Being too cheap to pay bus fare for four kiddos, every day I have to camp out at the bottom of the grand staircase of their school and try to collect them as they scamper down in the crush of students. It’s like playing Plinko crossed with Whack-a-Mole. But this particular day it was all that plus Operation, complete with weird buzzing alarms because apparently a student had gotten a case of the vapors and swooned at the top of the staircase. Elementary school kids are hyper anyhow at the end of the day so this only ignited the powder keg as I tried to make sense of all the kids yelling.
“He can’t breathe!”
“He fainted!”
“He’s having an asthma attack!
“He’s having a heart attack!”
I knew it was legit when the sweet 3rd grade teacher snowplowed up the stairs literally chucking kids out of her way. Soon there was a crowd and once I was reassured that the school nurse was there and an ambulance had been called – the general consensus was the poor kid was having a really bad asthma attack – I decided the best way I could help would just be to herd kids out the doors and give the boy some room. (Seriously I swear the universe is telling me I need to become an EMT.) As I pushed kids towards their buses one little boy ran up to his mom and, caught up in the zeitgeist of emergency, yelled “MOM! A BOY JUST DIED!!!”
You should have seen all the panicked parents on that sidewalk. This is, after all, the state of Columbine. “No, no!” I yelled in my loudest Mom Voice (which, if you’ve met me, is on par with a bottle of pop opening. I have a very quiet voice). “He’s not dead! Nobody died! It’s just an asthma attack and the ambulance has already been called!”
I gave up the game of Telephone (playing Bingo yet with the number of kiddie games I’ve managed to work in here??) and got my kids to our van. At which point I discovered that I’d dropped my car keys in all the hustle and bustle inside the school. So I left my kids with a friend and ran back to the school. I found my keys… at the feet of the paramedics. The boy was crying so I figured that was a good sign. (Crying = breathing and breathing = living! That little life lesson is basically the only thing that got me through the 9 months of colic with Son #2.) All the paramedics seemed chill and unhurried so I asked if he was okay. (I swear I would not normally bother a working paramedic! They were just standing around.)
“Yeah,” he answered me. “It was just a panic attack.”
Yo. Medical pros. THERE IS NO SUCH THING AS “JUST” A PANIC ATTACK.
As a girl who’s had panic attacks her whole life – the first I remember was in 5th grade but by now I’m sure I’ve had hundreds – I can tell you with total assurance that a panic attack feels as much like you’re dying as if you’re, well, dying. Except maybe worse because you don’t actually die and then you have to do a repeat performance at random, inconvenient moments. And put up with people – including some medical professionals, sadly – mocking you, calling you crazy or telling you that you just need to think happy thoughts.
Truly though. Panic attacks are terrifying. Even I as an adult still get overwhelmed by them to the point where I vomit, get diarrhea, feel faint etc. And I know what’s happening to me! (Which is 80% of the battle, by the way. Being able to ID a panic attack for what it is is perhaps the best skill I’ve ever learned.) I can’t imagine how scared that poor kid must have been.
When I relayed this story to another mom she asked, “Well what set it off?” Meaning, I assume, “What was he so panicked about?”
I shrugged. “It’s the first week of school – who knows? It could be anything. Or it could have been nothing.”
“Well it had to have been SOMETHING,” she answered. “Who freaks out over nothing??”
Turns out lots of do, actually.
Here’s another interesting tidbit about panic attacks: There are actually two different kinds. Sometimes you know what sets them off – generally a fear of something bad happening or a phobia of a specific thing, like spiders or public speaking. These are called “triggered (or phobic) panic attacks”. But sometimes you have no idea. The attack comes out of the clear blue. These are “non-phobic spontaneous panic attacks.” (And then sometimes you can combine the two by triggering a panic attack simply by the fear of having one. Fun times ten!) The weird thing is we only ever talk about the phobic kind.
