A significant breakthrough could lead to the development of new medications that prevent panic attacks, researchers from the Salk Institute in California explain. The team identified a specific brain circuit composed of specialized neurons in mice. They believe this circuit can be manipulated to manage panic disorder effectively.
The team pinpointed a brain region responsible for initiating panic, which triggers both emotional and physical responses. Furthermore, the scientists discovered that inhibiting certain neural signals could diminish panic symptoms. This finding offers hope for creating drugs that could relieve panic disorder.
The Salk researchers charted the brain’s regions and connections involved in panic attacks. Their goal was to facilitate the creation of effective treatments in the future. Individuals with panic disorder frequently experience sudden, unexpected attacks. These episodes cause intense fear, sweaty palms, shortness of breath, and rapid heart rate.
To start mapping these brain regions, the researchers focused on the lateral parabrachial nucleus (PBL) within the brain stem. This area, known as the alarm center, is part of the pons and regulates breathing, heart rate, and body temperature.
Study authors found that the PBL plays a role in initiating panic and inducing emotional and physical changes. Additionally, this brain region produces the neuropeptide PACAP (pituitary adenylate cyclase-activating polypeptide), a critical regulator of stress responses.
However, the exact relationship between these elements remained unclear. Therefore, the researchers conducted experiments on mice to confirm and refine their proposed brain map.
“Emotional and stress-related behaviors have been associated with PACAP-expressing neurons in the past,” says co-first author Sukjae Kang in a media release. “By mimicking panic attacks in the mice, we were able to watch those neurons’ activity and discover a unique connection between the PACAP brain circuit and panic disorder.”
While studying the brains of mice during panic attacks, researchers discovered that neurons expressing the neuropeptide PACAP become activated. Upon activation, these neurons release the PACAP messenger to another brain region called the dorsal raphe, where neurons with PACAP receptors are located.
The released PACAP messengers then activate these receptor neurons, resulting in the mice exhibiting panic-associated behavioral and physical symptoms. This newly identified link between panic disorder and the PACAP brain circuit marks a significant advancement in understanding how panic disorder operates within the brain.
Furthermore, the team found that inhibiting PACAP signaling disrupted the flow of PACAP neuropeptides, leading to a reduction in panic symptoms. This discovery holds promise for the future development of targeted treatments for panic disorder.
Dr. Sung Han, the study’s senior author and an associate professor at the Salk Institute, notes that while panic disorder is classified as an anxiety disorder, it differs from anxiety in several ways. For instance, panic can trigger physical symptoms such as shortness of breath, rapid heart rate, sweating, and nausea, which are not typically induced by anxiety.
Additionally, panic attacks are often uncontrollable and spontaneous, unlike other anxiety disorders such as post-traumatic stress disorder (PTSD), which are more memory-based and have predictable triggers. According to Dr. Han, these distinctions underscore the importance of mapping the brain circuitry specific to panic disorder. Such mapping is crucial for developing treatments that are specifically tailored to address panic disorder.
“We found that the activity of PACAP-producing neurons in the brain’s parabrachial nucleus is inhibited during anxiety conditions and traumatic memory events—the mouse’s amygdala actually directly inhibits those neurons,” says Han, who is also the Pioneer Fund Developmental Chair at Salk.
“Because anxiety seems to be operating conversely to the panic brain circuit, it would be interesting to look at the interaction between anxiety and panic, since we need to explain now how people with anxiety disorder have a higher tendency to experience panic attack.”
Dr. Han’s team aims to investigate PACAP-expressing neurons and PACAP neuropeptides as potential targets for drugs treating panic disorder. The researchers, whose study is published in the journal Nature Neuroscience, also intend to expand their understanding of panic disorder’s neural map.
They plan to trace the pathways of PACAP receptor-producing neurons in the dorsal raphe to determine where these neurons send their signals. Additionally, they are interested in exploring how other brain areas associated with anxiety interact with the PACAP-related panic system.
25% of emergency room patients presenting with chest pain met the criteria for something else entirely, yet attending emergency department cardiologists failed to recognize it 98 times out of 100.
According to the U.S. Centers for Disease Control and Prevention, nearly 805,000 Americans have a heart attack each year, and 605,000 are first heart attacks. Knowing the risk factors, symptoms and how to take early action will increase your chances of survival.
However, what may look and feel like an apparent heart attack may actually be a panic attack, and according to researchers, the cost of misdiagnosing noncardiac chest pain is high. “It is important for physicians to be able to recognize panic attacks and to distinguish them from cardiac disease, thus avoiding unnecessary use of health care resources,” one report states.
