not achieving your goal, you can decide that's not a goal anymore.
2. Solving the problem.
Neither of these solutions are paint-by-numbers. Life is hard. Solving hard problems is hard. If you're a high motivation person and you set your goals to be aspirational, you may just have to live with the discomfort of anxiety.
Your body knows how to calm down. It knows how to unravel that stored emotion and feeling. You only need to allow it to come out. Breathing and observing the breath is the first step of accepting your experience. You can never get rid of your emotions - you can only accept, allow or resist and suffer.
Turns out I had a pinched nerve in my spine. The pain and nerve stuff caused my body anxiety sensation, which then caused the emotional anxiety.
Resolved with a lumbar fusion.
Which explains why most of my prior efforts to mitigate weren't effective (drugs, meditation, exercise, sleep hygiene).
Once your body is full of adrenaline it takes 10 to 15 minutes to physically calm down, there's no shortcut, and often trying to suppress the physical symptoms keeps the cycle going.
What generally works much better is to simply accept that your body is going mad for a few minutes, it's million years old biological systems you don't have any control over, fighting them isn't possible. Keeping a detached mind, breathing normally and remembering that panic attacks don't kill you (the racing thoughts are often the worst thing) helps immensely.
I spent a few months largely crippled by panic disorder (intermittent panic attacks spaced by anxiety – often about the panic attacks themselves). The whole experience was like a crash course in understanding out-of-body-experiences and accidental mental overreactions.
The underlying anxiety is a separate issue and required a few years of practiced mental discipline. Sorry, no silver bullets there.
Yeah, that's kind of what happened with me too. Only that the panic attack itself was only 2 months ago; Out of freaking nowhere.
I remember I was reading a piece of code and then suddenly I felt my hearting beating faster and just couldn't breathe properly; you really just feel like you're going to die - right where you are. And then, after it has passed, you are left with the anxiety of it all and all the bad thoughts. I had to take medications for high blood pressure because mine was like 16/9, and my normal is 12/8 (I'm 29 and I exercise daily).
After 2 months visiting doctors I can say I'm "normal" again, but I have to be aware of the "long fuse" thing, because that seems to be the real killer.
That's exactly my experience. I didn't know what was happening. I'd never had a panic attack before and it came totally out of nowhere. Someone ended up phoning an ambulance. By the time they got there, all that remained was the shame of having to say "I'm fine, please just ignore me". It wasn't until much later that I realized that I'd been stressy and anxious for a good while.
The linked ESPN article in Fred’s post is really good and worth reading. Reminds me of some of the mental health stigma that founders in the tech industry face. This quote in particular resonates with me: “Depression, anxiety and panic attacks are not a sign of weakness. They are signs of having tried to remain strong for so long.”
Humans are only so strong. Intense pressure can forge diamonds, or it can crush you underneath it. My hope is that the stigma of mental health goes away, and training our brains becomes as normal as training any other parts of our bodies.
Then one day I smoked too much marijuana and then had to go to a kids birthday party whose family I didn't know. About 10 minutes in I had what I can only describe as a panic attack. My face turned gray. My heart was probably beating somewhere around 190bpm. I was sweating profusely. I had to leave the party and on my drive home I was worried I might suddenly die and then veer into traffic. I nearly drove myself to the emergency room because I thought I was going to have a heart attack.
If that was a panic attack, I can't imagine what it must be like to suffer something like that chronically. It was utter hell.
The first serious attack I had (it wasn't preceded by any trigger, I was just watching T.V. and eating) sent me to the emergency room, although I knew it was a panic attack and not life-threatening it got so bad that I thought it'd be worth it for my peace of mind (sidenote: it's not, and I got a nice bill). Drinking alcohol can help, but I would recommend to just endure the attack. I don't get panic attacks randomly anymore, but I may after a night of heavy drinking (which, ironically, might begin to stave off general anxiety).
They are terrible. Fight-or-flight gone haywire. I'd know exactly what I was experiencing and could rationalize what was happening, but that made no difference. Thankfully, they are rare for me these days.
Had a couple of panic attacks unrelated to any sort of mind-altering drug as well and I actually did drive myself to the ER because I didn't know what was going on. I thought I was having a heart attack or a stroke or something (which of course doesn't help the panic attack). Heart wouldn't stop racing, blood pressure through the roof, dizzy, trouble speaking, etc.
I kept the rest of the handful of Xanax I was prescribed in case I have another one someday. No desire to pick up a benzo habit but the few times I thought I felt something similar coming on in subsequent years, half a tablet (whether through placebo or drug effectiveness) made it fizzle out before ramping up into a full panic attack.
