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SYSK Selects: How Panic Attacks Work · Stuff You Should Know

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