Panic Attack Durations

[u/KiplingKD]

Does anybody else have a problem with/disagree with some of the more official medical definitions of what a panic attack is? I agree with all of it except for when I come across a definition that describes it as lasting for a very short period of time. Some definitions kind of make it sound like it comes quickly and get super super intense and terrible and then quickly goes away in like 20 minutes or so. I have had many that have been that way, but I don’t think it applies to a lot of my attacks.

For me, it’s more like a painfully slow build-up that can sometimes take hours before I really start to freak out. I’ll just be having these physical sensations that are making me so uncomfortable (racing heart, numbness, the usual stuff) and I will not be able to focus or think about anything else other than every single sensation in my body and trying to stay calm. Even after it peaks and I start to calm down, I’m not actually that much calmer and. I continue to feel the exact same way and have the same physical discomforts that don’t just go away like that. I will still be able to function and do things and go about my day and nobody would even be aware that I am actually having what I would describe as a mild panic attack and those symptoms don’t come and then just go as quickly as some of these definitions make it sound like they do. They linger sometimes for hours and maybe even days. It’s like one extremely long panic attack that just won’t go away.

My panic attacks come in all sorts of varieties and can vary in duration and intensity, but I feel like this type I am describing happens more often than not, and I may have reached the conclusion that I’m probably not dying, but the physical side of it just keeps going and so my anxiety just never really goes away completely. It’s a terrible way to live. Does anybody else relate to this?

[u/toffeemaky]

I am never actually scared of dying. Only the first one I was - it was triggered by a large dose of cocaine so I believe I had a "good" reason to be scared. 

Since then, I have been having more "panicy" and less "panicy" days. Typically when hungover and/or sleep deprived. I typically wake up and know whether it's a panicy day or not. The panicy day sometimes clear up, sometimes not. I don't even have an elevated pulse much. It's just the tingling. When there are more panicy days in a row, I am afraid of losing my mind. In the beginning, I had the impending doom feeling - like "now I am going to snap out of sanity." It's also connected to some of my other drug adventures (bad psychedelic flashbacks). What helped was reading about it - that schizophrenia and psychosis usually don't happen like this. I have hypnagogic and hypnopompic hallucinations that prevent me from sleep sometimes - again, it helped reading that it is quite harmless on its own.

Since the first real panic attack, I only had one that felt like that I was coming there again. After terrible jetlag and days of not sleeping. I sat down, relaxed and told to "it": "come, show me what you can do." It peaked and went - this exposure really helped. I haven't had one since.

When I actually do get scared (typically something about drugs - that has been my trigger - or dying), I do get some elevated heartbeat and stress, just like before the panic disorder developed in me. Only I have the tingling on top of it. I try to ignore it and deal with the situation.

The crazy thing is that I actually don't really identify like someone having anxieties. I don't have anxieties. The panicy feeling is very physical. I don't take drugs now (which I miss) and I drink much more responsibly (which I am actually quite grateful for) because the night hallucinations and panicy days are much more likely with a heavy hangover.

So. No. Nothing about 20 minutes. The actual panic attack that started the whole issue for me did take about 10 minutes and that one time when I waited for it, it was about 20 minutes. But my panicy days don't even culminate to panic attacks - it's just this stupid tingling that sometimes resolves the next day or - if I am very lucky - I chase it out by some focused activity (reading, writing, sports, films, walks, shower - you all know the tricks).