Should You Go to Urgent Care or the Emergency Room for a Panic Attack?

Panic attacks. These sudden bursts of extreme anxiety and fear plague many people who suffer from anxiety disorders. In fact, according to the Anxiety and Depression Association of America, an estimated 40 million adults in the United States have anxiety disorders. That's a little over 18% of the U.S. population as a whole. 

While most people have heard of panic attacks, not everyone has experienced them firsthand. For this reason, it can be difficult to recognize the attacks as they’re happening, either in yourself or other people. Some people may go their whole lives without ever experiencing a panic attack. They're one of the lucky ones. Others might have experienced them in the past, but lack the knowledge to determine when this health issue has occurred.

That is why it's important to know what a panic attack looks and feels like. More importantly, it's vital that you know how to get the support you need. Here are some of the top things you should know about panic attacks and what you should do when you or a loved one is struck with this condition. 

What is a panic attack? 

A panic attack can take many forms but it's typically described as a physical response to intense feelings of stress, anxiety, or fear when there is not an actual threat posed to the individual. In some cases, panic attacks occur because of a traumatic event or as an anticipatory reaction; for example, people who are scared of flying might worry about an upcoming flight, triggering a panic attack before take-off. In other cases, feelings of stress can simply come to a head and trigger a fight or flight reaction. 

While panic attacks are not life-threatening, they can feel incredibly worrisome to the person experiencing the attack. Here are the most common symptoms someone might experience during a panic attack: 

• Racing heart and shortness of breath

• Chest pain (which can make the person feel like they're having a heart attack) 

• Feeling like they have lost control 

• Fearing sudden death 

• Sweating, nausea, and headaches

• Trembling, shaking, and chills 

• Dizziness or lightheadedness 

Keep in mind that these symptoms vary from person to person and there isn't always a trigger to inspire these sudden feelings. As such, it can be hard to tell whether the person is undergoing a panic attack or urgent health crisis. 

When you should go to the doctor, an urgent care clinic, or the emergency room

It's not uncommon for people suffering from a panic attack to fear death. After all, the sudden heart palpitations and chest pain can make many people think they're having a heart attack. If you are experiencing a panic attack for the first time, Webmd recommends that you go to the emergency room to be sure that it isn't a serious health issue. There, a doctor will be able to determine if you're experiencing something life-threatening, like a blood clot or heart attack. When it comes to your health, it's always better to be safe than sorry. 

If it’s the first time and you don’t know what’s happening, the emergency room is the right choice.

Should the ER doctor determine that you're suffering from a panic attack, they will encourage you to visit your primary care physician or a local urgent care center like these in Washingon State. (Editor’s note: Indigo Urgent Care actually put together this guide for us). At an urgent care center, you can expect a physician to go over your mental health concerns and offer advice regarding the next steps you can take. In most cases, this will be a referral to a mental health professional, like a psychiatrist or a psychologist. 

If you know you're having a panic attack, visiting your doctor or an urgent care center can also be a vital resource to help get you through the episode. For some people, simply knowing a medical professional is near can help them feel at ease to help the attack subside. 

What to do when you're experiencing a panic attack

If you know that you're having a panic attack, practicing relaxation techniques is one of the best ways to calm its effects. Deep breathing exercises and grounding activities can help distract you from the feelings of panic. You might also want to rely on a friend to help distract you. 

Keep in mind that most panic attacks usually subside within 30 minutes. Should this episode last even longer, seeking medical attention is advised for a more serious condition. 

At the end of the day, your health is the most important thing. Panic attacks are becoming increasingly common since more people are suffering from anxiety but it isn't always easy to tell when you're having an episode. Rely on the help of your doctors and mental health professionals to keep your health in check. 

I Experimented With... A New Way to Change My Body Temperature

The only prototype of a new Kickstarter campaign, Calm Cuffs is a great idea from two Wisconsin sisters.

I loved the note I got from Elizabeth Paulson, one of the women behind Calm Cuffs:

Our mother is a saint. Except when she gets too hot. It's always been like this. This sweet woman would be lovingly sewing our Halloween costumes one day and then the next she's hurling a spatula across the kitchen because the oven is on and the pasta is boiling and it's too hot.

She goes on, “Same for our nephew. He’s five and sometimes the world just gets to be a bit much for him. With him, it’s not big heat, it’s big emotions. One day, instead of letting OUR emotions get the better of us, we raced to the freezer and put a bag of frozen peas on our nephew’s wrists. It was as if we'd switched the "off" button. He felt calmer instantly and was back to his old self a lot faster than usual.”

