Panic Attacks

I've had panic attacks my entire life.Fortunately they're few and fair between these days and I can for the most part calm myself down when I feel one oncoming (they're almost always triggered by some event fortunately, very rarely just random ones).

I wouldn't wish them on anyone. That feeling of "I'm trapped, this is forever, I'm going to die, this is overwhelming, I need to escape" is genuinely the worst thing I've ever experienced. The brain misfiring the trigger that gets pulled when you're in a life or death situation is terrifying.

Fortunately recognizing that it's just a chemical response and I don't have an infinite supply of those chemicals and it will all be ok in a moment is one of the most calming thoughts and one that I always turn to when I'm panicking. Also remembering that I've felt amazing between panic attacks reminds me that soon I will feel that way again.

Just a few thoughts I turn to when I need to white knuckle that wave of panic that might be able to help someone else out.

From personal experience, years ago : learning to control your breathing is the key. Your fear of the symptoms can turn it into a self-fulfilling prophecy. When you've deeply internalised the assurance that you can defeat the symptoms any time you like by regulated breathing, you might well find like I did that they just stop happening quite naturally. It takes time and practice. Sometimes now when I find myself in stressful situations, I notice my breathing has switched over to this pattern without any deliberate intervention from me. Must be the practice.

There are many techniques out there (such as the 7-11 pattern, etc). I'd recommend practicing with any wristwatch or clock that has a ticking second hand. Breathe through the nose and not the mouth. In for five, out slowly for ten, repeat until comfortable. If you're not immediately able to do that, try holding your breath until you can begin. It's a great trick and general mental clarity hack to have in reserve.

Panic attacks are so mind bogglingly weird. For a few seconds (maybe a minute or so) your brain enters a completely different mode. Then it takes a few minutes to calm back down to regular human thought, again. It's so weird it is difficult to come to terms with what happened.

I spent a few months largely crippled by panic disorder (intermittent panic attacks spaced by anxiety – often about the panic attacks themselves). The whole experience was like a crash course in understanding out-of-body-experiences and accidental mental overreactions.

I’m a founder and suffer from intermittent panic attacks. This first one I had was terrifying. I ended up going to the hospital because I thought I was having a heart attack. Once I figured out what was happening and the pattern for the symptoms, they got a lot more manageable. Just knowing I’m not dying and telling myself that helps to calm me down.

The linked ESPN article in Fred’s post is really good and worth reading. Reminds me of some of the mental health stigma that founders in the tech industry face. This quote in particular resonates with me: “Depression, anxiety and panic attacks are not a sign of weakness. They are signs of having tried to remain strong for so long.”

Humans are only so strong. Intense pressure can forge diamonds, or it can crush you underneath it. My hope is that the stigma of mental health goes away, and training our brains becomes as normal as training any other parts of our bodies.

I suppose my own experience differs from the symptoms of a chronic sufferer, but I used to completely dismiss notions of "panic attacks". My thought was "why can't they just take a breather and calm down?"

Then one day I smoked too much marijuana and then had to go to a kids birthday party whose family I didn't know. About 10 minutes in I had what I can only describe as a panic attack. My face turned gray. My heart was probably beating somewhere around 190bpm. I was sweating profusely. I had to leave the party and on my drive home I was worried I might suddenly die and then veer into traffic. I nearly drove myself to the emergency room because I thought I was going to have a heart attack.

If that was a panic attack, I can't imagine what it must be like to suffer something like that chronically. It was utter hell.

I remember the first time I had a panic attack it was in the middle of the night, I woke up believing there was a thought, an idea, that if I accidentally thought about it would kill me instantly. It was the weirdest thing, and scary too. Eventually, and through some great discussions with a counselor, I narrowed it down to the stress and anxiety of being a single earner, in a field (engineering) that had been known to change directions and leave everyone behind. I had lived through the semiconductor recession in the Bay Area and black Monday (1987) where the DOW jones had crashed. When the dot.com bubble burst, the fear, unspoken, was that the world would crash, I'd be out on the streets, and there would be no way for me to provide for my wife and family.

