WEBVTT - SYSK Selects: How Panic Attacks Work 0:00:00.200 --> 0:00:05.200 Hi, everyone. From October to two, fourteen, my Saturday Select 0:00:05.240 --> 0:00:08.680 pick for the week. That's how panic attacks work. This 0:00:08.760 --> 0:00:13.480 is very sad and serious stuff. Everybody. Panic attacks are terrifying. 0:00:13.640 --> 0:00:15.520 They are a real deal stuff. I've never had one. 0:00:15.800 --> 0:00:18.279 I've had friends and family members that have had them, 0:00:18.320 --> 0:00:21.440 and uh, it's tough stuff. So if you suffer from 0:00:21.480 --> 0:00:24.200 them or have friends or family that do, why don't 0:00:24.200 --> 0:00:25.680 you give it a listen? And maybe this will help 0:00:25.680 --> 0:00:28.760 out or at least bring a better understanding about how 0:00:28.840 --> 0:00:36.640 panic attacks work. Welcome to Stuff You Should Know, a 0:00:36.760 --> 0:00:45.159 production of My Heart Radios How Stuff Works. Hey, and 0:00:45.200 --> 0:00:48.159 welcome to the podcast. I'm Josh Clark. There's Child's w 0:00:48.320 --> 0:00:53.320 Chuck Bryant, and Jerry. So it's stuff you should know. Yep, 0:00:53.320 --> 0:00:56.920 why it's spread panic? Yeah? Did you see that video? No? 0:00:57.120 --> 0:00:59.160 Which one? There was a dude. This is just like 0:00:59.200 --> 0:01:01.960 two days ago went up on stage and attacked the band. 0:01:02.280 --> 0:01:04.319 Oh no, I didn't see that. Yeah, and they've got 0:01:04.319 --> 0:01:06.000 the whole thing. And it was during one of the 0:01:06.440 --> 0:01:10.600 really repetitive droning parts of a song. And uh, I 0:01:10.600 --> 0:01:12.959 haven't seen an explanation but that there was. I went 0:01:13.120 --> 0:01:15.480 to the widespread Panic Facebook thing because it was a 0:01:15.520 --> 0:01:17.720 big thread about people talking about it and I just said, 0:01:18.000 --> 0:01:26.640 herod people gang violing me, going hero that's hilarious. I 0:01:26.680 --> 0:01:29.840 thought it was pretty funny. He attacked the members of 0:01:29.920 --> 0:01:33.920 the band, yeah, like physically, and I couldn't quite attack 0:01:33.959 --> 0:01:36.600 the drummer and he was upset and I don't know 0:01:36.640 --> 0:01:39.640 if that part of the song made him snap, but 0:01:39.800 --> 0:01:44.040 it was definitely one of those repetitive thank thank over. 0:01:45.040 --> 0:01:47.680 He's like stop. But he was at the show, so 0:01:47.720 --> 0:01:51.240 that'd be weird unless he went there to attack them. Yeah, 0:01:51.480 --> 0:01:55.440 it was probably the Bath Salts maybe, so, so we're 0:01:55.440 --> 0:01:57.680 not talking about that kind of panic. That's more a 0:01:57.760 --> 0:02:01.000 psychotic break And this is not widespread at all. It's 0:02:01.080 --> 0:02:04.440 very individualized panic, it is, but it turns out people 0:02:04.520 --> 0:02:08.960 suffering from this is kind of widespread. How about that? 0:02:09.120 --> 0:02:13.639 So it fits a little bit sure. Instead, um, we're 0:02:13.680 --> 0:02:19.280 talking about panic attacks and the combination of panic attacks 0:02:19.360 --> 0:02:21.400 or the culmination of panic attacks that can lead to 0:02:21.440 --> 0:02:27.600 something called panic disorder, and it is a sucky mental 0:02:27.680 --> 0:02:32.480 condition that about two point eight percent of Americans, which 0:02:32.480 --> 0:02:35.359 is a pretty significant amount of people. Yeah, that's that's 0:02:35.360 --> 0:02:38.600 more than bipolar which we've covered in schizophrenia, yeah, and 0:02:38.760 --> 0:02:40.880 O c D, which we well, we've covered all three 0:02:40.919 --> 0:02:44.960 of those. Um, so that's a pretty significant amount of 0:02:44.960 --> 0:02:49.160 people who suffer from panic disorder, right, But that's different 0:02:49.160 --> 0:02:52.520 than just plain old panic attacks. Even though to have 0:02:52.600 --> 0:02:55.160 panic disorder you have to have panic attacks, but if 0:02:55.160 --> 0:02:59.120 you have panic attacks, you don't necessarily have panic disorder exactly. 