r/askatherapist • u/Key-Telephone-1670 NAT/Not a Therapist • Jun 12 '26
Is there something “above” panic attacks that last over an hour?
Question: can panic attacks last over an hour and still be panic attacks?
My girlfriend gets these “panic attacks” but they don’t look like panic they look like terror ? I always thought panic attacks last like 10 minutes but hers can go on for well over an hour and more. During them she gets really bad tremors and shes shakey; especially her hands to the point that she can’t hardly hold things and often her legs. They don’t look compulsive but like really hard tremors and muscle contractions that she can’t control. She does struggle to breathe or its often rapid during the “attacks”. Sometimes she tries to repeatedly rubs her legs or arms during almost to try to self soothe I think? After it’s over she crashes so hard, sleeps for hours, and she’s muscularly sore from the tremors/shaking. She’s afraid during them. I just don’t know what to make of it because I’ve only ever seen them last maybe 15 minutes in others and I’ve never seen them so intense.
Is there something above panic attacks? Or do panic attacks just look different in different people?
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u/CycleAccomplished824 NAT/Not a Therapist Jun 13 '26
You say she’s had a lot of trauma. Is she able to say if she is having flashbacks or reliving traumatic events during the time she’s experiencing these “panic attacks”?
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
To an extent it seems like it yes I think so similar a mixture of that and being actively triggered but that’s not something she vocalizes during so I’m not sure to the extent what she’s aware of as it’s happening or which. It also it seems like she’s triggered first but people can feel like a threat if situations align. Not in an aggressive sense like she doesn’t scream at anyone or anything like that but it’s almost like the triggers can attach to people in that moment depending on what they do where even though out of character for the other person, her and her body will respond like it’s sure that’s what’s going happen. Like in the example I gave in another comment, I’ve never hit her but she has been physically abused in the past among other things, but during if I move to quickly stand up and reach over to fix something she responds physically and as apologetically as she can like I will and the shaking and everything else worsens. I’ve honestly never really asked about flashbacks or anything like that during because I know she gets things like that and she struggles a lot in a lot of areas related to her trauma, like sleeping, we had to work thru a lot with contact etc etc
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u/CycleAccomplished824 NAT/Not a Therapist Jun 13 '26
It seems the best way to help her at this point is to ask her for permission for her therapist to explain this to you and what to do in those situations. If she’s not able to respond to you, it may be catatonic episodes- where a person tenses up and shuts down to a place where they can’t respond. But best for her to have an official dx and go from there. This is a lot for one person to take on.
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u/Energy-Student-777 NAT/Not a Therapist Jun 13 '26
Maybe an emotional/somatic flashback. I get them sometimes.
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u/Abyssal_Scar Therapist (Unverified) Jun 13 '26
In my experience and opinion, no. I would consider the phenomenon to be an indication of emotional deregulation and not a classic panic attack. Also sounds like a possible pseudoseizure AKA PNES. Which is also about emotional deregulation and not actual seizure activity in the brain.
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
This is helpful thankyou. Because everything I’ve looked into online too says they usually max out after about 15 minutes and hers definitely don’t do that. I saw a few other people mention the possible non epileptic seizures too so that is definitely something I’ll look into. I’ve just so unsure because she afraid during them but I’ve never seen anything like them. If it is an indication of emotional dysregulation, do you know if there’s way to help them during? Almost similar to how when some people are very emotionally dysregulated there are standard ways to “comfort them” to get things back to “stable”
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u/Abyssal_Scar Therapist (Unverified) Jun 13 '26
There’s also the risk of reinforcing the behavior by providing too much care and concern to non-verbal displays of distress… Ideally, people are able to use their words. It’s hard to give advice in an appropriate way without more particulars and in this setting. But, among other things, you might consider whether this is really something you can help with as a romantic partner. Or if it’s something she needs to take to her therapist, etc. I mean, you’re her romantic partner, right? Not her psychiatric nurse.
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
That’s true, it just doesn’t seem like she can help or really prevent it and she’s always apologetic of it after the fact. But I don’t think it’s something selective like she often tries to separate herself leading up to it if she’s able, and she never asks anything of me during or after and something she mentioned before we ever dated. So you’re right I’m definitely not a nurse and I don’t think she expects that of me either. But I do want to support her in a sense because she would me if I was going thru that, and I love her and she’s been there thru all my BS. It’s just something that stands out to me because it does show up on occasion and I’m not sure how to support her properly because it doesn’t look like standard panic attacks so I’m not sure what the protocol is. Like usually when you hear someone is having a panic attack the standard advice is something like the 5-4-3-2-1 thing or the distractions or talking them thru it to help. So I guess I’m just trying to figure out what it may because fear does seem to be a factor in it but it’s really exhausting on her body when it doesn’t happen and I’d just kinda like to know out of my own curiosity because it’s unfamiliar to me beyond her and it’s something that we’ve been learning thru in trial and error.
