The changing face of panic attacks

[Apple86]

I recently posted in the anxiety section as I believed that I was suffering anxiety/OCD as a by-product of getting treated for an eating disorder. I've realised, however, that what I'm experiencing seems to be a string of panic attacks.

I've read a lot about the symptoms of panic attacks and it seems that for me, the attacks either come out of the blue, or I feel a physical symptom of anxiety (e.g. weak legs or dizziness) which then brings on an attack. My attacks are different every time - sometimes my heart races, but more often then not it doesn't. Sometimes I go dizzy, sometimes my limbs go weak. My thoughts always rush during an attack but the rushing thoughts are always something different. And the fear is always overwhelming.

I'm desperately trying to find a trigger so that I can try and rationalise the panic attacks, and I thought it was work as I experience them almost everyday whilst I'm sat at my desk. However, I had an attack at the weekend which has really put the fear in me because I don't understand it. Yes I was tired and yes I'd had a few beers and I was walking between pubs when it hit. My legs went like jelly, my vision became blurred, my heart raced and I felt in a surreal world.

I guess what I'm asking here is does anyone know how one can find the cause of panic attacks? I'm stuck in a horrible cycle of panic, fear of panic, panic, and I constantly feel tense and I'm constantly waiting for the next episode. I really need some relief...

[ana]

I completely understand where you're coming from, and I can also relate to the way you're feeling. I've been feeling like that, on and off (mostly on!) for 15 years now, and when I have bad spells of anxiety, I feel like I want to jump out of my skin for being so tense, I need to escape myself because the feelings of tension and panic are just so overwhelming. If feels like your life revolves around your anxiety, and each day is just another opportunity for a new panic attack!

The question you asked is the one I want answered myself, too! If I could just figure out what causes the anxiety, what triggers them, and most importantly, why I have them in the first place, and what purpose they serve, I'm fairly certain I'd be anxiety-free! However, as it is, I've been trying to get to the bottom of this in therapy, and have not had much success. I'm somewhat more capable of identifying what event or feeling has brought a panic attack on, but I'm still looking for the 'why?' in all this.

[Apple86]

Hi Ana, thanks for your response and I'm sorry to hear you've been suffering for so long.

You say that you're able to understand slightly better which thoughts and actions trigger a panic attack, does this enable you to prevent attacks by avoiding those thoughts/actions or is it a reflective process? Are these thoughts and actions different every time? I'm concerned that my panics are different every time as I don't know which angle to tackle. Sometimes I panic about physical health and think I'm about to collapse and die and sometimes I panic about my mental health and that I'm insane. Sometimes I panic that I may hurt someone and am a bad person and sometimes I just panic about panic attacks. I just don't know where the next attack is going to come from and so I find myself sitting and waiting for it to occur - basically second guessing my anxiety.

I don't know how to stop analysing my panic and I find it very hard just to "let the symptoms ride in" as when, for example, I suddenly get dizzy, the fearful reaction springs into life.

[ana]

Apple, reading your post is like reading something I'd write. Our thought processes sound very similar in that I, too, find that my panic attacks are different every time: in duration, intensity, sensation(s), the reason behind them, etc.
I think it's very difficult to stop a panic attack in its tracks, once it starts happening. I'm not sure hot possible it is to just surrender to the feelings and sensations instead of analysing them. Saying that, the reason why they happen sometimes is because of over-analysing.

To answer your questions, on rare occasions, I'm able to prevent having an attack because, as soon as the anxiety kicks in, I start thinking about the reasons behind it. I ask myself the question 'why am I feeling this way; what may have caused me to feel this right now; which events and thoughts preceded this state?' Usually, it's work-related stress, or sometimes it's anger, an unresolved situation, a feeling I channel into panic.

More often than not, however, it's a reflective process. The thoughts and actions are different every time, though I'd say it's predominately a fear of fear that causes my attacks.

Sorry if this reply is so long, I wanted to be as helpful as I could be.

[NoPoet]

There are most likely different "types" of panic attack. They'd come on in response to different triggers and would feel different from other types. That definitely sounds like the case here. You haven't learned how this works yet, so it seems bewildering, frightening and random, but it probably won't be random. There may be some logic to it. Don't burn yourself out over it, you will learn it one day.

Anxiety adapts in order to survive. Fear is a result of anxiety. If you squash one fear but don't overcome the cause of your anxiety, it just adapts and comes at you differently - it creates a new fear to replace the one you defeated. Always remember anxiety is very smart and it wants to live. You have to understand what your anxiety really is - maybe a series of negative self beliefs and self doubts. Start ripping them out and chucking them away.

[Apple86]

Thanks No Poet. I think I may have figured out the cause of my anxiety:

I’ve been in my job for 10 months following studying, and being very successful, in a master’s programme – this lead me to being offered a funded PhD which I turned down due to logistical reasons. From day one I disliked the job role, the team and the set up.

For the first few months I reacted badly – I was very low and upset about my decision and I cried a lot at home (this is a rarity for me). I felt lonely whilst at work (my team mostly work from home) and when my colleagues were in the office they were really negative about the job and the organisation. I started looking for other jobs immediately – constantly regretting not taking the PhD. During this time I was hardly sleeping and I felt like a breakdown was imminent. I spent 10 days over Christmas sleeping and recovering from the previous 3 months at work.

After the new year it didn’t take long for the negativity and feelings of low self-worth to return. I was feeling more and more downtrodden in my role and I noticed I was feeling more on edge whilst in the office. I started emailing my friend whilst I was at work saying that I was worried I was about to have a stroke, or I had MS, or other health problems. One day I nearly approached a clinician who was in the building to ask her why my arm was numb. At this point, however, the panics weren’t frequent, but looking back it’s clear that my anxiety was building.

I would have days on end when I’d try to figure out my next career move, which involved endless searching for a new direction in life – this was driven by feelings of no self-worth and I’d often express to my partner that I felt like a useless human being.

In April my treatment for anorexia started. This means I have one day per week working from home. On these days I feel a lot calmer and able to function normally. Until now, I assumed this was because I was seeing a therapist who was calming me down, but now I believe it’s simply because I’m not in the office. When I’m in the office I feel tense most of the time, particularly in my stomach and jaw. I get bouts of dizziness every day when it feels like the room is falling away around me. I can often feel me heart beating in my chets. I’m finding it impossible to focus on the work and spend the days ruminating and waiting for a symptom to crop up which will trigger the panics.

I’m constantly being asked by my therapist “what do you think the root cause of this sudden bout of anxiety is?”, as it’s affecting my ability to focus on recovering from anorexia. I think I’ve found the underlying anxiety. Does this sound plausible to people??

[ana]

Apple, what you've said in your message definitely sounds plausible to me. In fact, I think you've done a brilliant job identifying the underlying cause of your anxiety issue, and it's clear that you've given it a lot of thought and reflection.
What you went through at work sounds very stressful, and I'm sure it was a massive trigger for your anxiety. The fact that you're calm when you work from home, and not calm otherwise tells you all you need to know. I really hope that, with this new knowledge and a better understanding of your issue, you can go into therapy and discuss things in greater detail, go even deeper into the issue.