The first question people always ask me when I have a panic attack is “What are you so worried about?” And 90% of the time I answer truthfully, “Nothing!” (At least nothing more than usual. I’m a consummate worrier.) Often people try to figure it out anyhow and try to solve it for me. It’s well intentioned but often meaningless to me because more often than not, my panic attacks start first – they feel like they have a biological root inside me – and then I start worrying about crap. But I’ve never understood why that is. So the other night while I was laying on the bathroom floor trying to stave off the nausea and waiting for my heart to stop going at rabbit speed, I decided to look it up. (Intellectualizing my panic attacks is my primary coping technique. You gotta do something right?) What I found was super interesting:
According to Dr. Jay Hedaya, “Nonphobic panic attacks are thought to be the result of abnormal, over- sensitivity of a brain alarm system whose function is to detect early signs of suffocation. This theory is called the suffocation alarm theory.”
The basic gist of the theory is that some of us just have more sensitive “suffocation reflexes” and so when CO2 levels rise in our body, our body kicks into overdrive with hyperventilating, faster pulse etc. to get oxygen in. The interesting part is that our CO2 levels rise naturally at certain times: Primarily when we’re in a relaxed state, as in getting ready for sleep or meditating. Then they rise again during sleep. And lastly, any decrease in progesterone. Dr. Hedaya writes that women in particular are prone to these spontaneous attacks.
“Interestingly, women are more vulnerable to panic attacks premenstrually and just after childbirth. These are both times when the levels of progesterone drop suddenly. Since progesterone decreases the levels of CO2 in the brain by increasing respiratory rate, the loss of progesterone at these points in time would lead to increased CO2, and more vulnerability to panic.”
You know when my panic attacks are the worst? I’ve talked about my crippling post-partum anxiety before and now I think I finally have an explanation for it! Also, my husband and I joke I have “Sundowner’s syndrome” because if I’m going to have a panic attack it’s always right before I go to sleep. And while I’ve never looked at the correlation between my cycle and attacks, this last time it definitely corresponded. I’m guessing they probably go together a lot.
I don’t know why this info helps. But it does. I guess it’s because it makes me feel like I’m not nuts? It’s this biological thing my body does – I can’t help it! So why did it take having panic attacks for over 20 years for me to finally learn about this?? According to Dr. Hedaya, phobic or triggered attacks are far more common (and are the type most people think of when they think of panic attacks) so those are the only ones we talk about. In fact, most doctors think there’s only one kind! Yet the distinction is an important one because clearly there are different treatment modalities required.
For triggered attacks, dealing with the underlying phobia is critical and can “heal” the attacks but this approach does nothing for spontaneous attacks. Since spontaneous attacks are more biologically rooted, a more medical approach would be helpful. Who knows – perhaps a little progesterone cream could have saved me from the six weeks of absolute hell I went through after each of my kids were born. Oh, and the worst thing you can tell a person having a spontaneous panic attack is to meditate or slow their breathing as this raises CO2 even more in their already panicked brain. The effect is so immediate that one doctor said this is how he tests his patients to see which type they have: If their panic improves with learning focused meditation then it’s the former but if meditative relaxed breathing makes it worse then there you go.
And, not to get all conspiracy theory up in here, but perhaps spontaneous attacks are a lot more common than doctors realize. Maybe they’ve been written off for years as a “women’s problem” – just us ladeez being all up in hysterics in herrrre! – instead of recognized for what they really are: a medical condition.
Another treatment for panic attacks regardless of source, that’s getting attention of late is the almighty probiotics thanks to their newly recognized ability to help reduce cortisol! Several recent studies have found that giving people probiotics not only reduces anxiety and panic attacks but can have sweeping emotional effects:
“[Psychiatrist James] Greenblatt’s provocative idea — that psychiatric woes can be solved by targeting the digestive system — is increasingly reinforced by cutting-edge science. For decades, researchers have known of the connection between the brain and the gut. Anxiety often causes nausea and diarrhea, and depression can change appetite. The connection may have been established, but scientists thought communication was one way: it traveled from the brain to the gut, and not the other way around.
But now, a new understanding of the trillions of microbes living in our guts reveals that this communication process is more like a multi-lane superhighway than a one-way street. By showing that changing bacteria in the gut can change behavior, this new research might one day transform the way we understand — and treat — a variety of mental health disorders.”
