Panic on the streets of London, Panic on the streets of Birmingham...
November 1, 2012 7:09 AM   Subscribe

Every morning for the past five days, I wake up and then immediately begin having a panic/anxiety attack. Please help me figure out what I am doing wrong!

I've had periodic, infrequent panic attacks since my dad became ill/died three years ago. (The first one was shortly after his hospitalization). Since then they generally have accompanied a huge immediate shock/change/stress: a job change, a breakup, travel, etc. I've mostly managed them without meds, though I have xanax on hand for emergencies.

Now all of a sudden I am having them every day. What happens is, my alarm clock goes off. I wake up. A second later my chest begins to ache, heart races, my palms start sweating, and before I know it I'm trapped in bed with a full-fledged panic attack.

I can't think of what is triggering these. If anything, I'm getting MORE sleep than I used to. My life is fairly awful and stressful and depressing, but that's not really anything different from how it typically is (that is, there are no NEW stresses; "my job sucks and I'm broke" could describe the past ten years of my life). I had a bad breakup about a month ago but we've since reconciled. I get more or less frequent exercise. I haven't changed my diet.

Is there something I might be missing that would cause these symptoms on such a "regularly scheduled" program?
posted by like_a_friend to Health & Fitness (15 answers total) 4 users marked this as a favorite
You should first figure out whether you're being triggered by your alarm clock or the act of waking up. Try skipping the alarm clock on your day off, or changing it to something less jarring (music, talk radio, phone vibrate).

Also, how is your bedding holding up with the change in seasons? Personally, the temperature is the first thing my body notices when I wake up. Maybe try getting warmer/colder.
posted by acidic at 7:21 AM on November 1, 2012 [3 favorites]

I think a lot of people with anxiety have those symptoms. I've been off medication and mostly anxiety-free for several years now, but I still often wake up with a sense of dread that could, if I didn't do something about it, easily result in the sort of panic you're experiencing.

My advice (this worked for me): As soon as you're awake in the morning, force yourself to get up, get dressed, go for a walk or have breakfast. Huddling in bed when you feel like this is the worst thing you can do. You may also be getting more sleep than you need; I find that over-sleeping is more likely to lead to feelings of dread first thing in the morning.
posted by pipeski at 7:23 AM on November 1, 2012

Reconciling after a bad breakup certainly counts as a new stress. Even if you're completely on-board and things are genuinely resolving, that's a rough thing. There's new issues that weren't there in the relationship, and less emotional security for many people. I'd look at that.
posted by stoneweaver at 7:24 AM on November 1, 2012 [5 favorites]

Have you had you heart checked or had a physical lately? rapid or irregular heartbeat can come from physical issues as well but feels similar to a panic attack. I benefited greatly from a beta blocker, for example.
posted by the young rope-rider at 7:29 AM on November 1, 2012

I had this, only I'd wake up out of a sound sleep at 3:30 AM. Then I'd panic, the only thing that could get me back to sleep was to turn on Scooby Doo really softly. I shudder when I remember how awful it was.

I've been on Celexa and now rarely have panic attacks. When I do, they're really weird, the physical symptoms, but no mental freak out.

Talk to your doc, you might need new meds.
posted by Ruthless Bunny at 7:57 AM on November 1, 2012

I get these and what I do is take a slow deep breath, put my hands on my abdomen to physically regulate my long, slow deep breaths.

I count each breath and try to slowly get control over my thoughts.

I don't get up until I am breathing normally and back in control. It usually takes up to 5 minutes then I'm ok.
posted by Tullyogallaghan at 8:17 AM on November 1, 2012

Is right now close to the anniversary of your father's diagnosis or death? You might be experiencing an anniversary reaction.
posted by Brody's chum at 8:23 AM on November 1, 2012

I think it could be related to the break up/reconciliation. There can be delayed reactions to this sort of thing, and there is probably still a lot of anxiety you feel about it, right?
I was also going to recommend changing your alarm/wake up time/routine and see if that helps, it could be the trigger. Another thing - have you been drinking more, or less, or doing any drugs? These things could have an affect too. Also, this sounds weird, but make sure you stay hydrated. Drink lots of water. For me, panic attacks are very physical, and being dehydrated makes you overall feel crappy, and makes my panic attacks worse.
posted by catatethebird at 8:26 AM on November 1, 2012 [1 favorite]

Also, avoid caffeine and other stimulants.
posted by catatethebird at 8:28 AM on November 1, 2012

Can you literally not move? It sounds like a weird sleep paralysis, which I get a lot; a sense of fear, an inability to move, and frequently associated with it is a chest pressure/pain that feels like you're being held down. The proximity to waking up is notable - though I don't think I've ever transitioned into one on the cue of an alarm.

