Very need help.
August 15, 2011 2:07 PM   Subscribe

What's the deal with this kind of panic attack?

I'm asking this question on metafilter because: a) I couldn't find anything on google, and b) I have nobody to talk to about this because I am living at home for the summer, away from my counselor/psychologist in the States.

This summer I started having panic attacks for the first time in my life. I had been drinking far too much caffeine and thinking about some very difficult emotional things, and I had an attack when I was lying down one night to go asleep. I thought it was a heart attack or something like that, and I was more scared than I have ever been before in my life (that I was going to die), so my mom and I went to the hospital at 3am to get it checked out.

I've been having panic attacks intermittently ever since, and if I'm not having panic attacks I usually have anxiety-induced nausea in the morning, sometimes extreme, until the afternoon when things start to get better. But I am most prone to have a panic attack at night when I try to lie down, because then I start to think about things and I can't stop. So I have been falling asleep to the TV every night since sometime in May, even though I never used to watch TV before. Most of the time it distracts me enough from my own thoughts.

One time though, a couple weeks ago, I was watching TV with my sister and I had another panic attack. This is really what I'm asking about, because this panic attack was not attended by the normal physiological symptoms (tingling, sweaty hands, chest tightness, etc.). In fact, there were no physical symptoms, except that I had what felt like an extreme "caffeine-rush" sensation in the front of my brain and in my chest as well (without tightness, though). I hadn't been drinking any caffeine at all since my first panic attack. But this "rush" feeling was so powerful that it felt like I needed to explode, but at the same time there was no physical outlet for the feeling. I think it was the only time in my life that I felt like I was undergoing torture, it was something completely new in terms of pain to me, and I never want to experience that again. It only stopped when I went upstairs and put my head in my mom's shoulders (even though I am a 20-year-old man), and then spontaneously started crying like crazy, completely weeping and howling, and then somehow that slowed it down and eventually it got better after 20 minutes. It really freaked my parents out and it freaked me out too, although I'm glad that people were there.

What scares me is that this wasn't like a normal panic attack, it was more unstoppable and getting up and talking to someone and all the normal things that used to end panic attacks for me didn't work. The self-talk had no effect, the breathing techniques didn't work, because there was no physical avenue for me to start calming down. It was like the parasympathetic part of my nervous system could no longer engage. Basically I'm asking, has anyone else (I know there are people with anxiety on metafilter) ever experienced this before, or anything similar? I wish I didn't have to ask something this specific on metafilter, but I'm kind of crying out for help here.

Also, but this is of less importance, I was recently diagnosed with ADHD, and I'm on track to start medication in the fall, but I'm scared to death that it's going to worsen the anxiety. I really want to start taking the meds though, for a huge variety of reasons. If anyone has been in this situation before (the ADD/anxiety co-morbidity situation), do you have any advice for dealing with these fears?

Thank you so much for your help and thoughts.
posted by superiorchicken to Health & Fitness (12 answers total) 5 users marked this as a favorite
I find taking minerals makes me feel more settled. I use higher nature ultratrace just cause the pills give me a dodgy stomach.

Body psychotherapy as a way of dealing with the trauma cycle.

You should probably cut the caffeine.

When you get meds for adhd, you will presumably be working with a psychiatrist, so don't be too scared. If you put a lot of health measures in place it shouldn't tip you into anything. And you're aware of the problem so you can keep an eye on it.

MeFi mail if you just feel like mailing someone.
posted by Not Supplied at 2:16 PM on August 15, 2011 [1 favorite]

My panic attacks are predominantly like the latter attack you described. I can't talk adrenaline away; it's there, it has to dissipate. If I'm somewhere "safe" (home) I'll cry like you described, but if I'm not safe (public, work) I just stoic it out and try not to faint or puke or cry.

Anyway, they vary. It doesn't necessarily mean anything.

And yes, lots of people on AD(H)D medication also take something for anxiety. I know someone on Adderall who was given Klonipin wafers which melt in the mouth and work like *that*, for unpredictable surges of anxiety. Very clever stuff.

Just tell your doctor you're having panic/anxiety attacks, and let them work out whatever they think is appropriate. It's totally handle-able.
posted by Lyn Never at 2:18 PM on August 15, 2011 [2 favorites]

I got rid of 30 years worth of anxiety attacks through Cognitive Behavioral Therapy. Took a few goes to get the right therapist but I've been anxiety attack free for nearly 10 years now. Just another option to throw into the mix and a vote for "this is curable"
posted by merocet at 2:53 PM on August 15, 2011 [3 favorites]

I get those, too, just a surge of adrenaline and the accompanying fight/flight reflex. It's terrible to feel so completely vulnerable to your anxiety. I'm sorry it's happening for you.

Despite what you think, some of the self-talk and anti-anxiety strategies CAN be helpful for this kind of attack if you keep trying. More or less, I've learned to just feel the rush without it (always) turning into a completely debilitating experience (it's not fun, but I am mostly successful at not letting them ruin my whole week). Now I know what they are, I know they don't kill me, and I just try to get through it.