An investigation published in 1996 found that 25% of emergency room patients presenting with chest pain met the DSM-III-R criteria for panic disorder, yet attending emergency department cardiologists failed to recognize patients having a panic attack 98% of the time. As noted by the authors:
“Panic disorder is a significantly distressful condition highly prevalent in ED [emergency department] chest pain patients that is rarely recognized by physicians. Nonrecognition may lead to mismanagement of a significant group of distressed patients with or without coronary artery disease.”
So, just how do you tell the two apart? Before we get into those details, let’s take a look at the common signs and symptoms associated with each.
Symptoms of Heart Attack
When a heart attack starts, blood flow to your heart has suddenly become blocked and the muscle can’t get oxygen. If not treated quickly, the muscle fails to pump and begins to die. While often a result of coronary heart disease, a heart attack can also be caused by a blood clot blocking an artery. Some of the most common symptoms of a heart attack include:
Chest pain or discomfort
Upper body discomfort
Shortness of breath
Breaking out in a cold sweat
Nausea
Sudden dizziness
Feeling unusually tired
Lightheadedness
Symptoms of Panic Attack
A panic attack typically comes on abruptly, producing intense fear and a sense of impending doom or even death that is typically severely disproportionate to the situation at hand. Common symptoms include:
Hyperventilation
Chest pain
Heart palpitations
Trembling
Sweating; hot or cold flashes
Nausea
Dizziness or lightheadedness
Numbness and/or tingling sensations
Panic attacks tend to peak within 10 minutes, and most subside within 30 minutes. Few last more than one hour. It’s not uncommon for people to seek medical help, thinking they’re having a heart attack or are dying, when panic attacks first set in and they’re unfamiliar with the symptoms.
How to Tell Them Apart
While it can be very difficult to tell a panic attack from a heart attack, some generalizations can be made that can help tell them apart.
Pain onset — The chest pain associated with a heart attack will typically start as a feeling of pressure, fullness or aching that escalates, reaching maximum severity after a few minutes, whereas the pain associated with a panic attack tends to be sharp and stabbing in the center of the chest, typically lasting only five to 10 seconds.
Pain location — The location of the pain also tends to differ between the two. Whereas panic-associated pain is localized in one small area of the chest, heart attack symptoms typically include pain or discomfort that radiates from the chest into other areas, such as one or both arms, abdomen, back, shoulders, neck, throat or jaw.
Don’t Ignore Your Symptoms
When in doubt, seek immediate medical attention. It’s better to be safe than sorry, as sudden death is the most common symptom of a heart attack. As noted by Dr. Sam Torbati, medical director of the Ruth and Harry Roman Emergency Department in an interview for Cedars-Sinai Medical Center:
“Unfortunately, there is great crossover between the symptoms of panic attack and heart attack, making it very challenging to discern between the two without a physician assessment and testing, such as an EKG.
Common symptoms that may affect patients with either a panic or heart attack include chest pain, shortness of breath, dizziness, sweating, passing out, tingling, or a sensation of impending doom.
These shared symptoms of heart and panic attack may also be caused by other serious conditions such as blood clots, lung infection or collapse, or tear in the large vessels of the chest for patients with certain pre-existing risk factors. So when in doubt, seek immediate medical attention …
The best predictor as to whether symptoms are due to panic versus heart attack is the patient’s age and previous history of panic attacks … Patients should immediately go to the ER if they have new onset chest pain (tightness, squeezing, heaviness), shortness of breath, sweating, lightheadedness, pain that radiates to the jaw or arm, or a ripping sensation in their chest or back.
Heart attacks tend to occur in middle-aged people and older age groups, so the older the person is, the lower a threshold they should have for coming to the ER right away.
Patients with pre-existing coronary artery disease and those with risk factors associated with coronary artery disease should also be evaluated immediately, including those with hypertension, diabetes, obesity, high cholesterol, or a history of smoking.”
Possible Connection Between Panic Disorder and CAD
It’s also worth getting your symptoms checked out even if you’re certain they’re due to a panic attack. Some research suggests there may in fact be a connection between panic disorder and coronary artery disease, although the exact relationship is still unclear. According to a 2008 review in The Primary Care Companion to the Journal of Clinical Psychiatry:
“There are several reasons to consider that a relationship between panic disorder and coronary artery disease (CAD) might exist. First, panic disorder has been linked to other forms of cardiac disease.
Second, the most likely source of the chest pain during panic attacks is ischemia. Finally, there is evidence that panic disorder may be associated with cardiovascular risk factors, such as hypertension, hyperlipidemia, and smoking.
Panic disorder is associated with several cardiac abnormalities. In addition to patients with panic disorder having elevated standing heart rates, 10% have an arrhythmia.
Panic disorder is associated with increased left ventricular mass and diameter, and patients with panic disorder have poorer cardiovascular fitness as demonstrated by lower maximum oxygen consumption and decreased exercise tolerance …
Case reports have linked panic disorder to a descending aortic aneurysm and pulmonary hypertension secondary to an atrial septal defect with pulmonic valve disease. However, the strongest association is between panic disorder and mitral valve prolapse (MVP) … but MVP is not likely to be the source of chest pain.
