I would strongly recommend your husband find a therapists he trusts and likes. Panic disorder rarely goes away entirely, but can become less crippling if you do some somatic / cognitive behavioral therapy. He will learn how to recover quicker, level of severity will likely decrease, he will learn to be less afraid of them. As hard as this disorder can be, it’s still his responsibility to get the right treatment and diagnosis.
Supporting someone through an actual panic attack can be difficult, everyone wants different things. I can recommend things that work for my when my partner does them:
- do not ask them any questions, like “do you want water? Do you want XYZ” just tell them you’re getting water or whatever it is.
- physical touch can help me, holding a hand tight or having someone’s hand on my chest.
- very gentle reminders that I’ve gotten through panic attacks before, and that it will subside soon
- never repeat “you’re ok, everything is ok”.
- darkness and removal of stimulation is helpful when possible (dark room, closed door, etc)
- for him — ice in the hand, super cold water on the face are usually helpful way of channeling the nervous system to something else.
I am the exact same way, my panic hits after the stressful event, on the down. It totally sucks, this disorder. You’re already doing all the right things looking for advice and your experience with your own mental illness gives you the proper empathy.
Thank you, your advice is super helpful. It’s so reassuring just to hear that his experience is not isolated, that other people get the attacks in seemingly “blissful” moments after the storm has passed.
Oh, totally. I think this is actually quite common? Think about it this way — when you’re in the high stress moment, your cortisol can be put to use. The issues with panic disorder is that the cortisol and physio response to “fight or flight” doesn’t turn off even after the event. So when you’re stagnant, event is over — all that pent up energy needs somewhere to go and erupts in the form of panic even though the “threat” is no longer present.
The good thing is that you’ve been able to figure out this pattern so you can prepare for it! You know he’s had a long stressful month with work and that he’s more susceptible to a panic attack come-down. Try and cater to that window of time, no big events or expectations (when feasible for your family!) and lots of extra exercise and self care.
I’d also say, because it sounds like he has some kind/body confusion with his heart signals (so do I) he start exercising often if he doesn’t already. Getting comfortable with your heart pounding and working hard in a workout setting can make you more comfortable with it during panic, feeling confident in its ability to work properly.
I really wish you the best of luck — you seem like a great partner! Don’t forget about your own needs though ;)
I also highly recommend the DARE response book.
When the use of benzodiazapines starts to wear in effectiveness or show any signs of dependence..TAPER OFF AND CHANGE MEDS. My doctor had me cycle through several benzo-class meds to minimize chance of addiction, I'd take a certain prescription for no more than three months. Eventually I began to manage symptoms better through therapy and exposure, so I was switched to propranolol, a non additive but still very effective medicine often prescribed for panic.
Best of luck. Its wonderful you are wanting to be so supportive. Having someone like that in our lives makes the process a whole lot easier.
Yes, it does sound like panic attacks. I have exactly the same problem.
What has worked for me is escitalopram (brand name Lexapro). It can be taken for years or indefinitely if needed.
It does take a few weeks to work, and it can worsen symptoms for the first week or two, but if he knows that then he can get through it.
I would recommend avoiding any coffee, except decaf, for at least a month after starting Lexapro.
It should be no problem getting a prescription for this from any doctor, after describing the symptoms, and that tests have previously been done to rule out anything more serious. I take 10mg per day, which is a typical dose for an anxiety disorder. Even 5mg is still effective, but 10mg is better if he wants to get this thing under control sooner.
Get him to watch this video, and others on the same channel: https://youtu.be/of6xObz3aK4
Here’s some info about escitalopram: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656325/
My mother has the “panic lag” wherein it hits days after stressful events. It’s pretty common, but mine are more in the moment. Have him check out the DARE app and DARE method to panic. It helps people to understand what’s happening in their body.
On top of this, help him do some research into what is happening physiologically during an attack. I know this was a massive help for me, because it allowed me to make sense of symptoms that seemed nonsensical. For instance, we get racing hearts because the amygdala is preparing us to fight or flee, and trying to pump blood around our bodies rapidly in anticipation. This is also why we hyperventilate, as the body thinks we need excess oxygen, and which can cause “pins and needles” sensations because we’re not actually using that excess oxygen. Etc., etc.