The scientists tested mice with different traits (and different gut microbiomes) and compared them with mice bred to have no intestinal bacteria (don’t ask me who figured that trick out). Not only did the mice with healthy germs in their guts have less cortisol (evidence of stress) but when they took bacteria from the happy mice and fed it to the anxious mice, the anxious mice changed! Bad news for me though: The effect only lasted up to a point. Once the mice reached adulthood, the effects were much harder to alter, suggesting that our guts are more easily manipulated in childhood but eventually become “set.”
Also, a separate study (which I think I’ll do a whole post on, it was that fascinating!) found that all this gut populating doesn’t happen in a vacuum. To get the “good” microbes to take hold you need to be eating healthy food. The little mice that ate junk saw no benefit from the bacteria!
Now I suppose the trick is to figure out which bugs exactly are helpful for mood disorders. And also which flavor of yogurt to put them in. (You know us ladies and our yogurt!)
So, have you ever seen anyone have a panic attack? Have you ever had one? Anyone ever noticed a correlation between anxiety and hormone fluctuations? Anyone else want to go out and buy stock in probiotics now??
I have suffered from Panic Attacks for about 6/7 years now? 6 months ago they were at the point where they were so bad I wasn’t leaving my house for weeks at a time. In my quest to understand why in 6 years i’ve been on that many different Anti-depressants – because they just *stopped* working, I discovered a HUGE range of information with the correlation between anxiety/depression and your gut! I was amazed and angry at the same time that I was never told this by my doctor. I was annoyed at how “easy” it was to be prescribed medication. The conversation I first had with my doctor when my attacks started went exactly like this
me; I’m feeling strange. Having trouble breathing, rapid heart rate, feeling dizzy, loosing my appetite etc – basically rattled off all the symptoms of anxiety to her
Her; You have anxiety. Heres 50 mg of Zoloft have a nice day
No ‘hrmm well I think possibly you may be experiencing a bit of anxiety, but lets run some bloods to make sure you’re not deficient in something (magnesium deficiency can mirror the same symptoms as anxiety)……
So because I was so god dam mad about this discussion never having taken place, I decided to do more research. I found out that 90% of the body’s seretonin is found IN THE GUT! …. IN THE GUT!!!!! So why am I taking medication for my head? Why was I not told that I needed to change my diet? Exercise? then maybe try some counselling and THEN come back… blagh…. I could go on all day, but basically I am currently starting up my clean eating and exercising and taking a probiotic everyday … so I can get off these meds…
One, that sucks i can relate w you about the onset and vicious circle panic attacks can create. I too suffered since the 6th grade. Now i’ve found 1200 mg of high EPA fish oil has quite positively kept them at bay since i started taking them in May. And have noticed the anxiety comes back if i inadvertently forget to take them. Two. Thats interesting about the digestive system and anxiety. And the correlation makes perfect sense. Hence better to eat real organic food as nature intended. 😉
Oh ya. I might add high EPA fish oil in addition to running, yoga/meditation, sleep schedule, and reducing my schedule (more me time)
Love this post, especially the correlation between health & probiotics. I don’t suffer from anxiety attacks, but I do have a friend that does. It doesn’t hurt to know this sort of information – even if it enables us to be a little more compassionate to only a few people. Still a stigma with anxiety. Thanks for the post.
I don’t know panic attacks, but I might know a person who can help you with your diet. Her name is Dr. Teri Mosey. She has an extremely interesting combination of degrees – B.S. Biochemistry, M.A. Exercise Physiology, Ph.D. Holistic Nutrition – and she is very knowledgeable about the gut, immune system, brain, neural pathways, & food. I’ve heard her speak at a number of conferences, and I think you’d love her.
I found this all really really interesting too.
My sister struggles and I wonder if this could be a clue as to why….
I’ve had ’em and they SUCK. Mostly in my 30’s and early 40’s but for whatever reason, gone now. (Aging? Better diet? Self-help cog/behavioral?)
Mine weren’t random; more of a claustrophobia like thing, being somewhere I could not easily leave, especially if there was any possibility of danger or making a public spectacle of myself. So fear of the fear itself would escalate mild anxiety into total panic. Airplanes, live theater or music performances seated anywhere but an aisle, driving over bridges or on fast freeways with no place to pull off (I’d be afraid I’d freak out and turn the wheel for no reason and crash) etc. etc.