In addition, the significance of the panic-MVP relationship is unclear … Indirect linkages via autonomic vulnerability or dysfunction have … been proposed. However, the most likely explanation is that the decreased left ventricular volume due to the tachycardia seen in panic disorder produces the MVP.”
The review cites evidence suggesting ischemia is the cause of the chest pain felt during a panic attack, and researchers have found there’s an association between panic attacks and ischemic and nonischemic chest pain alike. According to the authors, “Myocardial ischemia could cause panic attacks via increased catecholamines or cerebral carbon dioxide levels secondary to lactate.”
What’s more, when looking at a large managed care database, researchers found an association between panic disorder and coronary heart disease and this association remained even after controlling for covariates.
Overall, patients with panic disorder were between 80% and 91% more likely to also have coronary heart disease. Patients diagnosed with both panic disorder and depression were, on average, 260% more likely to develop coronary heart disease than patients without those mental health problems.
On the flip side, research published in 2017 also points out that “Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health.” According to this paper:
“Both physiologic (autonomic dysfunction, inflammation, endothelial dysfunction, changes in platelet aggregation) and health behavior mechanisms may help to explain the relationships between anxiety disorders and cardiovascular disease.”
Many Women Mistake Heart Attack Symptoms for Anxiety
It’s also important to realize that the symptoms of heart attack can vary from person to person and some may have very few symptoms, especially women. Importantly, research shows women are less likely to report chest pain when having a heart attack.
They’re also less likely to suspect their discomfort is related to a heart problem. Compared to just 11.8% of men, 20.9% of women attributed their chest pain to stress or anxiety. Women also tend to describe their pain differently. They’re more likely to use terms such as “pressure,” “tightness” or “discomfort” in the chest rather than referring to it as “chest pain.”
Doctors are also more likely to dismiss women’s complaints of chest pain as being noncardiac in nature. Overall, 53% of female heart attack patients reported that their doctor did not think their symptoms were heart-related, compared to 37% of male heart attack patients.
Approximately 29.5% of women had actually sought medical help before being hospitalized with a heart attack, compared to just 22.1% of men. What these findings suggest is that women and their doctors tend to misdiagnose or dismiss symptoms of heart attack, placing women at a higher risk of death than men. As noted by the authors:
“The presentation of AMI [acute myocardial infarction] symptoms was similar for young women and men, with chest pain as the predominant symptom for both sexes.
Women presented with a greater number of additional non-chest pain symptoms regardless of the presence of chest pain, and both women and their health care providers were less likely to attribute their prodromal symptoms to heart disease in comparison with men.”
Unfortunately, the absence of chest discomfort is a strong predictor of diagnosis and treatment delays. For this reason, it’s important to remember there are many other symptoms that might indicate a heart attack in progress, including the following:
Anxiety attack
Back pain
Heartburn
Hot flashes
Extreme fatigue
Feeling electric shocks down on the left side of your body
Numbness and stiffness in the left arm and neck
Feeling like you have a large pill stuck in your throat
Breathe Right to Quell Panic Attacks
When it comes to panic attacks, familiarizing yourself with the function of your fight-or-flight response can be helpful to guide you toward self-help strategies that work for your unique situation.
For example, contrary to popular belief, taking deep breaths can actually worsen a panic attack, as explained by Buteyko Breathing expert Patrick McKeown. A breathing exercise that can help quell anxiety and panic attacks is summarized below.
This sequence helps retain and gently accumulate carbon dioxide (CO2), leading to calmer breathing and reduced anxiety. In other words, the urge to breathe will decline as you go into a more relaxed state.
Take a small breath into your nose, a small breath out; hold your nose for five seconds in order to hold your breath, and then release to resume breathing.
Breathe normally for 10 seconds.
Repeat the sequence several more times: small breath in through your nose, small breath out; hold your breath for five seconds, then let go and breathe normally for 10 seconds.
McKeown has also written a book specifically aimed at the treatment of anxiety through optimal breathing, called “Anxiety Free: Stop Worrying and Quieten Your Mind — Featuring the Buteyko Breathing Method and Mindfulness,” which can be found on Amazon.com.
In addition to the book, ButeykoClinic.com also offers a one-hour online course and an audio version of the book, along with accompanying videos.
EFT — A Long-Term Solution to Anxiety
Energy psychology techniques such as the Emotional Freedom Techniques (EFT) can also be very effective for anxiety and panic attacks. EFT is akin to acupuncture, which is based on the concept that a vital energy flows through your body along invisible pathways known as meridians.