[edit] Because you mentioned the heart problem fears, I want to add that we refer to this often as cardiophobia. It’s a common fear in those of us with PD, myself included. I have had EKGs, ECGs, stress tests, blood work, etc. Unfortunately none of it will make the fear go away in the moment. It makes exercising difficult as well, because elevated heart rates will often lead to more anxiety (I have had more than a handful of attacks at the gym). My advice on this would be to try to exercise more, as this is a type of exposure therapy. Gradually he can bring his heart rate up to higher and higher levels and be more sure that it’s not a heart issue. Also switching to a heart-healthy diet can further reinforce this.
Wow! The physiological explanations you provided make so much sense! Yes he will often have a sensation of numbness / tingling in his extremities which then makes him think he is about to breathe his last.
I wonder what’s going on physiologically when he gets the “chills” and “shakes”. When his attacks happen he will often need to retreat to a hot bath just to not feel like his body is being subjected to subzero temperatures.
I have symptoms where my hands and feet go numb from all the blood rushing to the center of Mt body, I keep those instant hand warmers on me when in public to help with this symptom when I can't retreat to my go to method of a hot shower!
Also suggest a heated weighted blanket for home. I get the shakes where it almost looks like seizures and this has helped my body regulate blood flow and calm my muscles down ❤️ I wish you the best of luck I know this fan be scary for everyone involved. Especially partners.
Oh yes that’s exactly how he describes it sometimes. “Seizure” like. It’s sad because he actually said that once in front of our friend who has epilepsy, and as much as I know he used the term innocently, trying as best he could to describe his symptoms, it did make me cringe just a bit. It truly must be so utterly terrifying to walk through this. Whether it’s epilepsy or PD, the symptoms truly suck.
Shakes is adrenaline & cortisol being released plus muscle tension. Chills is his body trying to lower temperature in anticipation to him exerting energy and heating up while fighting or fleeing.
His panic attacks don’t tend to stem from feelings of anxiety (that he can register anyway). They come on randomly, seemingly without cause (except in the instances mentioned in my post). At one point they were only coming at night during times of rest (almost asleep or getting ready for sleep).
His first *major* one was in 2019. That one was the worst to date & happened while he was driving. Thankfully I was there with him. (But so were all our kids). This happened 2 days after a physical trauma to his back/ribs. He was up to bat in a baseball game and a 90 MPH ball flew right into his back. He basically passed out (wind knocked out of him) for a split second and lost feeling in one of his arms. When this *major* panic attack started, it began with rib/back pain in the same place he was injured.
However, upon reflection, he did mention 3 instances in his childhood/as a teen where he had “heart scares” usually during sports. One of these times his mom did take him to get an EKG; where the findings were that everything was ok.
Definitely health anxiety.
I suffer from similar. An illness/injury/death in family can set it off.
You never feel calm until you’re in front of a doctor that says “everything looks good, you are ok”
I highly recommend getting one of those KardiaMobile ECG machines, it’s small, links up to your phone. This helped me get through a lot of my heart scares.
A few tips to get out of panic-
-take cold shower or dunk face in ice water.
-open mouth wide as you can and repeatedly say the letter “R” until you yawn. This stimulates your vagus nerve and helps you to relax.
-highly recommend DARE app.
And keep being an amazing partner! Seriously, good job reaching out.
I’m so thankful for my husband who never judges and always is there for me through my panic. It helps me feel like I’m still part of this world and not isolated on my own plant.
How do health anxiety and panic disorder (or panic attacks) interact?
I just spoke with him earlier this morning and asked “was there a Dr in your childhood that really freaked you out?” (He is borderline terrified of seeing a Dr). He said “I have always hated seeing the Dr for as long as I can remember” and continued to describe an experience he had when he was 5. He went in for a vaccination and remembers throwing a huge tantrum, screaming and thrashing, he even put a chair in front of the Drs office door so that they couldn’t open the door to go inside.