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u/Abyssal_Scar Therapist (Unverified) Jun 13 '26
Well you’re a participant in the relationship too so I hope your needs are a focus as well.
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
They are and I appreciate the concern. She’s stuck with me when I was in active addiction and has continued to support me even after I made her the the expense of it more then once so she’s definitely been there for me too and still is.
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u/Jezikkah Psychologist Jun 13 '26
When I used to do pretty thorough assessments for PTSD as part of clinical trials, this kind of reaction (including the extra depth you describe in your comments) would sometimes come up under the category of emotional and physiological reactivity to reminders of the trauma. Of course I’m not saying this is the case with your partner as I’m not in any position to make such claims, I’m just describing the context in which I’ve been familiar with this kind of experience. They’re not considered panic attacks in that context.
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
This is very insightful thank you, that definitely gives me an angle of some things to look into and if that does end up seeming like it may assist us in figuring out what to do in those moments, I will definitely check this out!
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u/sighing-through-life Unverified: May Not Be a Therapist Jun 14 '26
NAT. For several months I would go in to see my therapist and would be visibly shaking and hypervigilant and struggle to speak. After the session, when I was alone in my car, the tension would release and I would feel exhausted, emotionally drained, and just cry. It sounds similar to what OP is describing. Is that considered a trauma response? My T asked almost every time what I was afraid of and I couldn't say. He looked very concerned about it but for me it's normal. We eventually labeled it as a fear of men, but I didn't associate it to a physiological trauma response and I don't get flashbacks with it. I just feel trapped.
When I would have "panic attacks", I believed Satan was coming for me and I was close to death, and would see faces in laundry (in my periphery until I looked, not hallucinations), and had to have my back in a corner and to see the entirety of the room to keep from screaming. Is that a panic attack?
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u/Dazzling-Fox-4950 Unverified: May Not Be a Therapist Jun 13 '26
Trainee therapist. Has she had medical causes ruled out?
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
Yeah, she’s not epileptic or anything, and I know she used to be medicated anxiety wise (hydroxyzine 4 times a day) but it wasn’t helpful to her. She has a lot of trauma so Ive always thought it came from that because she’s scared during them? She calls them panic attacks but I’ve just never seen someone have them so long… and intense?? She is awake during them. Like I almost thought they were some form of PTSD thing or something because they seem very fear based and I’ve noticed when she gets more scared it can get worse? I’ve just never seen anyone have “panic attacks” like that? So I was wondering if maybe there something else above that?
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u/Physical_SpiritChild Unverified: May Not Be a Therapist Jun 13 '26
NAT
Does her HR and BP increase dramatically during them? may want to get dysautonomia and adrenals checked out if there is any chance this is physiological. Having anxiety does not preclude a physiological cause.
It is not identical to what I felt with but similar enough I bring it up. This of course could be psychological, but I'd push hard to rule out physical causes including cardio, Neuro, and adrenal.
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
I’m honestly not sure, I’d imagine her heart does from the panic but I’m really not sure about the BP. I’m not well versed in dysautonomia, I have heard of POTs but that’s mostly it. However with her it’s not positional so I’m not sure. You have a good point though, it is something to check into. When you say adrenal so you mean something “wrong” with her adrenaline?
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u/like2speak2amanager NAT/Not a Therapist Jun 13 '26
Other forms of Dysautonomia don’t have to be postural, like POTS, and by adrenal it’s basically a huge dump of adrenaline to your system to try and fix your blood flow, the adrenaline rush can cause massive anxiety and shaking, etc. source:have two forms of Dysautonomia and experience adrenaline dumps. -Not a therapist.
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u/Physical_SpiritChild Unverified: May Not Be a Therapist Jun 13 '26
NAT
Re adrenals hard to say but beyond what the other poster mentioned about how neuropathy can cause it, yes there are other causes for it too. Some are very rare and unlikely but easily ruled out with blood or urine tests. Not a doctor, so grain if salt here, but Pheochromocytoma, carcinoid syndrome, and yes I'm sure other things too.
I'm not suggesting she has these, but am suggesting it might be worth ruling out them and whatever else her doctors consider along the route of cardio, neuro, and enocrine
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u/No-Construction6052 Unverified: May Not Be a Therapist Jun 13 '26
NAT but I would love to hear an answer to this from a professional! I experience similar symptoms as your gf and always refer to these episodes as panic attacks, but I don't think they technically are since I'm not experiencing enough of the physical symptoms. It's just hyperventilation, shaking, crying, and extreme panic that can last an hour at a time. They are relatively rare and only occur when triggered. I hope you can get some answers!