EFT stimulates different energy meridian points in your body by tapping them with your fingertips, while simultaneously using custom-made verbal affirmations. This can be done alone or under the supervision of a qualified therapist. By doing so, you reprogram the way your body responds to emotional stressors.
EFT is particularly powerful for treating stress and anxiety because it specifically targets your amygdala and hippocampus, which are the parts of your brain that help you decide whether or not something is a threat. EFT has also been scientifically shown to lower cortisol levels, which are elevated when you’re stressed or anxious.
In the video above, EFT therapist Julie Schiffman demonstrates how to tap for panic attacks. Please keep in mind that while anyone can learn to do EFT at home, self-treatment for serious issues like persistent anxiety is not recommended. For serious or complex issues, you need someone to guide you through the process. That said, the more you tap, the more skilled you’ll become.
Heart Attack Prevention
As for heart attacks, your best course of action is to take proactive measures to prevent them. According to a 2015 study, more than 70% of heart attacks could be prevented by implementing:
A healthy diet
Normal body mass index
Getting at least 2.5 hours of exercise each week and watching television seven or fewer hours per week
Avoiding smoking
Limiting alcohol to one drink or less per day
To this I would add maintaining a healthy iron level is important for your heart, as various studies show that both iron deficiency and iron overload can be a significant risk factor for heart attack.
For example, a Scandinavian study found elevated ferritin levels raised men’s risk of heart attack two- to threefold. Another found elevated ferritin raised the risk of a fatal heart attack by 218% in men, while women with high levels were 5.53 times more likely to have a fatal heart attack.
As discussed in “Why Hard Water Decreases Heart Attacks,” magnesium insufficiency has also been implicated in heart attacks, so you want to make sure you’re getting enough magnesium from your diet and/or supplements. In “Could You Have a Heart Attack and Not Know It?” I also review some of the underlying issues that cause heart attacks, and additional steps you can take to lower your risk.
If you suffer from anxiety or develop occasional panic attacks marked by bouts of hyperventilation, you could merely be experiencing the side effects of an underlying nutrient deficiency that is easily correctable. This definitely appears to have been the case with 21 people who participated in a recent study based out of Japan, which identified a lack of both vitamin B6 and iron among participants who experienced panic or hyperventilation attacks.
The relatively small study evaluated nutrient levels among a group of participants with varying degrees of anxiety and frequencies of panic and hyperventilation attacks, some of which resulted in emergency room visits. A control group was also evaluated, and its participants’ nutrient levels compared to those of the primary group.
Upon evaluation, researchers noted that both vitamin B6 and iron were lacking in the subjects with anxiety and hyperventilation issues, while those in the healthy group had adequate levels of these important nutrients. B vitamins and iron are particularly important for the synthesis of tryptophan into serotonin, a neurotransmitter that regulates not only mood and mental stability, but also sleep and cardiovascular function.
“These results suggest that low serum concentrations of vitamin B6 and iron are involved in PA (panic attacks) and HVA (hyperventilation),” wrote the authors in their study conclusion. “Further studies are needed to clarify the mechanisms involved in such differences.”
Supplementing with whole food-based vitamins may promote better mental health
Though this particular study did not identify a link between general deficiencies of other B vitamins like B2 and B12 and high frequency or intensity of panic attacks, all B vitamins are important for healthy brain and bodily function. A deficiency in any B vitamins, in other words, can lead to mental health problems, which is why it is important to keep your levels in check.
“Chronic stress, poor diet, and certain medical conditions can deplete the body’s stores of vital nutrients,” explains one source about the important of B vitamins. “Many of those who suffer from agoraphobia (fear of crowded spaces or enclosed public places) are deficient in certain B complex vitamins, and this may be the case for other anxiety-related conditions as well. Symptoms of vitamin B deficiency may include anxiety, restlessness, fatigue, irritability, and emotional instability.”
If you are looking to supplement with B vitamins, be sure to purchase only whole food-based varieties like those produced by companies like MegaFood and Garden of Life. Whole food-based supplements of any kind are not only better absorbed by the body than their synthetic counterparts, but they are also healthier than standard, run of the mill vitamins and better capable of providing optimal therapeutic benefit.
“Vitamins are made up of several different components – enzymes, co-enzymes, and co-factors – that must work together to produce their intended biologic effects,” explains Dr. Ben Kim. “The majority of vitamins that are sold in pharmacies, grocery stores, and vitamin shops are synthetic vitamins, which are only isolated portions of the vitamins that occur naturally in food.”
One minute you’re snoozing peacefully, the next you’re wide awake in the dead of night. Sound familiar? Unless you’re blessed enough to conk out like the most determined of logs, you may have experienced this form of sleeplessness before. Waking up during the night isn’t uncommon—a study of 8,937 people in Sleep Medicine estimates that about a third of American adults wake up in the night at least three times a week, and over 40 percent of that group might have trouble falling asleep again (this is sometimes referred to as sleep maintenance insomnia).