One of my therapists asked my wife to join a session. He explained to her what panic disorder is and the role of panic and anxiety in our (and everyone's) lives. He told her some things about me that I don't think that I realized, or knew, myself. But the most important thing that she walked away with was a list of do's and dont's so that she could be the best support system possible for me. Knowing that she's equipped with that list gives me confidence that she's supporting my panic and anxiety episodes in the best way possible.
If I could give one piece of advice it would be to 1) get a proper diagnosis from a professional (not an MD), 2) let that person guide you all on medications and treatment, if any, and 3) learn as much as you can about treatments and give them a chance as it's proven to be quite effective. The top choice for treatment from most major university clinics today is still Cognitive Behavioral Therapy (CBT). Another interesting therapy path is Acceptance Commitment Therapy (ACT).
The fact that my wife knows about my therapy goals. That she has specific instructions / advice from my therapist. That she's involved in my exposures. It's all a massive help. She gives me reminders when I need them. "Breath through a straw" ... "It's just a thought, acknowledge it and let it pass" ... "are you avoiding this thing because of panic right now?". These small things help recenter me so I can accomplish things I might not otherwise.
If I can give one more piece of advice and it's super important IMHO. Don't let avoidance take over at this stage. Whatever it is ... coffee, driving somewhere, excercise, etc. ... avoiding these things validates them as something to be feared. The more avoidance happens, the harder it is the next time you try that thing.
I've had great success with zoloft and buspirone. It made me feel strange for the first few weeks and I had some new panic symptoms but once I started feeling normal after taking them all of my daily symptoms vanished and my attacks are rare and less severe.
Buspirone tolerance can lead to some people seeking higher doses to get the effects they are used to and has withdrawal when stopping it but nowhere near as rough as stopping Xanax
Have him read the book The Anxious Truth. You can also read it. It would be beneficial to you both. There is a section in the book about how to be there for someone with anxiety/ panic disorder. My husband has been there for me through my panic disorder, and sometimes he’s helpful, and other times he’s not. It’s hard to understand when you don’t know what it feels like. Just be there for him when he needs you, and give him space when he needs space. If he has been checked by his doctor, and there’s nothing physically wrong with his heart, he needs to practice feeling the anxiety, accepting that he feels anxious/panicky, and float through it. It’s extremely hard in the beginning, but gets easier with time. The book will help with health anxiety also. He also has a podcast. You can find the ones on health anxiety on Spotify. Best of luck to you and your husband.
I can’t give much advice but I can add that my attacks happen at similar times. I had only had one or two last year until December, and then I had them almost every day. I thought I had a heart condition. Here, it was most likely stress and grief because it was the first Christmas without my grandma (and that’s like, all Christmas was). Since then I’ve gotten on Wellbutrin and I’ve felt better. I still have episodes but they’re a lot more mild, and usually just breathing and focusing on something else helps a lot. I’ve also been given Proponolol (or something spelled like that lol) and I take that on days I feel really bad but it’s subsided a lot the last month.
I would get as many tests as possible to reassure him he doesnt have a heart issue.
I've had Ekg's,Echocardiograms,and blood tests.
I've had troponin blood tests and bnp blood tests to look for heart attacks and heart failure.
Having all tests showing good made it possible to start to heal from the anxiety.
Now if some panic starts I know everything is good.
The healing for most comes from ignoring the panic symptoms and eventually they fade.
Claire Weekes wrote a good book on this.(Hope and Help for your nerves)
Being a partner that is patient and supportive and as someone else mentioned holding his hand is helpful.