It's weird because I had thought knowing it's a panic attack and not a heart attack/stroke/whatever would "disarm" the process but it doesn't seem to matter. Still interested in figuring out what can cause that to happen seemingly out of nowhere.
Feels like a feedback loop where normally mild anxiety comes and goes in the course of daily life but in rare cases, instead of "turning the mic off" it stays on and the feedback builds to a point that is overwhelming.
Exactly due to the subject matter, I choose to use my regular account. Mental health issues are not pretty, just like physical illness can be ugly. But we do not shy away from the people who have terminal cancer, we help them out the best they can.
For mental illness helping can mean admitting that you have issues too. Displaying that they are not alone, that these issues are not as uncommon as everyone makes out to be.
Not so much the drugs I was prescribed, but cannabis is still not legal for recreational use where I live and either way, there's a stigma. My usual username is easily traceable to me (at least by people who know me) and I don't necessarily want family or employers searching out a known username and running across tales of weed and panic attacks.
And trust me, I tried CBD (no noticeable effect) as well as strains of cannabis leaning more toward that side of the spectrum.
For better or worse, I just lost my tolerance for the stuff. Even small amounts have the potential to make me feel uncomfortable so rather than keep trying to like something that doesn't agree with me, I just tend to decline offers these days. No big deal. I've no problem with people enjoying what they enjoy. It's just not pleasant for me anymore.
I'm convinced I have a mild allergic reaction to it. I think people don't realize that can happen.
For some people anxiety disorders mean years of life lost to disability.
Not to come off as snarky, but if you interpreted my comment as looking for sympathy then I suggest you read more carefully.
Oddly enough, a friend of mine suggested doing arithmetic in my head in a panic state, and it worked quite well for me. The theory was that you can't panic (fight or flight) reflex while your brain is in calculation mode. I don't know whether or not that is a valid theory but I do know that for me by focusing on a concrete problem (like trying to divide two 5 digit numbers) my sense of panic fades right away. In later years I found I could just read a text book, didn't really matter which one.
The point of my anecdote? Medicine can often compound the problem or even create new problems that weren't there before. Once you're in the midst of this, it can be hard to even recognize the medication as the cause, specially if you're taking multiple medications. I'm not suggesting that anyone stop their medicine without talking to their doctor, but at least consider that the anti-anxiety cocktail you're on may be making things far worse. It happened to me, and some research has revealed that these paradoxical reactions are not at all uncommon.
Generally, you could go on an SNRI or SSRI coupled with some form of cognitive-behavioral therapy to try to treat the root cause of the anxiety.
But I'm not a big fan of GP MDs giving out benzos like that given their long-term effects (anxiety, dependence, tolerance, withdrawal syndromes). GP's don't have the time to spend with you that a psychiatrist or therapist might in order to figure out what's going on.
Meditation, medication, eating healthy, exercise, be aware of yourself and when you are pushing yourself beyond the breaking point. Everything will be ok. I avoid all illicit drugs, but alcohol is an anxiolytic and it’s partly why I like it.
One time I was on the subway, surrounded by people of all ages just relaxing and being bored, and I was trapped in a life or death struggle for survival as one of the worst panic attacks of my life attacked me. Then, when I thought I couldn’t make it, I realized how silly I was being and how absurd the whole situation was, and it gradually went away.
I still get panic attacks sometimes, but they get easier to manage.
"Involuntary actions operated by the autonomic nervous system involve lateral flapping or paddling with the arms to press them down into the water in the effort to raise the mouth long enough to breathe, and tilting the head back. As an instinctive reaction, this is not consciously mediated nor under conscious control."
You may be referring to the diving reflex instead?
I was trying to write about it as insomnia one day , looking over my list of symptoms, when it clicked that it didn't sound like other descriptions of insomnia. Once I figured out they were panic attacks I was able to take a step back and look at the cycle, so I don't have week-long waves of this anymore. The next night I decide I don't want to sleep - maybe I want to do an extra load of laundry, inexplicably at midnight when I've hardly slept, absurd as it is. It works, at least.
My cat loves the panic attacks though. I stay up later, and I'm petting her the whole time trying to calm down. Great for her.
When I'm away from home I can reduce an anxious feeling by imaging I'm petting one of the cats and feeling its rumbling purr.
