Latest / Stuff You Should Know / How Panic Attacks Work

Transcript

How Panic Attacks Work · Stuff You Should Know

0:01
Speaker 1: Welcome to you Stuff you should Know from House Stuff
0:04
Speaker 1: Works dot com. Hey, and welcome to the podcast. I'm
0:12
Speaker 1: Josh Clark. There's Child's w Chuck Bryant, and Jerry Stuff
0:16
Speaker 1: you should know. Yep, Wide Spread Panic. Did you see
0:22
Speaker 1: that video which one there was a dude this was
0:25
Speaker 1: just like two days ago that went up on stage
0:27
Speaker 1: and attacked the band. Oh no, I didn't see that. Yeah,
0:30
Speaker 1: and they've got the whole thing and it was during
0:31
Speaker 1: one of the really repetitive droning parts of a song.
0:35
Speaker 1: And uh, I haven't seen an explanation but that there was.
0:38
Speaker 1: I went to the Widespread Panic Facebook thing because there
0:41
Speaker 1: was a big thread about people talking about it, and
0:43
Speaker 1: I just said, Hero, did you really hate people gang
0:48
Speaker 1: filing me? Going Hero, that's hilarious danger Stroll. I thought
0:53
Speaker 1: it was pretty funny. He attacked the members of the band, yeah,
0:57
Speaker 1: like physically, and I couldn't quite the drummer and he
1:01
Speaker 1: was upset, and I don't know if that part of
1:03
Speaker 1: the song made him snap, but it was definitely one
1:06
Speaker 1: of those repetitive thank thank you, it's like stop. But
1:12
Speaker 1: he was at the show, so that'd be weird unless
1:15
Speaker 1: he went there to attack them. Yeah, that's probably the
1:18
Speaker 1: bath salts maybe, so, so we're not talking about that
1:22
Speaker 1: kind of panic. That's more a psychotic break. And this
1:25
Speaker 1: is not widespread at all. It's very individualized panic, it is.
1:29
Speaker 1: But it turns out people suffering from this is kind
1:32
Speaker 1: of widespread. How about that? So it fits a little
1:36
Speaker 1: bit sure. Instead, Um, we're talking about panic attacks and
1:42
Speaker 1: the combination of panic attacks or the culmination of panic
1:46
Speaker 1: attacks that can lead to something called panic disorder, and
1:49
Speaker 1: it is a sucky mental condition that about two point
1:56
Speaker 1: eight percent of Americans, which is a pretty significant amount
1:59
Speaker 1: of people. Yeah, that's that's more than bipolar, which we've
2:02
Speaker 1: covered in schizophrenia, Yeah, and o c D, which we well,
2:06
Speaker 1: we've covered all three of this. Yeah. Um, so that's
2:09
Speaker 1: a pretty significant amount of people who suffer from panic disorder. Right,
2:14
Speaker 1: But that's different than just plain old panic attacks. Even
2:17
Speaker 1: though to have panic disorder you have to have panic attacks,
2:21
Speaker 1: but if you have panic attacks, you don't necessarily have
2:23
Speaker 1: panic disorder exactly. And I've had two experiences which I'll
2:27
Speaker 1: talk about at some point through the show, not personally,
2:29
Speaker 1: but Emily had a panic attack once and uh friend
2:33
Speaker 1: in college had a panic attack a roommate and neither
2:36
Speaker 1: one of them have panic disorders. It was just an
2:38
Speaker 1: isolated incident. Yeah, so apparently that's I don't know if
2:42
Speaker 1: commons the right word, but people do have panic attacks
2:46
Speaker 1: and they but they they that might be the only
2:48
Speaker 1: one they ever have for their entire lives, hope, which
2:51
Speaker 1: makes the whole thing kind of mysterious. And we should
2:53
Speaker 1: say like science does not know what exactly is going
2:58
Speaker 1: on here. That's some theory, but there's there's no there's
3:03
Speaker 1: no way to predict what's happening now even know if
3:06
Speaker 1: it's genetic or what environmental. Well, they finally isolated a
3:10
Speaker 1: gene last year, Uh, I guess and go and talk
3:14
Speaker 1: about that. Now in December they isolated the gene and
3:19
Speaker 1: you know, genes are always so boring with their names,
3:21
Speaker 1: unless it's a Simmons. That's right. The n k r
3:25
Speaker 1: T three uh they think may be responsible um because
3:29
Speaker 1: its presence appears to cause an over estimation of fear
3:33
Speaker 1: and danger in an overactivation of the hippocampus and amygdala.
3:37
Speaker 1: So basically, if you have this gene, you're gonna exaggerate
3:41
Speaker 1: your fear overall. But it's not like they're saying they
3:45
Speaker 1: prove that's the cause. But that is a good step
3:47
Speaker 1: in scientifically in the right direction. That's a huge step,
3:50
Speaker 1: because I mean that does sound very much like what
3:52
Speaker 1: a panic attack is. A panic attack is where you
3:56
Speaker 1: experience a very pronounced sense of fear and basically your
4:02
Speaker 1: fight or flight symptoms response and really, from what I
4:07
Speaker 1: can understand, your flight response. Yeah, like you're not in
4:10
Speaker 1: a position to fight or freeze because you know now
4:14
Speaker 1: these days it's fight, flight or freeze. Really yeah, I
4:17
Speaker 1: don't think I knew that. Yeah, there's a third option now,
4:20
Speaker 1: um like kind of oh no, wait, those aren't options
4:23
Speaker 1: sets a sequence, right, This is these are options. So
4:27
Speaker 1: when you're confronted with danger. Nick Thune, our buddy, the comedian, dude,
4:30
Speaker 1: have you seen his hand of fit ads? Yeah, those
4:33
Speaker 1: are awesome. I was like, that's Nick Thune and he's
4:36
Speaker 1: on like Miss America. Yeah. The first thing I always
4:39
Speaker 1: think about is good for you cash those checks baby.