Are you sleeping on your back? It happens to me most often when I'm incredibly comfortable and sleeping flat on my back.
posted by MangyCarface at 8:35 AM on November 1, 2012

I used to get panic attacks when I was really stressed and in university. For the most part they have gone away, but sometimes I feel like one is starting and I have to calm down. For some reason last month I would wake up like that a few days in a row where my heart was beating really fast and it would start to trigger a panic attack. I don't know why but sometimes just waking up fast would make me feel like that. It never happened when I woke up slowly on a weekend, only when the alarm went off and I woke in the middle of a dream or something. Also, I would note that a lot of people only tend to get panic attacks when their mind is idle, not when they are busiest and feeling stressed in the moment. Its always when I start to worry about stuff and have time to think about all the stresses in my life. Maybe you are waking up a bit startled from the alarm then start thinking about all the stuff you need to get done that day and it is triggering the panic attack. I would try to not worry about it too much and try to eliminate possible physical things like suggested above (eating well, drinking enough water, etc.) From my experience it's never one thing, usually a pile of physical and mental stresses that all add up and start a sort of habit of panic attacks when your mind doesn't know how else to cope.
posted by photoexplorer at 8:52 AM on November 1, 2012

@ MangyCarface, yes, it does feel like I am actually immobile, and often results in me falling back into a kind of fitful, unpleasant half-sleep because I can't get up. I do not usually sleep on my back though.

@catatethebird: good point about hydration. I have been feeling incredibly thirsty of late and that's not typical for me. I'm typically a bit of a camel. Maybe it's very dry in the apartment with the change in weather. And yes, while the reconciliation has been going well, the relationship has always been insanely stressful at its best, so I'm probably underestimating the after-effects.
posted by like_a_friend at 9:10 AM on November 1, 2012

Given your response about your physical changes (thirst, etc), it sounds like a visit with your GP is in order.

I also agree with the advice about the alarm and looking at changes in habits like alcohol etc. If you had the same alarm through some of these recent difficult times, it may be that you hear the alarm and it triggers bad memories from your subconscious when you are in a dream-like state. Personally, I changed my alarm a few months after I left a job because I would wake up and get confused that I still had to go to that job. Just changing to a new $9 alarm made a big difference in my morning emotional state.
posted by artdesk at 9:37 AM on November 1, 2012

This has happened to me at various stressful times. I'm so sorry--it's such an awful way to start a day.

Visit your doctor and if you can afford it, I would suggest seeing a therapist too. It sounds like you have a lot of stress in your life. Even if there isn't anything new right now that stress can build up, and maybe the dam has just burst.

I also try to manage my anxiety without medication when I can, but I've started recognizing the times when the medication can be helpful. When I wake up in the middle of the night with anxiety, I take the medication because it's better to get back to sleep than try to spend an hour self-soothing. You may consider taking the medicine in the morning to break this pattern of waking up in panic. You definitely don't want your body to get used to feeling this way every morning.
posted by Colonel_Chappy at 9:53 AM on November 1, 2012

If you have a smart phone, you can download an app that uses a song from your playlist to wake you up, and which gradually increases the volume so you wake up more gently.

I don't have panic attacks, but I startle easily, and would wake up in fright when my alarm went off, which was a horrible way to start the day.

The app I use is "Alarm Clock Xtreme Free" for Android, and I set it to use familiar songs that I listen to for relaxation.

It sounds like you're developing a conditioned response - learning to panic in response to the alarm. You might be able to break the cycle before it becomes ingrained, by changing the alarm like I suggested, and trying to wake up naturally some mornings if you are able to.
posted by JeanDupont at 2:53 AM on November 2, 2012

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