Is this a panic attack?

April 22, 2006 12:26 AM

Please help me with a diagnosis of these symptoms. My girlfriend just had what I would describe as a panic attack. I understand we should probably talk to a doctor, but please help us out for the time-being.

My girlfriend and I were having an argument. She was (understandably) upset because my house was dirty and the emotion started to grow, until she couldn't breathe well. She describes it as being "hysterical". Her mind was racing. She was shaking hard, and screaming into the pillow. She also felt detached, as if these were happening to one person, and she was watching from outisde - afraid it wouldn't end, and thinking she made the whole thing up.

She calmed down after about 10 minutes, but couldn't respond to me right away. Now she feels weak, and her body is tired.

Help us figure out what's going on, please.

posted by Newbornstranger to health & fitness (20 comments total)

Sounds like a panic attack or generalized anxiety attack.
posted by gramcracker at 12:44 AM on April 22, 2006

well, you (she) said it your(her)self: hysterical neurosis?
posted by sergeant sandwich at 1:02 AM on April 22, 2006

sorry - 1st link got bargled. here it is.
posted by sergeant sandwich at 1:03 AM on April 22, 2006

Yeah, that sounds like a panic attack alright. I used to have them for a while, a couple years ago (although nowhere near as severe as what you're describing). In my case, I would suddenly start thinking that I was suffocating and that I was having some sort of severe allergic reaction, and being an asthmatic, I was pretty sure I was going to die. Everything became sort of surreal and I'd feel like I was totally losing control of myself (although it turns out most of those symptoms were really just a side effect of hyperventilating).

What seemed to bring these panic attacks on was some generalized anxiety combined with at least a few minutes of some more specific, intense anxiety from some immediate situation (like, say, an argument). I think during those few minutes of intense stress, I would subconsciously start to hyperventilate, creating a panic feedback loop. Then everything just goes downhill from there.

Even though I doubt what you're describing is life threatening, I think your idea of going to a doctor to get checked out is a good one. Best case scenario, you (or your girlfriend in this case) find out it's nothing and that will relieve some of the general anxiety surrounding these situations (objectively knowing you're OK when you have one of these episodes can really help calm you down). Worst case scenario, there's something wrong and you catch it early.

What really helped me when I was in the middle of an attack was to start performing breathing exercises. Single nostril breathing for a few minutes (which has an effect similar to breathing in and out of a paper bag) was my technique of choice. "Square breathing" (4 seconds inhaling, holding for 4 seconds, 4 seconds exhaling, holding for 4 seconds, repeat) will also help. It's not a complete cure (since you'll have to address the underlying anxiety to get rid of them completely) but it can be pretty useful in the heat of the moment.

As a side note, I've heard prolonged screaming can have a similar effect to hyperventilation, so that might be a factor here...
posted by johnsmith415 at 1:05 AM on April 22, 2006

Sounds like what happens to me when I have a panic attack.
posted by cmyk at 1:07 AM on April 22, 2006

Panic attack.

Breathe.

Realize you're having a panic attack.

Breathe.

Breathe.
posted by BitterOldPunk at 2:11 AM on April 22, 2006

Breathe, but if you can hear your breaths, either from breathing too quickly or deeply, you're doing it wrong. Try to not be able to hear yourself breathe.
posted by cogat at 4:22 AM on April 22, 2006

It seems like a panic attack, YET I wouldn't rule anything else out and I would call 911, one realistically doesn't have enough medical education to realize what other causes could be provoking that event in your gf.
posted by elpapacito at 4:43 AM on April 22, 2006

In the meantime she should stay away from things that can exacerbate panic like caffeine, drugs or alcohol. this was advice from a medical professional to a friend of mine who was experiencing regular panic attacks. He was able to be free of them through therapy/ behaioral modification and short term medication (like clonopin) in about a year.


I have only had a few panic attacks a long time ago and it is a horrible feeling. I never sought medical help, I guess I was lucky. I probably did mention it to my therapist at the time, but not in a "I think this is a big problem" way...I was doing a lot of self-medicating at the time lightly seasoned with destructive behavior...it was a hoot (sarcasm).

So basically, I am just saying one panic attack does not mean forever and if it is more frequent then consistent help can help her get over what causes these. Just know that she is the one that should be in control of her therapy (ie it doesn't have to be for the rest of her life, make it clear to the therapist what she is interested in accomplishing/ changing)

Good luck and take it easy this weekend. Maybe do things you would do when physically sick...relax, sit on the couch, eat comfort food, etc. and see a doctor Monday.
posted by TheLibrarian at 6:57 AM on April 22, 2006

Yes, a panic attack. But the sensation of watching yourself is called depersonalization disorder. It's not a huge deal, it's just a way in which the mind deals with trauma or extreme stress. Most people experience it at some point in their lives (though I don't think such infrequency is labeled a disorder) and some experience it a lot. I have it - it's freaky at times but knowing what it is and having a doctor explain it to me helped a lot. I found that at first it scared me so much that it perpetuated my panic attacks. A doctor may prescribe something like xanax to take when this happens, which could also be helpful. Definitely consult a doctor - I hope she's feeling better!
posted by meerkatty at 7:22 AM on April 22, 2006

I had a friend who used a cognitive behavioral therapist to work through her panic attacks. It might be an option.
posted by Bear at 8:26 AM on April 22, 2006

Panic and anxiety seem to be episodic and curable. I've had a couple panic attacks, but years ago, during a high-stress phase of life. I did have a good friend go through a longish episode of many.