4:43
Speaker 1: Uh yeah. He has that funny bit on stop dropping rolling,
4:45
Speaker 1: like they they needed to continue that, like keep rolling.
4:49
Speaker 1: He's like, that's kind of key. Don't stop dropping roll
4:52
Speaker 1: because you'll be consumed by fire. You need to keep rolling.
4:54
Speaker 1: Right until you get to a door. Yeah, it's very
4:56
Speaker 1: funny stuff. So this is a little different fight flight
5:01
Speaker 1: or freeze? Yeah? What what's freeze factor in? Like you
5:04
Speaker 1: just freeze up and toast? Yeah, at least beneficial of
5:08
Speaker 1: all of the these adaptations to danger. But basically, when
5:14
Speaker 1: you're when you're confronted with danger, you can either fight, fly,
5:17
Speaker 1: or freeze. That makes total sense. I don't know why
5:19
Speaker 1: freeze was never in there to begin with, because so
5:21
Speaker 1: many people freeze. They just added on the last couple
5:24
Speaker 1: of years. I think I'm a flyer or a freezer
5:27
Speaker 1: for sure. It depends. I don't know if do you
5:29
Speaker 1: think there's a personality type? Oh boy, I don't know. Um,
5:32
Speaker 1: you know, don't you think it's possibly like just what
5:35
Speaker 1: your body chemistry happens to be doing? Right then? No?
5:38
Speaker 1: I think some people are more inclined to fight for sure. Okay, Well,
5:41
Speaker 1: with panic attacks, you're flying like that's your only that's
5:46
Speaker 1: your jam right there. Um, and you're experiencing it in
5:49
Speaker 1: the exact same way that somebody's coming to mug you
5:53
Speaker 1: or has pulled a knife on you and you're running away,
5:55
Speaker 1: or there's a lion chasing you. Accept This is the
5:58
Speaker 1: key to panic attack. There is no lion, there is
6:02
Speaker 1: no mugger, there's no knife, there's no discernible reason for
6:06
Speaker 1: you to be experiencing this sudden onset of crippling fear. Um.
6:12
Speaker 1: But you're experiencing it nonetheless, that's right. No, no tangible
6:17
Speaker 1: thing happening right in that moment. So when you come
6:21
Speaker 1: out of it, and these things can they peak within
6:23
Speaker 1: about ten minutes, but these the symptoms can last for
6:28
Speaker 1: an hour more. Um. When you come out of it,
6:31
Speaker 1: you're like, I don't ever want that to happen again.
6:34
Speaker 1: The place that this just happened to, say, the park,
6:37
Speaker 1: I'm never going back to because now I associated with
6:40
Speaker 1: this because what you're doing when you experience fear, you're
6:43
Speaker 1: learning to stay away from something. So whether you want
6:47
Speaker 1: to or not, you've just been conditioned to fear the
6:49
Speaker 1: place that you just were because you had a panic attack. Um.
6:53
Speaker 1: And then lastly, you think possibly you're crazy, yeah, or
6:57
Speaker 1: having a heart attack. Yeah that's uh. Both both of
7:00
Speaker 1: the my wife and my friend both thought they were
7:04
Speaker 1: having heart attacks, which is super scary. And we'll get
7:07
Speaker 1: the difference later on. But um, I guess we should
7:09
Speaker 1: talk about just some of the initial symptoms of a
7:11
Speaker 1: panic attack. The old d s M Diagnostic and Statistical
7:15
Speaker 1: Manual Mental Disorders lists, Uh, it looks like about ten
7:20
Speaker 1: symptoms and if you have at least four of these,
7:24
Speaker 1: you may be having a panic attack, which is heart pounding, shaking, dizziness, sweating, choking,
7:29
Speaker 1: feeling nausea, shallow or short breath, chest pain, numbness or
7:33
Speaker 1: tingling chills, and hot flashes, feeling of unreality, feeling like
7:38
Speaker 1: you're going crazy, or feeling like you're about to die.
7:41
Speaker 1: You got four of those, you're having a panic attack, yes, Um.
7:45
Speaker 1: And if you have four panic attacks within four weeks,
7:50
Speaker 1: or you have one panic attack and then fear having
7:55
Speaker 1: another panic attack for about a month or so, then
7:59
Speaker 1: you can be die diagnosed with what's called panic disorder. So, uh,
8:03
Speaker 1: if you listen to our fear podcast, which was a
8:05
Speaker 1: really good one, UM, it's kind of the same as
8:09
Speaker 1: a panic attack. UM. We covered your Your autonomic nervous
8:13
Speaker 1: system is what maintains all the functions in your body,
8:16
Speaker 1: the involuntary functions in your body, that is, and it's
8:20
Speaker 1: gonna take signals from your central nervous system. It's gonna
8:23
Speaker 1: regulate your organs. That's why you don't have to tell
8:25
Speaker 1: your heart to beat or your kid needs to work.
