Do you have panic attacks?

If so, how do you deal with them? Short term (while they’re happening) and long-term (treatment)?

Used to. Short term: always have an ativan accessible. Just the knowledge that I have an ‘out’ is a strong preventative measure. Longer term: the more often I ‘almost’ have a panic attack, but end up keeping my cool, the less I worry about having one. As you know, the worry can feed on itself, and you have to find a way to break that cycle.

Yes. frequently. not so much anymore, but last year (fall '09) I went through a few months straight of constant anxiety and repeated panic attacks. I stood in my sister’s wedding, and I was up there on the sanctuary alternating between thinking I was going to puke and thinking I was going to pass out.

try to suppress the “OMG I’m going to die” feeling as best I can.

haven’t sought treatment (except for an expensive, useless trip to the ER.) I think just realizing what they are helps keep them at bay somewhat.

Since the OP is looking for personal experiences, this is better suited for IMHO than GQ.

General Questions Moderator

Yes I have panic attacks and have had bouts of agoraphobia as well. My treatment has been near-abstention from alcohol (4-10 units of alcohol per week at most), regular exercise, a diet which makes me feel better physically (low in animal fats, high in fiber, lots of vegetables), and medication (30 mg qd citalopram, and 1mg tablets of alprazolam as needed). The Xanax/alprazolam I have not found to be too effective, since my tolerance is such that I need basically a handful of them to get through anything tough, and the effect is rather short-lived, and the withdrawal effects are nothing to joke about. When I see my GP I’m going to try to switch to a longer-acting benzo like diazepam based on my success using them a few times a week during a rough year in grad school when they stuck me teaching French classes for a real shrew of a boss who actively disliked people from other departments poaching jobs from “her” students.

Some cognitive-behavioral techniques I’ve found to be helpful as well, although these ideas are just things I pulled out of books, not from a therapist.

The best way I have found to deal with panic attacks is to use paradox. Will yourself to make them worse, and keep it going until you go out the other side. Train your body not to fear anxiety.

Otherwise, I’d go with CBT–it’s effective for 90% of people.

Here’s a site that provides it for free:

I’d definitely avoid the benzo route if at all possible. You do not want to get addicted to them–they are the drug that led to my agoraphobia.

I had panic attacks in my teens, and I didn’t find out until years later that they were panic attacks. I also had some agoraphobia, but I had to overcome that to avoid flunking out of school. I really racked up the absences though.

I won’t go into the whole story of recovery because it’s too long. But the real breakthrough I had about the panic attacks was realizing that I was afraid of being afraid. Once I understood that I could be afraid and still get through what I had to do everyday, the attacks lost most of their power over me. I just allowed the fear to come and go. I wasn’t going to go insane, which is what most frightened me. The overpowering emotions might feel like insanity, but they aren’t. And emotions are only temporary things.

Remembering all that kept me going until Prozac came along.

I had them every night for almost 4 months last year after a bout of double pneumonia. I would wake up feeling like someone had thrown me off a cliff. Even though I realized what was happening and tried to talk myself down, it would be an hour or two before I could get my heart to quit pounding.
A prescription for xanax helped in the short term. The knowledge that I have a xanax has helped long term.
Mine seem to only occur in the middle of the night, and if I can’t control them within a half hour or so, I will take xanax (.25 mg). I have dropped down to only needing that once or twice a month, but I make sure there is always a pill in the nightstand, as that knowledge seems to work as a placebo to stop 'em before they start.

This is similar to how I learned to overcome stage fright at derived from anxiety to make it to various music jobs without having to rely on booze or pills. My method was to drink a lot of coffee (from which I normally abstain, which I think is generally recommended for people with various anxiety problems) and try to provoke a panic attack/high anxiety situation within my apartment, and play through a set regardless of how shaky or unstable I felt.

I’m sure something similar would be helpful for many people.

Like some of the above posters, I try not to take Xanax at all, but you best believe I’ve always got a bottle in my pocket, rattling around like the Tic-Tac guy from Seinfeld. Just in case, or something.

Thank you so much for those responses. I also keep .25 mg of xanax handy. Don’t take it often- never more than one a day and never more than three days in a row. The comment about “being afraid of being afraid” is brilliant. I’ve been around several partners who had life-threatening conditions (and died), so it’s hard for me to talk myself out of them. I’ve been grappling with a panic attack all day. Xanax finally kicked in about 30 minutes ago.

I had panic attacks before anyone really knew what they were. I used to work in an ER in admitting overnight, while going to colllege. And I’d go from totally calm to panic in seconds and it used to really confuse the doctors. They were like, “I’ve never seen anything like it.”

This went on for a year and no one really knew what it was. I found a young woman who just graduated college and got a job with Cook County (IL) health dept. She diagnosed me immediately. I was treated with behaviour therapy. She told me I was the worst case of panic she’d ever saw, and in five months, I managed to overcome them.