I especially loved the way Elizabeth described why they thought of creating this product: “And, as 30% of the population does, our sister suffers from anxiety. As we used cool to help our mom overcome menopause and our nephew take deep breaths in the midst of big feelings, we found that applying cold to the wrists of our anxious sister helped her feel better. “Someone should invent ice packs for wrists,” my mom said. “For all of us.” So we did!”

The result? Calm Cuffs launched today on Kickstarter. Check it out.

Calm Cuffs helps when anxiety hits by: 

• Immediately cooling the skin

• Applying pressure to wrists, a known acupressure point, that helps alleviate secondary symptoms of anxiety such as nausea

• Stopping the “fight” or “flight” reflex

• Giving your body time to cool down

The prototype Elizabeth sent me is smaller than the “real” product will be. At just 21 cm, it was too tight for me to wear comfortably. My daughter, however, gave it a try and gave it the thumbs up.

“I love it!”, she said. “I just want two and I hope they stay cold a long time.”

If you’re interested in experimenting with a product like this to alter your body temp, you might want to kick this duo a few bucks to get their product off the ground (and stay in the loop as soon as it comes on the market). Would you use something like this? Comment below and let us know.

Keep exploring, fellow Beautiful Voyager. And keep inventing.

I Experimented With...Diffusing New Smells In My Room

I took this video of the diffuser in action — you can hear that it has a little white noise element that is the sound of the oil bubbling, but is overall very quiet.

The good people at Organic Aromas were generous enough to send me a diffuser to test, to see how changing a scent in my room might help me with my anxiety symptoms like migraines and nausea. They also offered to give Beautiful Voyager a diffuser as a giveaway, so you will get the chance to try out a diffuser like the one yourself!

The diffuser they sent me is called the Opulence - Nebulizing Diffuser. I like its simplicity, and the way the glass lid fits into the glass carafe stem.

Gayle of Organic Aromas also sent me a lavender essential oil to try in the diffuser. The essential oil seems high-quality and very potent (though what do I really know about essential oils? Not much).

I really liked that this diffuser doesn’t need water added to it. You just drop in 20 drops of the essential oil, plug it in, and let it run. The effect is immediate in your room.

In terms of how the new smell affects me — it depends on the day! I find that hormones greatly affect my sensitivity to smells. On days when I am super sensitive, I run the diffuser just a short time to bring a relaxing smell into the room. On days when I’m less sensitive, I let it run more. If you don’t like smells, a product like this won’t be for you, but if you’re like me, and you like experimenting with new smells to change your state of mind in a subtle way, you might want to give it a try!

NOTE: I just learned from Gayle that the bubbling sound in my video is due to a need for me to add more essential oil! It is a soothing little notification that the diffuser is out. She notes, “if there is a bubbling that means that there is probably not enough oil on the diffuser. When you see or hear bubbling, if you dont like or want it, you can just add a few more drops of oil and it will go away. Also, you should try to use your diffuser on the LOW volume setting if you can. The diffuser is more than powerful enough on the LOW to cover any bedroom or small office space in a matter of minutes. Once the aroma reaches the desired level you can choose to turn the diffuser off at that time.” Thank you Gayle!

I’ll be updating this post with news about the giveaway as it happens. More soon!

I Experimented With...A CBD Subscription Box!

CBD bath bomb. This is the second one I’ve tried. Perhaps you remember the first ?

As a long time migraine sufferer with frequent nausea and motion sickness, I am always on the search for new products to experiment with. I never know what will help, so I have to keep an open mind when trying new methods. Recently the good people of Hemp Crate Co offered to send me one of their CBD subscription boxes filled with products to try. I took them up on it just to see what I could learn!

Here are the products the box included:

Dr Norm’s CBD chocolate chip cookies. These reminded me a bit of my childhood in the ‘80s with their Snackwell-esque vibe.

You put this CBD oil under your tongue and hold for 60-90 seconds. Once you’ve done that, you’re allowed to swallow any remaining oil.

I also haven’t tried this either but there’s no CBD here.

Truthfully I haven’t tried this yet but am looking forward to brewing it up.

I tried these first. Interestingly, I don’t see them on the site anymore, but they were tasty.

It was a treat to be able to try a variety of products, and I liked that this site tries to help educate its consumers about CBD in general.

CBD: Is it for me?

The truth is: I don’t totally know. I’m still finding my way through the world of CBD products. I’m also on 15 mg of Lexapro every day, so it’s hard to know whether the impacts of CBD would be felt more if I weren’t on an SSRI. I can say that CBD certainly doesn’t seem to have adverse effects on me, and as long as I am lucky enough to get to explore new products, from reputable sources like this one, it feels worth the try.

Have you tried any CBD products that helped you with anxiety or migraines? Share what worked for you!