8:28
Speaker 1: It's all your pancreas to secrete stuff. That's right. It's
8:32
Speaker 1: your autonomic nervous system. And it has two parts, the
8:35
Speaker 1: sympathetic and parasympathetic. And your parasympathetic controls like I said,
8:40
Speaker 1: your your heart beat and stuff like that. You're the
8:43
Speaker 1: normal aspect. Yeah, it's just right. Yeah, that balance that
8:48
Speaker 1: we all seek that we don't know we're seeking. And
8:51
Speaker 1: then the sympathetic is if you have that fight or flight,
8:55
Speaker 1: if you become excited, uh in any way, really, that's
8:58
Speaker 1: when that's gonna kick in. Yeah. It's like normal gear
9:00
Speaker 1: and then high gear. Yeah, but it's not always fear,
9:02
Speaker 1: you know, just any kind of excitement. Right, you could
9:05
Speaker 1: be super happy, it could be sexual arousal. That's all
9:08
Speaker 1: your sympathetic nervous system, right, And those two components make
9:11
Speaker 1: up the autonomic nervous system, which it kind of switches
9:14
Speaker 1: from one to the other depending on your state of arousal. Right,
9:17
Speaker 1: that's right. Um, But when fear has aroused you, um,
9:22
Speaker 1: your sympathetic nervous system kicks into high gear. Um. And
9:26
Speaker 1: adrenaline is released, which is a huge factor in causing
9:30
Speaker 1: the symptoms of a panic attack. Like you you start
9:33
Speaker 1: breathing very heavily and shallowly, um, your pupils dilate you. Uh.
9:40
Speaker 1: We always used to say if you're digesting food, you
9:42
Speaker 1: stop doing that. Basically, all of your energy is transferred
9:46
Speaker 1: over to either fighting or flying, and in the case
9:49
Speaker 1: of a panic attack, is transferred over to get you
9:52
Speaker 1: to be able to run away as fast as possible. Yeah,
9:55
Speaker 1: which can be a little scary, but in a real
9:58
Speaker 1: fear situation, if in danger, your parasympathetic nervous system is
10:02
Speaker 1: going to kick in and calm you down. But that
10:05
Speaker 1: is not what happens, uh, in the case of a
10:08
Speaker 1: panic attack, which is really perplexing. So let's recap this.
10:11
Speaker 1: A panic attack is when you experience this incredibly intense fear,
10:16
Speaker 1: so much so that you run away but there's nothing
10:19
Speaker 1: there to be afraid of. And then and then, to
10:23
Speaker 1: make everything a million times worse, your parasympathetic nervous system
10:29
Speaker 1: doesn't kick in and calm you down like it would
10:32
Speaker 1: under normal circumstances, so you get to experience this horrible
10:35
Speaker 1: thing even longer. That's right, and after this break, we
10:39
Speaker 1: are going to get into some of the potential causes
10:42
Speaker 1: of panic attacks. All right, So, like I said before,
10:48
Speaker 1: breaking news from December last year, they think they've isolated
10:51
Speaker 1: a gene. Previous to that, they've some research has said
10:56
Speaker 1: it could be genetic because identical twins experience it more
11:00
Speaker 1: than fraternal twins. But it's always been sort of up
11:04
Speaker 1: in the air. They's been contradictions as well the genetic basis.
11:07
Speaker 1: They think it's also possibly epigenetic or environmental like um.
11:12
Speaker 1: Apparently one study found that a lot of people who
11:14
Speaker 1: have panic disorder had some sort of traumatic incident happened
11:19
Speaker 1: in their childhood. My friend from college did, Is that right?
11:22
Speaker 1: So they're thinking like possibly it had some sort of
11:25
Speaker 1: effect and set up like a time bomb for later
11:28
Speaker 1: on in life. Yeah, the stored uh feelings that maybe
11:32
Speaker 1: you've never dealt with about some traumatic event are gonna
11:36
Speaker 1: they're gonna rear their head at some point in your
11:37
Speaker 1: life in some way. Yeah, Or it just rearranged the
11:41
Speaker 1: neural output in your brain so that one day you're
11:45
Speaker 1: just set up when everything is just right, that chemistry
11:49
Speaker 1: is flooding your brain in a certain way, and then Bam,
11:52
Speaker 1: it comes out of nowhere, you have a panic attack. Yeah.
11:55
Speaker 1: Another theory is that they think if you have an
11:59
Speaker 1: over active fear system, like you've basically have been scared
12:05
Speaker 1: too much in life, or you're a scared person, then
12:08
Speaker 1: it's just gonna make it a hair trigger for something
12:10
Speaker 1: to set it off, which makes a lot of sense.
12:13
Speaker 1: I think it could be a combo with a lot
12:15
Speaker 1: of things as usual. Yeah. I wonder though, what what
12:19
Speaker 1: it will end up being that if we'll find that
12:21
Speaker 1: there is one thing that that leads to this predictably
12:25
Speaker 1: like built up, but then there's the actual trigger. Yeah,
12:29
Speaker 1: and that's another thing too. So they don't know what
12:31
Speaker 1: triggers these things. They do know that a panic attack.