0:02:59.120 --> 0:03:01.680 And I've had two experiences which I'll talk about at 0:03:01.680 --> 0:03:04.920 some point through the show, not personally, but Emily had 0:03:04.919 --> 0:03:08.359 a panic attack once and uh Frien in college had 0:03:08.360 --> 0:03:11.160 a panic attack a roommate and neither one of them 0:03:11.200 --> 0:03:14.040 have panic disorders. It was just an isolated incident. Yeah, 0:03:14.080 --> 0:03:17.240 so apparently that's I don't know if commons the right word, 0:03:17.800 --> 0:03:21.560 but people do have panic attacks and they but they 0:03:21.600 --> 0:03:23.400 they that might be the only one they ever have 0:03:23.520 --> 0:03:26.000 for their entire lives, I hope. So, which makes the 0:03:26.040 --> 0:03:28.160 whole thing kind of mysterious. And we should say, like 0:03:28.280 --> 0:03:32.720 science does not know what exactly is going on here. 0:03:33.200 --> 0:03:37.560 They have some theories, but there's there's no there's no 0:03:37.600 --> 0:03:39.960 way to predict what's happening. They don't even know if 0:03:39.960 --> 0:03:44.520 it's genetic or what environmental. Well, they finally isolated a 0:03:44.600 --> 0:03:47.960 gene last year, Uh, I guess and go and talk 0:03:47.960 --> 0:03:53.200 about that now. In December they isolated the gene and 0:03:53.200 --> 0:03:55.280 you know, genes are always so boring with their names, 0:03:55.480 --> 0:03:58.720 unless it's a Simmons. That's right. The n k r 0:03:58.840 --> 0:04:03.560 T three they think may be responsible, um, because its 0:04:03.600 --> 0:04:07.440 presence appears to cause an overestimation of fear and danger 0:04:08.240 --> 0:04:12.240 in an overactivation of the hippocampus and amygdala. So basically, 0:04:13.440 --> 0:04:17.360 if you have this gene, you're gonna exaggerate your fear overall. Okay, 0:04:17.400 --> 0:04:19.960 but it's not like they're saying they've proved that's the cause. 0:04:20.400 --> 0:04:22.840 But that is a good step in scientifically in the 0:04:22.920 --> 0:04:25.279 right direction. That's a huge step, because I mean that 0:04:25.360 --> 0:04:27.680 does sound very much like what a panic attack is. 0:04:27.680 --> 0:04:33.200 A panic attack is where you experience a very pronounced 0:04:33.200 --> 0:04:38.080 sense of fear and basically your fight or flight symptoms 0:04:38.440 --> 0:04:43.880 response and really, from what I can understand, your flight response. Yeah, 0:04:44.040 --> 0:04:47.000 like you're not in a position to fight or freeze, 0:04:47.040 --> 0:04:50.440 because you know now these days it's fight, flight or freeze. 0:04:50.640 --> 0:04:52.520 Really yeah, I don't think I knew that. Yeah there's 0:04:52.520 --> 0:04:56.320 a third option now, um like kind of yeah, oh 0:04:56.400 --> 0:04:59.120 no way, those aren't options that's a sequence, right, This 0:04:59.200 --> 0:05:02.719 is these are a when you're confronted with danger. Nick 0:05:02.760 --> 0:05:04.960 Thune or Buddy the comedian, dude, have you seen his 0:05:05.040 --> 0:05:08.280 hand of fit ads? Yeah? Those are awesome. Yeah. I 0:05:08.320 --> 0:05:12.240 was like, that's Nick Thune and he's on like Miss America. Yeah. 0:05:12.320 --> 0:05:14.200 The first thing I always think about is good for 0:05:14.240 --> 0:05:17.640 you cash those checks? Baby? Uh yeah. He has that 0:05:17.720 --> 0:05:20.640 funny bit on stop dropping rolling, like they they needed 0:05:20.680 --> 0:05:24.320 to continue that, like keep rolling. He's like, that's kind 0:05:24.320 --> 0:05:26.360 of key. You don't stop dropping roll because you'll be 0:05:26.400 --> 0:05:28.760 consumed by fire. You need to keep rolling right until 0:05:28.760 --> 0:05:31.120 you get to a door. Yeah, it's very funny stuff. 0:05:31.440 --> 0:05:36.040 So this is a little different fight flight or freeze. 