What Is A Panic Attack? Blogtober – Day 22

First thing’s first – what is a panic attack? The HSE say that a panic attack is ‘a feeling of sudden and intense anxiety.’ That definitely sounds unpleasant but if you’ve never experienced a panic attack, it can be difficult to imagine what that actually feels like. If I have a loved one who would like to understand I ask them to imagine the thing they truly fear the most in the world and then imagine how they would feel if that thing were to actually happen. Now imagine feeling that level of intense fear and anxiety totally out of the blue. Imagining it is obviously not entirely the same thing but it goes some way towards helping them understand. (I just want to point out that I don’t go around asking people to think of the thing that scares them the most because that’s not nice, please don’t do that! However, if a loved one specifically asks then I’ll broach it.)

There are a ton of symptoms that come with panic attacks and different people experience different ones. Symptoms can include:

  • A racing heart, a pounding heart or palpitations
  • Chest pain or discomfort
  • Feeling short of breath or as though you can’t get enough oxygen
  • Hyperventilating (breathing too fast which speeds up heart rate)
  • A sensation of choking
  • Sweating
  • Trembling or shaking
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, light-headed or faint
  • Chills or heat sensations
  • Numbness or tingling sensations
  • Intrusive thoughts
  • Uncontrollable crying
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • A fear of losing control or “going crazy”
  • A fear of dying

Given the symptoms, it’s not surprising that many people think they are having a hear attack but it’s important to know that a panic attack will not kill you.

Panic itself is a good thing, it’s kept us alive for years. The ‘fight or flight’ response alerts us to potential danger and allows us to act in an appropriate manner. However, problems arise when this response is switched on when there’s no need, when there is no danger. It’s almost like a house or car alarm going off without reason.

There isn’t a definite answer as to why panic attacks occur*. Some people have specific triggers that they can easily identify such as particularly stressful events (losing a job, death of a loved one, etc) or major life changes (graduating college/uni, having a baby, getting married, etc). Panic attacks can also present with other illnesses. For example, a person with social anxiety disorder may have a panic attack before they’re due to give a presentation. Those who have experienced a panic attack may be so fearful and anxious about having another one that they develop panic disorder.

So, what can you do if you have a panic attack?

  • Try to remember that the panic attack can’t hurt you. It is no doubt unpleasant and frightening but you will be okay.
  • If you are hyperventilating try to focus on slowing your breathing. Breathe in for 4, hold for 1, breathe out for 4.
  • Try to focus on something other than the panic attack. Pick an object nearby and notice everything about it. Describe it to yourself in as much detail as possible. Sometimes drawing your attention away from the panic attack can stop it.
  • If your surroundings aren’t what triggered the panic attack pay attention to them. Do your best to ground yourself wherever you are. For example – I’m safe, I’m sitting at home, there’s nothing here that will hurt me, the tv is on, I can hear the clock, I can hear the birds outside, I know this place, I’m safe.
  • If your surroundings are causing your panic attack try closing your eyes (if it’s safe to do so!). Sometimes reducing stimuli can stop a panic attack.

If you’re experiencing panic attacks speak to your healthcare provider. There’s no need to be embarrassed about having panic attacks. Around 2.4 million Americans experience panic disorder in a given year** so you’re not alone and it’s likely that your doctor will be familiar with them. There are medications that can be used to help treat chronic panic attacks (panic disorder) as well as a number or therapies such as CBT or DBT so don’t feel like you’ll be stuck having them forever.

I lived with panic disorder for almost ten years. When it was at it’s worst I had several panic attacks every single day. It was so bad for me because initially I didn’t know what was happening and I didn’t have help. However, once I did have support and I was able to educate myself I found that the panic attacks subsided. I haven’t had one in almost five years but if I was to have one, I’d know how to deal with it. It can get better, there is hope.

Lastly, remember to be kind to yourself. Panic attacks are truly exhausting so give yourself a break! Take time to recover. If you are a loved one of someone who experiences panic attacks, keep in mind that they’ll probably be emotionally and physically drained after experiencing a panic attack, they may also be fearful of having another so do your best to let them know you’re there to support them.

