Physical triggers/clear panic - anxiety difference

[LEP]

Hi all
Sorry to post before introducing myself but I’ve got a mental health assessment tomorrow and in the last one I had the assessor really didn’t understand where I was coming from so I thought I’d try to find people with a similar issue.
Panic attack sufferer for 10 years but I make a very clear distinction between my panic and anxiety attacks (my hypnotherapist pointed this out and said he’d never had a client who did this before). For me anxiety attack = mental agitation, feeling physically uncomfortable, stressing about having a panic attack – usually when I’m stuck in a situation I can’t get out of e.g. traffic jam. Panic attack = totally physical response, no mental triggers at all (unless deeply subconscious and I’ve been trying for years to work out what they could be), always after physical exertion, when pulse/temperature are raised, but can be after walking around a shop too quickly or after a full workout in the gym. Symptoms are hyperventilation, weakness = end up lying on floor unable to move (even to prop myself up be sick!), unable to speak, vomiting, defecation, lasts about 20 minutes each time. (sorry for the gory details).
After 10 years I am able to clearly distinguish between the two, I understand panic disorder very well and have no anxiety before or during a panic attack – I simply think about what I will need to do when the attack has finished (e.g. clean up, get some food). The anxiety attacks happen after a bought of panic attacks and I am able to stop them with basic hypnotherapy so they really aren’t a problem. The panic attacks appear to start for no reason, then are triggered by some sort of rise in temperature/pulse/BP but not every time – I am totally unable to make myself have one, I even do the same activities in the same places and nothing will happen. This is really affecting my health as I am unable to do any form of exercise ‘just in case’, I know that sounds like classic avoidance but as explained I have gone out of my way to continue as normal and even push myself to see what is triggering attacks but they still appear a bit random but often enough for me to stop certain activities.
I have had several forms of treatment (usually 12 months SSSRIs, also CBT and hypnotherapy) but I have never been able to get to the bottom of why I have the attacks, I’ve had plenty of physical/medical tests, can get a bit stressed but this does not correlate with the onset of panic attacks, had no big medical or psychological events in my life and overall am a very happy content person with my dream job/house/partner/pet. The SSSRIs generally help with anxiety but don’t have an effect on the panic, CBT was pointless as the attacks are instant and there is no particular time/place/frame of mind/past event to work with and the hypnotherapy can stop me associating activities/places etc with attacks but not stop them completely.
If anyone out there understands what I’m talking about – the physical triggers and difference between panic and anxiety – please get in touch!!
Sorry this is so long but I really haven’t been able to find anyone who can relate to this. Thanks for reading.

[haz]

Hi there,

Suffered panic attacks/anxiety disorder/agaraphobia/severe depression for just over twenty years. Been on loads of different meds. Currently on Sertraline, diazepam and zopiclone. Four hospital admissions to psych wards, two since last June.

Anyway, I'm in psychology at the moment and my psychologist has said that I am VERY aware of my physical symptoms when I feel a panic attack coming on. I describe my physical symtoms much more than the thoughts going through my head. She says I am VERY sensitive to my physical symptoms and that as soon as I start to experience any of them i.e. dizziness, feeling hot, nauseous, hyperventilation etc., I panic about my PHYSICAL symptoms and this in turn CAUSES a full blown panic attack. She has advised me to "go with my physical symptoms", not worry about them until they pass.

It's hard, but I'm trying to follow her advice and hopefully it will eventually work.

I've had a physical examination to test for medical conditions that can cause anxiety/panic attacks e.g. thyriod function. Have you had medical conditions ruled out as the cause of your anxiety?

Good Luck and Best Wishes.

[hello]

hello, thats sounds very strange to me, i always thought panic attacks and anxiety were intrinsically linked and could not be so seperated ?

Are you sure you don't get ANY anxiety when sufferering from a panic attack ? a panic attack for me (i thought) is an anxiety ( causing adrenalin ?) overload although i do get depersonalisation when i am VERY anxious (and when having a panic attack) which doesn't help me rationalise things.

when i look upon panic attacks it is ALWAYS in hindisght so i can't speak as concisively about describing the two side by side.

for me a panic attack seems to occur, when the adrenaline levels increase that one iota beyond the point of no return, i think this point can vary from day to day on quality of sleep, temperature, diet, ambient goings on (myriad of factors), but once you go over, you have a panic attack.

I can tell the differnce between "the two" i suppose, as for me a panic attack is alot more extreme BUT increasing levels of anxiety always for me preludes a panic attack.

i found some of your text a bit confusing :

'For me anxiety attack = mental agitation, feeling physically uncomfortable, stressing about having a panic attack'

as in (you wrote) =

'This is really affecting my health as I am unable to do any form of exercise ‘just in case’'

This sounds very much like anxiety preluding a situation where you may have a panic attack ?

but you also wrote

'I understand panic disorder very well and have no anxiety before or during a panic attack'

Are you sure about what you think you are sure about ?

