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I deal with a panic disorder and what you're describing sounds super similar to what a garden-variety panic attack is like. Especially the part about your heart rate rising but your oxygen saturation staying pretty much the same (the difference between 94-97 and 97-100 is within the normal variation during physical activity). What's likely happening is that your brain is latching onto some small thing, like laying down on your back and putting more pressure on your diaphragm. Instead of interpreting that small thing as totally normal, your brain interprets it as a "warning sign," because of your stress/anxiety around COVID, and it goes into panic mode. At this point, it's pumping out a lot of chemicals that stimulate what's called a "fight or flight" response; it's your natural response to any perceived threat, real or otherwise. Those chemicals will cause your heart rate to increase and will often cause shortness of breath. Usually these can last 45 minutes-a few hours and will subside. Deep breathing exercises work for some people, but I find that when I focus on my breathing I end up spiraling more, so I focus on grounding exercises and progressive muscle relaxation. I'd recommend trying those out next time you have a bout of that and see if it helps :)!

Absolutely this. I've struggled with panic attacks that came on secondary to medical issues in the past couple years, and the elevated heart rate and perceived breathing problems are textbook. Other things to lookout for are: impending sense of doom (fixated on the idea something's wrong), lights appear brighter or have halos, bounding pulse (you feel your heart beating hard), eyelid twitching, amongst others.

Block breathing will help. Inhale into your belly until you can't hold more air, hold for 5, exhale slowly. Take a couple of normal breaths, then repeat the block breath. Do it for 10 minutes.

Other things to note: before and after the panic attack, you're in a "prodromal period", which means you're susceptible to subsequent attacks. Try to stay away from stimulants, like caffeine, and, honestly, get the hell off the internet and away from news.

> Try to stay away from stimulants, like caffeine

Something of an aside, but I've actually found caffeine (400mg/day + variable amount in drinks) _helps_ with OCD-induced panic attacks. If I do have an attack, it seems somewhat worse, but it makes it _significantly_ easier to shift my attention away from obsessive thoughts, thus avoiding triggering the attack in the first place.

I was pointed towards it by this paper - https://www.ncbi.nlm.nih.gov/pubmed/19573497 It's a pretty weak basis for making treatment decisions (n=24, caffeine was used as the control against d-amphetamine, both showed some effect), but my doctor and I reasoned that there was fairly limited risk in trying it. Other studies seem to have shown similar results - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559101/

You could be having panic attacks; based on the fact you've got numbers, it sounds to me like you're actively monitoring your own blood saturation, which already implies you may be worrying too much about things like that. Don't underestimate the effects of worry and stress. If it's temporary and you don't have other symptoms then you probably don't have the virus.

Definitely a possibility. I'm not monitoring it however. I just checked whenever it got extremely bad and again after it went away.

I do have the other symptoms though. Only the fever is missing.

This is classic anxiety. I've spoke with a surprising number of people who've never experienced something like this before, never thought they could get anxiety/panic attacks, think they have the virus, etc. In some cases, even a mild fever (99-100) isn't crazy; the human body is a fucked up piece of machinery, and reading all the news every day, even comments like the one I'm writing, it starts convincing itself that it has the virus even when it doesn't.

You just need to disconnect. Its both hard, and easy. Play video games. Focus on work if you're able. Shut out the news, Trump, all of that. Try to meditate. Pray. Cook. Go for walks. If it gets especially bad, I've had a couple friends who have gotten anxiety prescriptions from their doctor over the phone (its very common right now).

I'm not a doctor, but each time I hear about a possible diagnostic about panic attacks, it feels like somebody tells a patient having a rhinovirus "your symptoms are explained by the runny-nose illness!". I.e. just stating the symptom (sympathetic/parasympathetic system going weird, heart too fast, etc) but phrasing it as if it was found to be the cause.

Would you prefer them to say “psychogenic”?

Yes. Because then they have the duty to explicitly rule out non-psychogenic causes (like a pinched vagus nerve, viral infections, a pulmonary oedema, etc).

Sometimes it feels just like the "panic attack" is a wild card they default to when the investigation would be too complicated and the patients looks like anxious anyway (which is probably because the patients' body is playing castanets, who would not be scared of that? But they seem to invert cause and effect).