Slowing my breathing never helped, because then I’d start to “forget” how to breathe normally and that would just add to the freak out factor.
So hard to talk about this stuff with people who have no history of it without sounding totally weird, so I love that you have posted this! Great to see more research is being done and hopefully some answers and a lessening of stigma. Thanks! And good luck on yours, sounds like you have some more concrete leads to follow in getting rid of yours!
I have only had one panic attack. About 6 years ago, I was a guest on the Oprah Winfrey show. That morning getting ready I felt fine and I didn’t feel nervous about being on tv at all really so it came as a shock to me that once I sat down and they started taping, my neck got all hot and prickly, I broke out in a cold sweat, and my heart started going like a jack rabbit. I thought I was dying and my first warped thought was that I was going to be the first guest to DIE on the Oprah show. Oh the embarrassment!! Thankfully, once it was my turn to talk and I started talking, it all went away but man, for a minute there I was sure I was dying on national tv.
I haven’t had one since but I was recently diagnosed with PDD, curtosey of some post twin birth messed up hormones. Basically it is like I have PMS 3 weeks out of the month and with that I find myself feeling anxious all the time. The dr wanted to put me on Prozac but I wanted to try some natural stuff first and have been taking Magnesium, Calcium glucarate, primrose oil, Vit D, and Fish oil and I do feel like it is heping dial down the crazy i feel. l
I actually knew this to a point! I have had a plethora of stomach issues and whenever they seemed a little worse, depression also kicked in worse. My doctor at the time did mention that correlation, but to increase seratonin in my gut, gave me Zoloft. I need to find myself a really good probiotic at the moment, however if it lowers cortisol I might be in trouble. Maybe I’ll have to take it at night so sleep can be an option… 🙂
So interesting. My mom struggles with a lot of anxiety and was recently visiting. On the last day of her visit I asked her how she was and she said she was feeling a little anxious. I asked her about what and she said nothing. I know that feeling too, though I’ve only ever had a couple true panic attacks and they were triggered. But I often feel anxious about nothing in particular. I’m going to send this research to my mom. She’s always struggled with acid reflux too. Maybe probiotics could help. She’s cut out most dairy and caffeine with little improvement.
I am actually feeling a little panicky reading your blog Charlotte! I’ve had both from 3rd grade on. Sensitive child syndrome! Informative info. I’ve been on probiotics forever though and that doesn’t seem to kick for me. I will, however, pay attention to my deep breathing when I feel one coming on.
Some probiotics are much more effective than others. I swear by Dr. Ohhira’s five year, a lady on Amazon swears by Renew Life and didn’t find Dr. Ohhira’s effective. I have tried many brands and none had any effect on me at all except for Dr. Ohhira’s.
Thanks for the suggestions Marilyn.
I have had 4 panic attacks in my life and I guess they would be called phobic but the reality is they have all involved me pushing myself physically to exhaustion and talking negatively about it to myself. Each time I committed to too long a distance either swimming or hiking and now I was stuck having to finish. Maybe I am phobic about being trapped in a commitment I can’t get out of.
Thank you for this post! I have always struggled with anxiety, but it has become particularly severe in the past few weeks. I knew hormones were involved with me but hadn’t yet done any of my own research. You may have posted about this before, but any recommendations on specific probiotics? There are so many out there, and I feel like there’s no way to reliably tell which are the quality ones… I would be willing to spend more for a better product, but there’s just no way to tell. Also, I had been wondering if you had ever tried (or if it’s even possible??) to just head out the door for a run when you felt a panic attack coming on? In theory, it seems like it would help (especially seeing the research here), but I’ve never had a spontaneous attack (only the other kind), do not sure if it’s even a feasible was to deal with it. Thanks, as always, for such good information!
My uncle used to have panic attacks all the time when I was a kid. It was definitely a scary experience, but now I know just what to do when others start having panic attacks.
The thing about panic attacks is that they can strike at anytime, which is something the sufferer is profoundly aware of – and it’s through this inconsistent pattern of attacks that makes it so hard to attend even planned occasions, such as parties,weddings,interviews,speeches etc…you are aware of the sporadic nature of these attack, so you catastrophize the outcome of certain planned occasion you haven’t been to yet. I think panic attacks can be cured through the foods we eat and the thoughts that we think – people are so quick to take medication for it, because they doubt the power of natural methods – when really they should try all natural methods first before they even think about putting drugs into their bodies.