12:35
Speaker 1: Being worried about having a panic attack can actually trigger
12:38
Speaker 1: a panic attack. Absolutely. I feel so bad for people
12:41
Speaker 1: a panic disorder. This is like a terrible affliction because
12:46
Speaker 1: you do become very much afraid that you're going to
12:49
Speaker 1: have another panic attack. So that can set off a
12:51
Speaker 1: panic attack, but it also can set off a code
12:54
Speaker 1: morbidity called agoraphobia, where you are afraid to leave your house,
12:59
Speaker 1: but you're also afraid to be alone. And I read this,
13:03
Speaker 1: um this article that was from the eighties seven, and
13:06
Speaker 1: they were saying, like, the the freudis the Freudists, followers
13:14
Speaker 1: of Sigmund Freud. We're saying, um, oh, well, clearly, if
13:18
Speaker 1: you're in a gooraphobic you don't want to go outside
13:20
Speaker 1: because that's where sexual desire is, and you don't want
13:23
Speaker 1: to be alone because you're worried that you will like
13:25
Speaker 1: abuse yourself, So agoraphobia. And everybody went boom, sit down
13:31
Speaker 1: and shut up. Yeah, and um, so nowadays they have
13:36
Speaker 1: realized that agoraphobia is almost almost exclusively the result of
13:42
Speaker 1: panic disorder. Yeah, and it's because you you fear the
13:48
Speaker 1: place that you had a panic attack, so you don't
13:50
Speaker 1: want to go there again. And then maybe it happened
13:52
Speaker 1: again at the grocery store, so you don't want to
13:54
Speaker 1: go there, and it happened. You don't want to be alone,
13:58
Speaker 1: but you don't want to be around strangers, so you
14:00
Speaker 1: into your family members and now all of a sudden,
14:02
Speaker 1: you're not living your life anymore. Yeah, you're developing phobias
14:05
Speaker 1: because of your panic attacks in your association with them.
14:08
Speaker 1: Like if you're on an elevator and you have a
14:09
Speaker 1: panic attack, you're not getting on an elevator again, you've
14:13
Speaker 1: just developed a phobia for elevators, and so all of
14:16
Speaker 1: a sudden, you're not going to be working at a
14:18
Speaker 1: place where you might normally work because you have to
14:20
Speaker 1: take the elevator to to get there. Or do you
14:23
Speaker 1: develop a love of stairs? Right? But then what if
14:26
Speaker 1: you're you don't like confined spaces at all, like a
14:28
Speaker 1: stairwell either. Yeah you ever been locked in the stairwell
14:31
Speaker 1: here at the building? Yeah? I mean you just walk
14:33
Speaker 1: down however many flights until you're at the lobby. Oh,
14:38
Speaker 1: you can get out down there? Yes, okay, yeah, yeah,
14:41
Speaker 1: you're not actually locked in, you just have to walk
14:43
Speaker 1: all the way down to Usually just call you and
14:45
Speaker 1: say lee. Another theory is that when you're super tired,
14:50
Speaker 1: um and overworked was when a lot of times when
14:53
Speaker 1: these are set off, your brain is producing sodium lactate
14:57
Speaker 1: or c O two and when those increase, your brain
15:01
Speaker 1: uh says you know what, I think you're suffocating, and
15:04
Speaker 1: so I'm going to send a signal to get you
15:07
Speaker 1: a lot more oxygen. And I found this uh really
15:11
Speaker 1: sad case of this woman, a university student who died
15:16
Speaker 1: from a severe asthma attack like three days ago. Uh,
15:21
Speaker 1: and she had had a history of asthma, and then
15:24
Speaker 1: told the medics that she was going through like final
15:28
Speaker 1: exams and she had been having panic attacks uh for
15:31
Speaker 1: in the weeks like proceeding. So breathing is a huge
15:35
Speaker 1: part of panic attacks. And as evidenced by her, if
15:39
Speaker 1: you have asthma, it's can be deadly, which is super
15:41
Speaker 1: super scary and sad. Yeah. Um. Then one other I
15:47
Speaker 1: guess there's a neurological basis they believe for people who
15:50
Speaker 1: have panic attacks. People who suffer from panic disorder tend
15:54
Speaker 1: to have fewer serotonin receptors and apparently also UM gabba
15:59
Speaker 1: which helps us get to sleep. It's called a gamma
16:03
Speaker 1: immuno beautyic acid. Let's call it gabba gabba. Um. Those
16:10
Speaker 1: two have some sort of role in UM panic disorder.
16:15
Speaker 1: Like you don't have enough serotonin and your body is
16:18
Speaker 1: not producing enough gabba, you may be prone to panic disorder. Uh.
16:22
Speaker 1: They you know, there isn't like a specific type of
16:24
Speaker 1: person that necessarily gets a panic attack. It can happen
16:27
Speaker 1: to anyone, but um, usually it happens if you're you're
16:31
Speaker 1: in your twenties. Although they say kids can get it
16:34
Speaker 1: as well have a panic attack or a disorder. Um,
16:37
Speaker 1: twice as many women have a panic disorder developed one
16:40
Speaker 1: as men, which is pretty interesting. Um. And like you said,
16:45
Speaker 1: just the fear like having had one before, that fear
16:48
Speaker 1: can lead to more. So it's very cyclical, yes. And
16:51
Speaker 1: you know, um that one paper from seven. I can't
16:55
Speaker 1: tell if it was arguing in favor of panic disorder
16:59
Speaker 1: being like an evolutionary adaptation and like possibly beneficial, or
17:04
Speaker 1: if they were saying, like some people think this, can
17:06
Speaker 1: you believe this? But they were. One of the points
17:09
Speaker 1: that this guy made was well, twice as many women
17:13
Speaker 1: have panic disorders as men, So clearly it's an evolutionary
17:17
Speaker 1: adaptation because women wouldn't have had to have gone as
17:21
Speaker 1: far away from camp while they were gathering food as men.
