View Full Version : Panic Attacks Wake Me Up in the Morning
Hi all,
Lately I've been having bouts of panic attacks that wake me up in the middle of the night or very early in the morning. The first round a few weeks ago was quite bad (a temporary scrip for Zyprexa helped calm it down), but I'm in the middle of the latest one now. For the last five days, I wake up at 5 or 6am feeling okay, but then something startles me into a mild panic attack (elevated heart rate, pit in my stomach w/nausea, feeling shaky and uneasy) and I can't go back to sleep.
The problem is, the physical symptoms hang around, and as they start to subside, another minor panic attack usually hits and sends them through the roof again. So I spend all day on this rollercoaster, which is utterly exhausting and makes me feel like I'm barely keeping it together all day, every day. It's really wearing me down, and being stuck in my home without a job (I live in a major city in the US where COVID-19 is still running rampant) isn't making things any easier.
In all honesty, I've only recently started taking the non-medication parts of lessening anxiety seriously (journaling, meditating, getting outdoors, exercise, cutting down on caffeine and sugar, etc.). I used to rely solely on my meds (225mg Effexor, 100 mg Lamictal, with the occasional .5mg Xanax when things get really bad. I also take Lopressor for heart palpitations).
My main question is: how long does it usually take for these efforts to start making a noticeable difference in improving your panic and anxiety? And in the meantime, what do you do to keep from absolutely losing it?
Thank you all in advance for any guidance.
All anxiety/depressions medications take time to work usually weeks, in the meantime unfortunately you have to try and cope, I know it isn't easy but support groups and chatting with like minded people can help keep you calm.
Have you had any side effects while taking any meds?
Sorry, to clarify, I've been on the meds for quite a while. It's the non-medical stuff that's new (getting a regular routine going of meditation, journaling, exercise, being outdoors, etc.)
I'm wondering how long it took for people practicing those things to see/feel a benefit from them with regard to decreasing their anxiety. And what coping techniques people employ while waiting for them to start helping.
Midnight-mouse
17-06-20, 07:41
Sorry, to clarify, I've been on the meds for quite a while. It's the non-medical stuff that's new (getting a regular routine going of meditation, journaling, exercise, being outdoors, etc.)
I'm wondering how long it took for people practicing those things to see/feel a benefit from them with regard to decreasing their anxiety. And what coping techniques people employ while waiting for them to start helping.
There’s no fixed timeframe, just preforming the actions isn’t what decreases the anxiety it’s the change in mental state that occurs because of those things that does. But it’s not automatic, it still takes time and effort from us to change the way we respond to panic/racing thoughts etc, the routine of meditation, journaling and exercise just helps reinforce the changes your making in the way you deal with your mental health.
Unfortunately there’s no magic bullet, a person can be perfect at preforming all the things in the world that can aid lessening anxiety and still be an anxious mess because without gaining the control to break the cycle it’s still nothing more than a performance. Of course not to say that these things aren’t brilliant in helping with anxiety for some, it’s more the frame of mind achieved while doing them that helps.
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ankietyjoe
17-06-20, 15:10
There’s no fixed timeframe, just preforming the actions isn’t what decreases the anxiety it’s the change in mental state that occurs because of those things that does. But it’s not automatic, it still takes time and effort from us to change the way we respond to panic/racing thoughts etc, the routine of meditation, journaling and exercise just helps reinforce the changes your making in the way you deal with your mental health.
Unfortunately there’s no magic bullet, a person can be perfect at preforming all the things in the world that can aid lessening anxiety and still be an anxious mess because without gaining the control to break the cycle it’s still nothing more than a performance. Of course not to say that these things aren’t brilliant in helping with anxiety for some, it’s more the frame of mind achieved while doing them that helps.
This is absolutely spot on.
The key part of all of this is accepting where you are right now. If you wake up at 5am with anxiety and then fret about it all day, waiting for the next symptom there's nothing you can do or take that will make the anxiety go away, not a single thing.
When you wake up at 5am tomorrow, tell yourself that you know this is just a symptom, and that it will pass. Also accept that the current situation for you and billions of other people is incredibly unsettling, and if you can even begin to keep a lid on your anxiety right now you'll doing better than most.
Look at the language you're using both externally and internally 'barely keeping it together' or 'sends them through the roof'. It's mental sensationalising and doesn't do any good, and isn't necessary. We ALL do it, but it's another habit that's worth leaving behind. Tomorrow morning say 'this is just anxiety', 'this is just a sensation', because in reality that's all it actually is. Anxiety disorder is a problem of reaction. You observe a stimulus, and you react. How you react is where the magic bullet can appear, with practice.