I remained free of panic for over 15 years, then I went through a very stressfull time and got them back. This time I used imipramine and it was amazing. It stopped my attacks in a day. Now that is highly unusual. Usually an antidepressent will take weeks. Paxil is also good for panic attacks. I used Paxil to get over a fear of flying.

Today I do not take any meds for anxiety, but meds can help. But you can use behavior therapy as well. I view meds as a short cut.

It’s like having a headache. Yeah you could go into a dark room and lie down and in two or three hours your headache will be over. Or you could take two Tylenol pills and the headache will be gone in 30 minutes.

Whatever route you choose I highly recommend two books. The first is called, Stop Running Scared. It’s out of print but you can get it used on Amazon.

The second is an oldie but goodie called, How To Stop Worrying And Start Living, by Dale Carnegie. Your local library probably has this book.

Remember there is no one right solution for everyone. You have to work with what you have.

But remember you can beat this. I don’t say this as a slam to people who are suffering from it now. I’ve been there and I know how easy it is to say when you’re on the other side.

I say this to encourage you. When you get an attack remember “This is distressing but not dangerous.” Keep saying that to yourself.

You don’t go crazy, you don’t lose your mind, you don’t have a heart attack.

The worst thing I ever did, was once I was in a grocery store and I had an attack and just left my cart full of things and left the store. But I maintained my dignity. If and I say, IF anyone noticed, they probably thought, I suddenly remembered something and had to leave suddenly.

So start by getting those books. Then get some help. If you don’t have insurance, go to your county health dept and look. They usually have sliding fee scales. Then use some meds.

Antidepressents are NOT UPPERS. People with panic attacks often think this. They think if you’re depressed you’re “down” so an antidepressent is an upper. But it’s not. I will not make you nervous.

And remember not every med works for everyone. Paxil worked for me for a very bad fear of flying. They gave me Prozac first. That did NOTHING for me. Imipramine worked beautifully for me. But it’s an older antidepressent with side effects. Nothing bad, just irritating. Like constipation and dry mouth. So you eat some prunes and chew gum and that takes care of those minor side effects.

And remember other posters have had this and they got better. So can you. You are just the same as others, they did it and so will you.

Some days will be better than others. You will have setbacks, but you will beat this.

Oh, yeah.

Long before my doc gave me meds for them (low-dose Xanax, which I use as infrequently as possible), I developed some coping mechanisms for them. For one, looking at the sweep second-hand on any clock seems to help (maybe because it reminds me that time is passing?); two, physical contact with another human helps; I can put a hand on their shoulder, leg, whatever. It helps. Don’t know why. Three, because I always feel nauseated during the attack, I give myself permission to vomit. I’ve never actually done it, but knowing that I could, and it would be OK, seems to help.

If these things are unsuccessful, I go to the Xanax. If I have more than two attacks in a fairly brief period of time (say, a couple of hours), medication can help. If I don’t cut it off at the pass with meds, I can look forward to a dozen or more attacks in the next 24 hours.

The day after a ‘cluster’ of attacks, I can induce one simply by recalling what it felt like the previous day.

The very worst, imo, is waking up in the middle of one.

I imagine the slight sedative effect I get (infrequently now, but very prominent when I first started) from citalopram (Celexa) is common with a great many other SSRIs. I credit citalopram with much of my progress over the past four or five months, and just got lucky that I found something that worked for me the first go-around.

If you can hack the initial side effects which seem omnipresent with all classes of antidepressants, those could be an excellent option to consider discussing with your doctor. Generic versions also tend to be crazy cheap, which I like.

Also, this is a bizarre technique, but I’ve found that walking with excellent posture helps with my confidence in public, high-density situations – maybe similar to the old saw about how if you smile when you’re sad, your mood is elevated, or something. The hunched over slouch seems to only exacerbate anxiety for me.

In my experience, there are generally 2 kinds, one involves a fear (rational or otherwise) of some potential event or outcome. The other is purely neurochemical.

I suspect that psychotherapeutic approaches will be beneficial for some people in the first type. I seriously doubt their usefullness in the second type.

When I used to get the first type, I found that taking niacin eliminated them completely. Most places sell both niacin and niacinimide. Biologically they are supposed to be the same except that the latter doesn’t cause a temporary dilation of your capillaries (a very unpleasant effect called “flushing”). My comment relates only to niacin. I don’t know if niacinamide would work also.

For the second kind, the type I get now almost exclusively, 25mg of the atypical anti-psychotic Seroquel works wonderfully. It is also extremely sedating - for me at least. I find that if I also take it every day before bed, it seems to ward off these attacks - not always, but almost always. The downside is that being under patent, it is extremely expensive - even for such a small dose.

