Understanding Panic Attacks and Anxiety Disorders: How Your Body Sounds the Alarm

Hello, and I'm your host today, Dr. Valda Crowder, also known as Dr. V. As many of you know, I'm a board certified emergency medicine physician, and I'm committed to actually giving you empowering information that will actually help with your health and wellness. Please make sure to subscribe to my channels and my YouTube and my AskDr. V website and also channelofhealth.org. So today we are going to talk about when your body sounds the alarm, understanding panic attacks and anxiety disorders. So May is Mental Health Awareness Month, and today we are tackling something that affects millions of people who are struggling in silence. They're often thinking that, you know, am I dying? Am I going crazy? Am I completely alone in this whole experience? So we are talking about anxiety disorders and panic attacks. This actually impacts everyone of every age group. As an emergency medicine physician, I can tell you I see this in the emergency department a lot. And it can really be a terrifying experience for the person that is actually having the symptoms. And it is often really, really misunderstood by family members and people that are there that want to support them. So today I really want to uh change that. This is a live show. If you want to join into the conversation, you can call in at 1-800-450-7876. 1-800-450-7876. All right, so anxiety is the body's natural response to perceived stress or danger. It's not really a character flaw. I know there's some people who go, I never, I never experience any fear or danger. If if you had a tiger coming at you, you would experience fear and danger. So everyone actually experiences fear and danger. So, and it is not something that is uh that you can just think your way out of. So, and it kind of exists on a spectrum, right? So all of us actually have some degree of everyday worry or concern. And then sometimes what happens is these symptoms become so debilitating that it actually significantly impacts the quality of your life. So, how do you know when it's normal anxiety or worry or concern for daily activities versus an actual anxiety disorder? So I'm gonna go over that. So if you have a piece of paper, you might want to get it out right now because I'm gonna actually go over the scoring mechanism for how we actually determine this. So there is a thing called a GAD seven score, and it is seven questions that people actually answer. You give yourself a zero if you don't experience this at all, a one if you experience it only a couple of days, a two if you experience it more than 50% of the time, and a four if you experience it all the time. So it's a zero to four scale with seven questions. So people at the end of the scoring either end up with some number between zero and twenty one. So here are the questions. Over the last two weeks, how often have you felt nervous or anxious or on the edge? Not at all. One one or more days, more than 50% of the days in in the last two weeks, or every day. How often have you not been able to stop or control your worrying? The third question, over the last two weeks, how many times have you caught yourself worrying too much about a lot of different things? Fourth question, over the last two weeks have you had trouble relaxing? Fifth question, over the last two weeks have you been restless and unable to sit still? And if so, how often? Six, over the last two weeks have you been easily annoyed or irritable? And seven, over the last two weeks, have you been bothered by feeling afraid as if something awful might happen? So these are the seven questions, and again they're all scored zero to four, with four being you know that you're actually experiencing these symptoms very frequently. Zero to four score means minimal anxiety, that's sort of kind of normal everyday stuff. Five to nine score is mild anxiety, ten to fourteen is moderate anxiety, you're getting to the point where it actually is impacting daily life, and a score of 15 or more is severe anxiety, which actually really does impact people's daily life. So when you look at when you look at anxiety disorders, there's there's different types of anxiety disorders. So some people call it a generalized anxiety disorder, and that's a persistent excessive worry about everyday things. Then you have some people that actually have a panic attack or a panic disorder. So they don't necessarily have anxiety all the time. It is more of a sudden rush and a sudden fear, and sometimes it can be overwhelming. It can be a fear that you might faint or die or have a heart attack. Then there's social anxiety, um, and this is sort of a fear of social situations, excessive concern about being judged by others, or what is what what are other people's opinion of me? That's more of a social anxiety. And then some people have specific phobias. They may have fear of the water or fear of bridges or fear of animals or fear of insects. It could be anything along uh anything along that or anything along that line. Um, another form of uh anxiety disorder is agoraphobia. And agoraphobia is a fear of situations where escape may be difficult. So a lot of times they may have problems being in an elevator or in a um in a building with uh that has a lot of floors. They also may have uh problems being in a crowded uh mall or a crowded concert facility. And there you mainly see that there is sort of like a concern about either losing control, not being able to have an exit, feeling trapped. In some cases, they may also uh uh have fainting. Um then the um the last category um or the second last category is separation anxiety disorder. So that's a significant uh fear of separation from either a parent or a child or a loved one. Um you