Beating the panic

Recognising that it is a stress response, that you are not about to die, and that there are things that you can do to beat the anxiety, will give you more confidence, and that will help you deal with it.

It is July, six months since I started to feel unwell with a git of a respiratory virus, panic attacks and chronic fatigue. The good news is that today I feel 90% better and having shared my experience I am very grateful to all of the lovely people that have been in touch to tell me that they have had similar issues. Some of you have managed it into submission, others are still struggling and for those in the second category I decided to write down some of the things that I’ve done that have helped – starting with talking about it.

Don’t suffer in silence!  Almost everyone that I’ve talked to about this has felt better once they realised what it was. And to do that you have to talk about it. Panic attacks have less power once we know what they are. Recognising that it is a stress response, that you are not about to die, and that there are things that you can do to beat the anxiety, will give you more confidence, and that will help you deal with it. But unfortunately that won’t be enough in the long run. It takes a long time to undo the damage, uncoil the spring and unlearn the responses that have led to these reactions.

For me there were two things I needed to do. First was deal with the short term issues like the panic attacks. Second was the long term stuff – making sure that I made changes so that I didn’t end up back at square one as soon as I started feeling “normal” again.

Short term

BREATHING – Breathing through the panic attacks was the only way I could stop them. I think its called circular breathing. When the panic started I’d breathe in for 5, hold my breath for 5, then slowly exhale (for at least 5). Doing this for maybe 10 breaths would be enough to stop an attack. Simple but effective. The doctor said a paper bag also does the trick because you are reversing the effects of hyperventilating by inhaling the carbon dioxide. I preferred the circular breaths.

REST – I reduced my workload massively and spent A LOT of time on the sofa. I didn’t do anything physical at all. My lovely friend (you know who you are and you were brilliant) walked my dog for me and my family helped with the kids. My husband stepped up a gear admitting that he had just left me to do everything – because I never asked him to help. A partnership of one is not very effective. Only after a couple of weeks of resting properly and demanding more from my husband, did I start to feel like I could breathe normally. The boa constrictor that had wound itself around my chest had stopped squeezing. I was not going to be eaten by a snake.

NUTR20160615_122859[1]ITION – I drank lots of water and swapped the caffeine and sugar that had habitually powered me through the day (until dinner), for a diet full of meat, veg, fruit, and dairy products. I ate every couple of hours. My brother got me a brilliant recipe book “The Power of Three” by Dale Pinnock and I really recommend it. Eating like this just felt right. My body knew what it needed*.

Long term

This was more tricky. I was offered a beta blocker called propranalol to help deal with stress, but I decided not to take it. I instinctively felt that the cause of the issues was having too much on my plate. I felt like I needed to unwind myself. If I could unpick the stitches that had drawn me in too tightly then surely the pressure would ease and I would start to feel better? This turned out to be true. But one of the reasons that I could “unwind” was that I work for myself so I was able to reduce my workload and only work from home for a few weeks. I appreciate that for some people this isn’t the case and more immediate treatment such as propranalol is invaluable in order to regain normal function. Everyone is different.

Blood tests also showed that I had severely low Vitamin D.

“I don’t want to get your hopes up but a lot of people with very low levels of Vitamin D feel a lot better when they take supplements. I am giving you a big dose,” said the doctor.

“So what you are really saying is that I need to go abroad and lie in the sun for a month,” I said. “Can you give me a prescription for that?”

“Sunshine would certainly help,” she said.

I became more organised. Living in a state of chaos makes all of this worse. We (instead of I) write meal plans, create lists of things that we need for the week, we plan ahead. Lots of people do this already but for me it is new ground.