So, what’s causing you to wake up in the middle of the night, and how can you stop it from happening? Here are eight common reasons, plus what you can do to get a good night’s rest.
1. Your room is too hot, cold, noisy, or bright.
Your arousal threshold—meaning how easy it is for something to wake you up—varies depending on what sleep stage you’re in, Rita Aouad, M.D., a sleep medicine physician at The Ohio State University Wexner Medical Center, tells SELF.
When you sleep, your body cycles through different sleep stages: 1, 2, 3, 4, and rapid-eye movement (REM). (Some schools of thought lump together stages 3 and 4.) The first stage of sleep is the lightest, Dr. Aouad explains. That’s when you’re most likely to startle awake because a door slams, a passing car’s headlights shine into your window, or because of some other environmental factor like your room being too hot or cold.
Ideally, your room should be dark, comfortably cool, and quiet when you sleep. This might not all be under your control, but do what you can, like using earplugs and an eye mask to block out errant noise and light, or buying a fan if your room is stifling.
2. You have anxiety.
“Anxiety can absolutely wake you up at night,” Nesochi Okeke-Igbokwe, M.D., a physician in New York, tells SELF. In fact, trouble sleeping is one of the most common symptoms of an anxiety disorder, according to the Mayo Clinic. That’s because you can experience anxiety-induced issues that are severe enough to rouse you, like a galloping heartbeat or nightmares.
“Additionally, there are people who may experience what are called nocturnal panic attacks, meaning they may have transient episodes of intense panic that wake them up from their slumber,” Dr. Okeke-Igbokwe says.
If your anxiety regularly wakes you up, Dr. Okeke-Igbokwe recommends mentioning it to your doctor, who should be able to help you get a handle on any underlying anxiety or panic disorder at play. Doing so may involve cognitive behavioral therapy, anti-anxiety medication, or a combination of the two. “Meditation and deep-breathing exercises can also sometimes alleviate symptoms in some people,” Dr. Okeke-Igbokwe says.
3. Your full bladder can’t wait until the morning.
Nocturia—a condition that’s generally viewed as getting up to pee at least once during the night, though some experts say that’s not often enough to qualify—appears to be fairly common. A study in the International Neurourology Journal found that out of the 856 people surveyed, around 23 percent of women and 29 percent of men experienced nocturia.
Causes of nocturia include drinking too much fluid before bedtime, urinary tract infections, and an overactive bladder, per the Cleveland Clinic. Untreated type 1 or type 2 diabetes may also be a factor; having too much sugar in your bloodstream forces your body to extract fluid from your tissues, making you thirsty and possibly prompting you to drink and pee more, according to the Mayo Clinic.
If cutting back on your evening fluid intake doesn’t reduce your number of nightly bathroom trips, consult a doctor for other possible explanations.
4. You had a couple of alcoholic drinks.
Sure, alcohol can make it easy to drift off—even when you’re, say, on a friend’s couch instead of tucked into your bed—but it also has a tendency to cause fitful sleep. This is because alcohol can play around with your sleep stages in various ways. For instance, it seems as though alcohol is associated with more stage 1 sleep than usual in the second half of the night. Remember, stage 1 sleep is the period in which you’re most likely to wake up due to environmental factors. So if you’re looking for quality, sleep-through-the-night rest, it’s worth taking a look at how much alcohol you’re consuming.
Everyone metabolizes alcohol differently depending on factors like genetics, diet, and body size. However, Alexea Gaffney Adams, M.D., a board-certified internist at Stony Brook Medicine, recommends that people stop drinking at least three hours before going to bed to give their bodies time to process the alcohol. Since drinking often happens at night, we realize that can be an optimistic time cushion. Based on your personal factors and how much you drank, you might not need that much. But having some kind of buffer—and drinking plenty of water so you’re more likely to booze in moderation—may prevent alcohol from interfering with your sleep.
Also, Dr. Gaffney Adams notes that drinking alcohol too soon before bed will make you need to pee, increasing the likelihood you’ll wake up in the night to use the bathroom. Double whammy, that one.
5. You’ve got sleep apnea.
If you find yourself jolting awake and feeling like you need to catch your breath, sleep apnea might be the culprit. This disorder slows and/or stops your breathing while you are asleep.
If you have obstructive sleep apnea, the muscles in your throat relax too much, which narrows your airway, causing your oxygen levels to drop, the Mayo Clinic explains. If you have central sleep apnea, your brain doesn’t send the right signals to the muscles controlling your breathing, again causing this potentially harmful drop in oxygen. Complex sleep apnea features characteristics of both conditions.
