Panic Attacks Are Back

[MarkyMark88]

This is my first time back in a long time. I take that as making strides in my treatment for panic and health anxiety but I always value this site as a tool for help.

That being said I am back as is my panic. I haven't had a panic attack (full blown) in a couple of years but yesterday out of nowhere I had one. And I couldn't help but be brought back to the day I had my first one.

My day was going fine and then after a healthy lunch I started having bad heart palpitations. To the point where I couldn't concentrate on anything. I'm used to them but these were happening very frequently, like prior to my first one two years ago. I took .25 mg of clonazapam to take the edge off which seemed to work but I was still feeling fluttering throughout the day. I had a good work out in the evening with the stair machine and boxing, which helped.

But then at around 9 at night I was just sitting in my bed and BOOM, I felt a MASSIVE head rush that seemed to last about 3-5 seconds and my heart rate elevated. I thought my vision seemed to get a little blurry. After that I became so exhausted I slept up until my alarm, which I never do.

I'm worried I'm falling back into the old days of fear. My health anxiety has always been there but I've learned how to better deal with it. That's not to say some days are worse than others but these episodes have lied dormant for the last two years and are back and I can't explain why.

Sorry for writing a book but I needed to put my thoughts down and hopefully seek some words of wisdom.

Mark

[Darksky]

Maybe don't try to explain why they are back. Don't look for a reason. You have hit a relapse that's all. It happens to everyone. You will get out of it quicker if you don't delve too deeply into the why's and wherefores of why it's happened.

revisit your coping strategies that aided your improvement last time. You did improve otherwise you wouldn't have known things had slipped again. You did it once and you can do it again. How long it lasts is up to your attitude towards it.

[MarkyMark88]

Thank you for the response. I have tried breathing techniques. However at times I feel the deep breathing is exacerbating them. FWIW I have an inhaler I take twice daily, once in the morning and once in the evening. I've been on it for a couple of months but I haven't been able to take it the last two days because the pharmacy took their sweet time refilling the order. I read inhalers can cause palpitations but I'm not sure if that's while taking them of being off them for a period of time.

[PanickyGuy]

@MarkyMark88 I just want to say, I'm in the same boat as you man. My Panic Disorder came back again last month with a vengeance. It had been about a year and a half that I managed to keep them at bay. And so, much like you, that's why I'm here roaming the No More Panic website again. But you know, I think Panic Disorder gets less and less frequent each time it hits us again and again after so much time without them. I guess it takes time and patience to finally conquer them in the long run.

Although to tell you the truth, at this point in my life, I'm starting to get really irritated with this damn PD of mine. But who knows, maybe that is the trick to stopping the madness.

[MarkyMark88]

Although to tell you the truth, at this point in my life, I'm starting to get really irritated with this damn PD of mine. But who knows, maybe that is the trick to stopping the madness.

Absolutely. It got to the point yesterday where my heart palpitations (which lead to the panic attack on Monday) were so frequent that fear turned into anger. Every time I would get one I would slowly get more and more agitated. So far so good today though. As much as I hate to admit it, it got to the point where I gave in and took a clonzapam. I've tapered down to half a tablet a day from two full tablets a day over the last year and a half, but it got so bad I've taken two full ones the last two days, and so far nothing as catastrophic as days past. That to me shows it has to be anxiety. If it was truly a heart defect I can't imagine anti anxiety meds stopping symptoms in such a short time. We'll see how I do once I go back down to half a tablet.

Good luck in dealing with your panic. It's great to know we are not alone, this site being an example. The thing that has also really helped me the last couple of days is exercise. Specifically boxing. You can feel your heart rate elevate and beat at a steady, constant pace with no palpitations to be found. And you get to take out those frustrations out on a punching bag. :winks:

[ankietyjoe]

Don't use anger, it does not work. I used to do the same, but ultimately it will prolong the issue.

As much as I agree that you just need to accept that you're having a relapse, I also disagree that you don't need to look for a reason. You don't need to go on a soul searching quest, but it is a good idea to have a look at what might be stressing you right now, and this can include over exercising. Over exercising is a massive issue for a lot of people because we are being sold the idea that you have to push yourself to the max, and this ain't good for you unless you really know what you're doing. Unless you have a prescribed dietary and physical recovery plan, you may well be doing more harm than good.

So, are you doing too much intense exercise AND letting your diet slip AND not getting enough sleep AND overworking AND worrying about X, Y and Z? In isolation these things seem trivial, but they can add up.