Horses, not zebras.

I mean, panic attacks have no "real" cause by definition. They are your body overreacting in response to a perceived threat that isn't really there; they are a type of cognitive distortion. If a panic attack was in response to a "real" cause, it wouldn't be a panic attack, it would be a normal response to a threat.

I know, but look, it is not the correct behavior of the body, right? So obviously something is wrong, and I find it hard to believe that the problem is from the mind if the patient is not himself stating it. In most cases, if he has an anxiety problem, he would straightly start by talking about it, like "I have been in wrong terms with my neighbors for years, and now just thinking they are next door is hurting my chest and making me hard to breathe"...

I admit that in some cases the problem origin could have been repressed, but this is not very common.

> "I have been in wrong terms with my neighbors for years, and now just thinking they are next door is hurting my chest and making me hard to breathe"...

Not at all. Anxiety is hearing the boss music in a video game and not seeing any enemies. I'll often find myself so tense I'm holding my breath with no ability to rationalize why I'm in that state. It's a real bastard.

You're right. So (I agree with you but from here I'm trying to think about some path to search an explanation) maybe could it be explained by some long-term learning of the body-mind connection under repeated stress situations (like being in a crowd while being self-conscious), and then it repeats itself without the obvious stimulus?

What I resent, actually, is when physicians are presented with a package of somatic symptoms and sympathetic/parasympathetic symptoms, and readily discard the somatic part in order to jump to the "panic attack" conclusion.

> if he has an anxiety problem, he would straightly start by talking about it

In my experience, with an OCD component with general anxiety, it can twist your thoughts so much that it's difficult to unpick what the root problem is, other than a general and overwhelming feeling of "Something's wrong". I've often likened it to having two threads running - one is your normal, rational thoughts, and the other is irrational/incoherent, anxiety fueled nonsense, which often overrides the first - but it took me months (if not more) to be able to articulate it in those terms and keep some semblance of a rational thought process rather than just going into a blind panic for no reason.

When it was first happening, it definitely felt like something of a physical origin, as I could feel my heart rate going up and up, my mouth going dry, and breathing wasn't easy (and you think the panic is _due_ to those symptoms). However, as I was getting very similar symptoms from trying to ignore certain recurring thoughts (just coupled with an overwhelming compulsion to do certain things in response), it pointed me at an anxiety-based cause pretty quickly. Without that side of it, I'd not sure when I'd've come to that conclusion.

I'm now more or less at the point where it's 'just' my OCD obsessions that set me off, which are at least foreseeable and thus somewhat more manageable, but I'll still occasionally have periods where all I feel is "something _very_ bad's about to happen"/"something's wrong"/"I need to be anywhere but here" for no apparent reason. The analogy in other post about hearing the boss music is apt - that's exactly how they feel. Thankfully they're not full-blown panic attacks (no shortness of breath or chest pain), but heart rate jumps ~40BPM, not having a wall behind me _really_ freaks me out, and I can't concentrate on anything else or really talk to anyone. They're short-lived (30 seconds-10 minutes), but it's a really sudden onset (it hits me like a wall) and I feel jumpy for the rest of the day.

Slowing my breathing helps - deliberately breathing in for 5s, then out for 5s, and trying to focus on that seems to shorten the duration, and in the situations where I can tell one is coming (OCD triggered - I usually feel increasingly tense rather than it being so sudden), it can sometimes prevent them. Drinking water also helps for those - my mouth going dry is one of the first physical things I notice, and that just increases the anxiety. Keeping my mouth wet for that period helps stop that feedback loop.

You're right to point me out that the state can actually origin in pure, causeless, anxiety. Thanks, I was blinded by the reasoning I wanted to defend.

However I think that there could be cases where it would come from, e.g. thyroid instability. Usually nobody is monitored 24/7 on its thyroid hormone levels, etc. Could be also adrenal glands. Maybe when they are weak, or subject to autoimmune problems, their secretions can be irregular, or their reactions to stimuli can be too weak, too strong, quick or slow.

Then the subject would not be anymore resilient to normal stress. That would explain why normal stress => pathological effects on some people.