Is Migraine a Chronic Illness?

I’ve suffered from migraines for as long as I can remember. There were times I’d come home from elementary school, go straight to bed, sleep until 7pm, wake up for 30 minutes, eat some pudding and go back to bed. The next morning I would have a “leftover headache,” a general achey gross feeling that lingered until I got moving for the day.

I am 34 now. To say that my migraines have gotten worse since those early days would be an understatement. They are much worse and MUCH MUCH more frequent than when I was a child. I’ve been told countless times that I would grow out of them, or that it is just a stage in my life, or that I should eat more bananas, or maybe I should change my diet or go see (fill-in-the-blank).

I have NOT grown out of them and judging from my family history, there is a good chance I won’t. It’s OK. I’ve come to accept that, this is just part of who I am. This isn’t resignation but it is a sort of acceptance, radical acceptance as they say in the psychology world. It’s accepting something for what it is, moving forward and coping, because not accepting it tends to make it worse, I become angry and frustrated. It isn’t giving up on trying to learn more about them or hoping for a change, but it does mean being able to accept the migraine and MOVE ON with my day.

I’ve tried so many different things to try and get relief but I also get so much unsolicited advice, so I thought I would go over what I do do to fight my headaches.

Things I’ve Explored to Help with Migraines

1. Message therapy

2. Chiropractor

3. Acupucture

4. Physiotherapy

5. Excercise

6. Prophylatic Medication (I have had some success with Gabapentin)

7. Botox (not for my wrinkles!)

8. Nerve block

9. Medication for acute migraine attacks

10. Dietary Modification (I don’t eat gluten)

11. Hormone manipulation (birth control pills to regulate the hormone levels)

I’ve done all these things and yet I still suffer ALOT! Yesterday was my first headache free day for about a month and a half. I recently changed my medications around and it was NOT working well, so I have really suffered.

I’m not one to complain, although I’m sure my family is as tired of my headaches as I am and although I speak of acceptance, the anger, bitterness and frustration certainly mounts at times. Yesterday when I was headache free I had more patience, and energy for my kids then I normally do. It made me realize how much my headaches affect me. People are often amazed at how much pain I live in on a daily basis. I try not to let it affect me, I try and push through, or “sit in the pain”, as I’ve called it. Obviously there are days where I can’t push through, those days are the ones where the migraine kicks my ass! I HATE those days, because it’s yet another lost day!

I’m sitting right now, with yet another headache and a head cold, I feel gross, I feel exhausted, but I’m thankful. I’m thankful I had a day like yesterday, pain-free, light, clear, because I know I’ll get it again. The pain-free days are the days I hold onto when I’m dealing with a long stretch of migraines, they are the light at the end of tunnel.

Do I have a chronic illness? Yes. Do I like that? Obviously no! Does it define me? Hell no! Sometimes I wonder if it should though. Should I live my life in a way that allows me to accept my chronic migraines into my daily life? I don’t know, sometimes I think so, but what would that really accomplish? I have a career, I’m currently doing my Master’s of Nursing to become a Nurse Practitioner. My migraine friend is always with me, but it doesn’t stop me, it might slow me down somedays, but it doesn’t stop me.

I am having a hard time posting this blog to be honest. Not that I keep my headaches a secret but because as much as I say I’ve accepted it, writing about it makes it more real, makes it public. But whatever right? Maybe this will inspire someone else to push through!

So…..it is what it is! It’s part of me, it’s made me stronger.

Do you have migraines or another chronic illness? How has it affected you? Comment below!

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This essay was originally published in the Beautiful Voyager Medium publication.

What Chronic Illness is Like for a Nurse

Pamela Fellbaum, cozying up.

I don’t love talking about chronic illness, especially when I’m referring to myself. I balk at the notion I belong to that category. Over the years, however, I’ve come to accept that about myself.

I’m currently finishing up a two year full time Nurse Practitioner program. This has easily been the hardest two years of my life. I’ve appropriately taken on the word “PERSISTENCE” as my motto as I feel that although I have worked my way through the program it has taken more persistence then I ever thought possible.

For example: I suffered a significant concussion in the first two months of my program that limited my ability to read (try reading endless articles and writing scholarly papers feeling dizzy and nauseous and knowing medically that you were probably doing more damage by not resting your brain). This past January I was in a car accident where a pedestrian was struck and I was the first on scene. Luckily the young man was ok, but to say it wasn’t traumatic would be an understatement. Then on top of all of this is the chronic pain of my migraines. It’s hard to explain really, and probably even harder for someone to understand, but I pretty much function on a daily basis with some form of a headache, sometime mind numbing pain, other times just a general feeling of pressure! To make matters worse stress will frequently increase the pain and severity of my headaches! (and its been stressful!)