0:05:36.200 --> 0:05:38.479 Yeah what what's so? How does freeze factor in? Like 0:05:38.520 --> 0:05:41.920 you just freeze up and toasts. Yeah, that at least 0:05:41.960 --> 0:05:46.880 beneficial of all of the these adaptations to danger. But basically, 0:05:47.640 --> 0:05:51.200 when you're when you're confronted with danger, you can either fight, fly, 0:05:51.440 --> 0:05:53.400 or freeze. That makes total sense. I don't know why 0:05:53.400 --> 0:05:55.440 freeze was never in there to begin with, because so 0:05:55.480 --> 0:05:58.039 many people freeze. They just added on the last couple 0:05:58.080 --> 0:06:00.919 of years. I think I'm a liar or a freezer 0:06:00.960 --> 0:06:03.120 for sure. It depends. I don't know if do you 0:06:03.120 --> 0:06:06.400 think there's a personality type. Oh boy, I don't know. Um, 0:06:06.600 --> 0:06:08.760 you know, don't you think it's possibly like just what 0:06:08.839 --> 0:06:11.960 your body chemistry happens to be doing? Right then? No? 0:06:12.120 --> 0:06:15.120 I think some people are more inclined to fight for sure. Okay, Well, 0:06:15.120 --> 0:06:19.880 with panic attacks, you're flying like that's your only that's 0:06:19.880 --> 0:06:23.200 your jam right there. Um, And you're experiencing it in 0:06:23.400 --> 0:06:26.640 the exact same way that somebody's coming to mug you 0:06:27.320 --> 0:06:29.560 or has pulled a knife on you and you're running away, 0:06:29.640 --> 0:06:32.520 or there's a lion chasing you. Accept and this is 0:06:32.600 --> 0:06:36.240 the key to panic attack. There is no lion, there 0:06:36.320 --> 0:06:40.240 is no mugger, there's no knife, there's no discernible reason 0:06:40.320 --> 0:06:46.719 for you to be experiencing this sudden onset of crippling fear. Um. 0:06:46.800 --> 0:06:51.039 But you're experiencing it nonetheless, that's right. No, no tangible 0:06:51.080 --> 0:06:54.560 thing happening right in that moment. Right. So when you 0:06:54.680 --> 0:06:57.400 come out of it, and these things can they peak 0:06:57.440 --> 0:07:01.000 within about ten minutes, but these the symptoms can last 0:07:01.080 --> 0:07:05.039 for an hour more. Um. When you come out of it, 0:07:05.120 --> 0:07:07.440 you're like, I don't ever want that to happen again. 0:07:08.040 --> 0:07:10.800 The place that this just happened to, say, the park 0:07:11.520 --> 0:07:14.280 I'm never going back to because now I associated with this. 0:07:14.360 --> 0:07:17.440 Because what you're doing when you experience fear, you're learning 0:07:17.800 --> 0:07:20.760 to stay away from something. Yeah, So, whether you want 0:07:20.840 --> 0:07:22.960 to or not, you've just been conditioned to fear the 0:07:22.960 --> 0:07:26.920 place that you just were because you had a panic attack. Um. 0:07:27.040 --> 0:07:31.280 And then lastly, you think possibly you're crazy, yeah, or 0:07:31.320 --> 0:07:34.560 having a heart attack. Yeah, that's uh. Both both of 0:07:34.560 --> 0:07:38.120 the my wife and my friend both thought they were 0:07:38.120 --> 0:07:41.000 having heart attacks, which is super scary. And we'll get 0:07:41.040 --> 0:07:42.960 the difference later on. But um, I guess we should 0:07:42.960 --> 0:07:45.320 talk about just some of the initial symptoms of a 0:07:45.360 --> 0:07:49.760 panic attack. The old d s M Diagnostic and Statistical 0:07:49.800 --> 0:07:54.480 Manual Mental Disorders lists, Uh, it looks like about ten 0:07:54.680 --> 0:07:57.720 symptoms and if you have at least four of these, 0:07:58.400 --> 0:08:03.240 you may be having a panic attack, which is heart pounding, shaking, dizziness, sweating, choking, 0:08:03.280 --> 0:08:08.440 feeling nausea, shallow or short breath, chest pain, numbness or tingling, chills, 0:08:08.480 --> 0:08:12.560 and hot flashes, feeling of unreality, feeling like you're going crazy, 0:08:12.680 --> 0:08:15.920 or feeling like you're about to die. You got four 0:08:15.960 --> 0:08:19.200 of those, you're having a panic attack. Yes, um, and 0:08:19.240 --> 0:08:24.640 if you have four panic attacks within four weeks, or 0:08:24.760 --> 0:08:29.720 you have one panic attack and then fear having another 0:08:29.760 --> 0:08:33.200 panic attack for about a month or so, then you 0:08:33.280 --> 0:08:37.120 can be diagnosed with what's called panic disorder. So, uh, 0:08:37.160 --> 0:08:39.760 if you listen to our fear podcast, which was a 0:08:39.800 --> 0:08:43.120 really good one, UM, it's kind of the same as 0:08:43.120 --> 0:08:46.800 a panic attack. Um, we covered your Your autonomic nervous 0:08:46.840 --> 0:08:50.280 system is what maintains all the functions in your body, 