How do you know you're having a panic attack

My panic attacks have the following symptoms: overwhelming fear that I am in some sort of danger, profuse sweating, racing heart, desire to just make it stop somehow because it feels so awful, shakes and tremors, inability to think rationally, and nausea. For me, it is often followed by the worry that it will happen again, thus anxiety.

You don’t know until later that you hit someone or ran out of the room or cried and felt like the world was ending.

@user_ch783e933 Not saying you had a hypertensive crises, but I had something like happen to me a few years ago. My BP went as high as 200/120...I was given a supplement blood pressure medication only to take when my blood pressure was 150/100. I may have used it once or twice and I never had an issue again. I had a cardiac workup and nothing significant was found to have caused this. Honestly, I do not remember any significant life experience that would have triggered a panic attack. I have had a panic attack before, but this felt different. So, I had no idea why my blood spiked so high and I will probably never will.

Something that caught my attention was your mental health history. Thank you for having the courage to mention it. I suffered greatly from depression from a cardiac event from three years ago. I am much better now but never really got over it. About 2 years ago, I was driving to work and broke down and cried. I did not understand why at the time. I told my psychologist that I suddenly felt like I was going backwards in my recovery. We talked and she asked when was the onset of my depression (July 6, 2022) and the date I started feel depressed again was July 10th, 2023. Subconsciously, I emotionally reliving the experience. These days, I still have trigger moments but I now recognize and handle them better. To be honest, before this, I used to think people were overboard about triggers...I was skeptical. I now admit how wrong I was about that.

Here is what Mayo Clinic has to say about panic attacks: https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

Definitely a scary time for you. The fact that you want to understand what is going on, and how to deal with it, is very encouraging, from how I see it. Sometimes it might take a lot of self-reflection to understand the triggers, and then you can work with that. No one is going to tell you it will be easy, that's for sure.
Ginger

You certainly are on the right track trying to figure out how to identify and approach what you are experiencing. Your past experiences sound heartbreaking and please accept my condolences on your loss.

I can just relate my experience with panic attacks and anxiety, which occurred many years ago. For me, I felt like I was going to die. Unless, you’ve experienced it it’s difficult to describe. They started soon after I was diagnosed with type 1 diabetes. I was going through some other personal issues. Mine appeared for no apparent reason. I could be driving, shopping, working, etc. I realized later caffeine was a trigger. I gave it up for one year.

After a particularly severe attack and ending up in the ED of a large hospital where they checked me out completely….heart, lungs, blood, etc. they found no problems. After consulting with my primary and having treadmill test to be sure heart was ok, she diagnosed panic attack and prescribed a short term med to take as needed, which I used judiciously.

I then began my search to learn as much about anxiety and panic attacks as I could. I learned how to talk to myself when I felt one approaching. I found comfort that I would not die from it and that I would be alright. Eventually, they left. Years later I started feeling similar feelings approaching and I started talk therapy. Great decision and it helps so much with my regular anxiety. I keep a low dose med just in case, but only need it every couple of times a year. I was offered prescription for a daily med to treat my overall anxiety, but chose to avoid that if I possibly can. I will take it if I need to. I manage pretty well now with working out daily, nutritious diet, talk therapy and keeping an internal dialogue that I’m ok. A therapist can provide tools to help you talk yourself through it.

Have they offered to let you wear a heart monitor? To me, once you have the confirmation it’s anxiety causing the symptoms, you can gain the confidence to manage it.

Good luck with your recovery. Some people get a lot from support groups.

@_ch783e933
I have had anxiety/panic attacks. It seems the way a body responds is a personal one. I felt overwhelming fear and body started shaking uncontrollable.

My wife has them and she gets cold sweats, shaking, etc.

I go to Mayo. My phsyciatric medication specialist recommended a depressing anxiety medication to help reduce my PTSD anxiety/panic disorder. She checked with all my other Mayo doctors to make sure did not hinder any other medication on or inferere with any medical condition.