17:25
Speaker 1: For men couldn't stand to have a panic attack, or
17:27
Speaker 1: they couldn't, it wouldn't be an adaptation for men, it
17:30
Speaker 1: would be for women. Plus women can't run as fast
17:33
Speaker 1: when they have kids to carry, so they need to
17:36
Speaker 1: be on alert a little more. It's just smelled like
17:39
Speaker 1: bunk bunk. That was a big year for bunk. Yeah. Um,
17:46
Speaker 1: if you do have a panic disorder. You may have
17:48
Speaker 1: a hard time getting your family to understand it. UM.
17:53
Speaker 1: Sometimes they overreact and think it's like way more severe
17:56
Speaker 1: than it is. UM. Sometimes they underreact and say, uh,
18:01
Speaker 1: you know, it's all in your head, like just calm down. UM.
18:05
Speaker 1: But either way it's saying, boy, you're nuts or you
18:08
Speaker 1: just need to relax. Neither one of those is going
18:10
Speaker 1: to help out the loved one. Chill out, there's no lion.
18:15
Speaker 1: One thing I've learned in arguments and fights with my
18:19
Speaker 1: wife is and I'm boilerning this early on is saying
18:23
Speaker 1: telling someone to relax never causes someone to relax. It's
18:27
Speaker 1: like the worst thing you can do if something's heated
18:30
Speaker 1: is to say just relax. That's just gonna ramp it up.
18:35
Speaker 1: So that's my advice for couples out there in any relationship.
18:38
Speaker 1: Really good, Thank you. UM. There is a silverlying to
18:42
Speaker 1: all this in that panic disorder is actually highly treatable.
18:47
Speaker 1: It's the treatments that they've come up with are pretty successful,
18:51
Speaker 1: and we will talk about those treatments right after this.
19:03
Speaker 1: All right, So you mentioned that they are treatable. They
19:06
Speaker 1: have found success rates through medication and therapy, which seemed
19:10
Speaker 1: to be about the same as far as how affective
19:12
Speaker 1: they are between sixty and of the time. That's pretty good. Yeah,
19:16
Speaker 1: that's not bad at all. So that's the good news.
19:19
Speaker 1: So there's three. There's three UM typical methods of treatment
19:24
Speaker 1: UM antidepressants, anti anxiety, pills, and therapy. And you might
19:30
Speaker 1: use them, you know, independent of what another in conjunction
19:33
Speaker 1: with one another. I also saw beta blockers. Some people
19:35
Speaker 1: use beta blockers to treat them, but they're not quite
19:37
Speaker 1: sure what's going on with that. I've used those before
19:41
Speaker 1: live performances. Those are the ones I read about that UM,
19:44
Speaker 1: you gave me one, and I was like a useless worm. Yeah,
19:48
Speaker 1: it didn't affect me like that. I I was, I
19:51
Speaker 1: just like totally lost my personality. I wasn't nervous, but
19:53
Speaker 1: I didn't do anything. Well, I've gotten used to live
19:57
Speaker 1: performing now, so I don't need them anymore. But I
19:59
Speaker 1: got that to from apparently a bunch of musicians, like
20:04
Speaker 1: in symphonies and stuff use And I was like, well,
20:06
Speaker 1: if first chair of Violinist, if it's good for them
20:09
Speaker 1: to give me some beta blockers. But it worked for me.
20:12
Speaker 1: But like I said, I'm over all that. I enjoy
20:14
Speaker 1: being on stage. Now. So with s SR eyes, which
20:18
Speaker 1: is what you moved on too from beta blockers, right, No,
20:21
Speaker 1: I'm not on it. So with SSR eyes, UM, those
20:25
Speaker 1: are selective serotonin reuptake inhibitors, and they do exactly what
20:29
Speaker 1: they sound like. You've got a bunch of serotonin receptors
20:32
Speaker 1: in your brain. If you have panic disorder, you may
20:35
Speaker 1: have fewer serotonin receptors in your brain. Serotonin is a
20:39
Speaker 1: neurotransmitter that helps basically stabilize your mood by either causing
20:44
Speaker 1: a neuron to fire or inhibiting a neuron to fire
20:47
Speaker 1: in this really beautiful, perfectly balanced chemical reaction. Right, So
20:53
Speaker 1: if you have a few of these receptors the normal,
20:56
Speaker 1: you're going to be comparatively out of balanced. What an
20:59
Speaker 1: SSR I, an antidepressant, does is it allows the serotonin
21:04
Speaker 1: to kind of stay in your synaps is a little
21:06
Speaker 1: longer than as normal, so that you are releasing a
21:10
Speaker 1: little more serotonin than you would under normal circumstances. And
21:14
Speaker 1: it's proven pretty effective for UM for panic disorder. Yeah,
21:18
Speaker 1: I mean, they'd work wonders for a lot of people
21:20
Speaker 1: for a lot of reasons, UM, but not everyone. And
21:23
Speaker 1: they can cause a lot of negative side effects. Uh.
