Real Panic Attack...maybe It Is All In My Head?

[Science girl]

So I'm an educated women who for the last two years has been fighting the system and do gooders that say...it's burn out, stress, anxiety. My GP has again and again said your too happy and balanced for this to be depression or anxiety related. Positive tilt test, etc establish as POTS, mast cell issues, and osetomalacia...but...

On Friday we had some friends over who wanted to try and help me and my husband. The tension between us was high and I was on the verge of traveling to the other side of the world to my parents to rest (if my body would of coped with that). I had fainted on Wednesday which is only the third time for me (I'm normally hyper) and after these episodes I'm in a major flare. My husband was not coping with this at all. He was mad at the world and me. So that's the scene...lots of stress.

The thing that's got me in a spin is I had a major panic attack and throw everyone out of the house...I'm normally a very gentle and kind person! My heart was jumping out of my chest I was having symptoms lying down and I just snapped...I needed them to leave to stop the tension and to stop what was happening to me.

So do I actually have a panic disorder and not POTS? I figure that being in an overdrive place with my POTS and then the stressful situation my body just was tipped into a panic attack. Problem is I can't handle much relational stress at all now...I feel fragile (not exactly how I'd usually like to thing of myself!)

Guess my question is has this happened to anyone else? I've always felt so assured of my POTS diagnosis as the symptoms were all physical...even when I fainted and couldn't get myself to the couch I watch a movie with my girls to care for their emotional needs. So this event has thrown me.

By the way...hubby has got his act together so that good!

[lejones1]

If your question is whether you might just have a panic disorder, that seems very unlikely! Positive tilt table test, mast cell issues, fainting...you're not imagining those things or imposing them on yourself. It's not all in your head!

I definitely understand what you're describing though and have had all the same thoughts myself. I'm a pretty rational person and sometimes I have these moments where it's like my body and part of my brain are freaking out and the other part of my brain is like "what is going on? This is ridiculous." I'd had a few panic attacks a while before getting POTS, but I knew how I talk myself out of them. Then when I suddenly got POTS (but didn't know it at the time) I started getting "panic attacks" all the time, out of the blue, and I couldn't talk myself out of them. It was incredibly frustrating and I didn't tell a doctor about it for months because I thought it was just me being crazy. When I found out it was actually because of POTS and my body freaking out, it helped me manage them a lot. I've found my triggers - dehydration, low blood sugar, upright too long, overstimulation - and try to avoid them. And pay attention to how you feel leading up to these attacks. If you can learn your warning signs, you can nip them in the bud. So, for example, the other night once you felt your symptoms building you could have excused yourself and lay down in a dark room for 10 minutes, deep breathe, drink some water, etc. Some people will think it's weird or rude but that's their issue - you have to take care of yourself. This is not just panic - these are physical symptoms that you're not just going to be able to talk yourself out of.

I was reading something about POTS that other day that said that said the autonomic nervous system is at the intersection of mind and body, and I think that's so true. This is definitely a physical illness. But there are aspects of it that blur the lines with our emotional state as well - a fight or flight response is going to feel like a panic attack, regardless of whether you are actually worried about anything; neurotransmitters may just be chemical responses, but they can seriously affect your mood and behavior. Sometimes we get brain fog and we may seem really spacey, but there's a physical reason for that, it's not because we're boring or rude. And it goes the other way too - I think we're much more sensitive to stress, good or bad, than most people, because our nervous systems are overactive.

Try to learn to calm your sympathetic nervous system. As I mentioned before, pay attention to triggers. Try deep breathing and meditation. I started taking magnesium (natural calm) and it's been incredibly helpful. I usually just drink it at night, but if I feel really antsy and drink a glass, I can feel myself relax within a few minutes. (Warning - in some people it lowers their blood pressure.). Also, so glad you said your husband came around! I know this stuff can be really hard on partners as well, so try to help him understand how much of this is because of POTS so you can figure out how to manage it together. Good luck!