This is me. I had what I feel was a panic attack / semi nervous breakdown on the last day of my internship this summer. It was basically a 12 week interview for a job. On second to last day I received a full-time job offer, and there where a few times where I had embarrassed myself in front of the VP and I was afraid If I got sick and vomited on the last day I embarrass myself again, so my brain just locked into panic mode. I asked my team leader to give me a ride home, and as soon as I walked in the door the panic subsided. I've still had a few flare ups over the last week; we're looking for houses now (our first home purchase) and I'll have to commute for a while, so I'm nervous about that too. I may have to stop drinking coffee and practice more meditation.
I think I just get over-exhausted and loose the ability to absorb and cope with stress, so when it happens its like any incoming stress hits my reptile brain directly like touching a raw nerve. I'm very happy that I've had the last week off to relax and rebuild my stress-buffer!
Part of the cure I think is figuring out what your body is telling you through emotions and then figuring out what to do with that information (dealing with the stressor or finding an outlet).
In my experience, the following helped me.
* Deep breathing exercises
* Exercising especially cardio.
* Cold water showers
* Learning about panic attacks
But they also know many doctors aren’t able to help much with panic/anxiety, not because they’re ignorant or incompetent but because the causes and effective treatment options vary so much from person to person, and the whole topic is not very well understood by anyone, really.
One of the treatment options suggested above (CBT) is a conventional medical approach.
The others are often reported to be beneficial for some people and are not commonly reported to do any harm, so it is fine for someone to suggest them.
Anecdotally it's very helpful to myself.
Deep breathing can be part of CBT too.
Breathing exercises and realizing that that I'm going through a panic attack usually helps defuse it a little though most of the time you can only just wait it out.
I've found avoiding caffeine has helped a lot.
Have you tried any other treatments like CBT or EMDR? Sometimes after a traumatic event the brain can be guided into reprocessing / repacking the memory of the event in a way that somehow relieves these kinds of after-effects.
High doses of L-Ascorbic acid eliminated my panic attacks. I slowly worked up to 60mg per KG of bodyweight. I weighed 250 (113kg) works out to ~7 grams per day. I slowly worked up to 2g before breakfast, 3g before lunch, and 2g before dinner. Once I started taking 4g per day the attacks lessened, and when I hit 6 they went away for good.
L-Ascorbic acid is an anti-stressor hormone in animals, humans have a mutation that prevents us from making it in our livers.
And here's the interesting part, things that you don't necessarily experience till it goes full blown, it's when you reach that point, the end of fear basically, your mind becomes calm. You don't necessarily realize it in the instant but that's it, you've stared into the abyss and it's not as awful as you imagined. At that point, you still have anxiety but that's it, it doesn't control you anymore, you're out of the 2 states loop, panic or fear it may happens. It's still painful, but it's not hell anymore, you know how it's gonna end, there's no more question.
Now, it's an incredible experience, can even become an spiritual one, it did for me, experiencing first hand how reality is subjective and how the mind works.
All in all, I wouldn't trade all those experiences for anything, it gives you an understanding of the human condition that not a lot of things can give you.
The next few months, I would get panic attacks as soon as my head hit the pillow - nothing to do with the dog at this point. Though, the dog was quite a handful. I'd take it for two hour walks, and after a 5-minute rest, it'd be back to rampaging.
Now, I'll get a panic attack once every few years - still, always in bed. I usually have no idea what sets them off.
Edit: I got my first dog so late, because I'm allergic to dogs, and I was a sick kid. My parents didn't want to exacerbate my allergies. I have dogs do this day, and I just deal with the allergies.
I've had them for 50 years, and the single most effective thing I can do remains finding a paper bag to breathe into when I feel the hyperventilation begin.
I suspect most other sufferers know this, but just in case this is a new problem for anyone.
I don't want to derail, but this strikes me as very odd:
"Right after it happened I went to see my regular doctor and got a prescription for medication that can calm me down in that situation"
I mentioned it to doc at next visit, quite some time later. He also decided it was probably just a panic attack and unless they start to repeat to forget about it. It wouldn't occur to me to seek and carry medication for something that happened once in a lifetime. Unless it had turned out to be the symptoms of something serious and life threatening.
To each their own I suppose. Also, if you’re reading this and struggling with anxiety or panic attacks, you’re not alone, but the thing that helps you cope may be unique to your situation, so please work directly with a therapist or a doctor!
Finally took him to a clinical psychologist that focuses on them and I was embarrassed on how few sessions it took this guy to solve them.
Or does your son have to do ongoing treatment like meditation / prescription medication?
It basically boiled down to (in his case) "so your heart is beating fast? that's ok. not a big deal."