*https://www.psycom.net/what-does-a-panic-attack-feel-like/

**http://www.fearclinic.ufl.edu/PanicDisorders.html

Need help or advice? Click here for a list of support charities and organisations.

My Mental Health Story – Blogtober Days 9, 10 & 11

TW: Depression, anxiety, social anxiety, depression, self harm & overdose. I adhere to best practice when writing about mental health so there are no explicit details in the following post.

I’ve been blogging about mental health for over a year now. During that time I’ve shared snippets of my own experiences but I’ve never shared them in full. I didn’t post anything for days 9 and 10 of Blogtober because I was busy writing this. I had intended to share it yesterday, on World Mental Health Day but it didn’t feel right so I held off. WMHD is a fantastic initiative and it was great to see so much conversation around mental health but I think it’s important to remember that mental health is for everyone, every day and not just on Hashtag Holidays. Anyway, here’s my story in full for the first time…

My mental health journey began at five years old. My very first teacher wrote on my school report ‘anxious at times.’ It seemed to set the tone for the next fifteen years.

I don’t remember a lot of my childhood before the age of ten but there are some stand out moments. Some of the best memories are  of my first day of school, my first nephew being born and getting a bike from Santa one Christmas. Other memories aren’t so great. I watched as a new neighbour moved in, a girl I wanted to be friends with but I was absolutely terrified to speak to her, we did eventually become friends (hi Ailish!) but that feeling of terror became a familiar one. I often left the classroom to avoid situations that I was afraid of such as reading aloud and after a particularly bad day, my teacher pulled me aside to ask if I was sick because I was spending so much time in the bathroom. I was sick but not in the way she was thinking and I didn’t know how to explain that. When I was eight an aunty of mine passed away after months of battling cancer. We spent a lot of time at her house while my mam helped care for her. I knew she was ill but I didn’t understand the severity of it and I was shocked when she died. My family was doing their best to protect me from it but you can’t protect anyone from the reality of death. Her passing had a massive impact on me but I didn’t realise quite how much until about eight years later. As a child I constantly worried about ‘something bad’ happening to my parents when I wasn’t there which made being in school or at a friend’s house difficult. I struggled with that a lot more at night time so I’d often get upset and be unable to sleep which had a knock on effect the following day.

I moved house and school when I was nine. At my new school I made friends pretty quickly but I still struggled with the overall situation. By all accounts I was a bright child and I loved learning (I still do, I’m a nerd!) but the classroom environment was a big issue for me. I began to have panic attacks at twelve years old. Everyone, myself included, seemed a bit baffled by that – nobody really knew anything about them or how to handle them. I had no idea what was happening to me and my parents were concerned that there was something physically wrong with me so I had lots of tests done to be sure that I was physically well. I did have asthma but the majority of these attacks weren’t asthma related. In school, when I would have a panic attack my teacher would move me to a table at the back of the classroom where I would sit and sharpen a box of pencils. As a more educated adult I can assume that they thought that giving something else to focus on might help me but it didn’t. It made me feel more separated from the rest of the class, it further marked me out as different. However, at the time, I didn’t know what I needed and even I had known, I wouldn’t have had the language to explain it.

My first year of secondary school continued in much the same way. I would have a panic attack and be put on the side, sent to the sick bay or excused from class to get some fresh air. By age fourteen and in Second Year, I was really mentally unwell. I was having multiple panic attacks every single day and they were so draining. I wasn’t sleeping well and I’d spend most nights crying because I was dreading the next day so much. I felt like I was losing my mind.

At that point I was invited to join the Rainbows Programme in my school along with attending a thirty minute session with the school counselor once a week. Both the woman running the Rainbows group and that school counselor have had a massive impact on my life. I’m so grateful to have had them. I think of them quite often and wish I had a way to contact them ten years on. Rainbows and the counselling service were great resources. However, I don’t believe either can cope with being the only support available for hundreds of students (more on this in a later post!). In my opinion, as a result of that, warning signs were missed and it’s quite possible that it’s still the case.

