The Sopranos does not really portray panic attacks realistically

I’ve been re-watching The Sopranos (up to the 3rd season at this point) and I have got to say, I don’t feel that the show presents an accurate representation of what it’s like to have panic attacks. The main character, Tony Soprano, is constantly having panic attacks - this is a major plot point of the show. But every time he has a panic attack, he physically passes out, and his body hits the floor, and he regains consciousness later.

I just accepted this, the first time I watched the series, but now, I’m a veteran of panic attacks myself. I had many of them last year. And they were nothing like how this show makes it seem. I WISH I could have passed out during my panic attacks. For me, they were the exact opposite of passing out - I became hyper-aware, and unbelievably afraid, for no reason.

Wikipedia lists these mental symptoms for a panic attack:

Intense and/or frightening realizations of reality
Loss of the ability to react logically to stimuli
Loss of cognitive ability in general
Racing thoughts (often based on fear)
Irrational thoughts
Loud internal dialogue
Feeling like nothing is real
Feeling of impending doom
Feeling of “going crazy” or becoming insane
Feeling out of control
Feeling like no one understands what is happening
Vision is somewhat impaired (eyes may feel like they are shaking.)
Feeling that death will come any second
Avoidance behavior
Agoraphobia
Feeling like nobody else is feeling like you

With the exception of vision impairment, I experienced all of these things. It was absolutely horrible, and there was no escape from it. I had to swallow some pills and then ride it out until they kicked in. There was certainly no passing out, blacking out, fainting, or anything that the show shows. Tony Soprano is never shown to experience any of those symptoms, he basically just gets blurred vision and then hits the floor, every time.

And yet they keep referring to this as panic attacks, throughout the show.

I don’t think that is really a panic attack. I think it is a completely different disorder.

Does anyone agree or disagree?

They should not call them “panic attacks” and they should not conceptualize them as psychiatric or mental phenomena. They are a physiological occurrence with a definitive cause and would be better named “adrenaline flood” or some such thing. The body dumps an inordinate amount of epinephrine into the bloodstream and all the basic constellation of fight-or-flight responses to that, both physical and psychological, manifest at full volume. It’s easier to cope with (at least for most people) if they know that that’s what’s going on, that their body’s “in danger” wiring has misfired and shot them chock full of a strong drugs that induces this state and then dissipates in a bit.

Once I learned the specific physiological mechanisms behind it, I found it much easier to deal with them. But for someone who has no experience with these attacks, I really don’t think passing out would be the realistic response. More likely, he would think that he was having a heart attack or a seizure or something. That is how I felt when it first happened to me.

Tony’s panic attacks were plot points. They moved the episode story and the storyline arc for the season along. For the vast majority of viewers, it just doesn’t matter whether they are portrayed accurately or not. Minimally, that is how HBO and the show’s creators see it.
Who looks to The Sopranos for accurate fictional character medical diagnoses anyway?

I don’t think it’s that anyone is looking to The Sopranos for medical diagnoses. It’s more like, if you’re one of the many who suffer from actual panic attacks (I do), having one portrayed so unrealistically just yanks you right out of the story. So instead of following the story, you’re left sitting there cogitating on, why, if the story line requires him to be unconscious for a time, can’t they “give” him narcolepsy or something?

I’ve never seen the show, don’t have HBO, etc. But I understand exactly what the OP is talking about. :frowning:

Sounds like my pet peeve regarding characters in movies wearing glasses with flat glass in them…

it’s a completely stupid detail, yet there’s all these movies that have spent a lot on special effects, stuntpeople and whatnot, and that little detail manages to totally “pull me out” of the movie.

You are right. I used to have panic attacks and they are horrible. I am not afraid of flying at all but I had one when boarding a business flight once and a panic attack started just after they closed the door. I came within one second of asking to be let off at any cost but it was winter and I just started ripping clothes off until it would be indecent exposure if I went any further. I am sure that my row mates were not amused.

They could have used something like that. Believing he was having a heart attack would be another. There are many other ways to portray panic attacks as well.