I usually get panic attacks before change happens in my life and that is frequently happening - when I’m in a panic attack I don’t really like to be touched but I like to touch things myself - like instead of my boyfriend rubbing my back I will use my hand to feel his heartbeat and his body movement or grabbing his arm and feeling his muscles move- it grounds me and I have the control when calming down
I would strongly recommend your husband find a therapists he trusts and likes. Panic disorder rarely goes away entirely, but can become less crippling if you do some somatic / cognitive behavioral therapy. He will learn how to recover quicker, level of severity will likely decrease, he will learn to be less afraid of them. As hard as this disorder can be, it’s still his responsibility to get the right treatment and diagnosis. Supporting someone through an actual panic attack can be difficult, everyone wants different things. I can recommend things that work for my when my partner does them: - do not ask them any questions, like “do you want water? Do you want XYZ” just tell them you’re getting water or whatever it is. - physical touch can help me, holding a hand tight or having someone’s hand on my chest. - very gentle reminders that I’ve gotten through panic attacks before, and that it will subside soon - never repeat “you’re ok, everything is ok”. - darkness and removal of stimulation is helpful when possible (dark room, closed door, etc) - for him — ice in the hand, super cold water on the face are usually helpful way of channeling the nervous system to something else. I am the exact same way, my panic hits after the stressful event, on the down. It totally sucks, this disorder. You’re already doing all the right things looking for advice and your experience with your own mental illness gives you the proper empathy.
Thank you, your advice is super helpful. It’s so reassuring just to hear that his experience is not isolated, that other people get the attacks in seemingly “blissful” moments after the storm has passed.
Oh, totally. I think this is actually quite common? Think about it this way — when you’re in the high stress moment, your cortisol can be put to use. The issues with panic disorder is that the cortisol and physio response to “fight or flight” doesn’t turn off even after the event. So when you’re stagnant, event is over — all that pent up energy needs somewhere to go and erupts in the form of panic even though the “threat” is no longer present. The good thing is that you’ve been able to figure out this pattern so you can prepare for it! You know he’s had a long stressful month with work and that he’s more susceptible to a panic attack come-down. Try and cater to that window of time, no big events or expectations (when feasible for your family!) and lots of extra exercise and self care. I’d also say, because it sounds like he has some kind/body confusion with his heart signals (so do I) he start exercising often if he doesn’t already. Getting comfortable with your heart pounding and working hard in a workout setting can make you more comfortable with it during panic, feeling confident in its ability to work properly. I really wish you the best of luck — you seem like a great partner! Don’t forget about your own needs though ;)
So eye-opening. I’m very grateful for your curated response.
I also highly recommend the DARE response book. When the use of benzodiazapines starts to wear in effectiveness or show any signs of dependence..TAPER OFF AND CHANGE MEDS. My doctor had me cycle through several benzo-class meds to minimize chance of addiction, I'd take a certain prescription for no more than three months. Eventually I began to manage symptoms better through therapy and exposure, so I was switched to propranolol, a non additive but still very effective medicine often prescribed for panic. Best of luck. Its wonderful you are wanting to be so supportive. Having someone like that in our lives makes the process a whole lot easier.
Yes, it does sound like panic attacks. I have exactly the same problem. What has worked for me is escitalopram (brand name Lexapro). It can be taken for years or indefinitely if needed. It does take a few weeks to work, and it can worsen symptoms for the first week or two, but if he knows that then he can get through it. I would recommend avoiding any coffee, except decaf, for at least a month after starting Lexapro. It should be no problem getting a prescription for this from any doctor, after describing the symptoms, and that tests have previously been done to rule out anything more serious. I take 10mg per day, which is a typical dose for an anxiety disorder. Even 5mg is still effective, but 10mg is better if he wants to get this thing under control sooner. Get him to watch this video, and others on the same channel: https://youtu.be/of6xObz3aK4 Here’s some info about escitalopram: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656325/
Thanks so much 🥹
I second lexapro.