I’ve had panic attacks the whole of my life that I can remember. They make me physically ill by turning my gut to water and then I need a restroom NOW! Which is interesting to find that the gut is so involved with regulating seratonin. I also “forget” how to breathe normally and start to hyperventilate and get tingly and it’s just so awful. The worst is riding with someone on a freeway or highway with nowhere to stop and be able to use the bathroom. It is a self-perpetuating cycle of panic. The worst is that my husband, who is so laid back that he’s almost never on time, when we get everybody buckled in and ready to go usually says, especially when we’re running late, “Now I suppose you’re gonna have to stop and crap fifteen times before we get where we’re going…” It makes it SO. MUCH. WORSE. And he either won’t stop, or he’ll do it while sighing and rolling his eyes and complaining how late we’re gonna be. (Makes him sound like a monster, but it’s really the only bad thing about him.) I would love for him to have just ONE panic attack to see what it was like. Maybe he wouldn’t be so calloused about it. So, other panic attack sufferers, I feel your pain. I get them less now than I used to, but I’ve learned to turn my attention inwards to quiet it down, kind of like a mini meditation. It doesn’t always work, though.
For a few years I had repeated panic attacks throughout the day, seemingly triggered by nothing. And yes, having a panic attack because you’re afraid you’re going to have a panic attack is VERY common (and loads o’ fun! Snort.)
The program “Attacking Anxiety and Depression” finally stopped my attacks, and now I tap the base of my thumb when I feel nervous or anxious, and it helps right away. I also take Pharma Gaba as needed (which, these days, thankfully isn’t often), and do yoga nearly every day.
It’s also very common for anxiety to begin in childhood, and to go undiagnosed for decades. In my case, my doctor thought it was a particularly virulent strain of stomach flu.
That lasted 4 years.
Oy.
Oh gosh. THANK you for this post! I’ve tried to explain my nonphobic panic attacks to SO many people and I guess they just don’t understand. It’s a very frustrating thing to experience and go through one, while people are telling you to just breathe deeply and meditate. Um no – when you think you are at deaths door this is not helpful…or when you go to the hospital and they just think you’re nuts 😉
Panic disorder is something I wouldn’t wish on anyone, but it makes it easier to deal with when I know I’m not the only one who is struggling…and when more people write about it. It’s kind of calming for me to read.
This is super interesting!
Although I definitely have anxiety (lately I’ve had this thing where I keep getting anxious right when I’m falling asleep – something about getting into a relaxed state and being able to “feel” the heartbeat freaks me out to the point that I worry that I’m having some kind of heart attack or something), I’ve only had panic attacks a few times. They tend to be triggered over eating or a lack of cleanliness (the former of which has led me to wonder if my eating disorder is a manifestation of my anxiety issue? Hmmm).
My eating disorder was definitely due to my anxiety. It’s possible your is too. Through the years my anxiety has taken all kinds of fun manifestations: hypochondria, anorexia, insomnia, panic attacks, hives, and on and on.
Your articles are just a pleasure to read, Charlotte.
I’m a psychology student and the more I study, the more I realize that we really cannot judge anyone. I hope as people become more educated, we will become more tolerant of each other.
I don’t have panic attacks but I can get very anxious so I really empathize with you.
Regarding the mice and junk food and robiotics and gut flora, do you know whether eating very healthily all day but having chocolate (I’d say a bit of chocolate but let’s be realistic, it’s never just bit) will prevent the good bacteria from populating?
I’ve had only 2 or 3 full-blown panic attacks but often will find myself uncomfortably anxious. The comment about deep breathing really got my attention, when I’m feeling stressed, taking deep breaths definitely makes things worse. Trying to “breathe mindfully” at bed time is just a recipe for disaster. Actively trying to calm myself down makes me more anxious – distraction is a much better strategy for me. I do puzzles or work or whatever and if my body tries to break in with “I’m really freaking out here!” messages, I basically tell it “you’re fine, let’s keep going, let’s go back to that paper”.
