Panic Attacks, what's actually happening to me?
I can only speak from my experience. This is not professional help.
This article is intended to help you understand what is happening during a panic attack in order to better know how to help yourself or a loved one.
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If you’ve had a panic attack before, you’ll most likely resonate with some of the following examples. If you haven't had an attack and you’re here to understand someone in your life who experiences them, try to imagine what it would be like to be in their shoes in order to have compassion and possibly be of help.
List of some of the effects panic attack can have on perception during an attack:
Feeling unable to breathe
Being confused
Feeling overwhelming emotions of fear, sadness, and/or anger among others.
Depersonalization. Perhaps it is an out of body experience, or being unable to know who you are.
Feeling stuck and like there is no way out.
Hallucinations or feeling as if you are inside of a dream. Everything seems unreal.
List of some of the effects panic attacks can have on the physical body:
Increased heart rate
Hyperventilation
Uncontrollable crying
Shaking
Violent behaviors
Chest pain
Stomach aches
Muscle aches
Hot flashes
The way to overcome panic attacks is to understand what is happening to the body and identifying our unique patterns and triggers. A “trigger” is a well known term that refers to a person, place, experience or feeling that begins the onset of a panic attack. These are very important to pay attention to as often an attack may seem like it comes out of nowhere. However, with awareness of the unique triggers one may have, we are able to be proactive when an attack happens or even prevent it completely.
We want to understand what’s happening to our body during an attack so that we are able to stay aware during the attack. If you can stay even partially aware, you can put that awareness into remembering to breathe. This involves practicing awareness on the regular. Don’t wait to practice your breathing in the middle of an attack. Practice beforehand.
In order to be able to remember to breathe, it is best to practice breath awareness throughout everyday, as often as possible. This is so pivotal! Every single panic attack I have ever experienced came with hyperventilation and I’ve had a lot. I was having attacks once every other week to once a month for about 4 years until it started to taper off in the last 2 years since I've been doubling down on what I can do to overcome them.
Regardless, hyperventilation is very common during an attack. Therefore, I can say from experience that breath awareness is the very best tool we can use to overcome panic attacks or anxiety attacks. No matter where we are in our journey, we can expect massive shifts when we start paying attention to your breathing throughout regular everyday life.
Hyperventilation causes the regular blood flow through the brain to be disrupted. That’s when things start to feel foggy and we get disoriented. When breathing rapidly, more carbon dioxide is exhaled from the body than usual. Carbon dioxide regulates the pH in our blood and affects every single cell of our body. When pH increases above normal it is called, “alkalosis” and all cells become more alkaline than normal. We’ll discuss the effect alkalosis has further along in this post.
Additionally, the pressure of carbon dioxide in the blood is what stimulates breathing. So someone who is having a panic attack may not even think about breathing. It just simply doesn’t register that they aren’t breathing and there’s nothing to remind them.
Anxiety affects our nervous system and vice versa. Having an unregulated nervous system due to improper eating or rest causes stress without any mental triggers being involved. The same is true the other way around, negative thoughts will bring disharmony to our nervous system.
Breathing deeply and slowly is the best way to regulate your nervous system while having a panic attack. Our breath is the one automatic function of our nervous system that we also have the ability to control through conscious thinking.
Breathing deeply could be a challenge due to crying. While crying your mouth is preoccupied with noise and it doesn’t help to have a stopped up nose. In fact, crying often led me to hyperventilation because I was not breathing properly. Often my attacks came with intense uncontrollable crying that would last for 30 minutes to 2 or 3 hours.
The long lasting effects of crying have caused me to hyperventilate more than once during an episode, causing multiple waves of panic attacks. I started timing my attacks because it is a grounding exercise for me. Plus, that's what you do when you have panic attacks on the regular, you do your best to get familiar with your unique patterns. Track them in a journal.