The following year I was approaching my fifteenth birthday and I was incredibly mentally ill. One morning, over breakfast, my mam asked if I was feeling depressed. I didn’t fully grasp what that meant, I’d never heard it spoken about in any detail at home or in school but it seemed like saying yes was the right thing to do. My mam was great, she arranged an appointment with my GP right away. I can’t remember the appointment itself but I know that I left with a prescription for Xanax. I took the medication but it didn’t suit me. I was walking around like a zombie, I wasn’t present any more. I was going through my days knowing things were happening and that people were interacting with me but it was as if I was behind a pane of glass where I couldn’t reach anyone. Thankfully, my mam noticed and asked for my medication to be changed. It took switching medications a couple of times for me to find the one that suited me best in terms of side effects but I still didn’t feel as though it was helping.

Life continued in a similar fashion until 2008. By then I’d been self harming in various ways for months. Every night I was crying my heart out on the bathroom floor. Every school morning I was vomiting from the intensity of the anxiety I was experiencing. I went to school but I was rarely in class because of the panic attacks and when I was there I couldn’t keep up with the work because I’d missed so much. I rarely lasted a full day in school. My parents would get a call from the school most days asking if I could go home. At this point they asked if I was missing so much school because I was being bullied but I wasn’t at that time. The next logical conclusion for them was that I was just acting out, being a troublemaker. They were frustrated that I was missing so much school and they tried everything to get me to stay there. They couldn’t see what was going on and I couldn’t tell them. They tried to frighten me in to staying in school by telling me they’d make me change schools, that they’d send me to a boarding school or even send me to live with relatives in England. They were at the end of their tether. The relationship between my parents and I began to suffer. I began to feel angry all the time. I was angry that I was surrounded by all of these adults but none of them could see that I was in serious need of help. I was experiencing angry outbursts over seemingly insignificant things. My mam would ask me to empty the dishwasher and I’d start a full blown shouting match. I couldn’t regulate my responses. I was constantly ready to blow up over anything. I think my family saw that behaviour partly as teenage mood swings and partly as me trying to make life more difficult. I turned that anger inwards and the self harm became worse. ‘Why can’t I just be normal? Look at what I’m doing to my parents. My family hate me. Why do I feel this way? Why can’t anyone else see it? Am I crazy?’. It took me a long time to realise it but I held on to that anger for years. Anger at everyone around me and anger at myself.

I didn’t know how to tell them what was going on with me, I thought it was in my head, that I was abnormal. Neither my teachers or family had the knowledge to realise what was happening. It wasn’t their fault and it wasn’t mine.

Approaching the summer of that third year of secondary school, I attempted to take an overdose in school but I was interrupted. A goodbye text I had sent to a friend was shown to a member of staff, my parents were called to the school, I was found and brought to them. They had been told everything. The school principal told me that I would be leaving with immediate effect so that I could get help. I wasn’t sure what came next.

I want to break the narrative here for just a moment to be really clear about something – I am so glad that I was interrupted that day, that my friends told a member of staff what was happening. I didn’t want to die. I wanted to be free of the immense pain and turmoil I was feeling every minute of every day and, in the state I was in, death seemed like the only way to achieve that but it wasn’t the only way. I will always be sorry that my teenage friends had to deal with that. I have apologised and thanked them since but I wish it had never gotten to that point. Those friendships were changed by the events of that day and what followed. I’m no longer in contact with most of those people and I’ll doubt they’ll ever see this but I hope they know that they saved a life that day. Anyway, back to it…

My school let me return after a few weeks under a new set of rules. My parents and I met with the principal who had drawn up a ‘contract’ for me to sign before returning to class. I can’t remember every rule from it but the ones that have stuck in my mind are that I wasn’t to be alone, including going to and from school, going to the bathroom and during lunch. I wasn’t allowed to speak to any student about the events leading up to my ‘break’ from school or anything that took place while I was away. If I was feeling down or struggling again (I was never not struggling, those couple of weeks off school didn’t magically make me better) I wasn’t to discuss it with any student including friends. I signed it like I was supposed to and I stuck to it.

I can 100% understand the need to safeguard other students but that ‘contract’ really affected our relationships. My friends wanted an explanation and I couldn’t give it to them. I was pretending to be someone I wasn’t, they could tell but I couldn’t do anything about it. I couldn’t risk getting kicked out of school and upsetting my family even more. I became isolated in school, rumours began. I’d had quite a large group of friends up to that point but now I found myself with just one who wasn’t in the same year as me. She really kept me going through those times but  not having a friendly face around for most of the day was difficult.