21:27
Speaker 1: So obviously, you know, work with your doctor on a program,
21:31
Speaker 1: and it takes them a little while, like two to
21:33
Speaker 1: four weeks to begin working. Uh for a panic attack. Um,
21:37
Speaker 1: an anti anxiety drug like xan x might be a
21:40
Speaker 1: little more effective because that is immediately hits you. It
21:44
Speaker 1: is a tranquilizer benzodiazepine, right yeah, and it's um, you know,
21:50
Speaker 1: the zanex is going to help chill you out immediately,
21:53
Speaker 1: but you can get hooked on those things pretty quick. Yeah,
21:56
Speaker 1: and they're dangerous to quit cold turkey and um, yeah,
22:02
Speaker 1: it's it's not the best thing to go to xanex
22:04
Speaker 1: a lot. Well, yeah, they say that you should, um
22:08
Speaker 1: basically if you if you undertake an ssr I regimen,
22:12
Speaker 1: you can conceivably stay on it for years. If you
22:16
Speaker 1: undertake anti anxiety or benzo diazepine regimen, like it shouldn't
22:21
Speaker 1: last for more than a couple of weeks or month
22:24
Speaker 1: from what I understand, because of the dependency. And again,
22:28
Speaker 1: you want to like really do all of this with
22:30
Speaker 1: like a um qualified competent doctor's assistants, not a doctor's assistant,
22:37
Speaker 1: doctor's assistant. It depends if it's a qualified competent doctor's
22:41
Speaker 1: assistant who can write prescriptions, who trust go for it,
22:45
Speaker 1: that's true. Uh. And then there's therapy of course, the
22:47
Speaker 1: old CBT cognitive behavioral therapy, which we've talked about a bunch,
22:52
Speaker 1: but um, that is Uh, they're gonna sort of the
22:56
Speaker 1: processes is gonna play out like this. They're gonna teach
22:59
Speaker 1: you out your panic disorder, which is a big step.
23:03
Speaker 1: If you understand something, uh, you can overcome it more easily.
23:06
Speaker 1: I think they're gonna monitor you and you're gonna self
23:09
Speaker 1: monitor and record your symptoms and when they happen and
23:13
Speaker 1: why they happen, what the circumstance was. Breathing, like we mentioned,
23:16
Speaker 1: is a huge part of it. Um, anything from meditation
23:20
Speaker 1: to just regular breathing exercises which will give you some
23:22
Speaker 1: tips on that in a minute too, are going to
23:25
Speaker 1: help you out. And then the old exposure two uh situations.
23:31
Speaker 1: Then this is once you've rethought, like your what your
23:34
Speaker 1: approach is going to be, Like here's your new outlook
23:36
Speaker 1: and now here's a situation that might give you a
23:38
Speaker 1: panic attack. How do you feel? Yeah, or like if
23:41
Speaker 1: you had a panic attack and an elevator, like they
23:43
Speaker 1: may tell you to imagine you're in an elevator. Your
23:46
Speaker 1: therapy might progress until you're actually in an elevator and
23:50
Speaker 1: you're chilling out. And the hope is that if if
23:53
Speaker 1: you can undergo exposure therapy to that degree, it will
23:57
Speaker 1: get you over your panic attacks in general. Another aspect
24:01
Speaker 1: of it, Chuck, is rethinking, uh, and that is basically
24:05
Speaker 1: accepting the fact that you have panic attacks. Apparently if
24:09
Speaker 1: you can say I'm having a panic attack or I
24:12
Speaker 1: have panic attacks and you acknowledge it to yourself and
24:15
Speaker 1: to other people, it immediately turns down the volume on
24:18
Speaker 1: the whole thing. Yeah, I noticed some similarities and uh,
24:22
Speaker 1: someone guiding through someone through an LSD trip and guiding
24:26
Speaker 1: someone through a panic attack. It's interesting. A lot of
24:29
Speaker 1: it is like understanding, like I am having an acid trip,
24:33
Speaker 1: I am not having a good time. It's the same
24:35
Speaker 1: thing as I'm having a panic attack and this is
24:37
Speaker 1: no good And if I understand that, then I can
24:41
Speaker 1: calm down more easily and keeping it in just lead
24:44
Speaker 1: you to freak out more exactly. Um, So that's CBT
24:48
Speaker 1: cognitive behavioral therapy and um, if you if you undergo
24:54
Speaker 1: therapy and you're still suffering from panic attacks. The apparently
24:58
Speaker 1: being discouraged as a a real problem with people with
25:02
Speaker 1: panic disorder because you can still suffer them even if
25:05
Speaker 1: you're doing everything right. Um, and so a lot of
25:08
Speaker 1: people have learned to cope, and there's some pretty common
25:11
Speaker 1: coping techniques for a panic disorder. And like you said,
25:15
Speaker 1: the heart of the whole thing is breathing. Like when
25:18
Speaker 1: you suffer a panic attack, you start breathing shallowly and quickly,
25:22
Speaker 1: and um, you can hyperventilate. What you want to do
25:26
Speaker 1: is breathe from your diaphragm and that you can actually
25:30
Speaker 1: practice this in the times when you're not having a
25:32
Speaker 1: panic attack. Yeah, if you're a singer, you know how