At best, you're looking at a couple of months for any anxiety 'cure' to take effect, but stuck indoors with no work during a pandemic is not going to lessen that time, right? But you're doing the right thing and it will work eventually.
In the meantime, moan about it here! But moan constructively. Don't fall into the trap of using a forum or journal to whine about how bad you feel (again, we've all been there). It's not good for you.
Thank you both for taking the time to respond; it really means a lot. You've given me some things to really think about.
My use of language never even occurred to me, but you're totally right. I'm still in the earliest stages of learning CBT, which I'm hoping will be really helpful in changing my mental state and teaching me about fallacies in my thought process. My new therapist told me that I have to "get comfortable with being uncomfortable" which is generally a feeling I try to avoid at all costs. I'm so used to the "tweak your meds and ignore it and it will go away...for a while" way of handling things, but I know that's not healthy and won't bring about the change I'm looking for.
I'm really trying; it's just so difficult to feel so bad so much of the time. Sometimes I don't know how I can possibly keep this up except that I know that I have to. This is honestly the hardest thing I've ever done, and I'm only at the beginning.
ankietyjoe
19-06-20, 12:27
My new therapist told me that I have to "get comfortable with being uncomfortable" which is generally a feeling I try to avoid at all costs.
Then your new therapist is a good one. This is crucial to recovery, you cannot recover while running.
Sometimes I don't know how I can possibly keep this up except that I know that I have to.
Well, to put it bluntly, you don't have a choice. There is no quick exit. Accept that, and you're another step closer to 'winning'.
Yes, it's a long journey, but once you 'get' what CBT is about and alter your view on constantly trying to avoid any kind of anxiety it makes it much, much easier to cope with in the short term.
Meditation goes hand in hand with CBT and acceptance. You are basically rewiring your brain to not react to every single little thing.
I'd also like to add that idleness is the enemy of most anxiety sufferers. There are some people that we know here on NMP that only have flare-ups of their anxiety when they are forced to be idle. It's like the anxious brain will fill your thoughts with something to worry about if you don't keep it occupied or learn how to change your thinking. The fact that you're home with nothing to do has probably made things worse. Are there some new hobbies that you could start as you work on changing your thinking?
I know the acceptance will be hard for me, but I'm working on it. Same with the not running. I've 100% lived my life thus far not being able to accept that sometimes things are less than ideal (or have to be for a while) and running away from super uncomfortable things.
My therapist and I started with grounding techniques today, so we've officially kicked off down the CBT road. I'm actually excited to start putting this stuff into practice and trying to wrap my head around it conceptually.
Ugh, the idleness is such a problem. You're totally right about that. I have an intense phobia surrounding death and dying (I lost my mom to cancer a while back and I was her primary support during the whole process) so being in the middle of COVID-19 and the resurgence of (necessary) attention to the BLM movement makes me feel like I'm surrounded by it all the time.
I've been trying to fill my time as much as I can. Taking a couple of online courses, doing puzzles, painting, baking...anything that requires focus and concentration.
Some other things you might consider: daily exercise (can't stress this one enough, especially to help with physical symptoms), yoga, journaling, self-help books, book clubs.
Another thing you might want to consider is that you might have some residual trauma from your mother's loss. Sometimes instead of dealing with our trauma, we invent other things to solve, like a sickness we don't have.
ankietyjoe
24-06-20, 12:07
I know the acceptance will be hard for me, but I'm working on it. Same with the not running. I've 100% lived my life thus far not being able to accept that sometimes things are less than ideal (or have to be for a while) and running away from super uncomfortable things.
My therapist and I started with grounding techniques today, so we've officially kicked off down the CBT road. I'm actually excited to start putting this stuff into practice and trying to wrap my head around it conceptually.
Ugh, the idleness is such a problem. You're totally right about that. I have an intense phobia surrounding death and dying (I lost my mom to cancer a while back and I was her primary support during the whole process) so being in the middle of COVID-19 and the resurgence of (necessary) attention to the BLM movement makes me feel like I'm surrounded by it all the time.
I've been trying to fill my time as much as I can. Taking a couple of online courses, doing puzzles, painting, baking...anything that requires focus and concentration.
Sorry to hear about your Mum, that will of course be an additional complication in your mental process.