It did work. Also every doctor I have recommends doing an exercise that you enjoy doing (after they give advice okay to do). And if not find a hobby that you enjoy doing. Stress and anxiety affect mental health that affects physical health and vice versa.

What my doctors have told me most panic attacks are caused by stress. The hormone adrenaline is the fight or flight hormone. It is released in body when you are under stress and anxiety. The body can only take so much of it before it has to respond (again per my Mayo doctors not my opinion). Thus you get panic attacks.

I wish I could pass on to you what exactly you will feel but from my doctors and my exeperience an overwhelmy feeling. I a lot have chest pains, a lot have hyper breathing, some like my wife and I body shakes, etc.

Talk to our medical professionals about medications to help prevent them along with finding exercise and hobbies to also reduce your stress and anxiety.

Aside from a really huge panic attack I had summer 2023 when I was dealing with sudden driving anxiety, and I've defeated it now so no problem unless I'm on the thruway and then I actually yell at myself out loud and it calms me, I have no idea I'm having a panic attack. I concentrate on the physical symptom like feeling spaced out, or cold suddenly, and I lose total ability engage cognition.

No I have no emotional dysregulation in terms of my behavior toward others or in public, that's an entirely different mental illness.

Heart attack is a terrifying experience, as I've read much about the psychological effects, and the PTSD and fear can last quite a long time. I'm assuming they found the artery and repaired it? Usually that's what happens, either with a stent or open heart surgery. The mental aftereffects of any sort of intervention on your heart is very common and a therapist who has an awareness of this can probably help you to deal with it. A spike of 200/120 is apparently not uncommon, and does occur more often than we know, according to my cardiologist's PA who sees this all day. If the cardiologist wants me to take an additional medication when that happens again, I certainly will, but daily that would be a problem since my BP last night was 113/68. I take it first thing before getting out of bed, it's usually in the 120s/70s, perfectly normal first thing in the morning after all I'm not 20 any more. And at night, sitting in bed watching TV, doing tablet stuff, etc. it's usually the same or lower. I only take it once. I know if I take it again, it will probably go lower each time, but lately the anxiety of taking it more than once can cause it to rise. Your mind can take your BP to heights unheard of and it has nothing to do with any crisis except in your subconscious. It sounds like you definitely are reliving the experience that was so frightening at the more or less same time of year. We really don't seem to be able to control the subconscious and it's a real enemy. But at least you have a definitive reason that you can work on to slowly desensitize yourself and if the reason your heart attack occurred has been successfully addressed, you're very unlikely to have another one, especially if your cardiologist keeps an eye on things as the years progress.

I've worn many heart monitors over the years because I have PVCs which are also worsened by anxiety (which they CAUSE so there's a real problem) and mine are cardio/gastro (meaning, my stomach causes the heart to "skip a beat") so I've learned to basically ignore them. I even had three during a nuclear stress test, totally unremarkable, not even a blip on the report so alot of people have them. Heart monitor doesn't explain spikes in BP and even a 24 hour BP monitor doesn't explain them, just shows them. Both times this spike occurred, I took my BP under extreme stress. Cardiologist's PA told me it's the STRESS, a normal healthy reaction to stress is elevated BP. They want me to try to get some control of my anxiety so the spikes won't occur because significant BP spikes over and over again can cause damage but I'm old already, I'm going to drop dead one day sooner than later. It's not like when I was young, especially in my 40s while raising my daughter, when I had PVCs butnever took my BP which I bet was sky high also. I can't tell myself this isn't going to kill me because one day it will, whatever "it" is. I probably won't be alive in five years. So telling myself well I'm young and this isn't going to kill me doesn't work. I'm not young and it certainly might kill me. What I do now is anticipate a higher BP reading and try to avoid taking it in the middle of the day because now I'm anticipating it's going to be high and so it will be.