Panic attacks affect your breathing just like they affect everything else in your body from increased heart rate to the decreased blood flow to the prefrontal cortex of our brain. This is the part of the brain responsible for rational thinking such as memory, conception of time, focus, the concept of self, and reflection and contemplation (the big picture perspective). In fact, not only does a panic attack restrict blood flow to the brain, it also changes the way blood circulates in the brain. When a panic attack is triggered, it only takes a few seconds or minutes before the blood flow is restricted to the prefrontal cortex. Let’s discuss why blood flow is restricted and how this affects the brain.
Low amounts of carbon dioxide in the blood narrow the arteries supplying the brain with blood, causing the cerebral blood flow to be reduced. What is happening is directly related to the carbon dioxide pressure in the blood. We already discussed how carbon dioxide is thrown out of whack during a panic attack due to improper breathing.
Since not having enough carbon dioxide makes the blood acidic (alkalosis), oxygen will bind more tightly to hemoglobin in the blood and not be as easily released into our tissues. Therefore, even though there is enough oxygen in our blood during hyperventilation we are not able to absorb it.
So we can see, there’s more than one factor reducing oxygen to the brain and causing those “crazy” reactions. The lower the carbon dioxide, the lower the blood flow to the brain. Lower blood flow means less oxygen is making it into our brain. Not having enough oxygen in our tissues is called “hypoxia”, which can lead to confusion and many of the symptoms listed at the beginning of the post.
Some of my personal experiences with panic attacks
May you get a better understanding of what someone in your life is experiencing or know you yourself are not alone if you experience episodes.
Jump to “How to overcome panic attacks? | 4 Tools”
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The first time it was obvious to me that I was hyperventilating, I didn’t know I was also having a panic attack. In fact it was at least a year of having attacks on the regular before I started to realize I had anxiety. Then finally I put two and two together and realized I was experiencing panic attacks and not just anxiety or anger issues.
I started to be afraid of having more attacks, at this point they seemed like clockwork. I began walking on eggshells in my own skin. I was very resistant to the attacks, causing even more anxiety. This caused them to get worse. However, as uncomfortable as they were, now in hindsight I see each attack brought more awareness around what could be triggering me and the patterns I saw in myself to watch out for.
At first, I thought that my attacks were a moral issue. I thought I needed to control my anger and yet felt completely powerless to do so. Then I would beat myself up with shame for the next few days, wishing I could be different. My inner dialogue was very mean and self-degrading. Not realizing that the anger during an attack was often triggered by attachment issues or simply being angry at myself for having another attack.
Many attacks seemed like out of body experiences or at least came with depersonalization. The first time I noticed this was at about 21 yrs old, I felt like I was floating in a yellow funnel (very spiral like). I was very afraid, I had no idea what was happening to me, and I didn’t know who I was.
Thinking back, I realized this feeling was similar to one I felt as a very young child. I was on the top bunk of my bed and I felt like I was dreaming but I knew I was fully awake. Although I didn’t see anything visually or feel anything physically, I could sense that I was in a factory and that my body was being smashed and cut in pieces to be used for clothing. I felt stuck and confused. My body didn’t feel comfortable, I’m sure my nervous system was playing tricks on me. I was very scared and I remember going to my mom saying I had a bad dream but that I wasn't asleep.
Other attacks were simply induced by primal fear, such as a fear of heights. Although often it was still irrational and only perceived fear. Last winter I had an attack in public while at work. Since I was at work I couldn’t leave immediately and I was surrounded by people I knew and lots of people were asking me if I was ok, I felt very embarrassed and could not stop crying. Many attacks have involved embarrassment.
Recently I had a very bad attack where I purposely hit my head on the floor and somehow my nose was bleeding. I was also trying to pull out my hair. This is nothing I would never do in my right mind. I love myself deeply and have spent years cultivating my inner relationship. This recent attack is what inspired me to write this post as I know I can gain more awareness of myself through speaking about it and hopefully help someone in the process.