The book called Best Ever Anxiety Management Techniques has been helpful to me in developing coping skills. I also do daily guided meditation when I'm having frequent panic attacks. They can really reduce the intensity of attacks if I do it regularly and I've also found it really helps me get through the attacks themselves. I say guided meditation (like Meditation Oasis) because I need to voice and the directions for what to visualize so that I can focus on something other than what I'm feeling.

I also fall asleep with the TV on as a coping mechanism. Just FYI, if you haven't discovered "sleep timer", most TVs have a function to shut off in a specified number of minutes. I have to do that, otherwise the TV wakes me up in the middle of the night.
posted by parkerjackson at 2:56 PM on August 15, 2011 [1 favorite]

I would like to echo Lyn Never's point that you can get on top of this by working with your doctor. What you've described sound like textbook panic attacks, which one out of three people in the US will have at some point in their lifetime. (Disclaimer: I am a medical student, I am not qualified to diagnose/treat you...). My point is that you are definitely not alone in this and plenty of others have had similar episodes and have been able to control them by working with their doctors. In addition to the anxiety management techniques, there are medications that you can take when the attacks break through that are very effective (and don't necessarily need to be taken long term). It may help to see a psychiatrist, they would be better able than your primary doc to evaluate how to best treat both of these problems.
posted by msharp at 3:33 PM on August 15, 2011

While it's quite likely that this was a panic attack, it's certainly worth getting a physical workup to rule out other possibilities. Great if you're giving up caffeine, but also consider other aspects of your lifestyle (diet, exercise, social relations, etc.)

If indeed it is a panic attack, what you experienced is how panic attacks feel for many people. Panic, and then panic about the panic, and then panic about the panic about the panic, etc. It's awful because it feels bad and it feels out of control.

Watching TV endlessly *feels* like it's a good thing to do because it seems as though it's distracting you from the awful feeling. However, it's exclusively a short range coping strategy at best, because you may actually be making the anxiety scarier and scarier by trying to avoid it (it's sooo bad that I have to drown it out all the time!!!!). Avoidance often doesn't work all that well, certainly not in the long run.

Anxiety is very treatable - meds can help, CBT has a good track record, and ACT is making inroads in the treatment literature as well. If you can, see a good therapist. If not, maybe check out Kelly Wilson's (an ACT founder) self-help book about anxiety.
posted by jasper411 at 3:56 PM on August 15, 2011 [1 favorite]

You should probably try a non-stimulant medication for the ADHD to prevent anxiety. I am prescribed Adderall, and stopped taking it when I was going to school because it would almost always lead to an anxiety attack. Also definitely ask about anxiety meds, Klonopin or something similar will help a lot.
posted by catatethebird at 4:34 PM on August 15, 2011

I had a period of panic attacks a couple years ago, and had a similar experience to yours in that the terror or having another one became a source of anxiety in itself. My GP prescribed an anxiolytic med to be taken whenever one started, and this was helpful for my peace of mind. Just knowing that you have a way to control it if it happens helps a lot.
posted by ella wren at 4:46 PM on August 15, 2011

I was waking up in the middle of panic attacks, and my doc split my anti-anxiety med dose. Instead of two pills in the morning, I take one in the morning and one at night. Worked like a charm.
posted by FunkyHelix at 6:50 PM on August 15, 2011

I can't really speak to full-on panic attacks, but I also feel that I need to watch TV or videos when going to bed just to distract myself from my own thoughts... like this.
posted by bendy at 8:35 PM on August 15, 2011

Splash lots of cold water on yourself and don't dry it off, just let it drip until you're shivering from cold rather than trembling from anxiety. Fill up the sink with water and immerse your head for a while. And, of course, open all windows, turn on the fan, etc. until you feel better. Even in winter. The anxiety will subside as your body starts dealing with the cold instead.
posted by serena15221 at 8:49 PM on August 15, 2011

Definitely bring this up to the shrink who is prescribing the ADHD meds. They will have seen it all before and will know exactly what to do. But if they're not a specialist, ask them to refer you to one. It is worth it to get this right.

It's good that you stopped the caffeine. Caffeinism is something that ADHDers are vulnerable to because we just love our stimulants, but we have better ways of meeting those needs than chain-chugging espresso. Three cups of coffee a day is the sweet spot for balancing coffee's health benefits with its detriments, and I don't tend to exceed that.

As crazy as this may sound or actually be, I have a strategy when my brain starts getting mischievous on me. My brain is a conscious entity that can hear me... so, I talk to it and remind it that we're in this together, that if I'm happy it's happy, and that it surely knows the best strategy for working through our problems, and that we both have to remember that despite the temptation to get frantic it's easy to do something self-defeating even though at least one of us knows better.

This may not help you, of course. It's possible that it doesn't even help me. But it won't hurt.
posted by tel3path at 3:57 AM on August 16, 2011 [2 favorites]

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