[LEP]

Hi both

Thanks for that. I know it's difficult to appreciate panic without anxiety. The 'attack' starts when the adrenalin level is tipped over but that is a purely physical response, i have had no mental clues that an attack is coming and once i'm in one i just go with it and think about mundane things - no anxiety whatsoever!

Plenty of tests have ruled out a medical condition. The whole avoiding excercise situations is more about putting other people in bad situations, i don't avoid carrying on as normal when in a controlled situation (e.g. at home/wth close friends).

Now being refered to a consultant so we'll see what happens - hopefully a change of medication as SSSRIs really aren't working for me.

Cheers
LEP

[xhyperyogix]

yes, a very interesting post. I currently post from a place of no anx and no panic, so i hope I can be completely rational about how I see the two, as it does change sometimes.

For many years I had panic attacks (and I know I'll experience them again as they always come back - just how i deal with it changes I guess) - I suppose it could be precluded by building anxiety... mainly the 'oh crap, here we go again, lets try to control this...etc etc... thoughts). And the panic would be mainly 'mental' i.e. dp, dr, collapsing, utter FEAR! Oddly I NEVER EVER thought I'd die, just wished I would in order for it to stop. I never thought I was having a heart attack (my sister has ened up in a and e before thinking she had a HA). Mainly my mind and body separate witgout my control, and my heart does race and all that but that doesn't bother me as much. I either faint / collapase or manged to shout / scream / run to safety, depending on the situation. This is total body close-down - it can'r cope, so it gives up! Wild up and down feelings, i.e they don't last more than 10 mins, but I can get them in spikes all days... i.e 10 in 4 hours.

So, for many years I had just these, and they were sometimes situational, like outside, crowded places etc, and sometimes not, so that was very unpredictable. They come and go etc, so I can carry on in genral, and also am very good at hiding them, and not being in places where they would occur.....

Then, so onto anx. To me, this is a baseline 'worry' that is ever-present, but doesn't stop you leaving the house / driving the car etc. It's a level 4 /6 rather than a 10 of the panic-scale should we have one! When I'm here I'm on edge and jumpy, prefer people to be where I can see them, and not get too close without me knowibng beforehand. It's knowing that I'm beginning to get into 'information overlaod' stage!

So, yes, in conclusion yes, I do see a big differnce between the two, but also I do belive anx, can develop into panic. Although I had panic way before I ever had anx......

Obviously sometimes, I can get 'both' together, sometimes anx, causes panic, and then sometimes panic would come by itself. Mostly all of this just utterly confuses and scares me!!

Soz and the myriad of typos and hope it makes a littel sense!

Love Hyper xx

[Pat77]

Hi there, I am 34 and have PA for about 10 years. At this point I am a bit like you on understanding the difference between the two, PA and ANX. In my case nowadays they are completly separate and I do not have ANX b4 a PA. I have done a few treatments with psychiatry, psychologist and learned how to be my PA's best friend. There is nothing I can do to stop it when it comes apart from knowing it as much as I can, recognising the symptoms and let them go away. It is not as easy as it seems when reading this, but is basically what I do. I read a lot about it. Did 2yrs of psychology university and realised I learned enough about it's root and left. Found a therapist, was on it over a year every week ( very expensive) but I can say was the best investment I've done. I still have my roller coaster rides, very heard sometimes, but I am a surviver and as therapy helped me to achieve " I won't die of it, but with it, so we better be best friends" because I intend to stick around for a long time .
I was on medication for 16 months when was first diagnosed (sertraline) but Decided with my doc to stop and give a try without it, with therapy only and worked. I do have , what I call SOS medication close by " in case" I need, it's good to know it's there, but I only take it on extreme PA for about 3 days. But I can tell you that during these 10yrs medication free I took my SOS about 5x, because I only take it if I cannot handle.
I also noticed that the symptoms changed over the years, and I can make a endless list of the new ones. One good thing that helped me was understanding each one individually why they happen physically , hyperventilation, shivering, heart racing, numbiness arms and face, fatigue, etc. That helps, once u know that it's going to be ok once adrenalin sets, basically ...

Physical exercise regular also helped me a lot .... If you have a chance, try it.
To be honest, I am not here because I was surfing on the net, I've been having a few bad days with PA this week with apparently no reason as usual after a long time without. After finding forums like this u realise you aren't alone.

Good luck on your search for balance ... Do not try to find the cure, look for a way to balance it in life ... You'll manage!

Pat