During this recent attack I was begging for help. I have spent many hours begging for outside help. I used to pray with utter desperation for my anxiety to go away or be taken away from me, then feeling abandoned by an idea of ~God~ that I had when the magic wand wasn’t waved. There are no shortcuts, we must learn and grow at our own pace.
Now I realize all strength and comfort is within me. It’s my choice what kind of life I live from here on out. Some things from the past may still show up inconsistently. Even having an attack recently seemed out of place compared to how long it had been since I’d had an attack. My mental state is at an all time high as far as consistency goes.
One of the biggest ways I have been able to overcome recurring panic attacks in the long run, is realizing how few and far between the attacks become with practice. Not identifying with “yet another attack” is very pivotal. I can choose to see it for what it is, just an attack and not a moral issue. Not an identity issue.
Will they ever go away completely? Yes, because belief is what makes things possible. Perseverance and the will to refine my emotional wellbeing will drive me on until the day. For in truth, all is complete. I am even now at the finish line, and so are you. Today is the day! We must see ourselves in light of who we truly are. Seeing ourselves in the present tense of all we aspire to be; now already fully realized. It only makes sense to involve our mental attitude when dealing with mental health.
A powerful tool to understand recurring panic attacks is getting to the root of where things started. This allows us to understand our history of attacks and find patterns. If you want to find one of your own first occurrences do this mental exercise:
While in a relaxed state see if you can imagine what it feels like to have an attack. Tune into what it felt like to have a panic attack and try to remember other times that felt that way. Don’t get lost in these memories, only feel them long enough to pinpoint them and then release them. We are not trying to recreate these experiences by reflecting on them for too long. We don’t want to dwell there, we just want to be aware. Once we have a greater awareness of ourselves we will be able to understand our triggers and what disempowering beliefs or fears need to be addressed. Often when we find what originally caused a pattern of behavior, we will know what step is needed to move us towards greater wholeness.
One of the first memories I found was of myself as a child crying uncontrollably after getting angry at a sibling. I felt unforgivable, like I was very “bad” and stuck that way. I remember wanting someone to comfort me but when someone would come to my rescue I would scream at them to leave me alone. Then I would feel even alone and guilty, wishing I could have allowed them to stay. I remember many times feeling this way. Of course these patterns showed up in adulthood as well.
Sure enough these reactions to triggers were long since practiced reactions. Ones rooted in shame, attachment issues, and low self-esteem. When anyone practices things for years it’s going to be fairly easy to recreate those experiences. If, like me, you had no idea what was happening from a young age, you probably found yourself in adulthood with subconscious work to do.
In fact, I know so well that this particular scenario is at the root of my attacks. One of the reasons I felt so guilty for getting angry at my siblings was because I had a deep desire to please an idea of ~God~ that I had. I felt like I wasn’t living up to the mark. This exact feeling showed up the first time I realized I was hyperventilating as an adult. I had just taken a psychedelic for the first time and I had no idea what I was getting into, I had never been “high” from any substance in all my life and I took more than someone would want as a first dose. I grew up very conservative and so after being triggered by embarrassment, I started feeling guilty for taking what I now see as medicine, but then saw as “sin”. Due to my perspective, I started hyperventilating because I felt a sense of my current (at the time) view of ~God~ and it was very scary, dark, black and shadowy, very incongruent with the perspective of ~God~ I wanted to hold for myself and that I now understand to be true for me.
It is very possible that taking psychedelics is what started my adulthood panic attacks. It is likely someone will have another panic attack after they have experienced one for the first time. However, I am an advocate of psychedelic medicine being used in mental health, especially that of micro dosing. That being said, I would not encourage anyone to do or try anything (especially something illegal), I’m only speaking from my own experience. There are places where psychedelic medicine is legal and offer professional services where someone can sit with you and guide you through the experience.
In the end, panic attacks have helped me surface many subconscious beliefs that do not serve me and I am very thankful for how far I have come. I see that I am ahead of where I would be without them, I’m more conscious than ever before.
How to overcome panic attacks
Start with the triggers. Figure out what they are for you and take note of them.