25:34
Speaker 1: to breathe with your diaphragm. But if you're not, what
25:38
Speaker 1: you can do is lie down on your back, put
25:40
Speaker 1: some pillows on your head and knees, and um, put
25:43
Speaker 1: a hand on your stomach and a hand on your chest,
25:46
Speaker 1: and then practice breathing, uh, and making your hand on
25:49
Speaker 1: your stomach move without the hand on your chest moving
25:52
Speaker 1: and then tap the hand on your stomach while you
25:56
Speaker 1: make a circle with a hand on your chest. When
25:58
Speaker 1: you're really advanced. Wow, it's pretty impressive. Uh. And then
26:03
Speaker 1: another thing you can do is just literally like put
26:06
Speaker 1: a weight on your stomach and make sure to heavy
26:10
Speaker 1: like a book. Yeah, like a nice something that you
26:14
Speaker 1: can see going up and down when you're breathing with
26:16
Speaker 1: your diaphragm, that's right. Um, And you want to just
26:19
Speaker 1: kind of breathe in the good exhale the bad. Yeah,
26:23
Speaker 1: Like I'm having a panic attack. This will pass, you know,
26:25
Speaker 1: this will subside. This is a temporary feeling. That's what
26:29
Speaker 1: you should be saying to yourself. And if you're a
26:31
Speaker 1: person who's like out in public and you see somebody
26:33
Speaker 1: having a panic attack, you basically want to do the
26:36
Speaker 1: same thing that they're trying to do for themselves. You
26:38
Speaker 1: want to remain calm. You want to tell them that
26:40
Speaker 1: it's going to be over with pretty soon, that everything's okay,
26:44
Speaker 1: they have nothing to fear. Um. Yeah, you don't want
26:48
Speaker 1: to tell them to chill out, though. Uh. Guiding someone
26:53
Speaker 1: through relaxation is different than saying chill out, by the way, right,
26:56
Speaker 1: very different. Uh. They do recommend that you, um, if
27:00
Speaker 1: you have a problem with with attacks in general, or
27:03
Speaker 1: if you have a disorder, you should exercise a lot.
27:06
Speaker 1: You should practice Um, they don't call it meditation, but
27:09
Speaker 1: that's really what it is, is deep breathing and relaxation.
27:12
Speaker 1: It's called mindfulness these days, isn't it. I don't know.
27:15
Speaker 1: I think that's what they call it, because meditation turns
27:18
Speaker 1: people off, right, guess interesting? Uh cut cut out the
27:22
Speaker 1: caffeine and sugar and nicotine. Yeah, that's not gonna help
27:25
Speaker 1: you at all, Uh doing all those things. Uh. And
27:29
Speaker 1: you know, if this stuff is stuff that's building up
27:31
Speaker 1: inside of you, which it often is, learn how to
27:33
Speaker 1: express yourself a little more and um and talk about
27:37
Speaker 1: your issues. Um. I know that in both of my cases.
27:41
Speaker 1: My buddy in college, it was during finals week and
27:45
Speaker 1: I had gone to bed and my roommate and another
27:47
Speaker 1: dude had were out in the living room staying up,
27:51
Speaker 1: and one of them came and woke me up and
27:52
Speaker 1: he's like, dude, he's having a heart attack. He's having
27:54
Speaker 1: a heart attack. And um, I didn't know anything about
27:57
Speaker 1: panic attacks. So we took him the hospital, of course,
28:00
Speaker 1: and that's all it was. It was a panic attack.
28:01
Speaker 1: He calmed down. I think, um, I think it might
28:05
Speaker 1: have given him something there. I met some sort of
28:08
Speaker 1: medication to calm him down. Probably Benzo. Yeah, probably like
28:11
Speaker 1: a good shot in the arm of that stuff. And
28:13
Speaker 1: he was like, I'm fine. Right With Emily's case, she
28:17
Speaker 1: had been under a lot of stress and was and
28:21
Speaker 1: driving back from Akron, Ohio to Atlanta. I think she
28:25
Speaker 1: went to get I think she had to get some
28:27
Speaker 1: furniture or something. So she was in a truck, like
28:30
Speaker 1: a moving truck, had been drinking caffeine like crazy, like
28:34
Speaker 1: she does, and um, basically, uh started to have trouble
28:40
Speaker 1: breathing on the highway going like e d down the
28:41
Speaker 1: highway and had to pull over. Called me, and you know,
28:45
Speaker 1: I calmed her down. I was like, all right, now,
28:47
Speaker 1: let's get back on the road. See how you do.
28:48
Speaker 1: She got back on the highway and immediately freaked out again.
28:52
Speaker 1: And Uh, I flew to Cincinnati and went to a
28:57
Speaker 1: hotel and drove her home. Yeah, I mean there was
28:59
Speaker 1: really no choice at that point. Uh. You know, when
29:01
Speaker 1: it's your wife, you Plus, it was a good opportunity
29:04
Speaker 1: to get on the white horse, you know, and right
29:07
Speaker 1: in and save the day. I think everyone loves those opportunities,
29:12
Speaker 1: you know. And it's and I've always also wanted to
29:15
Speaker 1: run to the airport, like give me a one way
29:17
Speaker 1: ticket this somewhere I have time for your body scan.