In terms of acceptance, yes it's hard. Try not to tell yourself that though. Lots of things in life are hard, but we just have to get on with it. 'Yeah but'.....is a subtly powerful statement as it's a mental excuse to repeat negative behaviour. That was my experience with it at least.
There's a fine line between filling your time and not being mindful. Sometimes acceptance just means doing nothing and dealing with the consequences. So if you're sitting around doing nothing and you start to feel bad, say to yourself 'so what?'. What's really going to happen? The answer is nothing, it's just sensation. That's a more powerful reaction than immediately distracting yourself with something else, because in the long run it removes a lot of the power of anxiety.
There's a fine line between filling your time and not being mindful. Sometimes acceptance just means doing nothing and dealing with the consequences. So if you're sitting around doing nothing and you start to feel bad, say to yourself 'so what?'. What's really going to happen? The answer is nothing, it's just sensation. That's a more powerful reaction than immediately distracting yourself with something else, because in the long run it removes a lot of the power of anxiety.
I think that's where I'm having the most trouble. I'm used to having my medication adjusted and then things usually "get better," meaning my anxiety pretty much goes away, at least for a while. What's happening now is very new and scary to me: not dwelling on anxiety-inducing thoughts and being mostly okay while I'm actively doing something else, but when there's any kind of lull, the anxiety-inducing thoughts come back to the forefront.
It's scary to me to think that this might keep happening for who knows how long while I really work on myself and handling my anxiety. It's hard to feel anxiety and dread every day in my "downtime"; I'm very much not used to it.
Would love to hear I'm not alone in my experiences, and that hopefully this will eventually go away if I work hard and learn the techniques and mindset necessary to get a handle in my anxiety. It's so exhausting to try and lasso my panic every day so it doesn't run wild.
ankietyjoe
27-06-20, 13:50
I think something to take away from this might be that medication isn't the answer. I know a lot of people rely on it, and that it may work for them, but if your anxiety keeps returning despite the pills....what's the point?
So you're left with the same problem as before. Running away from something that you can't run away from.
The good news is, it's fixable. It still comes back to you being able to sit WITH anxiety, and choosing not to react in the way you used to. So what if it runs wild? It always subsides right? If you have a shitty few hours or few days, it's not really the end of the world. Caveat....I know that it feels like it is, but it's not. I know what it feels like to be so amped up on adrenaline and fear that you genuinely think that today is the day you die....but that's not how anxiety works. It's just sensation.
Let the lull happen, confront the anxiety. Choose to do the things (in your case nothing?) that create an atmosphere of anxiety. This is the fundamental core of how something like CBT works. Make it your choice to be ok with anxiety and shrugging it off. What's the worst that can happen?
Hi all,
Unfortunately, my morning panic attacks are back.
Same deal as before: I wake up at about 6:30am, then my heart starts racing and I start cold sweating. I get up, and then my stomach gets super acidic and I usually end up throwing up. I take my meds (including one I take to help with palpitations that usually also brings my heart rate down, but it doesn't do much in these situations) and eat something gentle and try to be kind to myself. I do end up exhausted and feeling sick to my stomach for most of the first part of my day.
Unlike the last bout I had with this, however, this time I really do know that it's only anxiety. I have bad health anxiety, but I know nothing dangerous is going on. I also started CBT therapy a bit ago, though we've mostly worked on grounding strategies so far, not yet coping strategies. I'm also doing my best not to worry that this is the start of another bad bout (meta'anxiety). I feel like I'm doing everything I'm supposed to - at the very least, putting in the kind of mental effort I wasn't before - but my body still won't listen to what my mind is telling it.
Would very much appreciate any support, thoughts, or suggestions. Thanks in advance.
Hang in there. Your thinking is in the right place. :hugs:
Thanks.
It's so hard because my heart never stops racing ALL DAY, and that's exhausting. It also means it's hard for me to eat much because my stomach is so unsettled. I also have a WFH job now, which isn't particularly stressful, but it does mean I have to focus and *do* it eight hours a day. And I have no idea how long it will last. Last time, it was a couple WEEKS, and by the end I was ready to check myself into a treatment center.
Has anyone else had panic attacks last pretty much all day for days at a time? How did you deal?
Hi all,
Unfortunately, my morning panic attacks are back.
Same deal as before: I wake up at about 6:30am, then my heart starts racing and I start cold sweating. I get up, and then my stomach gets super acidic and I usually end up throwing up. I take my meds (including one I take to help with palpitations that usually also brings my heart rate down, but it doesn't do much in these situations) and eat something gentle and try to be kind to myself. I do end up exhausted and feeling sick to my stomach for most of the first part of my day.
