I'm scared, is this "Just" Panic attacks or something else? Any advice welcome.

So I’m having the worst couple of days of my life right now. It started yesterday when driving home from work. I suddenly felt light headed, tunnel visioned, felt short of breath, and felt like I was passing out. Basically, I thought I was having a heart attack.

It passed within a few moments, but scared me enough that I went to the doctor. It happened again there, lasting even longer. It’s the worse feeling in the world. you feel like you’re having a heart attack and you’re going to die, any moment it’s lights out. I think about my young son, and how he’s going to grow up without remembering his daddy. This of course turns into a feedback loop. I worry about having an other attack, I worry about my family, I get an attack.

The doctor said it was probably a panic attack. My blood pressure was high, but the EKG came back normal. She prescribed Xanax and told me she would call and check up on me the next day. Also mentioned we’d discuss possible psychiatric help.

Well, I couldn’t fill the prescription as everything nearby was closed, so I went home. Well, things continued to get worse during the evening, and eventually It go so bad last night I collapsed on the floor and had my wife call 911. I figured it was a heart attack for sure.

The ambulance guys ALSO said it was a panic attack, elevated blood pressure too asked if I wanted to go to the hospital and I said hell yes. Another EKG later which was normal, and again I’m told it’s a panic attack, and they game me Xanax. I felt better, but at home, the symptoms returned a few time,s though not as bad as before. Eventually fell to sleep.

So far today I’ve had another scary episode, even after taking Xanax again.

I’m totally scared. It’s a terrifying experience that I’m now dreading every moment, which I’m guessing only helps trigger it more. I’m in constant fear of another attack.

I don’t know what to do. Moreover I’m concerned it’s some other physiological issue, that it’s not “just” a panic attack. That there’s something wrong with my heart (I do have var high bad cholesterol) or even my head (I’ve been suffering from some terrible, debilitating migraines, sometimes as often as twice a week). And the thing is now everyone just keeps saying it could only be a panic attack.

Would an EKG definitively rule out a possible heart issue? Is there anything you guys would recommend I ask my doctor? I’m thinking about asking for a referral for a stress test, maybe getting a cat scan of my head. And asking for a new round of cholesterol lowering pills.

If these are panic attacks, then these concerns are probably only making things worse. I have also been suffering from tremendous stress at work. I’m even thinking of quitting or taking an extended leave, even if that means they’ll fire me, cause they’re going to have to find another developer to finish he current projects. ANYTHING not to feel the way I’m feeling now - then again losing my job is probably not going to help me.

I have so many questions and worries. I suffer from social anxiety that I’ve never really done anything about. I was doing a presentation a few weeks ago at work and there were at least two moment when I almost passed out. I was sweating, had trouble getting my thoughts out, I don’t know if that could be related too.

I would appreciate any advice you might have about my situation. Have you suffered from something similar? How did you work through these panic attacks? Did you have something diagnosed as panic attacks but turned out to be something else?

I worked as an EMT for almost 5 years. On one call, a woman called 911 from her hotel room because her husband wasn’t breathing. We were way too late to save the guy, but this story isn’t about him. It’s about her.

The woman who called us was as distressed as you can imagine. There’s an interesting phenomenon that happens when a person is having a panic attack and they start to hyperventilate. You can actually see it happening to them. This woman’s vision went unfocused, her back slid down against the wall, and she suddenly had an overwhelming urge to call her son. I saw she was in bad shape, and I tried to convince her to wait to make that phone call. I could see her deep, rapid, gasp-like breathing, and I knew for sure she would be unconscious soon.

She ignored me, pulled out her phone, and called her son. I could barely hear him on the other end saying, “hello? Mom? Hello?” but she couldn’t say anything. After what seemed like forever, she blurted out, “Your daddy’s dead!” and slumped over, unconscious. I set her in the recovery position and picked up her still-live phone, and had a conversation with the guy on the other line about how there’s been a medical emergency and his dad needs to go to the hospital, but his mother will be just fine.

The whole point of the story is that your body will respond to stress and anxiety in predictable ways. Panic attacks are no joke, and it’s hard at first to tell the difference between a panic attack and a heart attack, but ultimately panic attacks are an absolutely normal, predictable response to stress. Funny thing is, anxiety and distress over time will actually increase risk to your heart, too, so in a way one kind of leads to the other. It’s an awful cycle that I hope you can break soon.