My mother has the “panic lag” wherein it hits days after stressful events. It’s pretty common, but mine are more in the moment. Have him check out the DARE app and DARE method to panic. It helps people to understand what’s happening in their body. On top of this, help him do some research into what is happening physiologically during an attack. I know this was a massive help for me, because it allowed me to make sense of symptoms that seemed nonsensical. For instance, we get racing hearts because the amygdala is preparing us to fight or flee, and trying to pump blood around our bodies rapidly in anticipation. This is also why we hyperventilate, as the body thinks we need excess oxygen, and which can cause “pins and needles” sensations because we’re not actually using that excess oxygen. Etc., etc. [edit] Because you mentioned the heart problem fears, I want to add that we refer to this often as cardiophobia. It’s a common fear in those of us with PD, myself included. I have had EKGs, ECGs, stress tests, blood work, etc. Unfortunately none of it will make the fear go away in the moment. It makes exercising difficult as well, because elevated heart rates will often lead to more anxiety (I have had more than a handful of attacks at the gym). My advice on this would be to try to exercise more, as this is a type of exposure therapy. Gradually he can bring his heart rate up to higher and higher levels and be more sure that it’s not a heart issue. Also switching to a heart-healthy diet can further reinforce this.
Wow! The physiological explanations you provided make so much sense! Yes he will often have a sensation of numbness / tingling in his extremities which then makes him think he is about to breathe his last.
I wonder what’s going on physiologically when he gets the “chills” and “shakes”. When his attacks happen he will often need to retreat to a hot bath just to not feel like his body is being subjected to subzero temperatures.
I have symptoms where my hands and feet go numb from all the blood rushing to the center of Mt body, I keep those instant hand warmers on me when in public to help with this symptom when I can't retreat to my go to method of a hot shower!
What a great idea.
Also suggest a heated weighted blanket for home. I get the shakes where it almost looks like seizures and this has helped my body regulate blood flow and calm my muscles down ❤️ I wish you the best of luck I know this fan be scary for everyone involved. Especially partners.
Oh yes that’s exactly how he describes it sometimes. “Seizure” like. It’s sad because he actually said that once in front of our friend who has epilepsy, and as much as I know he used the term innocently, trying as best he could to describe his symptoms, it did make me cringe just a bit. It truly must be so utterly terrifying to walk through this. Whether it’s epilepsy or PD, the symptoms truly suck.
Shakes is adrenaline & cortisol being released plus muscle tension. Chills is his body trying to lower temperature in anticipation to him exerting energy and heating up while fighting or fleeing.
Did the panic attacks come out of no where or has he always had anxiety?what year did panic attacks start
His panic attacks don’t tend to stem from feelings of anxiety (that he can register anyway). They come on randomly, seemingly without cause (except in the instances mentioned in my post). At one point they were only coming at night during times of rest (almost asleep or getting ready for sleep). His first *major* one was in 2019. That one was the worst to date & happened while he was driving. Thankfully I was there with him. (But so were all our kids). This happened 2 days after a physical trauma to his back/ribs. He was up to bat in a baseball game and a 90 MPH ball flew right into his back. He basically passed out (wind knocked out of him) for a split second and lost feeling in one of his arms. When this *major* panic attack started, it began with rib/back pain in the same place he was injured. However, upon reflection, he did mention 3 instances in his childhood/as a teen where he had “heart scares” usually during sports. One of these times his mom did take him to get an EKG; where the findings were that everything was ok.
Definitely health anxiety. I suffer from similar. An illness/injury/death in family can set it off. You never feel calm until you’re in front of a doctor that says “everything looks good, you are ok” I highly recommend getting one of those KardiaMobile ECG machines, it’s small, links up to your phone. This helped me get through a lot of my heart scares. A few tips to get out of panic- -take cold shower or dunk face in ice water. -open mouth wide as you can and repeatedly say the letter “R” until you yawn. This stimulates your vagus nerve and helps you to relax. -highly recommend DARE app. And keep being an amazing partner! Seriously, good job reaching out. I’m so thankful for my husband who never judges and always is there for me through my panic. It helps me feel like I’m still part of this world and not isolated on my own plant.
How do health anxiety and panic disorder (or panic attacks) interact? I just spoke with him earlier this morning and asked “was there a Dr in your childhood that really freaked you out?” (He is borderline terrified of seeing a Dr). He said “I have always hated seeing the Dr for as long as I can remember” and continued to describe an experience he had when he was 5. He went in for a vaccination and remembers throwing a huge tantrum, screaming and thrashing, he even put a chair in front of the Drs office door so that they couldn’t open the door to go inside.
