My information on panic attacks comes from personal experience. Like most people who suffer a first panic attack I called 911 because I was sure I was having a heart attack. I was only thirty three years old at the time and very physically fit. I do not smoke or drink and my cholesterol level has always been fine. Once in the emergency room the attending doctor witnessed the second panic attack first hand. My heart was beating at one hundred and sixty beats a minute. I could not feel my feet or hands and I was trembling from head to foot. He administered a beta blocker and ordered a chest xray. Then after an over night stay and a complete heart work up which proved no structural abnormalities I was released. My discharge instructions were to follow up with my primary care doctor and a heart specialist just to be on the safe side. I also was armed with a prescription for propranolol which is a beta blocker. As I waited at the pharmacy for my prescription to be filled I thought, “what was that, and when will it happen again?
That is the second part of a panic attack. The fear that another is going to come and the not knowing when begins a cycle that is very hard to break. It took a full year for me to believe that I did not in fact have a heart problem. When I met with the cardiologist who repeated the stress test in the hospital he assured me that my heart was fine. What he said next surprised me. “You know a heart problem is a lot easier to treat than panic disorder”. Upon, pressing him for clarification of that comment he said that I was suffering from panic disorder. He told me to continue with the beta blocker as it blocks the body from reacting to adrenalin.
Now, here is the key to what happens when a person is experiencing a panic attack. For absolutely no good reason your adrenal glands send out a flood of adrenalin inappropriately. All of the symptoms that accompany a panic attack are a reaction to that chemical. Imagine you are a gladiator and you are standing in the middle of the arena in ancient Rome. The gate is about to open and you have no idea what will be coming at you. Adrenalin begins to flood your body and your muscles tense. Your pupils dilate and your heart and respiration speed up. You are prepared to fight because flight is impossible. The gate opens and it’s on! You are being attacked by a giant wielding a sword and a large ball with spikes on a chain. He hits your leg with the ball and though you are bleeding you can barely feel it. You are just trying to stay alive. Again, he hits your arm but this time with the sword and you know you are sliced to the bone still there is hardly any pain. It is only right before the giant delivers the final death blow do you feel anything at all. You are on the ground exhausted and depleted of all adrenalin and now the pain is unbearable.
When a person experiences the “flight or fight” response the body undergoes physiological changes to facilitate survival. The reason why arms and legs go numb is because once adrenalin is released the body protects the main organs by sending them more oxygen rich blood. That explains the increased heart rate and respiration. It is a fantastic survival tool. We have all heard the stories of people performing heroic acts with unnatural strength in times of disaster. I knew of one young lady that was able to lift up a car because it had fallen on her father while he was working underneath it. This also explains why people feel very little pain in their extremities when they have been attacked or are in accidents. Less blood and oxygen to these areas dull nerve receptors that receive pain signals from the brain.
A person with panic disorder feels all of these physiological changes and are in absolutely no danger at all. The affect this has on the sufferer is a feeling of impending doom or death. It is a terrifying experience each and every time. The fear of the next attack becomes just as debilitating as an actual panic attack. One tries to avoid the situations where panic attacks have occurred. I have difficulty with driving on highways because I have had many panic attacks on them. For the longest time I took the back roads to anywhere even if it took me twenty minutes longer to get there. Being in confined spaces are also problematic for most panic sufferers. A person with panic disorder usually needs to know that they can exit wherever they are quickly and with not much fanfare.
Unfortunately, the last aspect of panic disorder is how it affects a persons quality of life. Avoidance of situations that may bring on a panic attack can cause agoraphobia. Agoraphobia is fear of open spaces or of leaving ones house. Getting help before that happens is very important. Some people do well with medication and some with behavioral therapy. I do better with behavioral therapy than with beta blockers. After sixteen years of having clusters of panic attacks I have learned some helpful techniques. First I do not hide the fact that I have panic disorder. As recently as last month I had to leave a restaurant for about ten minutes so the attack could take place outside. Being with family members that are privy to my situation was helpful. I just stood up and said, “I need to get out of her for a few minutes but I’ll be back”. I do normally sit in locations that have easy access to the door. I have learned some very good breathing practices that help short circuit a panic attack.
Shallow breathing is very common at the beginning of an attack and can lead to hyperventilation. Taking in a nice full breath so that you can feel your stomach expand and then slowly let it out while counting to fifteen slows the heart rate. I commonly do this a few times during the day just to stay calm even when I do not feel panicky. It is very difficult for people to understand what this feels like. Even when you do explain it to them. One of my most memorable panic attacks took place in a MRI machine. For someone that needs to see the exit and have easy access to it these machines can be a nightmare. I took all the precautions I could possibly think to take. I informed the technician of my situation. She assured me that she could hear me while I was in the machine. I was promised that if I had a problem she would let me out. All I can say is, “liar,liar pants on fire! I thought this was going to go okay. Even as she tied me up with these thick velcroed straps and slid me into what resembled a cylindrical coffin. At some point I needed to get out. She was telling me that I was moving too much. Of course, I was moving too much my heart was pounding and my hands were shaking. Well, I cried “uncle”, and told her I needed to get out for a minute. She said, oh honey, we’re almost through and I have two more people waiting”.
A medium sized panic attack very quickly became full blown at that point. What my brain does when I am escalating into a full blown panic attack is to rapidly do a full internal body scan of my own. In under ten seconds I know which fingers are numb and which leg muscles are twitching. My mind becomes hyper aware of every feeling my body is experiencing. This is pretty common among panic attack sufferers. We become too in-tuned to bodily sensations and we scrutinize them. We chronically do an all systems check to make sure that we are okay before we embark on whatever activity in order to circumvent a panic attack. So, operating under those circumstances and being told I will not be let out of the MRI machine did not go over so well. It is hard to yell when you have the feeling that someone is squeezing your neck but I did the best I could. Still, she was not letting me out. That’s when I really became unglued. With arms outstretched above my head and sticking out of the machine I started beating on it. Every word I uttered accompanied a strike against a very expensive piece of equipment. “You (bang), promised (bang), to (bang), let (bang), me (bang), out (bang). That convinced her and she did get me out real fast. She unstrapped me and saw that I was shaking from head to toe. She asked, “what are you afraid of honey”? I told her that I wasn’t afraid of anything that I was having a panic attack!
Eventually I got through the test but I am pretty sure she put on my permanent record that I was a nut job. The next time I had to get an MRI test at a completely different location I was informed that I had a possible allergy to the dye. I explained the situation again and this time was met with a reassuring response. Turns out this technician had panic attacks too and was aware that it goes way beyond being just a little nervous.