The exercise may help during the moment, but I found that when I suffered with stress based anxiety I would get massive rebound anxiety 2-4 hours after I did the exercise.

[MarkyMark88]

All of that stuff most likely is playing a part as I am trying to get back on track from vacation and the holidays. I would disagree with the exercise part though. But I am keeping in mind that not one person is the same and everybody's bodies and mental landscapes are different.

I'm sure it has to do with recent labs I had done and an upcoming hematology appointment I have. But I wasn't fretting about it has much after I had the blood work done. Some of the values had elevated past the normal standard a little but nothing crazy, and my fiance and I researched it and I felt better afterwards.

It's just that these palpitations seemed very abnormal. Not like the ones I'm used to that pop up every once and a while. That specifically is what stoked the fear.

[ankietyjoe]

But I am keeping in mind that not one person is the same and everybody's bodies and mental landscapes are different.



Mental landscapes yes, bodies...no. Physically, we are all more or less identical in terms of CNS makeups. Over exercise is a stress, this is Universal. The only way the stress can differ between people is what they have in reserve (are they already stressed, do they eat and sleep right etc).

Try and look at your own evidence -



But then at around 9 at night I was just sitting in my bed and BOOM, I felt a MASSIVE head rush that seemed to last about 3-5 seconds and my heart rate elevated. I thought my vision seemed to get a little blurry. After that I became so exhausted I slept up until my alarm, which I never do.


The fact that your anxiety is coming back points towards a stressed system, and stress comes in multiple forms. Is there a reason you're having regular bloodwork done?

[MarkyMark88]

Is there a reason you're having regular bloodwork done?

There is. Last year I was diagnosed with hemolytic anemia. This is my one year follow up with my hematologist in regards to it. I have these same blood tests done again during my routine physical in the summer with my PCP. In total from when I was diagnosed until now I've probably had 50 different specific blood tests done. Not 50 needle pokes but viles filled. Not including ultrasounds and MRIs of my liver, spleen and pancreas and everything else in that general area. It was a lot.

I just get naturally worked up when it comes to blood tests. Some of the values on my liver panel were elevated, specifically my bilirubin. My reticulocytes were also elevated, which makes sense with this disease. But still elevated from my last test. I'm not so much worried about this disorder specifically, with him saying last year if anything became catastrophically out of wack it would just be a matter of putting me on a steroid. I just get worried they will find some underlying cancer or something. It's how I'm wired. I get that worry in the back of my head for every CBC or Diff test. Kind of went off with my whole life story there lol.

[ankietyjoe]

Ok, it's not 'just how you're wired'. People often cite this as a reason for persistent health anxiety, but it's just not true (in my opinion). Everything we think about is a combination of experience and habit. Neuroplasticity is a thing, and is another Universal truth. You can un-learn thought patterns, even when you have a specific and identifiable worry like you do.

In any case, have you investigated the reason for the condition? Have you been told why the hemolytic anemia exists in the first place?

What generally happens is that you'll be given a diagnosis, and then self research starts to happen and that inevitably leads to the ultimate conclusion that something terrible and terminal is going to happen, and that thought becomes lodged in the brain as we practice re-thinking it over and over again. This form of anemia could potentially have been caused by a course of medication you took for example, has any of this been investigated?

Either way, during the time where you have elevated stress hormones, it is important that you keep yourself physically and mentally relaxed, hence mentioning the exercise as a potential additional trigger. Especially if it's intense boxing training (there's nothing more intense than that in my experience!).

[MarkyMark88]

He was very thorough in telling me some of the reasons for this and what it is .There were a few different tests we did for said reasons which all came back negative. Which is why the tests and diagnosis of this anemia doesn't bother me that much. It's the, "we incidentally found something while testing you for this." And that fear stems from hearing stories and reading things in the past. That's my biggest problem.

I do practice relaxation techniques but exercise is key for me with relieving stress. I find it easier to relax and sleep better after a good workout. It also puts my mind at ease to know I'm only strengthening my heart, cells and body because of the workout.

I agree with your points in regards to workouts exacerbating anxiety as you experience the same symptoms as with panic attacks. When I was having panic attacks regularly I became afraid of exercise. The lightheadedness and elevated heart rate would play tricks with me at one point I did have a panic attack in the middle of a workout. In fact, that's when I had my first one. But I had to retrain my brain to realize those are normal sensations you get when exerting yourself.

[ankietyjoe]

What you're saying is very familiar to me. The evolving nature of fears surrounding the heart.