To diagnose sleep apnea, your doctor may have you do an overnight sleep study that monitors your breathing, according to the Mayo Clinic. The most common treatment for sleep apnea is a continuous positive airway pressure (CPAP) machine, which is basically a mask you wear during sleep to help keep your airways open, but your doctor can help you explore the alternatives if necessary.
6. You have an overactive thyroid gland.
“This gland controls the function of several other organs,” Dr. Gaffney Adams tells SELF. When it’s overactive (also called hyperthyroidism), it creates too much of the hormone thyroxine, which can have ripple effects on many different systems in your body, according to the Mayo Clinic. Common symptoms of an overactive thyroid include trouble sleeping, an increased heart rate, sweating (including at night), anxiety, tremors, and more.
Your primary care physician or an endocrinologist (a doctor specializing in hormones) can test your blood to evaluate your hormone levels. If you do have an overactive thyroid, your doctor can walk you through the potential ways of treating it, including medications to slow your thyroid’s hormone production and beta blockers to reduce symptoms like a wild heartbeat.
7. You ate right before bedtime, or you didn’t eat recently enough before you went to sleep.
“Eating too heavy of a meal too close to bedtime can make it difficult to fall asleep or stay asleep,” Dr. Aouad says. One potential reason behind this is acid reflux, which is when your stomach acid moves up into your throat and causes painful nighttime heartburn. And if you eat food right before bed that makes you gassy, the resulting abdominal pain could drag you out of dreamland, too.
On the flip side, going too long without eating before you sleep can also cause this type of insomnia, Dr. Aouad says. There’s the simple fact that your growling, crampy stomach can wake you up. Hunger could also mess with your blood sugar while you sleep, especially if you have diabetes. Going too long without eating can provoke hypoglycemia, which is when your blood sugar drops too low. This can lead to restless sleep, per the Cleveland Clinic, along with issues like weakness or shaking, dizziness, and confusion. Although hypoglycemia can happen to anyone, it’s much more likely in people with diabetes. If you have the condition, work with your doctor on a plan for keeping your blood sugar stable, including during sleep.
8. You have restless legs syndrome.
Restless legs syndrome, or RLS, may make your lower extremities feel like they are throbbing, itching, aching, pulling, or crawling, among other sensations, according to the National Institute of Neurological Disorders and Stroke (NINDS). If you have RLS, you’ll also feel an uncontrollable urge to move your legs. These symptoms are most common during the evening and night and become more intense during periods of inactivity, like…you guessed it, sleep.
Experts aren’t totally sure what causes RLS, but it seems as though there’s a hereditary factor in the mix, according to the NINDS. Researchers are also investigating how issues with dopamine, a neurotransmitter your muscles need to work correctly, may cause RLS. Sometimes there are other underlying issues bringing about RLS as well, such as iron deficiency.
After diagnosing you with RLS via questions and lab exams, your doctor may prescribe medications to increase your dopamine levels or other drugs, such as muscle relaxants. They may also be able to counsel you on home remedies to soothe your muscles, like warm baths.
To sum it up, there are a bunch of possible reasons you are waking up at night. Some are pretty easy to change on your own, others not so much.
If you think all you need to do to fix this is tweak a habit, like falling asleep with the TV on or chugging a liter of water before bed, start there. If you’ve done everything you can think of and still don’t see a change, it’s worth mentioning your nighttime wakeups to an expert who can help you stay put after you drift off.
Are you sick and tired of being afraid all the time?
I was. There was a time in my life when I had trouble getting out of bed. Thinking of that time in my life, I realize that was not a life at all. In fact, being overwhelmed , panicked, and stuck in suffering is not something I’d wish on my worst enemy. I was exhausted and beaten down. I felt helpless and vulnerable. I was anxious about dying or losing someone that I loved. I worried about living through war, being murdered or being in a plane crash. I also stressed over what people thought of me and about making a fool of myself. My mind ran 100 miles a minute and this immobilized me making me panic more.
There was no joy or peace in my world. It was not a life I wanted to live.
Anxiety and fear may hold you back from doing everything you want to do, but it doesn’t have to.Pixabay, Public DomainAs a social worker in an outpatient psychiatric clinic, I was supposed to be helping people like me and I felt like a fraud. When I’d hear about cases during our weekly clinical meetings I was horrified thinking I was worse. My anxiety was worse than my coworkers hardest clients. I began to get angry at my anxiety. And that’s when I decided that I needed to get better: For me, for my new growing family and for my present and future clients. I needed to grab my mindspace now monopolized by anxiety and put it toward making the world a better place.
I had to stop giving fear power and start giving myself power, I just didn’t know how. So I tried one thing, and then another, and then another. Some things worked and some didn’t but I didn’t give up. Step by step, I figured it out.
In this video I outline the exact four steps I took to break down the fear and move on to a happy future. Number four is the most important! It took me years to get this one. Without it, I improved a little, but kept having to work very hard for minuscule results. Here are the four things that I did to get my life back on track. Please do these if you are sick and tired of letting fear stop you from living your life:
Commit to getting over your fear.