It is always amazing to watch an expert in any field distill a seemingly complex problem into a simple one with a simple solution (at least in my son's case).
Obviously, his decades of expertise was able to eliminate a world of root-cause possibilities and guide the conversation to help my son believe this simple conclusion.
He'd also induce panic attacks by having him breathe through a narrow straw. Probably helped to demystify them and practice dealing with them.
In my own experience, the key to coping with panic attacks is the right breathing technique to prevent hyperventilation from happening.
Ever since I had a few panic attacks many years ago, I am using a technique which works great for me: Short deep inhaling and very slow, long exhaling. Every exhale has to be significantly longer in duration than every inhale.
I've been in many situations in which I felt the first signs of a possible attack, but with this breathing technique, I always was able to stop it from actually happening.
The therapist said this cures 99% of patients. The "golden feather" in a CBT therapist's hat.
Sitting down, as rapidly as you can, take a deep breath in and blow it out. Do this 40 times. Blow out all your air and hold your breath for as long as you can (1 - 2 minutes for me, stop when you start to get convulsions or you may pass out). During this time observe your tingling hands, light headed feeling, sweaty palms etc. This is a normal result of an excess of oxygen in your body. It cannot hurt you. Now take a deep breath and hold it for 15-20 seconds. Start immediately and repeat two more times for a total of three. Repeat three times a week for a month. If you start to feel panic more often, start your treatment again (this is rarely necessary).
The first time will be the scariest. After that it gets MUCH easier I promise. It may be helpful to see a CBT therapist to talk you through it the first time. It will change your life.
That technique coupled with a mild anti anxiety medication has completely feed me of anxiety and panic.
I hope this helps others :)
I've been having more and more conversations with friends and co workers about anxiety recently and that's helped a bit but realistically this is something that I'm going to have to do real work on.
Luckily it was not debilitating, and happened in the car five minutes from home, so I could get to a sofa and work through it; it also helped that I had somewhere to be with friends that was in no way connected to my triggers and so I could use that as a useful distraction.
I think the scariest thing for me, now, is that now I have to add panic/anxiety attacks to my understanding of my own condition, which up until now has been either some very black (but ultimately rational) periods of suffering, or just general low mood to the point where I have dismissed the idea of medication.
But this is now probably a game-changer for me.
This seems so stereotypically American to me.
> But the real solution has come from many years of trying to understand the root causes of the panic and anxiety and working to deal with them.
What the doctor should have helped doing in the first place.
The cause of back pain is, in day-to-day circumstances, because of bad posture. It can be fixed by stopping the bad posture, with some good habits and perhaps yoga. You can make money from yoga, but not enough for national TV advertising budgets.
Luckily in the UK we don't have the completely insane position of having prescription drugs being advertised in mainstream media. I think that is peculiarly North American.
(Yes of course there are serious chronic conditions, for those you see a doctor not watch a TV advert)
I loved his anecdote of doing jumping jacks while having a panic attack. The lightheartedness of the way he approaches the disorder is kind of nice.
One weird thing that helped me was reading everything I could possibly find on panic attacks over some short period of time. Every paper, book, medication, etc. Unlike some disorders, the truth seems to mostly be positive (non-dangerous, relatively straight-forward ways to beat it), and so the more you know the better you'll be at approaching it.
I've got it more or less under control now. I've figured out when to notice when an anxiety attack is coming on, and just lay down and relax. And cutting down on caffeine helped a lot. Anything that's a stimulant triggers them for me. I now have like half a cup of coffee in the morning and nothing for the rest of the day.
In those situations I keep my shit together and think rationally, but when it comes out of nowhere, you add to that threatening sensation the confusion of not knowing where it comes from. So you think you're having a heart attack, or a stroke, or who the fuck knows. It's a feeling of impending doom.
I see it the same our tendency to see faces on surfaces, our brain is wired that way. It's also wired to sense danger, adrenergic pareidolia, so to speak. And sometimes there are neither faces nor threats.
I remember thinking "This is it. This is how I die, here on the station platform, alone, with nobody noticing." It was a terrifying, helpless feeling. It passed after maybe 30 seconds, as soon as I managed to take a gasp of air.
It was only once and more than a decade ago but even typing this is kind of freaking me out.
Of course being winded could induce panic too, but not being able to breathe in that circumstance has a physical cause.
I had that happen once on my home's stairs -- hurt my back, and then opened my mouth but couldn't speak, breath, etc for a couple or minutes (or so it seemed).
But it's not a panic attack itself. Had 2 of those quite young (at 15 and like 22 or something like that) and never had them again since, but they're different experience (and quite scary), like people here described it.