Over the next eighteen months I made a couple of new friends and I became close to one of the girls I’d been friends with previously but understandably she felt caught in the middle. I was still having issues with those former friends. I would find thinly veiled comments about me online, they would whisper, point and laugh while sitting behind me in classes or while walking the corridors at lunch. One of them wrote me a very scathing letter telling me she never wanted anything to do with me again and had someone else deliver it to me which led to a screaming match in the middle of a hallway during lunch – not ideal!

Things weren’t great outside of school either, my dad had a heart attack, a relative had died which brought up some of the feelings I hadn’t dealt with years before and my mam was diagnosed with cancer. I was seeing CAMHS and on medication but the meds didn’t seem to agree with me and seeing different doctors at the CAMHS sessions meant I couldn’t build a rapport with anyone. My sessions weren’t frequent enough or long enough for me to feel any benefit from them so even if I did get to see the same doctor for a couple of sessions it didn’t make a difference.

Eventually, it all became too much and after a heart to heart with my mam, I made the decision to leave school in December 2009, six months before I was due to sit my final exams. I left because I knew that if I continued on I would end up at crisis point again. It was the right decision but it didn’t lessen the heartache of seeing my friends prepare for their exams and college. I began to feel alone again because I was missing all the ‘in jokes’ and conversations happening at school.

The following six years were tumultuous. I started jobs and courses because I felt like I should but I wasn’t ready. I couldn’t cope and I ended up leaving all of them. The panic disorder didn’t have so much of a grip on me but the social anxiety was worse. I couldn’t get a bus or taxi on my own, I couldn’t interact with retail staff, I couldn’t make a phone call, some days I couldn’t leave the house at all. I switched from CAMHS to adult mental health services where I would often be waiting an hour passed my appointment time just to see a another doctor that I’d never met before. They would run through their  checklist –

  • In the past month have you had any thoughts of killing yourself?
  • In the past month have you engaged in any self harming behaviour?
  • Have you been sleeping well?
  • Have you been eating well?
  • Are you currently a risk to yourself or anyone around you?
  • Have you been taking your medication?

Then I would be given my next appointment date and sent on my way. It wasn’t the doctor’s fault that they couldn’t give me or their other patients more time. They were overstretched and struggling to meet the demand of so many cases.

Labels don’t work for everyone but, for me, the one benefit of attending HSE mental health services was getting formal diagnoses of Depression, Panic Disorder and Social Anxiety Disorder. Having that information allowed me to find a community of others who were experiencing the same thing I was, which meant I felt less alone. I realised just how many people went through what I did. I found peer support. Most importantly, I was able to educate myself which is exactly what I did. That’s when ‘recovery’ (more on this in a later post!) became a possibility.

In 2015 I decided to return to education as an adult and over the next eighteen months I gained three qualifications and secured a place on a bachelor’s degree. I wasn’t entirely well during that time. I never managed to do a formal presentation and I missed a lot of Tuesday classes because I found that day particularly difficult to cope with but I did manage to finish all three courses and I left with great results.

The results weren’t the best part of the course though, the people were. I’d always joked that I hated people to cover up the fact that I found it difficult to interact with more than one person at a time but those people changed that for me. They embraced my quirks, they supported me and they made me laugh every day (they even made me laugh about those Tuesdays!). Most days I looked forward to going to school because I knew they would be there. They probably don’t know the impact they had but I don’t think I’d have gotten through that year and a half without them.

I began my degree and I was really enjoying it but I had to leave it after a few months because of a problem with my hip. It derailed me somewhat and I began to struggle again. I felt like I was letting people down. I applied for and got a job hoping it would ease some of the guilt I was feeling but I couldn’t cope and I quickly left. I realised that if I was to be well again I had to go back to basics and figure out what would get me well and help me stay that way.