Oddly enough, a friend of mine suggested doing arithmetic in my head in a panic state, and it worked quite well for me. The theory was that you can't panic (fight or flight) reflex while your brain is in calculation mode. I don't know whether or not that is a valid theory but I do know that for me by focusing on a concrete problem (like trying to divide two 5 digit numbers) my sense of panic fades right away. In later years I found I could just read a text book, didn't really matter which one.

I have always suffered from some level of social anxiety, but never really considered it crippling. Years ago, I brought this up to a doctor who promptly prescribed me a drug of the benzodiazepine class. At first I felt like an idiot. Slightly less anxious I guess, but I became kind of loose of the mouth (like you get when you're drunk), forgot a lot of things, and generally didn't like it. However, I stuck with it and a strange thing happened - as I adjusted to the medicine, my anxiety started getting worse. At this point, not taking the medicine had a rebound effect as well that was pretty terrifying, so I avoided that. All the while I was trapped - I couldn't stop using it or I would have panic attacks, but using it was also seemingly causing an increasing paradoxical reaction. I got to a pretty bad place with this over a few months, and ended up having physical manifestations of my inner anxiety (cramps, pins and needles, sweating, inability to sleep, etc). Eventually the only way out was a lengthy taper off the drug. It was literally 3 months of hell. After finally getting back to baseline, my normal anxiety level returned and it seemed like a walk in the park next to what I was experiencing on the medicine.

The point of my anecdote? Medicine can often compound the problem or even create new problems that weren't there before. Once you're in the midst of this, it can be hard to even recognize the medication as the cause, specially if you're taking multiple medications. I'm not suggesting that anyone stop their medicine without talking to their doctor, but at least consider that the anti-anxiety cocktail you're on may be making things far worse. It happened to me, and some research has revealed that these paradoxical reactions are not at all uncommon.

I will chime in here just to add my voice to everyone else. There is hope if you have chronic anxiety. I’ve had it as far as I can remember, even memories being in my crib and crying because I didn’t know where my parents were.

Meditation, medication, eating healthy, exercise, be aware of yourself and when you are pushing yourself beyond the breaking point. Everything will be ok. I avoid all illicit drugs, but alcohol is an anxiolytic and it’s partly why I like it.

One time I was on the subway, surrounded by people of all ages just relaxing and being bored, and I was trapped in a life or death struggle for survival as one of the worst panic attacks of my life attacked me. Then, when I thought I couldn’t make it, I realized how silly I was being and how absurd the whole situation was, and it gradually went away.

I still get panic attacks sometimes, but they get easier to manage.

Body based coping strategies are helpful those moments. Try sticking your hand in a bowl full of ice water and leaving it in there for a few seconds, or taking a very cold shower. Some folks even do something called Ice Diving, where they place their entire face into a bowl of ice cubes and water. This actually triggers the diving reflex and it automatically calms your body. But you have to be in a place (like home) to do that. Other body based techniques can be used too that utilize other senses such as smell and taste. Fire ball candies are a portable option, and I've seen some people carry around tiny packets of pepper. You have to experiment a bunch to see what works for you. All of these ideas are derived from DBT. Behavioral Tech is the official company of all things DBT if you want to know more about all of it.

I have periodic trouble with panic attacks at night, when I'm trying to sleep, usually linked to times of external stress. I thought it was insomnia. In the moment, they're miserable - rapid pulse, cold sweat, numb hands, impending doom, the whole shebang. The next day, after just a few hours of sleep, there's hell to pay. The next night, I lay in bed afraid it's going to happen again and that I'll get no sleep again - so of course it happens again. Finally, after a few days I'm so tired I fall asleep the moment I hit the bed, with no time to fret about anything, and the cycle ends.