0:08:50.320 --> 0:08:54.040 the involuntary functions in your body, that is, and it's 0:08:54.040 --> 0:08:57.480 gonna take signals from your central nervous system. It's gonna 0:08:57.520 --> 0:08:59.600 regulate your organs. That's why you don't have to tell 0:08:59.640 --> 0:09:02.600 your heart beat or your kid needs to work. It's 0:09:02.640 --> 0:09:06.200 all your pancreas to secrete stuff. That's right. It's your 0:09:06.240 --> 0:09:09.840 autonomic nervous system. And it has two parts, the sympathetic 0:09:09.880 --> 0:09:14.880 and parasympathetic. And your parasympathetic controls like I said, your 0:09:15.080 --> 0:09:19.080 your heartbeat and stuff like that. The normal aspect, Yeah, 0:09:19.120 --> 0:09:22.480 it's just like stasis, right, Yeah, that balance that we 0:09:22.520 --> 0:09:25.520 all seek that we don't know we're seeking. And then 0:09:25.520 --> 0:09:28.800 the sympathetic is if you have that fight or flight, 0:09:28.880 --> 0:09:32.199 if you become excited. Uh, in any way, really, that's 0:09:32.200 --> 0:09:33.920 when that's going to kick in. Yeah, it's like normal 0:09:33.960 --> 0:09:36.240 gear and then high gear. Yeah. But it's not always fear, 0:09:36.320 --> 0:09:38.920 you know, just any kind of excitement. Right, you could 0:09:38.920 --> 0:09:42.280 be super happy, it could be sexual arousal. That's all 0:09:42.360 --> 0:09:45.120 your sympathetic nervous system, right, and those two components make 0:09:45.160 --> 0:09:48.199 up the autonomic nervous system, which it kind of switches 0:09:48.240 --> 0:09:51.200 from one to the other depending on your state of arousal. Right, 0:09:51.280 --> 0:09:55.160 that's right. Um, But when fear has aroused you, um, 0:09:56.000 --> 0:10:00.120 your sympathetic nervous system kicks into high gear. Um, and 0:10:00.240 --> 0:10:04.000 adrenaline is released, which is a huge factor in causing 0:10:04.040 --> 0:10:07.440 the symptoms of a panic attack. Like you start breathing 0:10:07.520 --> 0:10:13.240 very heavily and shallowly. Um, your pupils dilate you. Uh. 0:10:13.840 --> 0:10:16.720 We always used to say if you're digesting food, you 0:10:16.800 --> 0:10:20.760 stop doing that. Basically, all of your energy is transferred 0:10:20.800 --> 0:10:23.680 over to either fighting or flying, and in the case 0:10:23.720 --> 0:10:26.559 of a panic attack, is transferred over to get you 0:10:26.600 --> 0:10:29.640 to be able to run away as fast as possible. Yeah, 0:10:29.720 --> 0:10:32.600 which can be a little scary, but in a real 0:10:32.679 --> 0:10:36.400 fear situation, if you're in danger, your parasympathetic nervous system 0:10:36.440 --> 0:10:38.960 is going to kick in and calm you down. But 0:10:39.040 --> 0:10:41.960 that is not what happens, uh in the case of 0:10:41.960 --> 0:10:45.040 a panic attack, which is really perplexing. So let's recap this. 0:10:45.160 --> 0:10:50.120 A panic attack is when you experience this incredibly intense fear, 0:10:50.800 --> 0:10:53.600 so much so that you run away, but there's nothing 0:10:53.600 --> 0:10:57.000 there to be afraid of. And then and then, to 0:10:57.120 --> 0:11:03.079 make everything a million times worse, your parasympathetic nervous system 0:11:03.200 --> 0:11:06.000 doesn't kick in and calm you down like it would 0:11:06.120 --> 0:11:09.439 under normal circumstances, so you get to experience this horrible 0:11:09.480 --> 0:11:31.920 thing even longer. That's right, all right. So, like I 0:11:31.960 --> 0:11:34.679 said before, breaking news from December of last year, they 0:11:34.800 --> 0:11:39.040 think they've isolated a gene. Previous to that, they've some 0:11:39.800 --> 0:11:42.960 research has said it could be genetic because identical twins 0:11:43.040 --> 0:11:47.160 experience it more than fraternal twins, but it's always been 0:11:47.200 --> 0:11:49.720 sort of up in the air. They's been contradictions as 0:11:49.720 --> 0:11:53.800 well of the genetic basis. They think it's also possibly 0:11:53.880 --> 0:11:58.040 epigenetic or environmental like um. Apparently, one study found that 0:11:58.160 --> 0:12:01.440 a lot of people who have Pannick disorder had some 