The past year and a half has been good. Sure, there are still some bad weeks but they’re never as bad as they once were and if I was to get to that crisis point again I know I have an action plan to get help. The problem with my hip hasn’t been resolved yet but physiotherapy has made it more manageable. I’ve been able to return to education part time where I’m studying Mental Health in the Community. I have this blog that enables me to interact with so many passionate and inspiring mental health bloggers and advocates every single day. I have a wonderful partner, friends and family who do their absolute best to understand and support me when I’m not doing so well. There might still be times when I struggle, in fact I’m sure there will be, but now I can see how good life can be, I know that I am capable of so much, I have hope and that changes everything.

 

There will be some posts coming up looking at youth mental health in Ireland, initiatives currently taking place and some questions about what happens next.

This was very long for one blog post so if you’ve managed to stick it out to this point, thank you.

If you need help or advice you can find a list of charities and organisations here.

Mental Health or Mental Illness

​Are mental illnesses real? Is there a difference between mental health and mental illness? Does it have to be one or the other? Do we ‘suffer’ with mental health?

I’ve seen some discussion around this in recent months and I’ve been thinking about it quite a bit. There seem to be two main views when it comes to this argument. The first is that mental illness doesn’t actually exist but rather we’re all on a spectrum of mental health throughout our lives and should be treated as such. The second view that I’ve seen quite a lot of is that mental illness is very real, it should be treated with medication and if other people are saying they are having difficulties without a diagnoses they are being dramatic/they need to just get on with things/they should just man up.

I can only ever speak from the point of view as a service user, patient and someone with an interest in mental health so please don’t take my view as gospel, it’s just my personal opinion. I don’t fall in to either of the above camps. However, I think they both have some valid points. I agree that we are all on a spectrum of mental health but I think that mental illness is very much part of that spectrum and I agree that medication is often needed to treat mental illness but I don’t think it should be the only treatment.

There is a lot of stigma surrounding conversation about mental health and illness. We’ve gotten much better at speaking in statistics but we’re not so great at talking about the reality of either. Often times those who are struggling will carry that in silence for many reasons – fear of being treated differently, fear of a label, shame that they’re not doing better, etc. I think if we were more open to the idea of mental health as a spectrum this wouldn’t be such a big issue.

Here’s the thing – WE ALL HAVE MENTAL HEALTH. 

we-all-have-mental-health

We all have mental health and we all have it for the entirety of our lives, not just when times are difficult. I often hear people saying ‘I suffer with mental health’, is that the right way to phrase that? If we’re always saying we’re ‘suffering’ with mental health then mental health becomes something negative. It may seem like a trivial thing but when that’s all we’re seeing it becomes ingrained and before anyone has realised we’ve subconsciously associated mental health with something ‘bad’. 

I try to stay away from saying that I am ‘suffering with mental health.’ I chat will simply say that I’m not well in the exact same at that I would if I had a cough or cold. A majority of the time the person I’m conversing with will ask me in what way I feel unwell and I have no problem telling them ‘I’ve been feeling down lately/I’m really burnt out/I’m overwhelmed with anxiety right now.’ Was it a bit odd to answer so plainly initially? You bet it was! There were a couple of times that the person I was speaking to seemed taken aback and maybe a little unsure about how they should respond but now it’s become normal for myself, my friends & my family. It’s important to challenge the way we speak about mental health and illness. Now, we speak about mental health in the same way we speak about physical health. It’s the equivalent of saying ‘I have a headache’. 

And that makes much more sense, right?

Mental health is not something that is inherently bad or good, it simply is. We all have physical health that is on a spectrum and we do things to take care of it – go for check ups, eat well, exercise. We all have mental health, shouldn’t we treat it in the same way? The reality is that the majority of us don’t, we ignore it until there is a crisis.

Maybe if we had a shift in attitude towards our mental health we would then treat mental illness and crisis differently? Mental illnesses are very real and they need treatment just like any other illness needs treatment. To say that mental illnesses don’t exist undermines the work of thousands. It takes away the relief felt by a patient when they finally get a diagnoses and treatment plan. Maybe if we treated mental health like physical health we would view a person with depression/anxiety/bipolar/etc in the same way we view a person with cancer/epilepsy/heart disease – with empathy and compassion, not fear, judgement and mistrust.