I was trying to write about it as insomnia one day , looking over my list of symptoms, when it clicked that it didn't sound like other descriptions of insomnia. Once I figured out they were panic attacks I was able to take a step back and look at the cycle, so I don't have week-long waves of this anymore. The next night I decide I don't want to sleep - maybe I want to do an extra load of laundry, inexplicably at midnight when I've hardly slept, absurd as it is. It works, at least.

My cat loves the panic attacks though. I stay up later, and I'm petting her the whole time trying to calm down. Great for her.

>> “I’m a type of guy who has a very long fuse,” Love says. “I try to be as non-confrontational as I can, but when that fuse breaks, I explode.

This is me. I had what I feel was a panic attack / semi nervous breakdown on the last day of my internship this summer. It was basically a 12 week interview for a job. On second to last day I received a full-time job offer, and there where a few times where I had embarrassed myself in front of the VP and I was afraid If I got sick and vomited on the last day I embarrass myself again, so my brain just locked into panic mode. I asked my team leader to give me a ride home, and as soon as I walked in the door the panic subsided. I've still had a few flare ups over the last week; we're looking for houses now (our first home purchase) and I'll have to commute for a while, so I'm nervous about that too. I may have to stop drinking coffee and practice more meditation.

I think I just get over-exhausted and loose the ability to absorb and cope with stress, so when it happens its like any incoming stress hits my reptile brain directly like touching a raw nerve. I'm very happy that I've had the last week off to relax and rebuild my stress-buffer!

Panic attacks are awful and terrifying, mine eventually turned into panic disorder, but after over a year of working on it and taking it step by step I was able to beat it and without any medication!

In my experience, the following helped me.

* Meditation

* Deep breathing exercises

* Exercising especially cardio.

* Cold water showers

* Learning about panic attacks

* CBT

I've had to deal with panic attacks my whole life and most of the time I can link it up to an invisible stress meter building up until it triggers an attack. Sometimes I sort of mentally ignore how much stress I'm putting on myself due to work, life circumstances etc which doesn't make me realize how much stress I'm actually under until a panic attack finally hits.

Breathing exercises and realizing that that I'm going through a panic attack usually helps defuse it a little though most of the time you can only just wait it out.

My first panic attack was triggered by smoking weed when I was 17 years old. Since then, it's been a lingering thing that has never left my mind and has kept me on a constant edge, especially in social situations.

I've found avoiding caffeine has helped a lot.

I had crippling panic attacks for almost 10 years, doctors, drugs, nothing helped, I quit one job before I got fired due to poor performance because of my panic attacks.

High doses of L-Ascorbic acid eliminated my panic attacks. I slowly worked up to 60mg per KG of bodyweight. I weighed 250 (113kg) works out to ~7 grams per day. I slowly worked up to 2g before breakfast, 3g before lunch, and 2g before dinner. Once I started taking 4g per day the attacks lessened, and when I hit 6 they went away for good.

L-Ascorbic acid is an anti-stressor hormone in animals, humans have a mutation that prevents us from making it in our livers.

Nobody has mentioned how effective it is to rebreathe when you feel a panic attack coming on.

I've had them for 50 years, and the single most effective thing I can do remains finding a paper bag to breathe into when I feel the hyperventilation begin.

I suspect most other sufferers know this, but just in case this is a new problem for anyone.

I've had them all my life, the first at 21, in my mid 40s now, spent a good 10 years of my life with crippling episodes, were I couldn't go out, drive, and have panic attacks lasting for hours. At the worst, it was so bad, I lost 30 pounds in 1 week, couldn't eat, couldn't sleep with a mind racing 24 hours/day. It's so exhausting for the mind that you start having visual hallucinations, you start thinking about ending your life etc, and then finally, you collapse, what you could call a complete breakdown.

And here's the interesting part, things that you don't necessarily experience till it goes full blown, it's when you reach that point, the end of fear basically, your mind becomes calm. You don't necessarily realize it in the instant but that's it, you've stared into the abyss and it's not as awful as you imagined. At that point, you still have anxiety but that's it, it doesn't control you anymore, you're out of the 2 states loop, panic or fear it may happens. It's still painful, but it's not hell anymore, you know how it's gonna end, there's no more question.