Mine is the orange truck…..I wasn’t hurt…but it was a crazy mess!!!

So…..yes, I’ve had some challenges, but I’m not writing this to ask for sympathy or a “good job”, I’m writing this because I’ve recently realized that there may be a purpose behind my struggles, behind my pain.

I’ve seen many patients that are dealing with chronic pain. I can see the mental pain when they realize this problem isn’t going away. As their practitioner, I don’t want to tell them that there is a cure, or that they may become pain free — perhaps it may happen for some, but it isn’t often the goal.

So I have sat back in my chair and listened as they tear up. They speak about the things they have given up and the stress that it causes their family. But as they speak, I have realized something — they are grieving, and THAT I could relate too.

When I label their pain as grief I can see the stress float away. There is a realization that it is ok to feel the way they feel, and that maybe, just maybe, there is a light at the end of the tunnel.

I wouldn’t have come to this conclusion without my personal struggles, and that being able to relate to my patients is a gift I’ve been given. Is my pain a curse on me? or a punishment for something I’ve done?? Well I’ve considered this, but in the end I reject those ideas and instead embrace the reality that my pain eases others, the empathy I possess gives others hope.

This gives my pain purpose, and this purpose gives ME hope which allows me to embrace it and move forward.

What about you? Do you experience chronic pain? How do you get through it?

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Pamela is a nurse practitioner in Canada. This essay originally appeared on the Beautiful Voyager Medium publication. Read Pamela’s essay What I've Learned By Chronicling Pain. Want to share your own story? Here’s how.

How I Faced My Travel Fears And Explored the World

Gilad at Lake Atitlan, Guatemala

I wanted to interview travel writer Gilad because I love that he focuses helping nervous would-be travelers realize that travel is for everyone. Gilad has hypochondriasis, OCD and moderate anxiety, but as you’ll see, it hasn’t stopped him. - Meredith

1. When did you first start working on your site? What prompted it?

I started working on Anxious & Abroad a few months ago because I wanted to fill a gap in the online travel community. Before my first trip, I did extensive, admittedly ridiculous research to find out everything I needed to know about where I was going (which happened to be Southeast Asia).  

Gilad in Dalat, Vietnam

What turned out happening was that the questions I really had about travel had more to do with my concerns and fears about it than the actual destination I was going to. I wanted to know what I needed to pack, how to effectively plan a trip, what sorts of things I would need to be prepared for, as a guy who struggles with anxiety and Obsessive Compulsive Disorder. I needed to hear from someone in my position that they had done it, that they shared my same concerns, and that they didn’t die in a Cambodian prison. And instead, all I was finding were these picture-perfect instagram nomads who seemed to have nothing in common with how I felt. 

 So in the end, I saw my site as an opportunity to add to both the travel and mental health communities as a way to show people that the fears they have about travel are manageable and worth pushing past. Before my first trip, I never saw myself as the type of person who backpacks. I had a mental image of what a “backpacker” looks like, and I just didn’t fit that mold. But since then, I realized that it couldn’t be more false, and I wanted to show other people that they don’t have to subscribe to this notion of the carefree nomad -- that they can (and do) fit into the travel community exactly the way they are. 

Gilad in Saba, Vietnam

2. What has been the hardest thing about connecting with others on the topic of anxiety?

Honestly, my biggest obstacle has been myself -- my blind confidence that I’d be rejected for talking about it. Before talking about my anxiety, I was so concerned about being judged or looked down upon for what I considered my emotional shortcomings. But I was pleasantly surprised by how many people in my life not only welcomed the conversation, but had deeply related to it themselves. 

I think a lot more people struggle with mental health than we think. Our anxiety wants us to think that we’re the only ones in the world who deals with these things, but the reality is that everyone has something they’re going through, and we can frequently find a common ground by talking about it. We just need to be brave and share our stories.  

GIlad with travel buddies in Minca, Columbia.

I also think that we live in a really, really remarkable time when empathy and mental health awareness are in vogue and not nearly as taboo as they used to be. 

3. What have you learned about travel? How has it changed over time?

 If I’ve learned anything about travel, it’s that it’s not nearly as scary as we think it is. I used to be convinced that if I went abroad I’d: 

• Get lost

• Get kidnapped

• Get sick

• Get into trouble

• Get murdered

• Get sold into sex slavery by a drug cartel and go to prison for having drugs in my butt 

 And now, after 4 years of travel to over 20 countries (some of them solo), I’ve noticed that the things we worry about are often so blown up in our heads that the reality is so much simpler. I’ve been welcomed by locals, I’ve taken buses alone, I’ve tried sketchy foods and I’ve lived to tell the tale. The only real solution to things that are blown out of proportion is using experience to put them back in proportion. I really believe that.