0:12:01.520 --> 0:12:05.160 sort of traumatic incident happened in their childhood. My friend 0:12:05.240 --> 0:12:08.000 from college did, Is that right? So they're thinking like 0:12:08.120 --> 0:12:11.040 possibly it had some sort of effect and set up 0:12:11.080 --> 0:12:13.320 like a time bomb for later on in life. Yeah, 0:12:13.400 --> 0:12:17.640 the stored uh feelings that maybe you've never dealt with 0:12:17.679 --> 0:12:21.200 about some traumatic event are gonna they're gonna rear their 0:12:21.200 --> 0:12:23.040 head at some point in your life in some way. Yeah. 0:12:23.160 --> 0:12:27.280 Or it just rearranged the neural output in your brain 0:12:27.400 --> 0:12:30.560 so that one day you're just set up when everything 0:12:30.960 --> 0:12:35.360 is just right, that chemistry is flooding your brain in 0:12:35.400 --> 0:12:37.240 a certain way, and then bam, it comes out of 0:12:37.280 --> 0:12:40.560 nowhere you have a panic attack. Yeah. Another theory is 0:12:40.640 --> 0:12:47.720 that they think if you have an over active fear system, 0:12:47.760 --> 0:12:50.439 like you've basically have been scared too much in life, 0:12:50.760 --> 0:12:53.520 or you're a scared person, then it's just gonna make 0:12:53.559 --> 0:12:55.520 it a hair trigger for something to set it off, 0:12:56.720 --> 0:12:58.760 which makes a lot of sense. I think it could 0:12:58.760 --> 0:13:01.800 be a combo of a lot of things, yeah, as usual. Yeah. 0:13:02.000 --> 0:13:04.439 I wonder though what what it will end up being though, 0:13:04.480 --> 0:13:07.280 if we'll find that there is one thing that that 0:13:07.559 --> 0:13:11.440 leads to this predictably like built up, but then there's 0:13:11.440 --> 0:13:14.840 the actual trigger and that's another thing too. So they 0:13:14.840 --> 0:13:17.640 don't know what triggers these things. They do know that 0:13:17.720 --> 0:13:21.320 a panic attack, being worried about having a panic attack 0:13:21.760 --> 0:13:25.600 can actually trigger a panic attack. I feel so bad 0:13:25.679 --> 0:13:28.280 for people with panic disorder. This is like a terrible 0:13:28.320 --> 0:13:32.920 affliction because you do become very much afraid that you're 0:13:32.960 --> 0:13:35.680 going to have another panic attack. So that can set 0:13:35.720 --> 0:13:38.400 off a panic attack, but it also can set off 0:13:38.440 --> 0:13:42.560 a co morbidity called agoraphobia, where you are afraid to 0:13:42.720 --> 0:13:45.680 leave your house, but you're also afraid to be alone. 0:13:46.520 --> 0:13:49.000 And I read this, um this article that was from 0:13:49.040 --> 0:13:55.319 the eighties seven, and they were saying, like the the Freudists, 0:13:56.120 --> 0:14:02.280 the Freudists followers of Sigmund Freud. We're saying, um, oh, well, clearly, 0:14:02.320 --> 0:14:04.280 if you're in a gooraphobic you don't want to go 0:14:04.320 --> 0:14:07.520 outside because that's where sexual desire is, and you don't 0:14:07.520 --> 0:14:09.480 want to be alone because you're worried that you will 0:14:09.600 --> 0:14:15.520 like abuse yourself. So agoraphobia. And everybody went boom, sit 0:14:15.600 --> 0:14:19.200 down and shut up. Yeah and um, So nowadays they 0:14:20.080 --> 0:14:25.920 have realized that agoraphobia is almost almost exclusively the result 0:14:26.040 --> 0:14:32.160 of panic disorder. Yeah, and it's because you you fear 0:14:32.400 --> 0:14:34.400 the place that you had a panic attack, so you 0:14:34.400 --> 0:14:36.880 don't want to go there again. And then maybe it 0:14:36.920 --> 0:14:38.720 happened again at the grocery store, so you don't want 0:14:38.720 --> 0:14:41.560 to go there, and it happened, but you don't want 0:14:41.560 --> 0:14:43.760 to be alone, but you don't want to be around strangers, 0:14:43.800 --> 0:14:46.160 so you clean to your family members. And now all 0:14:46.200 --> 0:14:48.920 of a sudden, you're not living your life anymore. You're 0:14:48.960 --> 0:14:52.400 developing phobias because of your panic attacks in your association 0:14:52.400 --> 0:14:54.000 with them. Like if you're on an elevator and you 0:14:54.040 --> 0:14:56.840 have a panic attack, you're not getting on an elevator again. 