What anxiety attacks really do to your body

By almost all accounts, full-blown anxiety can extraordinarily difficult to manage. Various levels of stress in anyone’s life are inevitable, of course. But when you have a chronic panic disorder, as the National Institute of Health estimates that many people do, even getting through a normal day can feel like an insurmountable hurdle.

But what exactly is severe anxiety, and where does it come from? The answers to that question are as scientific as they are subjective and existential, meaning that “causes,” if such a term can exist on an easily classifiable level, vary from individual to individual. As the Mayo Clinic points out, the fundamental difference between anxiety and panic is that the former generally tends to be triggered by a certain event, while the latter can come seemingly out of nowhere. But both are equally insidious.

Fortunately, however, fellow sufferers can support each other by sharing their stories, and by increasing their understanding of this still widely misunderstood condition. Here’s what really happens to your body when you have an anxiety attack.

You may have symptoms that mimic those of a heart attack

There’s a reason so many people end up in emergency rooms while in the throes of a panic attack. And those reasons aren’t just all in their heads, either. 

As the University of Michigan Health Center’s William Meurer, M.D., explains it, “There’s an overlap in symptoms associated with heart attack and panic attack.” Some of these include localized pain, stabbing pains in the chest, shortness of breath, rapid heart palpitations, pain that gets worse when you press on a given area, and pain that doesn’t stop even while you’re at rest.

Again, nearly all textbook signs of a cardiac event. So when in doubt, don’t stop and try to pick out the nuances (which you probably won’t be able to do while in a panicked state, anyway). If you have any of the above symptoms, just go to the ER. Better safe than sorry is always a sound, and sane, philosophy.

You may feel like you're looking at yourself from outside your body

Many sufferers maintain that one of the worst side effects of acute anxiety is de-realization. A similar condition, known as depersonalization, can also be present. In clinical terms, and as the Mayo Clinic staff explains it, these states are characterized by a “feeling that you’re observing yourself from outside your body.” Either malady may cause you to feel like you’re a robot or a zombie, even if you’re able to talk and answer questions as usual. In other words, you may feel like you don’t even have access to yourself. 

As frightening as that sounds, it’s important to remember that it will pass, and that it can’t last forever — any more than any other state of consciousness can. With treatment and time, you’ll eventually start feeling like you’re in control of your own personality, and your own emotions (or lack thereof), again. 

You may have a "fight or flight" reaction

When a person is confronted with a real, imminent danger, a reflex known as the fight or flight reaction kicks in. As as Nigel Barber, Ph.D, explained in an article he wrote for Psychology Today, this phenomenon is essential for survival, and is a “break glass in case of emergency” resource that nearly all mammals share. As Barber puts it, “the key quality of pathological anxiety is that it is out of proportion to any actual threat.”

Nevertheless, the actual symptoms, so to speak, are the same: accelerated pulse and breathing rates, sudden hyperawareness, and an urgent feeling that one needs to escape as soon as possible.

In other words, since experienced sufferers already know they’re having a panic attack, trying to intellectualize the problem is unlikely to help. Rather, some physicians recommend techniques like cognitive behavioral therapy and “relaxation training,” though the efficacy of almost any treatment is ultimately personal and subjective. 

You may have temporary (albeit dramatic) spikes in blood pressure

In the hurricane-eye of a panic attack, it can feel like your blood pressure is about to go through the roof. But it isn’t, really. Sheldon D. Sheps, M.D. wrote for the Mayo Clinic that anxiety, by itself, is not a cause of long-term hypertension. Nonetheless, people’s blood pressure has been known to “spike suddenly” while they’re having an attack. And if those attacks occur on a regular basis, they can (over a long period of time, and like any species of ongoing stress) eventually “cause damage to your blood vessels, heart and kidneys.”

As stated, this doesn’t qualify as an immediate life-threatening emergency equivalent to chronic high-blood pressure. But if anxiety is disrupting your life on an incessant basis, it’s not nothing. It’s imperative to seek treatment, whether that means getting therapy, taking medication, trying to get the problem under control yourself through your own methods, or any combination of the above.