Don’t be afraid to travel, you guys. In all honesty (and you can take it from me, a guy who catastrophizes everything under the sun) travel does not have to be intimidating, scary, or lonely. You can do it. I did it, and you can too.  

Looking out on Peru.

4. What do you wish other people knew about anxiety and travel?

I don’t know if other people share this same insecurity as me, but I genuinely thought that travel wasn't for me -- that somehow, because I didn’t fit that “backpacker” image that instagram was selling me, that I couldn’t backpack. I didn’t look like them so I didn’t think I’d think like them. Shared dorms, strangers, no cell service -- it all felt so impenetrable for a Type-A person.  

But once I started traveling, that feeling so quickly dissipated. Shared dorms were nicer and cleaner than expected; hostel strangers turned out to be super friendly; no cell service turned out to be a really freeing feeling. 

I want people to know that they are the type of person who travels. There is no one type of person who can do it and one who can’t. You just have to be open enough to push yourself past your comfortable boundaries.

Rainbow Mountain (ed note: I had never heard of this place, but now want to go).

5. If you could take a trip with one person, living or dead, who would it be?

Ooh...this is a good question...I’d think I’d have to say Steve Irwin. I’m a big nature buff...I leave big cities as soon as I can when I travel. Steve was my hero for most of my childhood, and it would be such a treat to hike, trek and dive with that guy. I feel like he’d just randomly pick stuff up and put it in my face, like “here, check out this fatally poisonous snake!” Hell...I’d even get some matching short shorts so we could be twins.

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If you have questions about travel and anxiety, ask them here! Gilad would be happy to answer and share travel tips, too.

The Small Habits That Helped My Social Anxiety

By Marc Kraft

Growing up, I was always on the shy side. I tended to let my actions speak louder than my words. Sometimes it was a good thing, although strong communication with others is important trait in our society today.

By the time I reached college, that shyness transformed into social anxiety. Even though I have a great network of friends and enjoy spending time with them, I would have intense panic attacks and get extremely nervous in certain situations.

This anxiety has sent me down the path of testing to options to reduce my anxiety and panic attacks. I’ve tried nearly everything under the sun to gain control of my mental state. While most approaches didn’t work for me, there are a handful of habits that have made a meaningful impact on my life.

Meditation

Meditation is now a critical part of my daily routine. It’s the first thing I do in the morning. Even before checking email or scrolling through Instagram. This helps me start the day with a clear mind.

Meditation is like going to the gym for your brain. While it may feel like a waste of time at first, it’s important for training your brain to improve concentration, focus, and have greater control of your thought patterns.

Supplements

This can be a controversial subject and it’s important to discuss any changes with a trained medical health professional. With that in mind, I’ve had great success taking ashwagandha and a multivitamin in the morning, and magnesium glycinate in the evening,   

While this combo may not work for everyone, I had positive results after taking these supplements within the first few weeks. It’s also important to note that supplements are not all created equal. Do your research on the products you purchase before opting to put them in your body.

Working Out

You’ve likely heard how beneficial exercise can be for your mental health. This approach is an easy one to skip because it takes some serious will-power to get your butt off the couch! But I’m telling you, it’s worth it!

Consistently going to the gym has done wonders for my mental health. My anxiety kicks in the most in the mornings which is when I try to get my exercising in (2-3 times per week).

Take a Bath

Taking a bath is an easy way to trigger instant relaxation. I use this a ritual when I’m feeling extra anxious or in prep for stressful events.

Add in some epsom salt (Magnesium Sulfate) to take your bath-time to the next level. This is another great way to get your magnesium levels up if you aren’t getting enough magnesium in your diet and are not a big fan of supplements.   

Limit Caffeine

My body is sensitive to caffeine. If I have more than one cup of regular coffee in a day, it leads to some nasty anxiety symptoms. Since I love the act of drinking coffee, I often mix regular coffee with decaf so I can enjoy a few cups of coffee with lower caffeine content.  

In Closing

With these habits, I’ve been able to shift my anxiety to levels that I am comfortable with and the panic attacks are less frequent. Also, when they do occur they are less pronounced and pass faster.

I hope some of these tips work as well for you as they did for me. Remember it’s all about testing to see what works best for your body and your particular state.

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Marc Kraft is the creator of Mindful Searching, a site dedicated to providing accurate information around mental health and wellness. Marc has improved his brain health through self-experimentation over the last 9 years. Curiosity is his driving force.