29:22
Speaker 1: Pretty much. That's how it happened. So she checked herself
29:24
Speaker 1: into a hotel and I went there and had some
29:27
Speaker 1: nice Cincinnati Skyline chili, and then the next morning we
29:30
Speaker 1: hit the road. Yeah, that was good, and she hasn't
29:34
Speaker 1: had one since then, despite like, uh, you know, she
29:38
Speaker 1: she has a lot of anxiety just as a human,
29:41
Speaker 1: but um, no panic attacks. So I definitely have seen
29:44
Speaker 1: the things I saw in this article and both of them,
29:47
Speaker 1: whether it was during finals, like the things going on
29:50
Speaker 1: in her life at the time, we're super stressful. I
29:52
Speaker 1: think the trigger was she doesn't like see great at
29:55
Speaker 1: night or in the rain when she's driving, and I
29:57
Speaker 1: think all these things compounded, um and just played out
30:01
Speaker 1: to where she felt like she's having a heart attack,
30:03
Speaker 1: and so did my friend. But I guess we should
30:06
Speaker 1: mention that there are some tailtale signs of a heart attack. Yeah,
30:10
Speaker 1: that's a big yeah, that you can recognize the difference,
30:15
Speaker 1: because you don't want to actually be having a heart
30:17
Speaker 1: attack and be like it's just a panic. Just breathe,
30:21
Speaker 1: just breathe while you're dying. Um. Here are a few
30:25
Speaker 1: tips from the American heart association. Pressure in the center
30:29
Speaker 1: of your chest that persists longer than a couple of minutes,
30:32
Speaker 1: or goes away then returns, shortness of breath, pain in
30:35
Speaker 1: the arm or upper body. You might feel nauseous or faint.
30:39
Speaker 1: And of course, if you're ever in doubt, call because,
30:44
Speaker 1: like you said, you don't want to be having a
30:45
Speaker 1: heart attack thinking it's will subside, there will be a
30:48
Speaker 1: guy in your face. Well to say the last exactly, Uh,
30:54
Speaker 1: If you want to know more about panic attacks and
30:56
Speaker 1: panic disorder, type either one of those sets of words
31:00
Speaker 1: into the search part how stuff works and it'll bring
31:02
Speaker 1: up this article. And since I said that it's time
31:06
Speaker 1: for a listener mail, I call this basement fear. Hey, guys,
31:12
Speaker 1: I know most listeners know your podcasts great for learning
31:14
Speaker 1: and entertainment, but I found another purpose distraction from stress
31:18
Speaker 1: induced irrational fears. This sounds familiar. We were just talking
31:23
Speaker 1: about this kind of thing. Oh yeah, And I didn't
31:25
Speaker 1: even realize that when I picked this out. How about
31:27
Speaker 1: that serendipity. Um, I grew up in a house with
31:30
Speaker 1: a creepy, gross basement where we did laundry, and it
31:32
Speaker 1: never bothered me. My fiance James, and I recently moved
31:35
Speaker 1: into a house with a non creepy and non gross basement.
31:39
Speaker 1: But I think the stress of planning a wedding is
31:41
Speaker 1: getting to me because when I need to go down
31:43
Speaker 1: into the basement to do laundry, I nearly have a
31:45
Speaker 1: panic attack imagining a person lurking in the basement. I've
31:49
Speaker 1: started playing an episode of Stuff You Should Know on
31:52
Speaker 1: my iPhone and carrying it in my pocket when I
31:54
Speaker 1: need to go down to the basement, stay back Spirit exactly,
31:58
Speaker 1: so we literally accompanied her into the basementch I think
32:00
Speaker 1: is hysterical. I am busy enough enjoying your humor and
32:04
Speaker 1: information that I don't get us overwhelmed by this irrational fear.
32:08
Speaker 1: I think it may even be waning now, so I
32:10
Speaker 1: continue to make myself go down into the basement and
32:12
Speaker 1: see that my fear is not really based in any
32:14
Speaker 1: reality at all. Uh. That's CBT, that's exposure therapy boom.
32:21
Speaker 1: Also before this weird basement, if you're popped up, I
32:23
Speaker 1: long called you guys my cleaning crew because I listened
32:26
Speaker 1: to episodes while doing my chores. And that is from
32:28
Speaker 1: Kelsey in Kansas City, Kansas, not Kansas City, Missouri, Missouri.
32:34
Speaker 1: And uh, Kelsey, good luck with that, and just don't
32:38
Speaker 1: look behind that door over near the washing machine. That's
32:42
Speaker 1: very helpful. Just getting Kelsey, there's nothing down there, and
32:45
Speaker 1: just take us with you. Well, we will protect you
32:48
Speaker 1: because spirits don't like us. The podcast is coming from
32:52
Speaker 1: inside the house. If you want to get in touch
32:56
Speaker 1: with Chuck or me, you can tweet to us at
32:58
Speaker 1: s y s K podcast. You can join us on
33:00
Speaker 1: Facebook dot com, slash stuff you Should Know. You can
33:04
Speaker 1: send us an email to Stuff Podcast at how stuff
33:07
Speaker 1: Works dot com and has always joined us at our
33:09
Speaker 1: home on the web, Stuff you Should Know dot com.
33:17
Speaker 1: For more on this and thousands of other topics, is
33:19
Speaker 1: it how stuff Works dot com.