0:14:57.200 --> 0:15:00.280 You've just developed a phobia for elevators. And so all 0:15:00.320 --> 0:15:02.440 of a sudden, you're not going to be working at 0:15:02.480 --> 0:15:04.920 a place where you might normally work because you have 0:15:04.960 --> 0:15:07.240 to take the elevator to to get there. Or you 0:15:07.280 --> 0:15:10.760 develop a love of stairs, right, but then what if 0:15:10.800 --> 0:15:13.120 you're you don't like confined spaces at all, like a 0:15:13.160 --> 0:15:15.640 stairwell either. Yeah, have you ever been locked in the 0:15:15.640 --> 0:15:17.840 stairwell you're at the building? Yeah, I mean you just 0:15:17.920 --> 0:15:22.000 walked down however many flights until you're at the lobby. 0:15:22.400 --> 0:15:25.320 Oh you can get out down there? Yes? Okay, yeah, yeah, 0:15:25.520 --> 0:15:27.480 you're not actually locked in you just have to walk 0:15:27.520 --> 0:15:30.120 all the way down to usually just call you and 0:15:30.160 --> 0:15:34.480 say let me. Another theory is that when you're super tired, 0:15:35.160 --> 0:15:38.160 um and overworked, was when a lot of times when 0:15:38.200 --> 0:15:41.920 these are set off, your brain is producing sodium lactate 0:15:42.080 --> 0:15:45.000 or c O two and when those levels increase, your 0:15:45.000 --> 0:15:48.360 brain uh says you know what, I think you're suffocating 0:15:48.800 --> 0:15:51.280 and so I'm going to send a signal to get 0:15:51.280 --> 0:15:55.200 you a lot more oxygen. And I found this, uh 0:15:55.360 --> 0:15:59.440 really sad case of this woman, a university student who 0:15:59.520 --> 0:16:05.240 died from a severe asthma attack like three days ago. Uh. 0:16:05.280 --> 0:16:08.480 And she had had a history of asthma and then 0:16:08.560 --> 0:16:12.200 told the medics that she was going through like final 0:16:12.240 --> 0:16:15.560 exams and she had been having panic attacks uh for 0:16:15.640 --> 0:16:19.600 in the weeks like proceeding. So breathing is a huge 0:16:19.680 --> 0:16:23.280 part of panic attacks and as evidenced by her, if 0:16:23.280 --> 0:16:26.160 you have asthma, it's can be deadly, which is super 0:16:26.160 --> 0:16:31.600 super scary. And said yeah, Um. Then one other I 0:16:31.640 --> 0:16:34.560 guess there's a neurological basis they believe for people who 0:16:34.560 --> 0:16:38.400 have panic attacks, people who suffer from panic disorder tend 0:16:38.440 --> 0:16:43.840 to have fewer serotonin receptors and apparently also um gabba 0:16:44.000 --> 0:16:47.480 which helps us get to sleep. It's called a gamma 0:16:47.840 --> 0:16:55.080 immuno beautyic acid. Let's call it gabba gabba. Um. Those 0:16:55.080 --> 0:16:59.560 two have some sort of role in UM panic disorder. 0:17:00.080 --> 0:17:02.480 You don't have enough serotonin and your body is not 0:17:02.520 --> 0:17:06.440 producing enough gabba, you may be prone to panic disorder. Uh. 0:17:06.480 --> 0:17:09.040 They You know, there isn't like a specific type of 0:17:09.040 --> 0:17:11.640 person that necessarily gets a panic attack. It can happen 0:17:11.680 --> 0:17:15.920 to anyone, but um, usually it happens if in you 0:17:15.920 --> 0:17:18.720 you're in your twenties, although they say kids can get 0:17:18.720 --> 0:17:21.440 it as well. Have a panic attack or a disorder. UM. 0:17:21.480 --> 0:17:24.760 Twice as many women have a panic disorder developed one 0:17:24.800 --> 0:17:29.440 as men, which is pretty interesting. Um. And like you said, 0:17:29.560 --> 0:17:32.240 just the fear like having had one before, that fear 0:17:32.280 --> 0:17:36.040 can lead to more. So it's very cyclical. Yes, and 0:17:36.119 --> 0:17:39.879 you know, um that one paper from seven I can't 0:17:39.920 --> 0:17:43.440 tell if it was arguing in favor of panic disorder 0:17:43.480 --> 0:17:48.760 being like an evolutionary adaptation and like possibly beneficial, or 0:17:48.800 --> 0:17:50.840 if they were saying, like some people think this, can 0:17:50.880 --> 0:17:54.040 you believe this? But they were. One of the points 0:17:54.080 --> 0:17:57.240 that this guy made was well, twice as many women 0:17:57.280 --> 0:18:01.480 have panic disorders as men. So clearly it's an evolutionary 0:18:01.560 --> 0:18:05.320 adaptation because women wouldn't have had to have gone as 0:18:05.359 --> 0:18:08.960 far away from camp while they were gathering food as men. 0:18:09.720 --> 0:18:12.520 Men couldn't stand to have a panic attack, or they couldn't. 0:18:13.119 --> 0:18:15.520 It wouldn't be an adaptation for men, it would be 0:18:15.560 --> 0:18:18.480 for women. Plus, women can't run as fast when they 0:18:18.480 --> 0:18:20.679 have kids to carry, so they need to be on 0:18:20.800 --> 0:18:26.960 alert a little more. It's just smelled like bunk yeah, bunk, Yeah, 0:18:27.000 --> 0:18:30.280 that's that was a big year for bunk. Yeah. Um, 0:18:30.320 --> 0:18:33.040 if you do have a panic disorder, you may have 0:18:33.119 --> 0:18:37.359 a hard time getting your family to understand it. Um. 0:18:37.440 --> 0:18:40.760 Sometimes they overreact and think it's like way more severe 0:18:40.800 --> 0:18:45.320 than it is. Um. Sometimes they underreact and say, uh, 0:18:45.359 --> 0:18:50.000 you know, it's all in your head, like just calm down. Um. 0:18:50.040 --> 0:18:53.240 But either way saying boy, you're nuts or you just 0:18:53.320 --> 0:18:55.080 need to relax, neither one of those is going to 0:18:55.160 --> 0:18:58.240 help out the loved one. Chill out. There's no lion. 0:18:58.800 --> 0:19:02.800 It wasn't. One thing I've learned in arguments and fights 0:19:02.920 --> 0:19:05.760 with my wife is and I'm boil. Learning this early 0:19:05.800 --> 0:19:10.520 on is saying telling someone to relax never causes someone 0:19:10.560 --> 0:19:13.120 to relax. No, it's like the worst thing you can 0:19:13.160 --> 0:19:16.280 do if something's heated is to say just relax. It 0:19:16.400 --> 0:19:19.640 is true, that's just gonna ramp it up. So that's 0:19:19.680 --> 0:19:22.840 my advice for couples out there in any relationship. Really, 0:19:22.880 --> 0:19:26.320 it's good advice, Chuck, thank you. Um. There is a 0:19:26.359 --> 0:19:30.120 silver lining to all this in that panic disorder is 0:19:30.200 --> 0:19:34.000 actually highly treatables. The treatments that they've come up with 0:19:34.359 --> 0:19:37.840 are pretty successful, and we will talk about those treatments 0:19:37.960 --> 0:19:55.080 right after this. All right, So you mentioned that they 0:19:55.080 --> 0:19:58.600 are treatable. They have found success rates through medication and 0:19:58.680 --> 0:20:01.680 therapy which seemed to be about the same as far 0:20:01.720 --> 0:20:04.359 as how affective they are, between sixty and nine of 0:20:04.400 --> 0:20:06.800 the time. That's pretty good. Yeah, that's not bad at all. 0:20:07.480 --> 0:20:10.480 So that's the good news. So there's three there's three 0:20:10.640 --> 0:20:17.320 UM typical methods of treatment UM antidepressants, anti anxiety pills, 0:20:17.880 --> 0:20:21.160 and therapy. And you might use them, you know, independent 0:20:21.200 --> 0:20:23.480 of one another, in conjunction with one another. I also 0:20:23.520 --> 0:20:26.600 saw beta blockers. Some people use beta blockers to treat them, 0:20:26.600 --> 0:20:28.840 but they're not quite sure what's going on with that. 0:20:29.160 --> 0:20:32.600 I've used those before live performances. Those are the ones 0:20:32.640 --> 0:20:35.040 I read about that, Um, you gave me one, and 0:20:35.080 --> 0:20:38.560 I was like a useless worm. Yeah, it didn't affect 0:20:38.560 --> 0:20:41.200 me like that. I I was, I just like totally 0:20:41.280 --> 0:20:45.640 lost my personality. I wasn't nervous, but I didn't do anything. Well. 0:20:45.680 --> 0:20:47.560 I've gotten used to live performing now, so I don't 0:20:47.560 --> 0:20:51.000 need them anymore. But I got that tip from apparently 0:20:51.040 --> 0:20:55.199 a bunch of musicians, like in symphonies and stuff use 0:20:55.240 --> 0:20:57.920 and I was like, well, if first chair of violinist, 0:20:57.960 --> 0:21:00.960 if it's good enough for them to give me some blocks. Yeah, 0:21:01.400 --> 0:21:03.479 but it worked for me. But like I said, overall 0:21:03.480 --> 0:21:07.480 that I enjoy being