Now, it's an incredible experience, can even become an spiritual one, it did for me, experiencing first hand how reality is subjective and how the mind works.

All in all, I wouldn't trade all those experiences for anything, it gives you an understanding of the human condition that not a lot of things can give you.

I've only had one panic attack in my life and it was out of nowhere as well. I was riding the subway and suddenly I had this urge to run away, as if I was late for something but didn't know what. I got out of the subway and just collapsed in the platform, unable to breathe, shaking uncontrollably. It was terrifying. Reading about the "long fuse" makes a lot of sense to me. I avoid confronting other people and always try to be the "team player" and I guess I just snapped that one time.

I suffered from panic attacks throughout my 20's. Recently I went to a cognitive behavioral therapist who guided me through a hyperventilation technique to simulate the physical symptoms of a panic attack. The results are amazing: practicing this technique three or so times a week for a month completely rid me of panic attacks. I recently was feeling stressed about a work trip and "tuned up" the night before by going through a session and had no issues.

The therapist said this cures 99% of patients. The "golden feather" in a CBT therapist's hat.

The technique:

Sitting down, as rapidly as you can, take a deep breath in and blow it out. Do this 40 times. Blow out all your air and hold your breath for as long as you can (1 - 2 minutes for me, stop when you start to get convulsions or you may pass out). During this time observe your tingling hands, light headed feeling, sweaty palms etc. This is a normal result of an excess of oxygen in your body. It cannot hurt you. Now take a deep breath and hold it for 15-20 seconds. Start immediately and repeat two more times for a total of three. Repeat three times a week for a month. If you start to feel panic more often, start your treatment again (this is rarely necessary).

The first time will be the scariest. After that it gets MUCH easier I promise. It may be helpful to see a CBT therapist to talk you through it the first time. It will change your life.

That technique coupled with a mild anti anxiety medication has completely feed me of anxiety and panic.

I hope this helps others :)

I never had panic attacks until the age of about 23. I adopted a dog (a Blackmout Cur) and brought it home for the first time, and it went off like a tornado as soon as it stepped foot in the door. I got it calmed down, and everything was fine. When I went to bed that night, though, the reality of the situation struck me, and I thought I was having a heart attack. The entire night, I hummed 'Rio Grande' by the Great Speckled Bird in my head, because I always found it to be a soothing song, and it just made it worse and worse.

The next few months, I would get panic attacks as soon as my head hit the pillow - nothing to do with the dog at this point. Though, the dog was quite a handful. I'd take it for two hour walks, and after a 5-minute rest, it'd be back to rampaging.

Now, I'll get a panic attack once every few years - still, always in bed. I usually have no idea what sets them off.

Edit: I got my first dog so late, because I'm allergic to dogs, and I was a sick kid. My parents didn't want to exacerbate my allergies. I have dogs do this day, and I just deal with the allergies.

Has happened to me once. All of a sudden I couldn't breathe and I had an ache in my chest. No doubt I was hyper ventilating, but I was also sweating and getting vision effects. Which had me convinced I was about to die of a heart attack.

I don't want to derail, but this strikes me as very odd:

"Right after it happened I went to see my regular doctor and got a prescription for medication that can calm me down in that situation"

I mentioned it to doc at next visit, quite some time later. He also decided it was probably just a panic attack and unless they start to repeat to forget about it. It wouldn't occur to me to seek and carry medication for something that happened once in a lifetime. Unless it had turned out to be the symptoms of something serious and life threatening.

My son was getting them for a couple years and the frequency was increasing. He was missing school. We tried all sorts of techniques that you can google.

Finally took him to a clinical psychologist that focuses on them and I was embarrassed on how few sessions it took this guy to solve them.