[Alison]

I've also been trying to figure out whether I have anxiety - I've not considered myself to have any emotional difficulties up till now, I'm 45. The experience that I had on the tilt table made me think that the POTS makes you have 'panic'. I have never fainted before the tilt table. I had an extended tilt table test (they didn't tell me but I'm guessing it was going to be for a maximum of an hour). After about 33 minutes I started to feel really uncomfortable, like I just needed to sit down, I asked for water, but I wasn't given it. This is actually how I've felt quite a lot, that I just need to sit down - and I always do, so maybe that is why I've never fainted. (I have no shame I'll sit down on the floor in an airport terminal, or where ever, I never knew there was a reason for me feeling this way). The minutes ticked on and I felt more and more uncomfortable, it was sort of agony standing there, I was very calm and matter of fact, just putting up with it, then suddenly my insides went crazy, I felt nauseous, and as if my body was frantic, perhaps like adrenalin fireworks were going off in my body, I didn't say anything, I was very calm, I realised I was going into a faint and then they lowered me down. That made me think that when people with POTS feel that they have anxiety and have panic attacks - may be they haven't, maybe they are just having a faint and that is how your body reacts.

I also think that it is stressful having this illness and carrying on normal life- we need to rest at times. That could be why you needed some space?

Despite not considering that I have emotional problems I have decided to try some therapy - I'll try anything and everything. I'll be interested to see whether the therapist thinks I have anxiety.

[gjensen]

The lines get blurred for me.

Panic/Anxiety came with this for me. It waxes and wanes, and it is no fun. I feel pretty certain that you do not have an anxiety or panic disorder. A doctor that I have discussed this with calls these spells of mine sympathetic over activity.

I can get these types of spells from a variety of triggers. A medication might be the trigger, pain might trigger it, something I am concerned about might make me vulnerable. The irony is I can be thinking rationally before, during, and after.

I trialed a medication four different times, and my body went into a panic each time. I thought it was the medication specifically, until I had the same reaction on a couple more things. It is as if my body feels the change and it panics. My HR goes sky high, and so does my BP.

Last night for no known reason, I was anxious and easily disturbed. I thought these feelings out rationally, but I was still in a state of alarm.

Generally speaking a panic or anxiety attack is often preceded by a thought process that feeds it. I do not have that. I can feel ok and be happy one minute, and going for a ride the next.

[TCP]

I've read many articles that say that the autonomic issues precede the anxiety. I strongly believe this as the nervous system responds so much to stress etc.

[Science girl]

Thanks for your replies. I guess this just took me by surprise. And there's that little part of me that says give up and say your crazy! I actually had a friend come over who has anxiety disorder and as she talked about it I realized that every little thing made her anxious. It's taken a lot to push me over the edge and so I'm hoping it's quite normal under the circumstances.

[gjensen]

I wish that it was as simple as it was "all in my head". They could have given me a pill for that a long time ago. I wonder how simple it is for people that do suffer from these disorders though. I realize that we could possibly work ourselves up into a frenzy of sorts, but I suspect for many of them it is not that simple either. I am certainly a lot more sympathetic to what that might be like than I would have been before.

[xRobin]

From what I understand (a very lay understanding at that) is when you stand up and your blood doesn't return to the brain and heart, your body releases stress chemicals to get the blood flowing which can lead to either tachycardia or a drop in blood pressure (fainting). These can make you anxious or agitated. I definitely get jittery after long bouts of standing.

As someone who has family members that are "crazy", ie suffering from mental illness, I think the mind/body distinction is kind of pointless and probably dated. Schizophrenia patients have been show to have elevated levels of inflammatory cytokines, depressives have abnormal cortisol levels, etc. People with parkinson's get mood problems. Our body is one unit, brain included.

[Hippycrip]

One of the hardest lessons I've learned about dealing with panic/anxiety is that when I start to get those feelings,I have to physically address-them now .I 'm way past the point of trying to stuff them down or ignore them.Mine come from more of a physical trigger than an emotional one but anyone who has them knows there very real and debilitating.What works for me is simply getting outside and moving my arms vigorously. After a few minutes the air hunger and anxiety becomes tolerable again and I get fresh air and exercise as well. You'll find your groove just experiment with some new things and don't ignore the warning signs your body gives you