I get nocturnal panic attacks which can kick in anytime from half an hour after falling asleep (around 11pm) to the early hours of the morning..
In a non-anxious person the stress hormone, cortisol, naturally increases so that we wake up relatively gently. It's a gradual process. It peaks about an hour after waking and then slowly decreases throughout the day and is lowest in the evening allowing us to be able to feel sleepy. With anxious people - this goes out the window. There is no gradual build up to wakening. There is no gentle 'It's time to get up, sweetie'. What we get anxiety doing a Johnny Rotten screech in our earholes. 'GET THE HELL UP NOOOOOOOOOW ARGGGHHHHHH!!! Our nervous systems are sensitised so we jump out of bed and try to cope with the numerous symptoms of the stress response, like nausea, racing heart, sweating etc.
How it works with me is that I have an anxiety dream, or my husband farts, and my brain snaps on the fight or flight response. I wake up abruptly at all hours with my body primed to run or beat the shit out of someone, but there is no actual danger. Then, my body is swimming in adrenalin and cortisol - and there is zero chance of falling back to sleep. So I have to get up and burn this energy off. Same applies in the morning when we wake abruptly. This is the time that we need to go for a walk or do some star-jumps to diffuse some of nervous energy.
Most importantly is to retrain your brain into thinking that it's not a problem, because telling yourself that it is a problem becomes a self-fulfilling prophecy - as in - you tell yourself you are going to have a panic attack, and you do - and you fear it. Whereas, I tell myself that it doesn't matter if I have a panic attack because I will deal with it. Plus, I've had that many now - I'm bored of them. But I still have to deal with the very physical response.
Deep breathing helps me and I can calm my heartrate down that way. Then I imagine myself on my favourite beach taking a walk with my first dog who has long since gone to Rainbow Bridge. Sometimes I'm just way too wired to do this, so I get up and move about.
Fight or flight is a very normal (and nessercary) bodily response - it's just that it goes out of whack with anxiety and fires when it doesn't need to, and often. We are firing out stress hormones all day long and they remain in the body which is why we have the symptoms all the time. The body is naturally releasing cortisol to wake us up, on top of what hasn't been burned off, so is it any wonder that we wake so abruptly and feeling so crap?
Also, meds can be helpful, but it's hard to tell what symptoms are side effects from meds and what aren't. I don't take anything because my body won't tolerate them, so I know that what I'm working with.
I feel like I'm doing everything I'm supposed to - at the very least, putting in the kind of mental effort I wasn't before - but my body still won't listen to what my mind is telling it.
What you're not doing is understanding what your body is doing and why. This is why you fear it, and all fear will do is keep those stress hormones flowing.
Also, the mind will resist because fear wants to be in control, and it will cling on like shit to a blanket - which is why you have to keep on with the mental effort, and for as long as it takes.
Research the stress response and anxiety, and try ginger tea for the nausea - it helps me no end.
What you're not doing is understanding what your body is doing and why. This is why you fear it, and all fear will do is keep those stress hormones flowing. Research the stress response and anxiety, and try ginger tea for the nausea - it helps me no end.
Thank you for taking the time to reply. I think this is a great point, and I'll definitely do some research so I can better understand what's actually happening. I know that I AM bringing it on because I'm expecting it to happen and being afraid that it will.
It's strange though, because I wake up and seem okay and go to the bathroom, and it's when I come back to bed and lie down that it all starts to kick in. For some reason, getting out of bed feels like giving up to me. I know it's silly; I just so desperately want to go back to sleep that I stubbornly keep lying there. I'm generally too afraid to get some exercise because I'm so nauseous I just *know* it will make me throw up (and I'm trying to keep meds down that I take first thing in the AM).
I realize that the above are excuses. I just want to be honest about my thought processes, to write them down and really look at them. And I'm pretty sure this latest bout of anxiety was largely brought on by my psychiatrist telling me that because I was doing so well with my new therapist and my anxiety was down and I was learning CBT, he was going to start bringing me down from one/some of my meds.
SIGH. I am determined to keep up the mental effort. I am finding it ridiculously hard, but I am so sick and tired of this cycle repeating over and over and not getting any better/easier.
Thank you for taking the time to reply. I think this is a great point, and I'll definitely do some research so I can better understand what's actually happening. I know that I AM bringing it on because I'm expecting it to happen and being afraid that it will.