If anyone's interested you can look into the work of Dr Bradley Nelson and more specifically his book The Emotion Code. I use a combination of Timeline therapy and emotion release and it does wonders for panic attacks.
However, I'm not so sure about The Emotion Code's pushing of "organ energy fields" or Dr Bradley Nelson's "message from above" to go write a book pushing this
I eventually became agoraphobic and wouldn't leave my house.
I did a 10-day vipassana meditation course (http://dhamma.org), where you can't read or write or listen to music or talk. You basically just meditate the whole time.
I had very bad panic attacks during the 10 days, but eventually meditation actually helped me to deal with it.
I'm now in my forties and meditation is the only thing that truly helps me with panic attacks.
I thought I was having some kind of stroke so I jumped out of bed and by the time I was in the kitchen 10 seconds later I was fighting not to faint, which I thought would lead to me dying. I kept pacing around the kitchen table quickly, basically walking laps for about an hour until it subsided.
Told my girlfriend to call an ambulance as soon as I hit the floor, which luckily didn't happen.
I now eat a low-potassium diet, which fixed the problem.
My potassium levels are normal. My doctors have never heard of this effect. I can't explain this, I just know it works for me, and I have some confidence from looking back at my food logs that it's not a placebo effect.
The usual kind of panic for me is "oh shit, I forgot to do this, if I cant fix it Im getting fired" kinda.
For me a panic attack is "oh shit, I forgot to do this, if I cant fix it Im getting fired. ooooooh no I cant fix it because im a idiot and <some stupid reason>. Im gonna get fired, not get another job ever again because I was only at this job for 6 months. Fuck, is this it? convenient life, gone, just like this? Why can I not just be neurotypical, with a working brain? What happened in the last few years, I used to be such an upbeat happy guy. my whole life will be like this. Full of bullshit, can't dos and more. How can my partner still be happy with me? All I do is be a cynical asshole"
Sorry, this turned out a bit longer than expected. It just leads down a rabbithole really quickly, and getting out of it is like climbing mount everest
> the purchase of the book is totally optional, so please do take the time to look around my site
Also, the book is only 13 pounds, so I don't they they are making a lot of money out of it. Perhaps they use the money to keep the website running?
A personal experience can be illuminating sometimes but it cannot be considered an alternative approach. For this reason, I do not consider it a good source. Just my opinion.
The closest thing I've found to a magic pill after years of searching has been CBD. Smoking a high CBD cannabis strain is probably the fastest way to get it in your system in an emergency. If you're somewhere smoking isn't an option, they have tinctures you can put under your tongue. Unlike Xanax or other pharmaceutical solutions, CBD is natural, has mild to no side effects, isn't addictive, and is non-toxic i.e. it won't kill you if you overdose.
That said, the placebo effect can be strong.
it turns out you can still have extreme anxiety and a panic attack if the overt physical symptoms aren't there, however. anxiety is a state of mind as much as it is a set of physical symptoms.
In a case of cruel irony, I actually became quite depressed during the time I was taking propranolol. (Recent studies suggest this is not coincidence.) It also had no effect whatsoever on my baseline anxiety, which remained uncomfortably high, though it did prevent me from having the actual attacks that I considered my worst symptom.
At one point I stopped taking propranolol for a year. The highlight of this year was losing a prestigious international post-grad fellowship when I had a complete anxious meltdown during my final telephone interview. When it was over, I vomited. After that, I finally gave in and told a doctor to give me the antidepressants (in my case, 75mg venlafaxine).
For me, the effect was immediate, and I can only compare it to a case of cured tinnitus. All of a sudden, this uncomfortable thing that I could feel at all times and that I was always conscious of possibly overwhelming me was gone. Presto. I must say I immediately felt remorseful and a bit stupid for prolonging my suffering for as long as I did by refusing to try antidepressants.
I stayed on venlafaxine until a couple years after my wife and I started dating, at which point I felt like I could taper off, and I did. I'll leave it as an exercise to the reader to look up how much of a pain that can be.
So, my recommendation to fellow anxiety sufferers is to not be afraid to try antidepressants even though you may feel anxiety is the opposite of depression. At least don't settle for a half-cure until you've explored all your options.
Also there can be a strong placebo effect of taking the pill.
the medical standard of the 2000s - present would also be pushing SSRIs as the remedy for chronic anxiety, though they're quite useless for acute panic attacks.
third-line treatment might be barbiturates or similar, which would work in cases of acute panic. not sure if they are actually used however.