It is winter here in the northern hemisphere, and while the temperatures at night have been dipping into the teens, I keep waking up drenched in sweat. My alarm clock is set to 6:45am, but hours before my brain stages a sabotage. At 3:45am I wake up in a full blown panic attack.
I’m not prone to having nightmares, and even when I do have them, I never sleep deeply enough to be much affected. It doesn’t much matter what the dreams are about. Panic attacks sneak in behind even the most pleasant dream, and last night, it ruined a perfectly good float on a lazy river.
Panic: the third wheel
Panic attacks are not necessarily indicative of a panic disorder or generalized anxiety. The human condition itself makes us all vulnerable, and many people experience at least one panic attack during their lifetime.
There is a correlation between mood disorders and panic disorders, however. Mood and panic disorders are often comorbid, particularly in the case of clinical depression, for which comorbidity runs upward of 50%.
The explanation for this phenomenon makes sense. Depression and Panic Disorder both affect the brain similarly, stimulating the hypothalamic-pituitary-adrenal axis function, as well as the neurotransmission of serotonin.
The good news is that because of this connection, many of the medications that treat depression can be beneficial for the treatment of panic attacks.
Identifying a panic attack
As the clock rounded 4am, my sweating had stopped, and my heart fell back down my throat. I wasn’t dizzy anymore, and my stomach had ceased screaming.
Panic attacks are typically quite short (peaking at about 10-15 minutes) although for me, it takes about another half-hour to fully come down.
My panic attacks are relatively infrequent, and mostly when my bipolar is swinging toward depression. When they do occur, they can be terrifying. Panic attacks, by definition are unprovoked. No one is quite clear of the triggers, and they very well may be different for everyone.
As a result, many people misinterpret panic attacks as heart attacks, or other medical emergencies. Even when sufferers are aware of the condition, the severity and terror that comes with it can cause great anxiety about having another attack.
When you look at the list of symptoms, it’s easy to understand why:
- Palpitations, pounding heart, or accelerated heart rate
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, light-headed, or faint
- Chills or heat sensations
- Paresthesia (numbness or tingling sensations)
- Derealization (feelings of unreality) or depersonalization (being detached from oneself)
- Fear of losing control or “going crazy”
- Fear of dying
Experiencing four or more of these symptoms simultaneously MAY suggest a panic attack.
What to do
There is no “one-size-fits-all” method of getting through a panic attack, but I’ve found my own method of riding it out, and it might be a good starting point to find a method that works for you.
- What’s Happening?
The first thing you have to do to fight a panic attack is to know that you are having one. The first instinct for me during the onset of an attack is to think that there is something wrong in my immediate environment. Once I notice there is no imminent danger, I can accept the panic for what it is and start the coping process.
Once I realize that I’m having an attack, I can use deep breathing to help get through the panic. There are countless breathing techniques, but what works best for me are just full, deep breaths.
Panic attacks are quite short (10-15 minutes). I made the decision one day to time my attack. It was over in 11 minutes. Now, every time I feel an attack starting, I set a stopwatch as a reminder to myself that it will all be over soon.
When an attack is over, it’s important for me to take a moment and realize what I’ve been through. I realize that I am able to get through a panic attack, that it was unpleasant, but that I came out not only OK, but stronger for practicing my coping skills. That way, when the fear of having another panic attack arises, I can remind myself that I have the skills to get through it.
Let go of Fear
When my wife woke up (at an actually reasonable hour), I told her that I had a mid-sleep panic attack. She hugged me and asked me if I was okay. In that moment, I finally was.
Panic attacks can not only be truly terrifying, but also somewhat embarrassing. For the uninitiated, a panic attack can seem like an out of nowhere irrationality (I’ve been told to stop “freaking out”) and as a result, a lot of people suffer in silence.
I want to tell you, you don’t have to be alone in your suffering. Tell someone. Be honest. Be open with those you love. You might be surprised.
You may be met with a “I’m so sorry, I get those too.”