I stopped running. Because I was doing it to go faster, and further and to push myself and because the dog needed walking so I was multi-tasking. But I wasn’t getting any better at it, which is not surprising really. I had nothing to put into it. I was quite literally running on empty. So I’ve started trying to build myself up slowly. At first, after about two months of doing absolutely nothing, I went to pilates and walked a bit. The first time I went to a class all my muscles were shaking and I couldn’t do it all. A year ago I had found it too easy and decided that it was boring. Now I appreciate that it is building my strength up slowly from the inside out. I am grateful that I can do it. I go once a week. Then I started doing a few weights, once or twice a week. And more recently I’ve reintroduced a bit or run/walking, but only when it is sunny and I feel full of energy.

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Low vitamin D? Get out into the sun. I look like a vampire.
I nap. I work from home so I am lucky enough that if I am struggling then I can take an hour and sleep. It helps a lot.

And finally I was advised by the doctor to spend time doing things that I enjoy. Oddly this one has been perhaps the most difficult to achieve. The past 7 years have mainly been about obligation and necessity. Looking after the kids and working took up all of my time. Like many (most?) parents I had forgotten what I enjoy. My hobby was facilitating the hobbies of my family. And even the rare social events that I was invited to felt like another stressful obligation. I’m still working on this one but I started small – picking TV box sets that I liked and books that I enjoyed. This week I’m trying out a new martial arts class which was a hobby I enjoyed 10 years ago and tonight we are going to a party.

Thanks to all of this I feel sure that the last 10% recovery will, eventually come. After a few good days I feel 95% better but after a few days of overdoing it I can quickly slide back to 50%. The moral of this story is that if you don’t look after yourself, you won’t be able to look after those that you love. And those that you love should look after you too. So look at your routines. Do you really need to do everything? Put down the washing, stop thinking about work, tell the kids that the word “Mum” is banned for half an hour, and do something less boring instead. And finally don’t suffer in silence. Talk to your friends and family. It makes it better.

*My body will always need cake too. I would never advocate giving that up. Life is too short.

 

 

 

Panic attacks: what the doctor said

“When you are stressed you start to breathe using shallow breaths and this leads to hyperventilation. When you hyperventilate your blood chemistry changes significantly and that has all sorts of effects,” said the GP

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The Scream, by Edvard Munch  is understood to depict the Norwegian artist’s own panic attacks (Public domain via Wikimedia Commons)

After the trip to A&E I went to see a GP that my brother (who is a mental health nurse) told me was good at dealing with stress related issues. He diagnosed me immediately. “These were classic panic attacks, brought on by hyperventilation, brought on by stress. You can’t get over a simple virus because you are too run down. You need to make some changes.”

Excellent. Whilst there can be no doubt that I was delighted to hear that I didn’t have a heart condition, pulmonary embolisms or some kind of persistent lung infection,  the news that it was something associated with stress and mental health was hard to hear. It wasn’t medicine that I needed, it was to make some lifestyle changes.

Continue reading “Panic attacks: what the doctor said”

Trying not to die on the way to football

I am sharing my experience because a lot of people suffer from physical manifestations of stress and anxiety and until it happened to me I didn’t think it was real. Now I know better.

I had been slightly breathless all morning but I didn’t have time to dwell on it. The mild respiratory virus that had been bothering me for a few weeks was refusing to shift but there wasn’t much I could do about that. Life sped on. I needed to file an article that I’d finished the night before; my 7yr old son needed to be ready for his football tournament which was starting at 9am (where were his socks – arrrggghhh); my 3yr old daughter needed getting ready for nursery (“I not going to nursery today,” she yelled) and I had planned to throw some food in the slow cooker before we left (it wasn’t going to happen).

But by the time we were on our way to the football, 20 minutes later than planned and struggling to find the ground, the breathlessness demanded my attention.  Every inhalation felt inadequate. There just wasn’t enough air getting into my lungs. My chest was tight and sore in a burning, itchy kind of way. I put my head back and inhaled harder. Only when my lungs were fully inflated did it feel OK. I did it again and again. But the dizziness and disorientation were getting worse. There were pains in my chest, high up near my left breast.  I opened the car window and the cold air flooded in. It felt better, a bit. “Mum it’s cold,” shouted a voice from the back. I ignored it.

