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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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Before episode/attack:*hands tremor, *raised voice/quickened

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Before episode/attack:*hands tremor, *raised voice/quickened speech, *heart starts to beat faster at a quick pace.
These symptoms worsen, then: *all muscles seem to tense up and tremor, hands visibily shake. *start shouting more aggressively *heart literally pounds as if it may jump out of my chest. *sweaty palms. *loss of concentration of what i may be doing making things fiddly and i get more frustrated. I then worry about controlling myself and remove myself from the room. 5 to 10 minutes later i cry with being so overwhelmed that i'd act so angrily infront of my 1 year old, i realise exactly how i have just acted and feel stupid for it, i then feel sad and around 60+ minutes later i feel back to "normal" and "happy". i feel so ashamed i keep it inside and it seems as if it builds up then that is it's way of release as i can go days sometimes weeks then i have these is causing more problems with my partner as he triggers it more and doesnt understand. what is wrong?


I am sorry to hear of the situation. It sounds very much like you are experiencing panic attacks. Panic attacks are usually triggered when our anxiety/stress levels get very high. Do you know anything about Panic Attacks? I can provide you with information on what they are and what you can do to start bringing them under control if you'd like?

Customer: replied 4 years ago.

I haven't experienced panic attacks up until these unexplained outbursts of anger and emotion began in July, therefore I don't know much about them or how to control them. I would also appreciate advice on how to explain to my partner that I can't control what happens to me as it is making cracks in our relationship. Thankyou for your help.

Ok, I'll post a description of Panic Attacks & Panic Disorder below for you to look at and then some direction on how to go about treating them. I will also post a link to a self-help guide that I think you and your partner should read through together so that he can begin to understand how difficult it can be to control yourself during a Panic Attack.

A panic attack is a sudden surge of overwhelming anxiety and fear. Your heart pounds and you can't breathe. You feel dizzy and sick to your stomach. You may even feel like you're dying or going crazy. Left untreated, panic attacks can lead to panic disorder and other problems. They may even cause you to withdraw from normal activities.

In many cases, panic attacks strike out of the blue, without any warning. Often, there is no clear reason for the attack. They may even occur when you're relaxed or asleep. A panic attack may be a one-time occurrence, but many people experience repeat episodes. Recurrent panic attacks are often triggered by a specific situation, such as crossing a bridge or speaking in public - especially if that situation has caused a panic attack before. Usually, the panic-inducing situation is one in which you feel endangered and unable to escape. You may experience one or more panic attacks, yet be otherwise perfectly happy and healthy. Or your panic attacks may occur as part of another disorder, such as panic disorder, social phobia, or depression.

Panic attacks often strike when you're away from home, but they can happen anywhere and at any time. You may have one while you're in a store shopping, walking down the street, driving in your car, or sitting on the couch at home. The
signs and symptoms of a panic attack develop abruptly and usually reach their
peak within 10 minutes. Most panic attacks end within 20 to 30 minutes, and they rarely last more than an hour.

A full blown panic attack can include any combination of the following signs and symptoms:

  • Shortness of breath or hyperventilation
  • Sweating
  • Nausea
  • Racing heart/ palpitations
  • Chest pain or discomfort
  • Trembling or shaking
  • Choking feeling
  • Feeling dizzy, lightheaded, or faint
  • Numbness or tingling sensations
  • Hot or cold flushes
  • Fear of dying, losing control or going crazy
  • Feeling unreal or detached from your surroundings.
  • Becoming suddenly very tearful & emotional
  • Becoming suddenly very angry

Many people experience panic attacks without further episodes or complications. There is little reason to worry if you've had just one or two panic attacks. However, some people who've experienced panic attacks go on to develop panic disorder. Panic disorder is characterized by repeated panic attacks, combined with major changes in behavior or persistent anxiety over having further attacks.

You may be suffering from panic disorder if you 1) Experience frequent, unexpected panic attacks that aren't tied to a specific situation, 2) Worry a lot about having another panic attack or 3) Are behaving differently because of the panic attacks, such as avoiding places where you've previously panicked.

While a single panic attack may only last a few minutes, the effects of the experience can leave a lasting imprint. If you have panic disorder, the recurrent panic attacks take an emotional toll. The memory of the intense fear and terror that you felt during the attacks can negatively impact your self-confidence and cause serious disruption to your everyday life.

Eventually, this leads to the following panic disorder symptoms:

Anticipatory anxiety - Instead of feeling relaxed and like yourself in between panic attacks, you feel anxious and tense. This anxiety stems from a fear of having future panic attacks. This "fear of fear" is present most of the time, and can be extremely disabling.

Phobic avoidance - You begin to avoid certain situations or environments. This avoidance may be based on the belief that the situation you're avoiding caused a previous panic attack. Or you may avoid places where escape would be difficult or help would be unavailable if you had a panic attack. Taken to its extreme, phobic avoidance becomes agoraphobia.

Aagoraphobia develops as a complication of panic attacks. With agoraphobia, you're afraid of having a panic attack in a situation where escape would be difficult or embarrassing. You may also be afraid of having a panic attack where you wouldn't be able to get help. Because of these fears, you start avoiding more and more situations. For example, you might begin to avoid crowded places such as shopping malls or sports arenas. You might also avoid cars, airplanes, subways, and other forms of travel. In more severe cases, you might only feel safe at home.

Cognitive Behavioral Therapy (CBT) is widely regarded as the gold standard treatment for Panic. CBT is a psychotherapeutic approach that aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a
goal-oriented, systematic procedure. CBT is technique-driven, brief, direct,
and time-limited (normally 10-12 sessions). CBT is used in individual therapy
as well as group settings, and the techniques are often adapted for self-help
applications. I would strongly encourage you consider CBT as a treatment option
as I would expect you to benefit greatly from this approach.

If you'd like to tackle the problem on your own I would suggest you start by taking a look at this excellent CBT based self-help program here. It will teach you everything you need to know about anxiety, panic attacks, panic disorder and what you can do to manage your own symptoms. I use this material with patients regularly and I find it to be very helpful. Alternatively you can access some published CBT based self-help material to learn more about using CBT techniques. I can recommend the book Overcoming Panic. A Self Help Guide Using Cognitive Behavioral Techniques, you can find it here .

If you decide that you need further help getting it all under control then I would
suggest you consult with a CBT trained therapist. CBT is usually offered by
Clinical Psychologists (although not exclusively) and you can contact the American Psychology Association for assistance with finding one near you. Take a look at the American Psychology Association's locator service here. You can use this to find Psychologists in your area and there is a phone number you can contact if you want a referral arranged for you. Also, take a look at an article published by the APA here. It's an interview with a senior Psychologist and covers some of the things you should consider when you are looking for a Psychologist.

I hope this has been of some help. If you have further questions or would like me to clarify or expand upon any part of my answer please let me know. If not....I wish you the best of luck!

Dr John B and other Mental Health Specialists are ready to help you
Hi Vikki,
I hope you making some progress with the Panic Attacks.
If I can be of further help, or if you ever have other questions in the future, please don't hesitate to contact me directly. You can do this by simply putting "For Dr John B" at the start of any question you post.