Formally decide that you want to do this and you’re not going to let anything stop you! People all the time overcome their fears, so you can too. And don’t say that you’re worse than all of them because I swear, you’re not.
Break it down.
Fear has all kinds of power, and it’s built itself up in your mind and in your life. It builds itself up through all kinds of evidence that makes you feel it’s true — failing a test or getting rejected by someone, for example — and this makes you feel like you should be afraid. Anxiety gets so invasive in our heads that we have difficulty clarifying what we’re afraid of. The anxiety usually doesn’t have too much beyond that, and if we break that down, we begin to see that there’s not much to be afraid of.
Take action.
Do something, even if you’re just pacing back and forth. You can also take a walk or partake in sports — any repeating movement will help you feel better as it takes your mind off your worries. Use your action to settle your worries. If you are afraid of losing someone you love, spend time with that person so you have no regrets. Or, when a natural disaster strikes far away, don’t allow yourself to be overwhelmed with helplessness. Gather supplies to send to the affected community to help them rebuild. Get involved in the healing.
Love yourself through it.
Be kind to yourself! Anxiety and fear is not something to beat yourself up about — it happens to everyone and getting worked up about it will just make it worse. Be gentle and understanding with yourself. Tell yourself, “I understand.” when you feel anxious. And then, when you do something to help yourself, consciously appreciate yourself for it.
Anxiety, whether in the form of generalized anxiety disorder, panic attacks, or just an anxious day, is rough to handle. Oftentimes, the advice anxious people are given to deal with their feelings of panic and worry seems distant, like the person giving the advice has never actually gone through it themselves. ButAsapSCIENCE‘s Jess Carroll has — she’s here to help.
For starters, avoid WebMD; there are a multitude of scary diseases and conditions are enough to worry a non-anxious person. Sure, its convenience is tempting, but spending hours looking up possible symptoms doesmore harm than good, Carroll said. She added that more often than not stomach problems are the result of anxiety, not an ulcer (but still go to your doctor if you think there’s a problem).
Another tip is to H.A.L.T. Carroll said asking yourself if you’re hungry, angry, lonely, or tired can lead to simple solutions, like helping yourself to a snack or meeting a friend for coffee. Figuring out the little ways to manage anxiety is ultimately what keeps it from getting worse. Even something as simple as a deep breathing exercise has the power to reduce anxiety and make the day just a little more bearable.
“For people with mental illness, normal stuff can sometimes feel hard, but it doesn’t make you a failure or a weirdo,” Carroll said. “It just means that you have an illness that you have to be constantly aware of. And sometimes it’s painful, but mostly it makes you the most interesting person in the room.”
Warning. If you have had panic attacks before, some of the imagery here may trigger you. If you start to feel what I call “the whitewater,” stop reading, remind yourself there are no bears, and count out 10 slow steady breaths. We can learn to make panic attacks our friends even though they totally suck. Hopefully this article will help.
If you are reading because someone you love has panic attacks, hopefully the imagery will give you a hint of what it is like. Take that hint and multiply it by a thousand. It can feel that bad; but that’s not the end of the story.
It started the moment I began to glide into the tube. The dread. The ugly rush (not the good kind of speeding fast on skis or your bike). The sick feeling came instantly. The MRI was for my chronic hip and as much as I enjoyed the pictures of purple flowers and blue sky on the ceiling panels before I went into the machine, the images didn’t stick with me.
I’ve had panic attacks periodically since college. Most of them at night. Others when I’m in enclosed spaces. I hadn’t been in an MRI before. An MRI is a very enclosed space.
I’m a big guy, 6 feet, 4 inches, 225. As I traveled through the tube, my shoulders touching the sides of the machine, I got a small reprieve. I’m so tall my head popped out the end. The adrenaline instantly slowed. And unfortunately, I was about to make the classic mistake when a panic attack is triggered by circumstances.
If you are blissfully unaware of the nuances of a panic attack, you can feel it coming. Everyone’s experience is a little different, but whether it is your stomach, chest, or a feeling of awful foreboding that signals the whitewater about to rage through your body, you know what’s about to happen.
Full scale panic attacks feel like you are going to die. It could be physical symptoms that manifest like a heart attack or emotional overload that makes general anxiety feel like a vacation. A panic attack makes you think you are going stark raving nuts. 2.7 percent of the American population, that’s six million people, struggle with panic disorder. Studies have shown that 5 to 10 percent of people have them during an MRI.
Multiple parts of the brain go into overdrive during a panic attack. The amygdala oralarm responsible for keeping us safe and midbrain regions responsible for pain and defense like running or freezing go into hyperdrive. When they send too many hormones and the parasympathetic nervous system doesn’t compensate, it truly feels like your world is coming to an end even though you are completely safe.