Some things to be aware of:

2. Panic attacks tend to mimic whatever serious health problem scares you most. Therefore, if you have a heart attack history in your family, panic might mimic chest pains. If you have athsma, as above, it might mimic suffocation. If apeople you know have ulcers, it might mimic stomach pain. You get the gist. The physical symptoms themselves are not as important as the classic characteristic feeling of panic, best described as "Oh my God, I feel like I might die."

2. If you do go to the ER, they will do due diligence, but you might be told 'it's nothing, you're fine' and have the treatment end there. It's surprising how many health professionals don't know to suggest being evaluated for panic/anxiety. So if you go, and they find nothing, ask about that. My friend went through a couple ER and doctor visits, having pointless heart tests and needless stress, before anyone said 'could this be panic disorder?'

3. It can be treated with drugs, but it can also be treated with behavioral therapy.

4. It's way more common than people realize. Your gf might feel embarrassed about her reaction, scared, weirded out. Maybe you can help her with that. If this is indeed PD, what she's going through isn't unknown or all that unusal, and she's reacting normally. Letting her know you don't see her as insane will be kind and helpful.
posted by Miko at 9:36 AM on April 22, 2006

2. If you do go to the ER, they will do due diligence, but you might be told 'it's nothing, you're fine' and have the treatment end there. It's surprising how many health professionals don't know to suggest being evaluated for panic/anxiety. So if you go, and they find nothing, ask about that. My friend went through a couple ER and doctor visits, having pointless heart tests and needless stress, before anyone said 'could this be panic disorder?'

Surely that is because it probably is nothing, and she probably is fine? Surely, to be a panic disorder, this has to be happening a lot more than once - like several times in a year..
posted by Chuckles at 1:43 PM on April 22, 2006

My ex got regular panic attacks, and ice water helped knock her out of it. Her therapist said if it got really bad to stick her head in it, but that idea freaked her out, and usually the shoch of hands/arms in the cold water calmed her down.
posted by honeydew at 2:20 PM on April 22, 2006

Surely that is because it probably is nothing, and she probably is fine? Surely, to be a panic disorder, this has to be happening a lot more than once - like several times in a year.

That's just it - that minimizes it, which tends to make it worse. A panic attack is not 'nothing'.
posted by Miko at 2:26 PM on April 22, 2006

Here's a good link.
posted by Miko at 2:52 PM on April 22, 2006

Well, there you go then (from Miko's link):

When to seek medical advice

You may have a condition called panic disorder if:

• Your panic attacks are frequent
• You worry persistently for a month or longer about having more attacks
• You change your behavior in response to ongoing panic attacks — for example, avoiding locations or situations in which you've previously had an attack

posted by Chuckles at 3:11 PM on April 22, 2006

That feeling of watching yourself, or being further away from your surroundings than you really are, is common in stress reactions, as stated above. Women who are being raped experience this, people who are being tortured, etc. It also happens to people seemingly out of the blue, and is really freaky.

The point is, her body reacted very severely to a stressful situation. Was this reaction appropriate to what was going on? If not, there might be something in her past that would cause her body/mind to interpret a somewhat normal situation as dire or life-threatening.

I can completely relate to her reaction. It's happened to me several times during arguments with SOs. She is not crazy. Something triggered her, maybe anger or yelling, maybe feeling attacked, or out of control. Exploring this could help, but it's best pursued with the help of a therapist, preferably an MD (shrink) because they can prescribe drugs if need be. Just let her know that she's not losing her mind. Her psyche is trying to protect her, and her fear was valid even if it felt inappropriate. And this kind of thing happens to a lot of people, they just don't like talking about it.

Kudos to you for being a friend to her and trying to understand. Help is out there. Best wishes to you both.
posted by shifafa at 4:33 PM on April 22, 2006

Chuckles, you're kind of talking past me. You're right, you don't have panic disorder if you have one attack. However, a panic attack is still a panic attack. If you show up in the ER complaining of heart palpitations and pressure in the chest, and they say "You're fine, go home," you haven't been treated properly. The protocol should include "It's possible you've had a panic attack. If you experience another episode like this, and physiological causes are ruled out, you should see a mental health professional."

That's all I'm saying. And it doesn't happen often enough. I didn't mention it before, but my father, who is a veteran, suffered PTSD for years, which included panic attacks presenting as heart problems. It took years (and several hospital/Dr. visits) before anyone said "Hm, might this be psychological?"

It's just one of those medical blind spots, apparently.
posted by Miko at 5:39 PM on April 22, 2006

I'm concerned about jumping to conclusions here. I'm also concerned that the description of the event is not typical of your garden-variety panic attack.

If this recurs, you should see a doctor. It would probably be a good idea to see one anyway, as you noted in the question.
posted by ikkyu2 at 1:59 PM on April 23, 2006