actually see separation anxiety disorder. We see that sometimes in um in animals that have been taken away from their mother at a very young age. Um they kind of bond with their owners and have a lot of anxiety if they're left at home alone. Um so you can see it in that you can actually see in um adults, uh children, and you also sometimes see it in pets. Um, and then uh the last category is post-traumatic stress disorder, or what we call PTSD. And that is anxiety that is rooted in a past trauma. Um, and whether or not that is that trauma is something you experienced when you were in the military, or whether or not it's a trauma that you experienced as a child, any sort of traumatic, traumatic episode can lead to an a form of anxiety that we call post-traumatic stress disorder. So, some people actually have um have heard or experienced family members who've actually had like a panic attack. So I want to talk a little bit about what is a panic attack. Um, so this is where people get a sudden surge of overwhelming fear and they get physical symptoms that peak really, really quickly. And sometimes they come on really quickly, and then sometimes they leave very quickly. Um, it can be very uh frightening and very um debilitating. Um, it often leads people to come to the emergency department. Um, in some cases, they can be convinced that they're having a heart attack, or they can be convinced that they're going to die. Um, and so the symptoms of a panic attack are heart racing, palpitations, chest pain, chest tightness, shortness of breath, feeling like they're actually choking, um, dizziness, lightheadedness, um, any sort of fainting, trembling, shaking, sweating. Um, sometimes people also get uh nausea and stomach pain or a kind of odd numbness and tingling in their arms and legs that doesn't really uh go along with anatomically where the nerve roots are. Um for some folks they get a fear of I feel like I'm I feel like I'm losing control or I feel like I'm going crazy or I feel like I'm dying. Um what is important is that these symptoms can really be similar to a heart attack, uh, an actual real heart attack. And you really don't know if you're having a heart attack or a panic attack, and you cannot assume that you're just having a panic attack. It's really important when you experience these symptoms to go to the emergency department. Myself as an emergency medicine physician, when I see these patients, I am not able to tell the difference between a panic attack and a heart attack unless I actually get blood work. So because I'm not able to tell the difference, I guarantee you're not able to tell the difference. So I tell people it's really, really important if you get any of these types of symptoms that I actually just listed, that you actually go to your emergency department and actually really get all of these things kind of distinguished. So, in general, um, panic attacks can last 10 minutes and they can resolve in 20 or 30 minutes. And interestingly, same thing with a heart attack. A heart attack can last 10 minutes and then can resolve. So again, you cannot tell the difference just because the symptoms went away. Um, and it can be really physiologically uh terrifying. And a lot of times when I meet people who've had panic attacks and we've done the lab work and done the EKGs and determined that this is a panic attack, um, they have really have quite a fear of having another one. Um, so what happens when you actually have a panic attack? So when you actually have a panic attack, your body is firing its fight and flight response system at the wrong time. So basically, uh you feel like the tiger is charging towards you and there is no tiger charging towards you, and your body is reacting as if you are really in a life and death threatening situation, and you are really not. Um, and this sort of is almost think of it like a false alarm, and it triggers a cascade of hormones, adrenaline, cortisol that all flood the body system. And your heart rate surges, your breathing becomes rapid, and every system in your body actually prepares to actually flee a situation or a danger that doesn't really exist. So that is basically what a panic attack actually feels like and what it actually how it actually occurs. When we look at anxiety disorders across the United States, um it affects about 40 million people. So one in three people have experienced some degree of an anxiety disorder or panic attack or agrophobia or PTSD. So this is something that is extremely common. Overall, uh panic disorders, which are which is a disorder where you have repeated panic attacks, uh, that affects about six million Americans. This is something that you will hear about, whether or not it's family members or your community. This is something that you will actually hear about. When you look at who's actually more at risk for this, women are twice as likely to actually have these sort of symptoms than men, although men do have these symptoms as well. Black and Latino Americans are also more likely to actually have these symptoms and less likely to receive mental health treatment as a result of it. Anxiety disorders, including panic attacks, cost the United States about $42 billion a year in health care costs and lost work productivity. Someone with anxiety disorders is three to five times more likely to visit the physician and six times more likely to be hospitalized. And again, they're often hospitalized because we have to do the test to make sure that there is nothing medically emergent going on. So it is very difficult to actually distinguish between these symptoms and actual real disease. So adverse childhood experiences are one of the strongest predictors of anxiety and panic disorders. We actually did a whole show on adverse