What was different for me with this attack is that I knew exactly what was happening. A panic attack often comes without warning, and the extreme symptoms last around ten minutes. The out-of-nowhere quality to many attacks only jacks up the terror. You feel completely out of control. You have no idea why your body is doing this or how to stop it.
My MRI experience was truly controlled. I knew when I recovered from the initial surge as I entered the machine that I could do my mindfulness exercises and be fine. I counted my breathes. I imagined myself in a safe space. I made up techno songs to the loud beat of the machine.
Then, I made my mistake. I started imagining using a machine like this for therapy. As exposure therapy can help some people recover from trauma, why couldn’t exposure to small spaces help us make friends with our alarms’ hyperactive tendencies. As I write about and coach brain health, I’m always looking for ways to integrate theory with solutions that help us feel better in our own skins.
I had been in the machine for five cycles totally 16 minutes; I was almost done. My thinking caused my alarm to kick in hard.
I remembered a CSI episode when one of the detectives was trapped in a coffin being eaten by ants. I imagined my self being in a coffin. I opened my eyes, trying to fight the rising tightness. I looked at the ceiling (that made it worse). I couldn’t move (I felt completely trapped). My feet were taped together (I began to lose it).
Just writing now I can bring up the sick feeling. Then the next cycle of sound kicked in. It was louder, more like bullets. I lost it.
Then I couldn’t find the balloon. The balloon is what they give you to squeeze if you melt down. I was melting down. If I could have grabbed the balloon, knowing I could get out if I needed to, maybe I could have breathed back into the moment. Not being able to find it was like losing a child in a crowd at the zoo.
I started screaming, “Help, help.” The worst part at first was watching myself cave in. I knew what was happening, but my conscious self couldn’t stop my old brain. I waved my hands. It probably took less than ten seconds from the start of the collapse for them to get me out.
It took another three or four minutes for the adrenaline to cascade. I didn’t think I could get it back under control at first. As usual, I was sweating. My heart thumped like a jack hammer. I couldn’t shake the sick feeling.
That’s what the alarm in our brain does in normal circumstances to get us out of trouble, aka away from lions, tigers, and bears. In this case, the alarms signals had no place to go. I couldn’t move or leave the situation. So it kept flooding my system until I did get out of there.
And after a few minutes and enough breathing, my frontal lobes began to kick in again. I had to finish the test. It was strange to know I was safe and have my body still reject reason. But once I was breathing normally, I closed my eyes, imagined I was on my grandmother’s porch, and finished the session. I have done this exercise enough that it worked, I made it through the last cycle (barely), and I walked away from the experience fascinated.
If I couldn’t stop my old brain from kicking in, what do we all need to do when panic attacks and their little brother anxiety keep us on edge all the time.
1. Remind yourself you’re not crazy. When we experience panic attacks in places where we are entirely safe, we can feel like we’re losing our minds. That unsettling feeling that lingers (I’m still having aftershocks five days later) is still your alarm. There is nothing wrong with you; our brains simply haven’t evolved enough yet to prevent this from happening to millions of us. Again, they suck. And, you can learn to recognize their signs, hopefully prevent a full-scale attack, and if not, at least recover quicker.
2. Practice mindfulness exercises when you are well. The secret to brain health is to be mindful all the time. You can’t use breathing exercises in an attack if you haven’t practiced them regularly when you are well. We have to create the neural pathways before we need them. Whatever mindful practice you do, do it regularly and often.
3. Have a friend to call who understands. We may still have attacks. We may not be able to figure out why; brains are still more mysterious than understood. Find that person who understands, who knows what you need to hear to feel better. Each of us need a different kind of support and there is someone in your life you can call. Let them know how important they are to you before you need them and they will happily listen when you need them.
4. Change your memory of the experience. Studies show our brains are plastic and can be trained. Memory, it turns out, is also pliable. The memory of past attacks is, in part, what causes the deeper fear of the next one. These attacks do not have to be seen as bad things. Again, they are terribly painful, but if we change our memories of the past experience, remembering how the panic helped us live differently, learn more, or appreciate our ordinary times in a new way, maybe it can help prevent future events.
5. Reframe the experience. And if we can’t stop them, we have to reframe them. Studies show that we can turn down the alarms in our brains by taking something awful, like a panic attack, and describing it unemotionally or in a helpful way. Hence, the whitewater. The technique is called reattribution. Rafting whitewater is insanely fun. While a panic attack may never be a joy, recovering from it can be something we decide to make meaningful. Name your experience. Own it as something you take control of the moment the adrenaline begins to cascade.
You are not your panic attacks and they can become something we make friends with. And maybe that’s what we need for them not to come back again.
ARYAN'S BLOG 