But you already have an advantage. You know that feeling now, and exactly what it is. You’ve had professionals examine you and tell you that your heart is functioning normally. Hopefully your body will catch up to what your brain already has figured out - that your heart is healthy and your body can go ahead and stop making you feel like you’re dying now. Best wishes, and I’m sorry you have to deal with this.

Breathing exercises. I won’t even recommend anything in particular, because I don’t want you to think this is woo, and I promise that you can easily figure it out yourself. Just work out how to effectively control your breathing and all will be well.

I think with 2x EKG taken at different locations and interpreted by different folks - well, I’d say you can relax on that point. I’d say your ticker sounds fine.

You have a history of anxiety. You are experiencing MAX stress. You currently suffer debilitating headaches. Sounds like a perfect recipe for the onset of panic attacks.
For now, I’d say you need to take some sick days from your job and follow doctor’s orders with regard to the Rx.

Frankly, a heart attack - even w/ the high cholesterol - is probably further down on the list of worries. If you keep at a job that consistently (?) stresses you to the point of having panic attacks and hypertension, then I’d be worried about a future stroke (not to say your current symptoms indicate that at all).

I’d look at these panic attacks as a wake up call - something isn’t working well in your life and you need to change it. May be as simple as taking better care of yourself. You need to stop digging your own grave.

If the migraines are a new thing and continue to plague you, then I’d say see a neurologist. Sounds like they could be stress headaches, though.

I had a heart attack in '09. It felt like a small rock was stuck under my sternum. I didn’t even think it was a heart attack at the time, until the pain and pressure kept growing and I fortunately decided to go to the hospital. I wound up having two stents put in.

Having my body betray me like that was pretty traumatic, and this has caused me no small amount of anxiety since the heart attack.

It doesn’t help that my GERD increased (possibly due to the medications I was put on), and changed in its presentation - it went from an acidic, bile-coming-up feeling to a sense of pain and pressure just under the sternum.

Yeah. And when the panic really kicks in, you get the other symptoms of a heart attack, like shortness of breath, dizziness, sense of doom, etc. I’ve been to the hospital three times for a false alarm.

So for the past few years I’ve done quite a bit of CBT work and mindfulness work sort of retraining myself to deal with the GERD symptoms and to stop constantly worrying that I’m on the verge of a heart attack. It has made a difference, but it’s a been a long process for me. Xanax helps when the anxiety overtakes my ability to handle it. Taking my blood pressure and finding it normal helps.

If I were in your shoes, I’d follow through with a cardiologist (maybe get a cardiac stress test?), and any other specialist my GP recommended - for me it was a gastroenterologist. Ruling out and/or identifying physical causes can be a bit expensive, but it can provide confidence that the anxiety/panic is not directly related to something physical. On that note, I have been told by a handful of cardiologists and ER docs that EKG results are very reliable in ruling out a cardiac event, so you can take your results as a good sign that you can breathe easy.

Many people will recommend a therapist. If you’re unfamiliar with CBT and mindfulness (both demonstrated to be effective in handling anxiety), a therapist should be able to direct you in how to teach yourself to do both techniques. Also, if there are pressing issues in your life contributing to anxiety/panic, a therapist might could help sort through that sort of thing.

It sounds like high levels of stress and anxiety, leading to panic attacks. I have been there.

I would get a referral (or find one on your own) to a psychiatrist and tackle the anxiety and stress. Xanax is a short-term fix, but there are much better long term meds that will help you control the physical symptoms, while you evaluate lifestyle changes and other things that you need to work on.

It’s not fun, but you’ve got a solid lead on what’s happening and why. There’s good help for this. You can get through it.

My doctor was very much against Xanax. He said, if you must go on Benzo therapy, go on a longer lasting one. He’s seen way too many patients who got addicted to Xanax.

Definitely go see a psychiatrist to get on a proper set of meds. They may out you on short teem benzo therapy, but, more importantly, they can put you on a long term drug. From there, see a psychologist trained in CBT techniques who can help you.

Do this before you get stuck at home.

Two years ago I was having the same symptoms, plus such a rapid heart beat, dripping sweat, I could barely do anything. Two trips to ER, one to cardiologist – same answers as yours. Except I KNEW it was not anxiety. Finally, after a year of hell, my primary care found the correct diagnosis: hyperthyroid. Do all three blood tests, not just TSH. Not saying at all that it’s what you have, but too often ERs don’t look past heart attack. Plus, not all cardiac problems show up on ekg. A pill a day for my thyroid and I’m fine. My best wishes to you as I know only too well what it feels like.

From personal experience, panic attacks can do that. I was on Xanax until I better learned how to handle the anxiety. It’s not perfect now, but manageable.