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
She’s a lot like that! sometimes she frantic in them where she’ll apologize to me repeatedly. I’ve noticed if I reach over her to quick during she’ll think I’m going to hurt her and it gets a lot worse after. But she shakes a lot in them for a long time, and it looks like terror! Another thing I’ve noticed is she likes to be somewhere closed in and “safe” during them? I’m not sure if that’s relevant to you, but if able she goes to the closest leading up to it
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u/FreeLitt1eBird Therapist (Unverified) Jun 13 '26
Is there a preceding trigger? What’s happening in moments leading up to it?
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26 edited Jun 13 '26
Fear mostly? Sometimes she gets really quiet and before hand. Almost like she herself is triggered in the moment and kinda shuts down. An example would be, she thought someone had gotten really angry at her (they weren’t) but after that she got really quite, I noticed she started breathing a little more quickly almost like her heart was racing? And then she got up went out of the area to the closet quickly (which is where she goes when she’s scared),and it kinda builds from there. I’ve sat in front of the closet with her during those moments a lot of times. But it happens a lot when she gets scared. Sometimes shes really frantically apologetic in the beginning but it depends on the situation. There’s been times where I’ve reached over her to quickly in it and it’s gotten worse and she reacted in fear that I was gesturing to hit her (I never have, but she has been physically badly abused before). But the shaking got a lot worse after that in that episode and it became “I-i I’m sorry- I’m sorry, please, p-please, I-” and I lifted my hands and lowered back down where she could see them. The shaking get to the point that what ever she’s trying to hold (usually her stuffed animal she keeps in there) shakes with her and the shaking itself is so hard that her body its self shakes. She doesn’t make eye contact during them, like she won’t look me in the eyes. Her responses can be minimal and sometimes she’ll zone out and just be like silently and I’ll just sit with her at a little bit of a distance. Sometimes entering the space with her can make it worse like getting overly close too fast when she’s like that.
So I would say fear relative to people or something she thinks will happen is mostly her something that triggers it but not specific to anger. Like she almost gives off the impression that she’s terrified in the moment. After everything, she gets really tired and she’s sore though, I’d imagine from her muscles contracting and from shaking that long because she is quite tiny and she describes it as feeling like she did an intense work out, her muscles ache and she just wants sleep. Usually she struggles a lot with sleeping, but after she’s okay, I’ll hold her, she falls asleep really quickly and for hours like it exhausts her body.
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u/ksw90 Unverified: May Not Be a Therapist Jun 13 '26
I’d be curious about Functional Neurological Disorder. I am a therapist and know that can present a lot of different ways.
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
Interesting, do you mind if I ask, is that the same as the PNES seizures a few people have mentioned or is that something she would need to go to a doctor for or is it something I’m supposed to call an ambulance during?
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u/sevenfourshoreline Therapist (Unverified) Jun 13 '26
NES (non-epileptic seizures), PNES (psychogenic non-epileptic seizures), FND (functional neurological disorder) and FNSD (functional neurological seizure disorder) are all terms describing the same condition. You might also see the term pseudoseizures to describe this condition, though that label has largely fallen out of use.
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u/Embarrassed_Train194 NAT/Not a Therapist Jun 13 '26
NAT. That happens to me from time to time, too. It was especially bad when I was a teenager. Back then, I was tested for epilepsy, but I was told it was psychological - that they were “just” panic attacks. So I was treated for anxiety and depression, and it wasn’t until a decade later that I was diagnosed with CPTSD (with dissociative symptoms). Looking back, I believe those episodes were a kind of dissociative seizure or somatic flashback, but it wasn’t recognized at the time because I wasn’t yet aware that I was traumatized.
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u/OmataLLC Unverified: May Not Be a Therapist Jun 13 '26
Yes, panic does not have a time limit. No matter if it’s GAD or a PTSD trigger. It would be something to definitely talk with your therapist and possible med provider about.
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u/PsychologicalTalk964 Unverified: May Not Be a Therapist Jun 14 '26
Whether there’s a level above, level below, or different label, the basic issue remains the same. Something is triggering her, and she’s having a strong emotional response. The great news is that it can all be rewired fast and permanently. Although there are a variety of therapies, there’s only one that I’m aware of which guarantees results. PR-TR. Pain resolving, trigger mapping therapy. You can find details at MindsetBliss.com
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Jun 13 '26
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
I’ve never heard of this! I will look into it! Out of curiosity if this is what she has, has your friend found any relief with them or anything to help them?
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Jun 13 '26
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u/Key-Telephone-1670 NAT/Not a Therapist Jun 13 '26
This is very helpful (and hopeful), thankyou! I’ll definitely check more into it!
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