The way my panic disorder worked is that I could be calm and not having catastrophic thoughts, and - boom - I'd have a nocturnal panic attack, and I was like, really? I had a good day today! Then I'd remind myself that stress hormones linger in the body, and sensitisation is a constant thing which is why relaxation has to be a constant thing in order to de-sensitise. So when I start having the panic attacks again, I take a look at what I've been doing/watching/eating/thinking etc and there will always be something that I've slipped with. Like the other week when I had three whiskies and then had a mofo of a panic attack at 2am when my liver started to metabolise the alcohol. I was in a hotel room at the time, but I dealt with it using the techniques I've learned. A little harder to get up and move when you're in a family hotel room, but I went into the bathroom and jogged on the spot. Once I had got rid of enough of the energy, I got back into bed with Matthew McConaughy (on my Calm sleep app) and got on with my holiday. Compared to the many which we had to come home early... Sometimes it can be as simple as my brain responding to my husband's breathing or a car door being closed. Not fearing the panic attack is key because there is nothing to be afraid of. If you see it as the normal bodily response that it is, then the fear is lessened or removed altogether. You will learn to address symptoms as soon as you are aware of them - most of which are caused by shallow breathing, so you will breathe deeply which sends a signal to your amygdala that there is no danger and it can stop firing out those stress hormones. Then, once your heartrate has steadied - you can work on diffusing the hormones that have been released..
[/QUOTE] It's strange though, because I wake up and seem okay and go to the bathroom, and it's when I come back to bed and lie down that it all starts to kick in.[/QUOTE]
Do you mean getting up in the morning? Or in the night?
For some reason, getting out of bed feels like giving up to me. I know it's silly; I just so desperately want to go back to sleep that I stubbornly keep lying there. I'm generally too afraid to get some exercise because I'm so nauseous I just *know* it will make me throw up (and I'm trying to keep meds down that I take first thing in the AM).
Staying in bed is futile because your body is swimming in adrenalin and cortisol. Your body is primed to move, which will naturally burn off those hormones. Getting up is not giving in. It's being proactive in getting control over this disorder.
At my worst, I was retching/vomiting every morning and long into the day. I couldn't speak without retching - my anxiety was so bad. So the ginger tea helped there. I got out of bed - no matter what time it was (I've seen a LOT of sunrises) and I made a drink of ginger, then I did some cleaning. Or sometimes I just paced or jogged on the spot - anything to diffuse the energy.
I realize that the above are excuses. I just want to be honest about my thought processes, to write them down and really look at them. And I'm pretty sure this latest bout of anxiety was largely brought on by my psychiatrist telling me that because I was doing so well with my new therapist and my anxiety was down and I was learning CBT, he was going to start bringing me down from one/some of my meds.
Not excuses, so much as lack of understanding that your body is trying to help you, not hurt you. It's responding to your thoughts as sure as if the danger is a real one. It's down to you to learn to control it.
The prospect of coming off meds is a massive stress, and if it helps you - I was able to get on top of my panic attacks without medication. I could never tolerate the medication they put me on, so I had no choice, but I kept one beta-blocker tablet in my handbag for a long time as a safety measure. One day I realised it was a crutch and I got rid of it. But coming off long-term medication is a different ball game. This will be a very gradual thing in bringing you off them, so try to go with the flow for now and see how your body responds?
SIGH. I am determined to keep up the mental effort. I am finding it ridiculously hard, but I am so sick and tired of this cycle repeating over and over and not getting any better/easier.
It is hard. But this is a journey, and as with any journey there will be bumps in the road. The reason you will beat this disorder is because you are so sick and tired of this being your life. You will get better when you understand that you can manage it and eventually control it. You need to teach your brain that these panic attacks are not dangerous, and they don't scare you, and you're just going to get up and do something when they come on. It will get the message, but it won't be an instant thing, and your mind will try to trick you time and time again before it gives up.
All the best.
There’s no fixed timeframe, just preforming the actions isn’t what decreases the anxiety it’s the change in mental state that occurs because of those things that does. But it’s not automatic, it still takes time and effort from us to change the way we respond to panic/racing thoughts etc, the routine of meditation, journaling and exercise just helps reinforce the changes your making in the way you deal with your mental health.
Unfortunately there’s no magic bullet, a person can be perfect at preforming all the things in the world that can aid lessening anxiety and still be an anxious mess because without gaining the control to break the cycle it’s still nothing more than a performance. Of course not to say that these things aren’t brilliant in helping with anxiety for some, it’s more the frame of mind achieved while doing them that helps.
Sent from my iPhone using Tapatalk
Sadly, but very true. :(
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