Mental Health Post #10: Panic Attacks

Take two—thanks Facebook for deleting my almost finished post…  ☹  Today’s topic is panic attacks.  If you had asked me even a couple years ago if I had ever had a panic attack, I would’ve said yes, I’ve had 2.  But in the short intervening time, I’ve learned that there is so much more depth to the presentation of panic attacks.  The experience is as individual as personal perception.  To this end, here are some of the symptoms I have had when I’ve had a panic attack:

·       intense trembling

·       racing heart

·       sweating

·       nausea

·       hyperventilating-

·       fight/flight/freeze response (Google this if you aren’t already familiar with it)

·       catastrophizing (imaging the worst outcome for many scenarios)

·       zoning out and/or dissociating

The beauty of the panic attack is you can have all of these symptoms or just one.  And rarely has one of my panic attacks looked like what I’ve seen in the theater.  (See meme below just for fun—remember none of this is medical information and should only be taken as anecdotal experience.)  To illustrate, here are three different panic attacks I’ve had in my life time.

1.     Over 20 years ago, someone called me out in front of a bunch of family members.  It was humiliating, and I felt unjustly accused.  It was a sore spot in my life (still is difficult today) and haunted me.  About a year later, it came to my thoughts again and I found myself becoming more and more upset.  I sought out my support human (aka Derek) and I talked while he just listened.  During that time, I was shaking uncontrollably to the point where my teeth were chattering and I could barely articulate words.  I was sweating and felt sick to my stomach.  I did not cry, I did not hyperventilate and I did not curl into the fetal position.  After about an hour, I was calmed down enough that I was able to get ready for bed.

2.     About 6 years ago, for absolutely no reason that I could understand, I was sitting in church and suddenly felt the need to flee.  I felt emotionally claustrophobic and could not sit through the service for one minute longer.  I immediately got up and walked home (thank goodness I live close!).  I took a nap (I did not feel the need to take a rescue medication, aka a benzodiazepine) and felt right as rain when I woke up.  I still do not know what triggered this response, so I blame hormones.  So easy to blame because they are so often the problem <<eye roll>>.  I did not cry, I did not have any physical symptom except perhaps a little faster heart rate. 

3.     I have had one stereotypical panic attack.  I contract influenza about 4 years ago (despite getting a flu shot) and found myself struggling to breathe.  Derek took me to the ER (because of course it was the weekend) where there about 300 million other people with influenza in the waiting room.  So we waited and waited and waited and then we waited a little more.  My throat started to close up and I felt like I was suffocating.  I started crying hard, hyperventilating, shaking and my heart was pounding out of my chest.  The nurses came over and took my O2 sats and they were well above 90 (I blame the hyperventilating).  So I was sent back to my chair and told to wait.  I was afraid so I told Derek we needed to leave (here’s the “flight” part).  The staff told me I should not leave but I would not change my mind.  We went instead to my family doctor and they diagnosed me with bronchitis bordering on pneumonia (no Xray to confirm that one of course) and gave me tons of medications.  This one was especially difficult for me because I felt I had been shamed at the ER for my “melodramatic” display—it was especially powerful since the people who had done the shaming were medical professionals.  (Please don’t judge them too harshly—people don’t understand the power dynamics they wield in their various positions and they were full well beyond capacity.)  In this situation, I displayed many of the stereotypical actions of someone having a panic attack.

When a person has a panic attack, they are in an extremely vulnerable position.  The way you act toward them at that moment and afterwards can affect your relationship for a long time.  When someone has been kind to me when I was experiencing severe mental illness, it has changed how I’ve seen them probably forever.  When someone has been short with me and shamed me, it has made me feel unsafe with them.

Here are some things that I do to prevent panic attacks from fully blooming when I feel them coming on.  You will notice that many of them are similar or the same as to what I do to manage my chronic anxiety.  The key for me is to not put off addressing it—taking action immediately is crucial to keep it from becoming consuming.

·       Make sure my physical needs have been met, particularly eating/blood sugar issues.

·       Go for a walk or get some kind of exercise, preferably alone at first.

·       Use the 5,4,3,2,1 rule (I’ll append a link at the end of this)

·       Talk to a trusted loved one about the cause of my stress, if I know what it is.

·       Sometimes I find journaling soothing.

·       Meditation/prayer is of course helpful.

·       The very few times when it was not otherwise controlled, I took my emergency medication, a benzodiazepine.  Thankfully I have only had to do this a handful of times.

 Later, I like to look back over the recent past and see if I can identify what might have been trigger so if possible it can be avoided, mitigated, or at least emotionally prepared for.

Like any other disease, panic disorders take patience and work.  Having a good support system is crucial to my success.  I have had to limit things that are difficult for me like toxic people, reading too much current news, and not overloading on depressing information.  For example I have had to limit how much exposure I have to WW2 media (yes, I am the one white person in America who has still not watched Schindler’s List) because it is so damaging to my mental health—don’t worry, I think I’ve learned the lessons I need to learn from what I have consumed.  I still have times when I get stressed (as laid out in a earlier post) but I don’t feel like I come as close to panicking as I used to.  Again I blame hormones (or maybe I thank them for diminishing?...) and time spent practicing good mental hygiene. 

54321 rule:

https://www.urmc.rochester.edu/behavioral-health-partners/bhp-blog/april-2018/5-4-3-2-1-coping-technique-for-anxiety.aspx