Personally I'm happy that I don't have to rely on medication (although I understand that it gives peace of mind to have access to it, just in case. This in itself might prevent future attacks)

In my own experience, the key to coping with panic attacks is the right breathing technique to prevent hyperventilation from happening.

Ever since I had a few panic attacks many years ago, I am using a technique which works great for me: Short deep inhaling and very slow, long exhaling. Every exhale has to be significantly longer in duration than every inhale.

I've been in many situations in which I felt the first signs of a possible attack, but with this breathing technique, I always was able to stop it from actually happening.

I was diagnosed with sever panic disorder in my early twenties. I tried everything (therapy, medication) but nothing really helped.

I eventually became agoraphobic and wouldn't leave my house.

I did a 10-day vipassana meditation course (http://dhamma.org), where you can't read or write or listen to music or talk. You basically just meditate the whole time.

I had very bad panic attacks during the 10 days, but eventually meditation actually helped me to deal with it.

I'm now in my forties and meditation is the only thing that truly helps me with panic attacks.

I've got near crippling social anxiety. It's hard because intellectually I know my brain is creating and responding to fear that is all artificial. However in the moment that's nearly impossible for me to realize or take in.

I've been having more and more conversations with friends and co workers about anxiety recently and that's helped a bit but realistically this is something that I'm going to have to do real work on.

My mental health has been suffering for the past couple of years for a variety of fairly definable reasons, but I actually had my first one last night. It was triggered so I kind of knew what was going on, but I really wasn't prepared for the smack of adrenaline and the half hour cooling down period of just trying to stop shaking and lose the desire to cry.

Luckily it was not debilitating, and happened in the car five minutes from home, so I could get to a sofa and work through it; it also helped that I had somewhere to be with friends that was in no way connected to my triggers and so I could use that as a useful distraction.

I think the scariest thing for me, now, is that now I have to add panic/anxiety attacks to my understanding of my own condition, which up until now has been either some very black (but ultimately rational) periods of suffering, or just general low mood to the point where I have dismissed the idea of medication.

But this is now probably a game-changer for me.

> Right after it happened I went to see my regular doctor and got a prescription for medication that can calm me down in that situation.

This seems so stereotypically American to me.

> But the real solution has come from many years of trying to understand the root causes of the panic and anxiety and working to deal with them.

What the doctor should have helped doing in the first place.

I'm a founder that has struggled with this (but it's basically been solved for a while). When Panic Attacks (https://www.amazon.co.uk/When-Panic-Attacks-drug-free-therap...) is a great book. Just being able to identify it and know it's not dangerous helped me the most.

I loved his anecdote of doing jumping jacks while having a panic attack. The lightheartedness of the way he approaches the disorder is kind of nice.

One weird thing that helped me was reading everything I could possibly find on panic attacks over some short period of time. Every paper, book, medication, etc. Unlike some disorders, the truth seems to mostly be positive (non-dangerous, relatively straight-forward ways to beat it), and so the more you know the better you'll be at approaching it.

I've always had sort of low key intermittent anxiety, but when my dad almost died from acute pancreatitis, I became hyperaware of anything unusual going on with my body -- and turning 40, there's a lot that's new going on. I made repeated visits to the doctor over the course of a few years, convinced I was dying of one thing or another. Realizing one day that almost all of the various symptoms I had were symptoms of anxiety, it was like a weight lifted off of me.

I've got it more or less under control now. I've figured out when to notice when an anxiety attack is coming on, and just lay down and relax. And cutting down on caffeine helped a lot. Anything that's a stimulant triggers them for me. I now have like half a cup of coffee in the morning and nothing for the rest of the day.

I've had a few, and the only way I can describe is it being the same sensation as if you're in a bad neighborhood, and suddenly you get surrounded, or a drug dealer seems to be very shady in the exchange, or some tweaker looks at you like you killed his dog.

In those situations I keep my shit together and think rationally, but when it comes out of nowhere, you add to that threatening sensation the confusion of not knowing where it comes from. So you think you're having a heart attack, or a stroke, or who the fuck knows. It's a feeling of impending doom.