on stage now. So with SSR eyes, 0:21:07.840 --> 0:21:10.920 which is what you moved on too, from beta blockers, right, No, 0:21:11.040 --> 0:21:14.720 I'm not on it. So with SSR eyes, Um, those 0:21:14.760 --> 0:21:18.840 are selective serotonin reuptake inhibitors and they do exactly what 0:21:18.880 --> 0:21:22.080 they sound like. You've got a bunch of serotonin receptors 0:21:22.080 --> 0:21:24.880 in your brain. If you have panic disorder, you may 0:21:24.920 --> 0:21:28.679 have fewer serotonin receptors in your brain. Serotonin is a 0:21:28.720 --> 0:21:33.600 neurotransmitter that helps basically stabilize your mood by either causing 0:21:33.640 --> 0:21:36.359 a neuron to fire or inhibiting a neuron to fire 0:21:36.600 --> 0:21:42.520 in this really beautiful, perfectly balanced chemical reaction. Right, So 0:21:42.600 --> 0:21:45.280 if you have a few of these receptors the normal 0:21:45.640 --> 0:21:48.880 you're going to be comparatively out of balanced. What an 0:21:48.920 --> 0:21:53.320 SSR I and antidepressant does is it allows the serotonin 0:21:53.800 --> 0:21:56.159 to kind of stay in your synaps is a little 0:21:56.200 --> 0:21:59.600 longer than as normal, so that you are releasing a 0:21:59.600 --> 0:22:03.560 little more serotonin then you would under normal circumstances. And 0:22:03.600 --> 0:22:08.080 it's proven pretty effective for UM, for panic disorder. Yeah. 0:22:08.160 --> 0:22:09.840 I mean they'd work wonders for a lot of people 0:22:09.880 --> 0:22:13.000 for a lot of reasons, UM, but not everyone, and 0:22:13.040 --> 0:22:16.920 they can cause a lot of negative side effects. Uh. 0:22:17.040 --> 0:22:20.880 So obviously you know, work with your doctor on a program, 0:22:20.920 --> 0:22:22.840 and it takes them a little while, like two to 0:22:22.920 --> 0:22:26.879 four weeks to begin working, uh for a panic attack. UM, 0:22:26.960 --> 0:22:30.000 an anti anxiety drug like xan x might be a 0:22:30.000 --> 0:22:34.200 little more effective because that is immediately hits you. It 0:22:34.280 --> 0:22:38.919 is a tranquilizer benzo diazepine, right yeah, and it's um, 0:22:38.960 --> 0:22:41.879 you know, the zanex is going to help chill you 0:22:41.920 --> 0:22:44.879 out immediately. But you can get hooked on those things 0:22:45.040 --> 0:22:49.560 pretty quick. Yeah, and they're dangerous to quit cold turkey 0:22:49.800 --> 0:22:53.159 and UM, Yeah, it's it's not the best thing to 0:22:53.440 --> 0:22:56.919 go to zanex a lot. Well, yeah, they say that 0:22:56.960 --> 0:23:00.240 you should. Um basically, if you if you under take 0:23:00.280 --> 0:23:03.800 an ssr I regimen, you can conceivably stay on it 0:23:03.880 --> 0:23:09.840 for years. If you undertake anti anxiety or benzo diazepine regimen, like, 0:23:10.200 --> 0:23:12.120 it shouldn't last for more than a couple of weeks 0:23:12.240 --> 0:23:16.880 or month from what I understand, because of the dependency. 0:23:17.040 --> 0:23:19.320 And again you want to like really do all of 0:23:19.320 --> 0:23:25.399 this with like a um, qualified competent doctor's assistants, not 0:23:25.520 --> 0:23:29.600 a doctor's assistant, doctor's assistant. It depends. If it's a 0:23:29.680 --> 0:23:34.439 qualified competent doctor's assistant who can write prescriptions. Trust, go 0:23:34.600 --> 0:23:37.200 for it, that's true. Uh. And then there's therapy, of course, 0:23:37.200 --> 0:23:40.800 the old CBT cognitive behavioral therapy, which we've talked about 0:23:40.800 --> 0:23:45.880 a bunch but um, that is Uh, they're gonna sort 0:23:45.880 --> 0:23:47.520 of the process is going to play out like this. 0:23:47.600 --> 0:23:51.639 They're gonna teach you about your panic disorder, which is 0:23:51.920 --> 0:23:54.880 a big step. If you understand something, uh, you can 0:23:54.920 --> 0:23:57.840 overcome it more easily. I think they're going to monitor 0:23:57.920 --> 0:24:00.960 you and you're gonna self monitor and cord your symptoms. 0:24:01.400 --> 0:24:03.399 And when they happen, and why they happen, what the 0:24:03.440 --> 0:24:07.240 circumstance was. Breathing, like we mentioned, is a huge part 0:24:07.280 --> 0:24:10.720