Learning more effective methods of dealing with stress is never a bad thing. CBT helps many people. Others find different ways of coping.

Were you ever examined while the attack was going on, or had it passed by the time the medical people saw you? I ask because the symptoms sound a little like paroxysmal atrial fibrillation. If you’re back in normal sinus rhythm by the time the EKG is done it wouldn’t show.

It sounds like panic, but there can be various biological contributors to your condition.

Has your thyroid been tested? What about your sex hormones? Have you done anything different in the last week that may contribute (I’ve had severe panic attacks that I was able to identify as being caused by doing something in the previous days that made me more susceptible to them).

I so agree. I trained myself in what my sister calls “yoga breathing” and it got me through a lot of rough times. The worst time was between 2-4 a.m. when I’d wake in a total panic (I was hospitalized at the time, on a boatload of psychoactive drugs, and still the panic). Useless to go out to the nurse’s desk. I’d force myself to start controlled breathing and the panic would eventually ease. I had lots of coping mechanisms, but the breathing was the most effective.

Panic attacks are terrifying. You can certainly feel as though death is imminent if you don’t know what is happening to you. As others have said, knowing what is happening is half the battle. I had my first one at the age of 14 and still do to this day but long term drug therapy has reduced them in strength and in frequency and there are effective mind tricks you can use.

I keep a panic attack journal, noting anything that has changed right before an attack or any new patterns if I have several attacks close to one another. This has taught me what is likely to bring on an attack and I can be proactive to avoid them. Since mine involve severe vertigo, I lay down to counteract it. I count anything I can, numbers, alphabet letters, etc., anything to establish a calm, regular rhythm. I concentrate on my breathing, trying to slow it down and be consciously aware of each inhalation and exhalation I make.

The key point is knowing what is going on and being able to tamp down the fear, which only feeds on and multiplies the anxiety. I get a dozen Xanax pills twice a year from my doctor. Sometimes just knowing I have them available enables me to get through the attack without taking one, if that makes sense. Since I have learned controlling and coping techniques, I have not come lose to needing all of those 24 pills per year.

What works for you may well be different. Don’t be afraid to try various things until you find something or a combo of things that help.

Yes, it does sound like panic attacks. Yes, it could be something else, or something causing the panic attacks. I used to describe them as “Feeling like a lion is chasing me, and I’m just about to collapse.”

My primary advice: Start polishing up your resume now. If you are feeling that badly, and the thought of taking care of yourself ends with " . . . even if that means they’ll fire me . . ." then you are putting money into the pockets of the wrong people.

Cognitive Behavior Therapy (CBT) is really enormously helpful. It can help you take charge of your brain and your thoughts. Interview therapists and pick someone who you trust to tell it like it is and be straight with you.

In the throes of a panic attack:

  • I find that just looking around me and naming the objects I see helps immensely.

  • Know that this is primarily a massive adrenaline overdose, and that takes about 20 minutes to wear off.

  • Gentle exercise helps to work it off sooner, but don’t fall into the trap of seriously exerting yourself, because strained muscles and ligaments are a complication you don’t need right now.

  • Adrenaline makes your body burn tons of glycogen (“Blood sugar”) so when it is over you may feel like you’ve just run a marathon.

  • Ingesting a reasonable dose of carbs while it’s happening can be helpful to replace the blood sugar and help you relax. Use whole grains, not soda or candy. Just a slice of bread and a glass of water will do it.

  • Try taking magnesium supplements. They can really help to relax you. Also, make sure you’re getting enough iodine. The thyroid doesn’t respond well to a deficit.

  • Start to recognize “Catastrophizing” thoughts. When we get anxious, folks will often ask “What’s the worst that can happen?” But that’s not a helpful path to go down. Watch for thoughts that blow the bad out of proportion and try to consciously turn your thoughts to “What’s the BEST that can happen?”

I hope this is helpful. Please ignore anything that isn’t.

I sympathize as I am going through the same thing. Got a cardiac checkup, no issues. Now I need to figure out if it’s panic or something else. I’ve had panic attacks before, but nothing so chronic. It’s a bitch because you don’t want to ignore legitimate non-psychological causes, but it’s so unusual it makes you worry, and possibly makes your anxiety worse. What makes me feel better is that it seems to go away when I am distracted.

I don’t have any more benzos on hand anymore (clonazepam usually) so I’ll need to get some somehow. Sometimes just knowing that you have them on hand can help without actually taking them.

I hope we can both figure this out.