I was so dizzy that I thought I was going to faint. I gripped my car seat and looked straight ahead hoping that I wouldn’t pass out. We were running late as it was. My son did not need to see his Mum fainting. My husband stoically kept driving. I don’t know what he was thinking.

A few minutes later we arrived at our destination. I couldn’t get out of the car because I couldn’t stand up on my own. I was too weak and I was shaking too much. “What the fuck was happening?” Surely a virus couldn’t cause a heart attack? Was I going to die? I didn’t know what to do. I used the car door to pull myself up. My husband took my arm and helped me out. My son ran ahead oblivious, excited about his match – I was glad that he hadn’t really noticed. We walked over to the pitch slowly and I leaned on my husband like I’d lost a leg. “Phone the doctor,” he said.

The duty GP at the surgery told me to go to the nearest A&E. “I had a chest X ray last week because of a respiratory virus and it was clear.” I said not wanting to waste anyone’s time. “Things can change in a week,” said the GP.  “It is not worth taking any risks.”

Luckily the grandparents had come to watch the football too, so we were able to get me to hospital without ruining the day for my son. By the time we walked into A&E it was all starting again. As I struggled to breathe, the dark patches in front of my eyes got bigger and I had to cling to the wall to stay upright. I was helped into a wheelchair and I wasn’t even embarrassed about it. I knew I couldn’t stand up. Then the shaking started. The only time I had ever had the shakes was when my body reacted badly to all the drugs I’d had when I was having my first baby. But it was happening again.

A nurse took me into the triage room and started to monitor me and ask questions. They did an ECG. My heart was galloping and I had an arrhythmia “But that can be normal,” she said gently.

They would take blood and monitor me for a couple of hours they said. I was put on a bed. I felt bad that I got a bed when there were some very frail and poorly people in that waiting area. “I am healthy. I am only 38. It was my birthday last week. I go running.” I said more to myself than anyone else. And to be honest I hadn’t run for weeks now.

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Norm being his usual sympathetic self

Next to me a lady was crying as she sat in her wheelchair. Blood from her hand was slowly dripping onto the floor. The man next to me was vomiting sporadically into a bag, you could hear that his stomach was empty from the empty wretching sounds. A drip was attached to replenish him. The girl opposite looked like she had been beaten up, her face was swollen and she was crying. Two police officers sat with her, two more were by the doors. In the corner a man sat coughing, hacking up flem into a cup every ten minutes or so. The woman next to him yelled “for God’s sake” every time he did it and sat with her back turned to him in disgust. An elderly man nearby was yellow and quiet, he told the doctor that he had the runs. They told him that his kidneys were struggling, he was very poorly and he needed to be admitted.

There is no such thing as privacy in A&E.

“Hello Sweetie,” said a gentle voice, so kindly it brings a lump to my throat to remember it. “I’m going to put this cannula in so that we can take some blood,” she said. Her name was Maria and despite the full waiting room, the police, the hacking, the bleeding, the crying and the relentless pressure that she was undoubtedly under, Maria still cared enough to make eye contact with me and be kind.

After 4 hours of tests and waiting the results were normal. I was not having a heart attack, there was no fluid in my lungs. But the score for a protein related to blood clots (D Dimer) was on the high side so they decided to do a CT scan to check for pulmonary embolisms. That too was clear. There was nothing wrong with me. I wasn’t dying. I should go home. But what was going on?

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CT scanner: the drugs that show up any clots make you feel like you have wet yourself – odd

“These were classic panic attacks, brought on by hyperventilation, brought on by stress,” said the GP that I visited a few days later to try and make sense of what had happened. “You can’t get over a simple virus because you are too run down. You need to make some changes.” he said*.

*He said a lot more than that and I’ll give more information in a future post

**I am sharing my experience because a lot of people suffer from physical manifestations of stress and anxiety and until it happened to me I didn’t think it was  real. Now I know better.

 

 

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