You may experience violent interruptions in sleep

Many sufferers of nocturnal panic attacks have described the sensation of being jolted out of a sound sleep into a world of acute terror. They recount intense “drowning” feelings, coupled with vertigo and an intense fear of dying.

As Craig N. Sawchuk, Ph.D., L.P. explains on the Mayo Clinic site, these episodes have the same characteristics of daytime panic attacks, which distinguishes them from “night terrors” or similar conditions. Symptoms include waking up suddenly to “sweating, rapid heart rate, trembling, shortness of breath, heavy breathing… and a sense of impending doom.”

Nocturnal attacks generally only last for a short time, but they can be difficult to recover from, much like shaking off any nightmare can be. Not surprisingly, people who have experienced one or more of them may be afraid to go back to sleep, which can facilitate additional problems, like insomnia.

You may feel like you're unable to breathe

Not being able to breathe — or at least feeling like you aren’t able to breathe — is yet another deeply disquieting manifestation of anxiety. Those suffering an attack will often gasp for breath, or feel like they’re at risk of smothering. At its worst, this can escalate into outright hyperventilation. Like many other physical manifestations of anxiety, the sensation almost always has nothing to do with actual respiration-obstruction — though it can feel exactly the same.

As counselor Katharina Star, Ph.D,, put it in Very Well Mindforcing yourself to take “deep, full and complete breaths” (as opposed to jagged and frantic ones) may be the answer. Even if this doesn’t alleviate your anxiety, it will at least establish a pattern of respiration that’s more controlled, thus greatly lessening the risk of hyperventilation. In other words, practicing deep breathing techniques is guaranteed to do more good than harm.

You may develop a social phobia

There is such a thing as social anxiety (a fear of being in public, or around strangers in general). But being prone to anxiety attacks, by themselves, can definitely exacerbate latent, or even previously non-existent, feelings of social unease. Let’s face it: no matter how distracted you are by your distress, having an anxiety attack in public is embarrassing. So if you start to freak out in the grocery store, don’t worry: you aren’t going crazy.

As Katharina Star, PhD wrote in Very Well Mind that some remedies for this situation include taking a friend with you if you have to go out, which can help you feel less paranoid about being conspicuous. Establishing a firm itinerary can also be profoundly useful.

Finally, remember that help is always available, and that the human mind (and body) has a miraculous, and wonderful, capacity for recovery. Nothing is forever — even anxiety attacks. Hang in there, you’re not alone.

Physical changes may occur even before the attack strikes

Most experienced anxiety sufferers gradually learn to “ride out” their milder attacks. In fact, many people even get somewhat used to co-existing with their condition. As a result, they might not even notice that they’re essentially living in a daily, and ongoing, state of low-grade anxiety. That’s why many of the physical changes that sometimes preempt attacks often go unnoticed.

During a study cited by WebMD, and reviewed by Smitha Bhandari, MD, participants with panic disorder agreed to wear tracking devices. Said monitors revealed an increase in breathing, “lower-than-normal levels of carbon dioxide,” and a substantial acceleration in heart activity and respiration. All of which occurred roughly 45 minutes before sufferers actually had full blown attacks. All of which may suggest that anxiety, like migraines, may have an “aura” of its own. Albeit one that’s not as easy to detect.

You actually might not be having an anxiety attack

It’s crucial to remember that just as anxiety attacks can mimic other medical conditions, other medical conditions can mimic anxiety attacks. As Michael J Formica, MS, MA, EdM explains in Psychology Today, there are a variety of un-psychiatric illnesses that share symptoms with anxiety and panic disorder. One of these is hyperthyroidism, which can present itself in the form of “heart palpitations, breathlessness and trembling hands,” as well as difficulty concentrating and extreme fatigue.

The answer, of course, is to rule out the possibility that you have an underlying condition that may be causing your distress. 300,000 people are diagnosed with hyperthyroidism annually, and women are more likely to develop the condition than men. Diabetes can also cause extreme anxiousness, and seeking treatment for it can therefore alleviate many anxiety-related symptoms. Having simple blood work done to test for a range of maladies is advisable, if only to rule out other health concerns.

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