To me, it seems like we need to overhaul our attitudes. We need to recognise that everyone goes through tough times, that they may need emotional support but not necessarily require medication. We need to see that a majority of these people will not receive a clinical diagnoses but that doesn’t invalidate their experience. We also need to recognise that some people do have an illness, that they will receive a clinical diagnoses, that they need a treatment plan that is right for them and their experience is valid too.

It doesn’t have to be one or the other.

What are your thoughts? Do you think mental illnesses are real? Do you think mental health is a spectrum? Do you ltreat your mental health in the same way as your physical health? 

*World Health Organisation 

Need help? Want information? Click here

Mental Health & Illness Charities/Support – Ireland & UK

Need help? Want more information?

The following are Irish Mental Health or Illness charities/support services.

Don’t be afraid to contact someone or do some research – it’s why they’re there.

IRELAND

Mental Health Ireland – ‘MHI’s aim is to promote positive mental health and wellbeing to all individuals and communities in Ireland.’ A fantastic site for information, MHI even provide training to the public. MHI have Mental Health Associations around the country that you can contact for info or volunteer with.

Aware – ‘Aware undertakes to create a society where people affected by stress, depression, bipolar and mood disorders are understood, supported, free from stigma, and are encouraged to access appropriate therapies.’ Aware’s services include Support Mail, Support Groups & Support Line as well as online courses, group education and school based courses. All of these services are free.

Samaritans – ‘We offer a safe place for you to talk any time you like, in your own way – about whatever’s getting to you. You don’t have to be suicidal.’  Samaritans offers a phone support line for anyone who needs to talk. This a non judgmental space, the volunteer you speak to won’t impose their beliefs on you and they’re available every day, no matter the time.

Jigsaw – ‘The National Centre for Youth Mental Health. There to ensure that no young person (age 12-25) feels alone, isolated and disconnected from others around them’ Jigsaw has ‘hubs’ or drop in centres around the country. Here, young people can access support from trained staff, short term counselling, advice and information about other support services that may be of help to them. To find your local centre click the link!

Your Mental Health – ‘YourMentalHealth.ie is a place to learn about mental health in Ireland, and how to support yourself and the people you love.’ This HSE website provides a list of services, real life stories and a wealth of information. Your Mental Health are the folks behind the prominent #littlethings campaign.

See Change – ‘See Change is Ireland’s national programme working to change minds about mental health problems in Ireland…working to create a disruptive, community driven social movement to reduce the stigma and discrimination associated with mental health problems.’ See Change brings together 70+ organisations to work towards a common goal. On the site you’ll find sections the Green Ribbon Campaign, blogs from See Change Ambassadors and Mental Health in the workplace and lots more.

Pieta House – ‘We support people and communities in crisis by providing freely accessible, professional services to all.’ Pieta House have 12 centres around the country where service users can access support for issues around suicide and self harm. A doctor referral is not needed and the service is free. There is also a Freephone helpline and text service available. Pieta House are the folks behind ‘Darkness Into Light’ one of Ireland’s biggest mental health fundraisers that takes place every year.

A Lust For Life ‘A Lust For Life is…an Irish wellbeing movement created to transform how we talk about and treat mental health.’ ALFL aims to get us talking about our mental health and encourages mental fitness. This site is great for tips, articles and research around both mental and physical health. ALFL along with Pieta House are the folks behind #SoundEffect & The Little Book Of Sound.

UK

Centre For Mental Health – ‘We change the lives of people with mental health problems by using research to bring about better services and fairer policies.’  A fantastic site for information.

Mental Health Foundation – ‘Dedicated to finding and addressing the sources of mental health problems.’  Lots of information presented in a very user friendly way, clear guides and explanations.

Together‘We believe that people experiencing mental distress can direct their own journey towards improved mental health and to living independent, fulfilling lives. Our role is to give people the tools and the support to achieve this.’ Here you’ll find community, acommodation and criminal justice support along with along with research & guides.

Rethink Mental Illness – ‘We believe a better life is possible for millions of people affected by mental illness.’ Rethink can provide accredited advice & information to anyone affected by mental health problems. They also provide support groups and services and they campaign nationally for policy change.

Mind – ‘We won’t give up until everyone experiencing a mental health problem gets support and respect.’ Mind campaign to raise awareness, promote understanding and improve services. They also provide advice and support to anyone who needs it.