I see it the same our tendency to see faces on surfaces, our brain is wired that way. It's also wired to sense danger, adrenergic pareidolia, so to speak. And sometimes there are neither faces nor threats.

I really appreciate when industry leaders talk frankly about things like this. In current culture, this can be easily treated as an admission of weakness and penalized accordingly. The more high-status people that speak up, the more the stigma will dissolve.

I've only had a 'true' panic attack once. I was running for a train and I slipped on the stairs and landed hard on my back. My throat closed up, my back ached and I couldn't shout, or call for help. Suddenly I couldn't breathe at all. I didn't know it was panic; I thought maybe I'd broken my back or something. Which of course made the panic worse.

I remember thinking "This is it. This is how I die, here on the station platform, alone, with nobody noticing." It was a terrifying, helpless feeling. It passed after maybe 30 seconds, as soon as I managed to take a gasp of air.

It was only once and more than a decade ago but even typing this is kind of freaking me out.

I'm going to politely disagree here and say solving panic attacks doesn't take years but instead minutes. I suffered many panic attacks in my mate twenties and early thirties and then learned some simple techniques that solved the panic attacks in one fell swoop. The whole process took less than two minutes. I've since helped a few friends with the same and they have positive experiences in the same way.

If anyone's interested you can look into the work of Dr Bradley Nelson and more specifically his book The Emotion Code. I use a combination of Timeline therapy and emotion release and it does wonders for panic attacks.

I've had just one of these and it was horrible. Lying in bed, I started to get subtle pins & needles in my feet which moved up to my knees and the numbness just kept moving up.

I thought I was having some kind of stroke so I jumped out of bed and by the time I was in the kitchen 10 seconds later I was fighting not to faint, which I thought would lead to me dying. I kept pacing around the kitchen table quickly, basically walking laps for about an hour until it subsided.

Told my girlfriend to call an ambulance as soon as I hit the floor, which luckily didn't happen.

I found that potassium gives me anxiety and panic attacks. I noticed this after drinking an electrolyte drink, and also eventually traced it back to fish and to chicken broth, both of which are high in potassium.

I now eat a low-potassium diet, which fixed the problem.

My potassium levels are normal. My doctors have never heard of this effect. I can't explain this, I just know it works for me, and I have some confidence from looking back at my food logs that it's not a placebo effect.

I have never had this problem. I have felt panic but it never became a full blown attack. I'm not sure what the difference between an attack and anxiety is.

I had them years ago and I found Mingyur Rinpoche's lesson on YT, and listening to his lesson helped me a lot. He made me realize something key. To add to that, just the fact that he also had them made me realize I was not alone. The technique he uses to deal with this issue applied to me wonderfully. It didn't take me years, it took me days, of course everyone's case is different.

This seems like a good resource:

https://anxietynomore.co.uk/

Avoid coffee, for me this have been key. https://en.wikipedia.org/wiki/Caffeine-induced_anxiety_disor...

Not to belittle panic attacks, for which I've suffered a couple during my lifetime and yes, they are quite scary, but am I the only one clicking on this thinking I'd be reading about kernel panic attacks?

I use to get one every morning into work crossing over one bridge. After years it never went away (never chanhed jobs either) but I started working from home

Does anyone get them after programming all day? Feels like my brain is in a different mode and the transition back can bring them on.

Our western/christian way of seeing the world has a lot to do with this condition. The illusion of control, this permanent struggle for betterment and perfection is a very good recipe for anxiety, depression and mental illnesses. Add to that the loss of faith, and that's it, you get millions of people on antidepressant...

so are there really just magic pills you can take that stop panic attacks? this guys carries them around but doesn't say if he's had to use them.

It's really strange because I still maintain a good amount of self-awareness during my panic attacks so I'm like 'yeah gimmie a sec my brain's just being silly' while also in the midst of crying and hyperventilating.