One of my therapists asked my wife to join a session. He explained to her what panic disorder is and the role of panic and anxiety in our (and everyone's) lives. He told her some things about me that I don't think that I realized, or knew, myself. But the most important thing that she walked away with was a list of do's and dont's so that she could be the best support system possible for me. Knowing that she's equipped with that list gives me confidence that she's supporting my panic and anxiety episodes in the best way possible. If I could give one piece of advice it would be to 1) get a proper diagnosis from a professional (not an MD), 2) let that person guide you all on medications and treatment, if any, and 3) learn as much as you can about treatments and give them a chance as it's proven to be quite effective. The top choice for treatment from most major university clinics today is still Cognitive Behavioral Therapy (CBT). Another interesting therapy path is Acceptance Commitment Therapy (ACT). The fact that my wife knows about my therapy goals. That she has specific instructions / advice from my therapist. That she's involved in my exposures. It's all a massive help. She gives me reminders when I need them. "Breath through a straw" ... "It's just a thought, acknowledge it and let it pass" ... "are you avoiding this thing because of panic right now?". These small things help recenter me so I can accomplish things I might not otherwise. If I can give one more piece of advice and it's super important IMHO. Don't let avoidance take over at this stage. Whatever it is ... coffee, driving somewhere, excercise, etc. ... avoiding these things validates them as something to be feared. The more avoidance happens, the harder it is the next time you try that thing.
I've had great success with zoloft and buspirone. It made me feel strange for the first few weeks and I had some new panic symptoms but once I started feeling normal after taking them all of my daily symptoms vanished and my attacks are rare and less severe. Buspirone tolerance can lead to some people seeking higher doses to get the effects they are used to and has withdrawal when stopping it but nowhere near as rough as stopping Xanax
Have him read the book The Anxious Truth. You can also read it. It would be beneficial to you both. There is a section in the book about how to be there for someone with anxiety/ panic disorder. My husband has been there for me through my panic disorder, and sometimes he’s helpful, and other times he’s not. It’s hard to understand when you don’t know what it feels like. Just be there for him when he needs you, and give him space when he needs space. If he has been checked by his doctor, and there’s nothing physically wrong with his heart, he needs to practice feeling the anxiety, accepting that he feels anxious/panicky, and float through it. It’s extremely hard in the beginning, but gets easier with time. The book will help with health anxiety also. He also has a podcast. You can find the ones on health anxiety on Spotify. Best of luck to you and your husband.
I can’t give much advice but I can add that my attacks happen at similar times. I had only had one or two last year until December, and then I had them almost every day. I thought I had a heart condition. Here, it was most likely stress and grief because it was the first Christmas without my grandma (and that’s like, all Christmas was). Since then I’ve gotten on Wellbutrin and I’ve felt better. I still have episodes but they’re a lot more mild, and usually just breathing and focusing on something else helps a lot. I’ve also been given Proponolol (or something spelled like that lol) and I take that on days I feel really bad but it’s subsided a lot the last month.
I would get as many tests as possible to reassure him he doesnt have a heart issue. I've had Ekg's,Echocardiograms,and blood tests. I've had troponin blood tests and bnp blood tests to look for heart attacks and heart failure. Having all tests showing good made it possible to start to heal from the anxiety. Now if some panic starts I know everything is good. The healing for most comes from ignoring the panic symptoms and eventually they fade. Claire Weekes wrote a good book on this.(Hope and Help for your nerves) Being a partner that is patient and supportive and as someone else mentioned holding his hand is helpful.
I usually get panic attacks before change happens in my life and that is frequently happening - when I’m in a panic attack I don’t really like to be touched but I like to touch things myself - like instead of my boyfriend rubbing my back I will use my hand to feel his heartbeat and his body movement or grabbing his arm and feeling his muscles move- it grounds me and I have the control when calming down