Then again the organ-level defects could be themselves a consequence of elevated stress during long periods, so one could raise the question about which is first of the egg or chicken...

Panic is a normal response to many situations. Panic can also be an abnormal response to normal stuff. When people experience panic that interferes with their day to day life, and causes them distress they may have an anxiety disorder.

Anxiety disorders are distressing and debilitating, and they lead to years of life lost to disability. Some of them have high rates of death by suicide.

Luckily, they're also very treatable. Most people experience pretty good recovery from an evidence based talking therapy. Sometimes that needs to be combined with medication, and sometimes the talking therapy needs to be repeated in a year or so.

So, hopefully, when people say "this sounds like a panic disorder" what they're really saying is "I understand the distress you're in, and here's some things that may help".

It doesn't even have to be a full on panic attack to raise your heart rate. I notice that when I am feeling anxious or read too much social media/news that my heart rate is elevated as a result.

Incidentally, I went the other way. I somehow got fixated on my breathing[1], and "thought" (rationally I knew it was wrong, but the anxiety overrides) that I wasn't breathing enough unless I forced myself to, to the point I didn't sleep for multiple nights as I was convinced I would be in trouble if I fell asleep. Got a cheap O2 sat. meter, checked it was above ~95, even after holding my breath for tens of seconds, and after a couple of hours it didn't bother me anymore. I think seeing actual evidence was enough to jolt me out of it, at least in that case.

Still got my baseline, for lack of a better word, OCD compulsions, but they're at least somewhat more manageable than that was.

[1] OCD/GAD can sometimes latch onto some weird things out of the blue, at least for me - having a diagnosis of central sleep apnea didn't really help either

Damn I had the same thing. I'm not particularly worried about covid19 when it comes to myself personally but I felt like it was hard to breathe and I don't do it often enough. As dumb as it sounds I panicked about forgetting to breath.

It was surreal because I'm not really worried usually about my health or wellbeing, if anything I should take it more seriously. I just gasped cold air from window and skipped sleeping that night.

I'm having the exact same experience. I live a few miles from the first outbreak location near Seattle. I first started experiencing symptoms at the end of February. Shortness of breath, extreme fatigue, loss of appetite, dry cough, and a fluctuating temperature that never went beyond mild fever (37.5C / 99.5F). My most concerning symptom was the sensation that I just couldn't get enough air.

I went to the ER one night in early March because I felt like I was going to pass out. They gave me a chest X-ray, blood tests, nasal flu swab, and ECG. Everything came back normal. No pneumonia visible in the X-Ray.

I continued to rest and recover, and things finally started to get back to normal a couple weeks ago. I thought I'd kicked this thing, whatever it was. But then the shortness of breath returned. (I've not had fever or cough.) I've cycled like this -- between struggling for breath and feeling normal -- for over 4 weeks now. I'm currently experiencing another downturn where I find it difficult to breathe normally. During my difficulties breathing, I find that standing up seems to help the most.

I'm open to the possibility that this is psychogenic. I've tried to avoid reading about the news, and that helps to distract me. But there doesn't seem to be any obvious psychological trigger to my breathing difficulties. I just wish I could get back to normal.

One thing to try to relax is to do breathing exercises. Deep breath from the nose for 4-5 seconds, hold for a few seconds and exhale over 6-8 seconds. This will lower your pulse and reflex you.

Try to refrain from constantly reading about Covid19. I find this brings stress to me and I relapse to same problems as you. Pick a time of day, as early as possible and concentrate your reading on the topic then.

I've had the exact same symptoms as you: * Chest pain and breathing difficulties that gets worse at night. * Actually ended up on hospital twice because of it. * Pulse and blood pressure went high too.

Similar symptoms a few weeks ago. I've had an off-on mild fever since.

There's been something going around since Jan at least, although it's impossible to know if it's Covid-related or something else.

Possibly an allergic/asthmatic response to something in your environment. It's worth keeping tabs on whether you used any cleaners, were outside, or in a specific room of your home when the breathing issues occurred.

I'm someone who has intermittent panic attacks and all of that sounds like panic attacks to me.

> i had to really force myself to fully breathe in

Focus on exhaling, emptying your lungs.