childhood experiences last week. Um, and so I'd remind people if you actually have not heard that show, make sure to go to any streaming platform, Audible, Apple, Podbean, etc., and actually listen to that. That show actually goes over what adverse childhood experiences are and how they are related. So, to hear more about today's topics and other topics that we actually have, you want to listen to my podcast, which is What the Health is Happening. What the Health is Happening is where we give you the inside scoop on all healthcare matters, from breaking news to life-changing medical updates. It is available on all podcast platforms. Please download, subscribe, and comment. All right, we're gonna get into news you can use, and we're gonna talk a couple of things that actually have been occurring recently that I think are uh related to this topic today and to our overall health in America. So the Trump administration is poised to drop an IRS lawsuit and instead launch a $1.7 billion weaponization fund for allies. This is taxpayer payer dollars that will actually settle claims brought by anyone who feels that they were harmed by the Biden administration. Um, and it includes 1,600 people that were involved in the January 6th capital attack. So this is actually giving money to people who were actually involved in the January 6th capital attack. Why am I bringing this up? Because this $1.7 billion could have provided Obamacare subsidies for a quarter million Americans. So I tell people all the time when you hear politicians say, oh, we don't have money for health care, that is untrue. We are spending this money and we are spending it in other areas. And we have to actually really think why, as a country, we do not value our health and the health of our fellow Americans. Second story: research uh shows that exercise and cognitive behavioral therapy can be very, very important in the treatment of panic attacks. So this was a recent study that was actually done, um, and it found that moderate to vigorous aerobic exercise, which actually could include aggressive walking or fast walking, was very effective and actually treatment of many psychological disorders, but also panic disorders. Um, and basically it found that typical exercise, which was 45 minutes three times a week, made a very significant difference in the frequency of panic disorders and also how often uh how how severe the panic disorders were. So it made a difference in the frequency as well as the severity of the panic disorders. Um I think this is really important as people look to kind of deal with this and they have certain medication options and non-medication options. This is a very important non-medication option. All right, before we get into uh our questions, um, I just wanted to uh just say the Ask Dr. V show and what the health is happening. We are going to be going on a year-in cruise, December 28th to August 4th on the Norwegian Gem. We're gonna be going to Belize and Kazumel. If you are interested in joining us, please send an email to info at asdrv.us. That's info ataskdrv.us. You can also just call. We have a number set up for folks that are interested in cruising with us. We're gonna have three days at sea where we're gonna be able to talk about medical issues. Uh, the phone number to call and join us is 774-367-3688. That's 774-367-3688. All right, my first question is from Marcus. Marcus says, I am an African American male and I don't talk about anxiety. Honestly, I was raised to just push through it. But lately, my anxiety has been affecting my job and my marriage. How do I uh deal with this and what should I do? So I really wanted to um this is a a really good question here from Marcus, and I want to just say that one is really dealing head on with uh anxiety disorders or panic attacks requires a lot of courage, and it is really a sign of mental intelligence that you decide to take on something that is actually making your life uh less great, if we were to say it just bluntly. Um, and really take it on and coming up with solutions for it. So I really want to talk about a couple of things, specifically for black men. There are websites now that have culturally competent therapists or black male therapists. Let me actually give you the uh the websites. It's therapyforblackmen.org, and then you can put in your zip code and you can actually see who's there. And there's also search blackmail therapist.com. And these sites are very, very important for you to be able to find someone that is culturally competent and actually help guide you through this. There are many non-medication as well as medication uh treatments uh for uh anxiety disorder, uh panic attacks, and other mental health disorders. And it's really important that you get guided through that with someone that you feel comfortable talking to. Um and um we've all we've found in general that the more cultural coordination coordinates there is, so the more you and your therapist are alike culturally, the better your outcomes when it comes to uh mental health and medical help. So um I think that's really, really important. So I'm gonna say those websites again, therapyforblackmen.org and search blackmailtherapist.com. All right, great. I hope that really I hope that really helps. Then Keisha asked a question. She said, I've been having panic attacks for years, and I've been just white knuckling through them. Is this doing damage to my body long term? I've been very afraid to go on medication. So when you think about what a panic attack is, a panic attack is basically your the fight and flight part of your body firing over and over and over and over again. So it is that sympathetic nerve stimulation over and over and over again. It also leads, there's an axis that is your