You should look into fecal transplants. Mostly I would just like to read what you have to say about them, but it might be a way to help with the physiological causes of anxiety.
The sight of a pig in glasses ( your avatar) telling Charlotte to look into fecal transplants made me spit out my coffee. Literally. Thank you, love. I needed that boost this morning.
Oh I did it Bekky! Ask and you shall receive… https://www.thegreatfitnessexperiment.com/2013/09/the-miraculous-science-behind-fecal-transplants-for-weight-loss-poop-the-other-brown-meat.html
P.S. The science behind this is seriously amazing – I had no idea!!
I get the point of fecal transplants, and I understand they can be quite beneficial, but wouldn’t just putting the right probiotics in the same place achieve the same goal, without the disgusting part?
I don’t know, I haven’t done much research on it. That’s why I asked Charlotte to :p
Apparently not – the human gut has a much wider range of bacteria than any supplement on the market. SUPER interesting research coming out about it now! https://www.thegreatfitnessexperiment.com/2013/09/the-miraculous-science-behind-fecal-transplants-for-weight-loss-poop-the-other-brown-meat.html
Hello! First off, I think you should listen to the universe and become and EMT! It is one of the most rewarding things you will ever do!
Second, I just have to say in defense of the paramedic that said it was “just a panic attack” – he wasn’t minimizing the experience in any way, he was probably just incredibly relieved! I am an EMT, and it is a terrifying thing to get a call for a child with difficulty breathing, or anything serious for that matter (yes, we get scared like everyone else, but we just can’t show it). We expect to get on scene and find blue kid with a compromised airway and a weak pulse, maybe even mentally prepare ourselves for some potential cpr. But instead we find a kid having a panic attack. I can’t even describe the wave of relief that washes over us. While the person experiencing an attack may feel like they are dying, they are most definitely not and that’s what matters! One quick breath to slow our own racing hearts, then we start treating the symptoms and trying to make the patient comfortable until the attack (which we understand is terrifying and sucks to experience) subsides. Which it always does. No life threats, no cpr, no children with lips and fingertips the color of the sky. Just a panic attack.
This is so very interesting and helpful. THANK YOU! I’ve always gotten my panic attacks within the week before my period. If I miss a night or two of sleep (only get a few hours) during that time, I’m SURE to have one. Mine definitely aren’t phobic, so until my last semester of college I didn’t even understand what was happening! I would have vision problems and throw up and think I was just REALLY sick. I figured the fear of vision changes was making me panic. It wasn’t until a whole side of my body went completely numb (including my tongue) that I thought I should maybe see a doctor… And they got much worse / more frequent after I did a round of colonics my Freshman year (which I didn’t realize at the time took pretty much all of the good bacteria out of my system). I’m terrible at remembering to take my probiotics… heading to the kitchen to take one now.
I’ve had horrendous panic episodes over the last 18 months – I noticed they definitely were considerably worse pre-menstrually. I was under a massive amount of stress, and my body got so out of whack that PMS was lasting around 18-20 days for me and was so severe it could be called clinical depression, and I could barely function. Now after 6 months of bio identical progesterone cream treatment I am feeling almost normal – PMS is a manageable 7 days, and the extreme shakiness, uncontrollable crying, and anxiety has evaporated. Eating healthy carbs also helped (I had been eating around 100g of carbs a day – tonnes of veggies, in an effort to correct pre-diabetes – which for most people is fine but with my brain chemistry was enough to tip me into depressive episode) – would highly recommend these books: potatoes not prozac, the mood cure, the hormone cure. and 5-HTP supplements if you suffer like this. Please ladies get your hormones tested (I’m only 32) our environment and lifestyle means so many of us our out of balance.
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I have panic attacks for several years. I found out that I have lactose intolerance and cutting dairy stops attacks. My prominent symptom is jamais vios (feeling unfimiliar) and overwhelming fear. the correlation between gut and brain is interesting. As I know some foods change the pH of the blood which in turn leads to psychiatric conditions. I suggest to read a paper entitled ” pH of soul ” by Dr. Farnam. I want to know if there is a relation between lactose intolerance and probiotics.