Y’all are so great- these posts really help. As I told my friend this evening on the phone, you feel so alone when you’re having a panic attack. Marxxx, I will definitely look for those books. If I feel one coming on and take 1/4 mg. of xanax right away, I can nip it in the bud. As you said, I can grapple with it and try to lick it on my own, but the xanax always works. Takes about an hour.

Norinew, I’ve also been known to wake up with one. If I wake up at the regular time- 7-ish in the a.m.- I just get up. But sometimes I’ll wake up with one in the middle of the night… UGH. Everything looks worse in the middle of the night. I live alone waaay out in the country. I’ll get up and watch tv or something… sometimes I’ll just walk from one end of my house to the other and back again over and over. In my town there’s a 24-hour Wal-Mart, and I’ve contemplated getting dressed and going there just to get out somewhere. For those of you who do occasionally wake up with panic attacks, do you get afraid to go to bed? I’m a little afraid of going to bed tonight. I may sit up in the living room and read and watch TV until I’m very very tired and sleepy. I do sleep with two cuddly dogs (one of whom absolutely ADORES me :slight_smile: ), and that helps a little. If I really were ALL by myself it would be very hard.

I really do feel less alone after reading these posts- thank you so much.

ETA: I did take Paxil for a while, but it didn’t help with panic. Plus you CANNOT have an orgasm while on it… at least I couldn’t (not even a solo one). And it was a bitch to stop. My miserly use of xanax seems to work for me. And y’all are so right: you have to find what works for you.

I have a history of them. First time was when I was 19…this out of the blue, full-frontal freak out with no obvious triggers save a massive aftershock in Mexico from their recent “big one” (we were living in Austin at the time and, as I found later, at the exact moment it began, I started freaking out, feeling as if the roof was going to fall on me/hot water heater explode/some other horrible thing was going to happen) that left me feeling as if I was crazy.

Thankfully my recent significant other who turned out to be my common-law husband of 23 yrs and father of our 2 children helped me through it, ran out the door with me as I fled in irrational terror, took me to dinner, and DIDN’T immediately leave me assuming I was nuts. :eek: Even though I asked him at one point if he had maybe slipped me some acid…he was rightly offended at the suggestion, but I was desperate to explain what I was feeling, it was so FUCKED UP! :smack:

I had a few others over the years, but few and far between.

In the few years before my SO/DH died and the few after, I had quite a few. (eta: they tend to be linked to stress)

I would not wish them on my worst enemy.

I rarely have them now…only now and then. I have gotten pretty good at riding them out.

Mantras. “It’s OK, you’re allright. You are NOT dying. It’s OK. You’ve been through this before and survived. Calm down.” etc…(cognitive therapy)

Physical activity. Get out and walk, bike, be around other people. Clean the house. It helps distract you from your panic/focus on yourself if nothing else.

Sleep. If you can. I have ridden out several by putting in a comforting movie and allowing it to lull me to sleep. Often, the simple act of falling asleep and re-awakening “cures” it. Other times, I have gone to sleep and awoken still in the midst of a panic attack. :confused:

I researched this issue long ago and found that the official defination fits my symptoms exactly EXCEPT for the duration. The official meme is that such attacks can only last 15-20 minutes because the body simply cannot sustain the “fight or flight” response longer than that. Bullshit. Mine last HOURS, and I have heard the same from several others. They are like migraines, in both their duration and the way they can be felt coming on.

I’m not sure those two types are actually separable. A purely neurochemical panic attack can be so traumatic – it is both natural and likely that one would fear a recurrence. Unfortunately fear is closely related to the part of the brain involved in panic. It is a viscous circle.

ETA: this was directed at dzero’s remark

I have to disagree with this. I’ve been on a few of the older tricyclic antidepressants and have experienced no effects of any kind. I can think of Anafranil and Nortryptaline off of the top of my head. However almost every SSRI has caused me to become extremely depressed as opposed to merely dysthymic. It really does vary tremendously from individual to individual.

That was a personal observation, not a professional one. I should have been clearer about what I meant. For me, neurochemical means that there is no apparent cause for the attack and that it subsides for no apparent reason. It is possible there are some suppressed emotions involved of which I am not aware, but I highly doubt that - for reasons I can’t possibly explain in any format shorter than a novel.

ETA #2: What happens with me is that I feel something in my body- something that feels “not quite right.” It could be anything, but most often is in the chest area. Heart attack symptoms for women don’t necessarily include the “elephant sitting on the chest.” So then the adrenaline starts, which feels like fear. Then my brain says, “If you’re feeling fear, it must be because something is wrong,” and from there it spirals out of control. And I’ve been with enough people who have had heart problems and who have died, that I can’t be 100% sure it IS nothing. People DO just drop down dead. I know no one dies of panic attacks, but I’m not sure I’m having a panic attack. This condition does NOT respond to logic, reason, or common sense. The xanax stops the physical feelings of anxiety and fear, and THAT seems to bring my thoughts under control.