hypothalamus, your pituitary, and your adrenal, and it's called the HPA axis. This is really, really important because this is actually what actually is important when you are looking at glucose metabolism. Uh also it impacts um cortisol, um, all and also cholesterol. So all of these things get dysregulated when you have panic attacks over and over again. So what it does is it leads to more epinephrine in your bloodstream, more cortisol in your bloodstream, more inflammation in your body, and all of the bad cholesterols and lipids go up. So, what we find in people who have panic attacks over and over again, which makes it even harder to diagnose as they get older, and they actually do maybe have some hardening of their arteries or clots in their in their coronary arteries, is they have an increased risk of heart attacks, hypertension, and strokes. So this is really something that you want to actually get a handle on as early as possible because it really, really does, it really does make a difference. All right, I got another question here from Sheila, and she says, I need to know what I can do right now today. She says, I'm watching the news all the time, and I'm getting more and more nervous. Um, this war is stressing me out. What can I do right now to actually make a difference? So I want to actually share, you know, I had a similar sort of experience myself uh during the uh 9-11 attacks. Um I was in Washington, D.C. My parents, who live in New York, um are usually never down at the World Trade Center, but had been down at the World Trade Center the day before. I wasn't really sure if they had left or not. And all the events of 9 11 actually really threw me into having like anxiety and panic attacks. And I I will share with you um some things. That I did. One is I did actually go to a therapist, and she gave me my the best advice. It was expensive advice because you know I had to pay almost $500 to see her, but it was turn off the TV. So I I still use that now. So when there are things and people sometimes were watching the news over and over and over and over and over again, it is really important. I know right now, sometimes not only do I turn it off, uh sometimes what I do is I also actually turn it to a cooking channel. I might turn it to a pet show. Um I might turn it to um maybe some voice competition show. Um so you want to kind of interrupt your uh ingestion of news over and over and over again during these times, particularly when it is something that you can't do anything about. The other thing that is really important is to actually bring voice to whatever is your actual uh concern, whether or not you talk to friends or family about it, it's really important to actually bring voice to it and to communicate rather than to actually worry and worry and worry about it in your head. When you actually bring voice to it, um one of the things that is important is to actually create a plan. I often tell people worrying is not a plan of action. Worrying is really just worrying. Um, and it takes up a lot of energy without the production of a plan. So the thing that you're worried about or the thing that you're concerned about, um, you really want to make sure that you create a plan, you're gonna feel better, just the fact that you have a plan if this thing should occur. In addition to turning TVs off, uh, some people also need to look at are their triggers their iPhones, uh, their social media feeds, um, they may need to uh withdraw and take turn those off. Talk therapy and going to the therapist is sometimes what is necessary. Again, we spoke earlier in news you can use about exercise, and that is important. The other thing that is um that a lot of people use is uh they activate their parasympathetic nervous system, which is the opposite of your sympathetic nervous system. And the way to actually activate that is to do a double inhale. So inhale and then inhale further and then slowly exhale. You will find if you're in a very tense situation that this immediately calms you and allows you to kind of think a little bit more about what your next step should actually be. So all of these things are really, really important uh when it comes to actually avoiding anxiety or panic attacks in a manner that are that become debilitating. So I a couple of things that I want to go over because um May is mental health awareness month, um, and that is part of the reason why we're actually doing this topic. So I want to make sure you guys have uh important resources. The National Alliance on Mental Health is NAMI, and they have a website, NAMI.org, N like and Nancy, A Mlickenmichael I.org. Um, Anxiety and Depression Association of America is ADAA.org. Again, we talked about therapy for black men, and that's therapyforblackmen.org. Um, on psychological today, they have a therapist finder, um, so you can actually go to that website. Also, too, remember that the Suicide and Crisis Hotline is 988, and you can call that and you can text that. I want to really thank you guys for joining me today. We're really committed to answering um all of your most pressing health care questions. You can email me or send me an audio message at info atasdrv.us. That's info at askdrv.us. You can also follow me on YouTube and Twitter. If you or someone you love is struggling with anxiety or panic attacks, please reach out. This is one of the most treatable conditions in medicine. You do not have to white knuckle through this alone. Help is available and it is available right now. In honor of Mental Health Awareness Month, let us commit together to breaking the silence, removing the stigma, and building a world where asking for help is the bravest and most powerful thing you can do. I want to thank you for joining us today, right here.