One thing I would suggest/urge is to try and not focus on the exercise strengthening your heart, because there's actually nothing wrong with your heart. I think that alone is a logical, but slightly anxiety supporting way of looking at things, if that makes sense? It's almost bordering into an OCD type behaviour where your brain fears repercussions if certain actions aren't undertaken.

Only you can gauge where the sweet spot lies with your exercise, but a lowering of volume will possibly still give you the calming and sleep benefits without pushing your CNS too much. Maybe try HIIT for a bit, as although it's high intensity (duh), the duration is low enough not to keep cortisol spiked for a very long time.

But going back to this idea that you need to keep topping up your heart health with exercise...maybe try and break that mental connection a bit too?

[MarkyMark88]

I believe my therapist put OCD down as part of my general anxiety on a form I needed him to fill out for work. There was a time I would poke and prod my body to make sure everything felt the same on one side as the other. If i felt a bump somewhere there better be a bump in the exact same place on the other side of my body.

As far as the mental conditioning relating to working out it's hard for me to break that cycle. It's not so much I'm exercising because, in my head I'm telling myself if I don't do this my heart will weaken, it's more along the lines of what it does for me as therapy. (At one time I was definitely more in that mind set.) That's one of the main reasons I got into boxing. Another workout I discovered is rebounding. Basically jumping on a small trampoline. The science behind putting your body through these types of exercises are incredibly beneficial. Not only physically but what these exercises do for your mind as well. But, if in the back of my mind I KNOW what I'm doing is benefiting my heart, I think that's an ok thought to have.

[ankietyjoe]

It sounds to me like you have a choice here, and that choice is whether you look after your mind or you look after your body. Now ultimately, the two are linked to such a great degree that you can't really make the choice of one or the other, but if you focus only on the physical, your mind WILL suffer as well. If you focus only on the mental, it will be months or years before your body really suffers, especially as you're starting out from a 'fit as fvck' starting point.

Yes it's hard to break the cycle, that's true of everybody in your/our position, but it still has to be done.

You can keep yourself in condition by just doing HIIT for 6 months. Yes, the intensity is high, but the duration is so low (relatively) that you're not spiking cortisol for long enough to stress the CNS. Maybe try and make the transition to only doing HIIT over the next month or so and pull back on the weights/boxing as they absolutely will keep you stressed, 100%.

As much as exercise does benefit the heart, you're only focusing on that and it's causing issues. In a way it's like saying salt benefits the electrical transportation of energy to the cells, and therefore only eating salt.

Nobody is telling you to stop exercising, merely suggesting you kick back on intensity.

[StilnotDead]

Hey there, i used to have heavy health anxiety, heart attacks were what i feared even though I gym every single day of my life. It got so bad that I could nt be alone and if i was to be alone i would drive myself to a hospital and wait there until somebody got home.. u know just incase.

I know you've heard this a million times before but fear feeds fear i know my pshycologist told me that over and over and I never bought it. One day I was sitting in the car waiting for a friend who had run into a store. I was fine and boom just like you that rush of impending doom came all over me, as i was sitting there planning how to get out of this i heard a knock on the window... it was a friend from hi school that i hadn't seen in more than a decade... he said hi and just started asking question all excited and you know we were really good friends because even i was excited, after he left ten mins later i had realised i forgot about my anxiety..... and thats when i realised fear feeds fear.

The big trick with this is not to say let me not think of this ( if i tell you dont think of waffles .. you will be thinking of waffles.) Distract yourself is also a nice short term solution but i feel its aversion to a point... a person sort of needs to get to that point of ok this is happening, its happening a million times before and im probably going to feel bad for the next hour at most... and move on... sometimes taking the power away from it greatly diminishes its intensity.

I would not lower exercise intensity...if you start limiting the things you know you are capable of doing you are giving it more power over you. Its also aversion. In my humble opinion and i know everybody is different Acceptance was a absolute anxiety killer.

Sorry for the SA :) Hope you are doing better now though !!

[ankietyjoe]

I would not lower exercise intensity...if you start limiting the things you know you are capable of doing you are giving it more power over you. Its also aversion. In my humble opinion and i know everybody is different Acceptance was a absolute anxiety killer.



There's a big difference between avoiding normal situations (going to the shops, seeing friends) and reducing something that is scientifically proven to increase stress, adrenaline and anxiety. Just because you're capable of doing something, doesn't mean it's the right thing to do right now.

But acceptance is definitely an anxiety killer, for sure.