If you have a fear of being unlovable, you must convince yourself on the regular that you love yourself. That way you have more than one thought pattern to choose from when triggered. Being triggered is nothing more than a habitual brain pattern, one that is all too familiar. Therefore in order to truly love yourself you would need to write a new pattern and get really familiar with it.
Sometimes all this takes is refraining from believing the old habits of thinking that bring you down and naturally good ones will take their place.
Other times it involves intense rewiring of the subconscious mind through repetition. Repeat the new thought patterns until they stick. I like audio recordings, what’s your learning style?
Take care that you don’t cancel out your positive affirmations by continuing the old mental beliefs. You want to be congruent through and through. Consistency is everything, stay consistent by empowering yourself with new thought patterns on the regular.
2. Have a goal that’s measurable.
An example of a good goal would be not to hurt yourself physically in any way, perhaps to remain non-violent. Another would be not to say a certain degrading phrase that keeps coming up repetitively in attacks like, “I don’t want to live anymore”. That way you will know you are successful if you can get through an attack not having experienced suicidal thoughts or self-harm. Will we always achieve our goal? Perhaps not, but it’s important to have a goal that is more specific than just “never have another panic attack”. That way we know when we are moving forward even if we still have an attack.
What is your goal? Write it down.
3. Make a list of grounding tools and safety cues to use.
Grounding tools and safety cues can be very helpful to review on a regular basis, that way they are not too far from your thoughts if an attack occurs.
A grounding tool is something you can do that keeps you centered in your body, such as breathing, which we discussed in detail.
A safety cue is something you have predetermined in your mind as something that makes you feel safe. Often loved ones are the best safety cue, but we cannot always rely on others, so I encourage you to use physical objects as well. An example would be a fuzzy blanket or a piece of jewelry given to you by someone special. Think about small things that are often on hand that make you feel safe and consider making a list.
Grounding Tools that have helped me are:
Breathing
Watching the clock
Using physical activity such as dance, exercise, or a simple walk
Asking someone for a hug
Asking someone for help
Writing
Listening to an uplifting recording or meditation
Putting on uplifting music
Using physical safety cues
4. Keep a written record of occurrences.
Ask these questions to yourself:
How long did the attack last?
What happened before the episode?
Was anything different from past episodes?
How aware was I during the episode? Was I able to realize what was happening to me?
Did I achieve my goal during this attack?
How can you be there for a loved one who experiences panic attacks?
Things you could do to help a loved one who experiences panic attacks:
Remain calm yourself.
Ask them gently for permission to help them or be in their presence.
Stay close by. Even if they do not want your help, remain nearby so that they feel supported, while still honoring their space.
Remind them to breathe. Coach them to breathe deeper and slower. Try to make it their idea, don’t be demanding.
Pay attention to changes in their breathing to gain insight into their current mental state.
Reassure them that everything is going to be ok and that this will pass soon.
Refrain from saying anything that might disrupt their mental state further. Even if they are acting crazy, don’t tell them they are crazy.
Refrain from trying to force them to calm down. Let them know it’s ok that they feel the way they do. Let them know you accept them the way they are.
A simple hug goes a long way, but make sure you ease into it. If you go up to hug someone having a panic attack it could cause further disruption. Attachment issues can often be a trigger.
A firm hug goes a long way. If someone is moving excessively, throwing themselves around or being violent, consider a firm hug. Sometimes restraining them from hurting themselves could make them feel safe. Always put your own safety first. If they are feeling extremely out of control they may benefit from feeling like someone else is in control. However, be careful to let them go if they resist for more than a few moments or you start to notice their mental state changing for the worse. If you do not see them start to calm down, let them go. You can repeat the process multiple times to allow them a sense of being in control, giving a firm hug and then letting them free. (As odd as this one is, I want to include it because it really helped me through some attacks, but use caution as everyone is different and holding someone down could be a trigger for some).
The Science Behind Hyperventilation: http://www.anesthesiaweb.org/hyperventilation.php