EP 168 – The Panic Attack “Hangover”

The Highlights

• Panic attacks start, peak, and end.  That is the physiology of panic.  There’s no mystery there.
• After a panic attack ends, there will be after effects. This is normal and to be expected!
• The after effects of panic – the aftershocks – the “hangover” – generally compromise three components:

1. The physical after effects may last for 15-30 minutes.  Your body will absolutely feel different even after the panic attack itself has ended.  Adrenaline is no longer at its peak concentration in your bloodstream, but it is still there and being metabolized away. You will feel the effects of adrenaline while this happens, just in decreasing intensity over time.  This is totally normal. It happens to all humans because … physiology!  Please note that the after effects may last beyond 30 minutes if you are still at the state of your disorder where you are bracing, fighting, and trying to fend off the “next wave”, which may trigger undulating or repeating panic that goes on for some times. That will get better as you get better surrendering to panic and passing through it without fighting.
2. The mental/emotional after effects may linger for hours after panic. This is also quite normal, because humans react mentally and emotionally to events like panic. You are allowed to be human.  You may feel unsafe, uncertain, weak, or vulnerable in those moments.  You may feel like you did something wrong, or that you have someone failed because you allowed yourself to panic.  This is not true!  You may ruminate on being back to “square one” in your recovery.  Above all, you may feel afraid that it will happen again.  This is the critical mental/emotional after effect of a panic attack – the fear that it may happen again.   The fear of the fear is one of the defining characteristics of panic based disordered anxiety.
3. The behavioral after effects are really where the protracted panic attack “hangover” happens.  When you change your behavior to accommodate the fear of the fear, you are creating the long lasting hangover after panic.  Retreating.  Protecting yourself against the next attack.  Trying to not “re-trigger” it. Bracing.  Scanning for it.  Canceling appointments, hiding, and making sure that you don’t “overdo it”.  These are all common behavioral changes that follow panic. These are the behaviors that literally create panic disorder and agoraphobia, and these are the behaviors that perpetuate and fuel those disorders. When you retreat, you are fanning the fires of fear.  Being immersed in retreat, safety, and avoidance behaviors for days after panic will cement you in that “hangover” state!

The panic attack “hangover” is just a re-run of your pre-recovery life.  It is fueled by reverting to the old behavioral habits that used to fuel your disorder before you started your recovery journey.

What Can I Do About The Panic Attack Hangover?

First, allow yourself to be human, physically, mentally, and emotionally.  Allow space for the panic itself and the emotions that follow.  Then be sure you check yourself to short-circuit that reversion to old habits. You can be angry, frustrated, or afraid based on experiencing panic.  That is not a crime.  Just do not allow yourself to be dragged by those emotions and thoughts into old avoidance, retreat and safety behaviors.

It’s not how you feel after panic that determines the level of “hangover”.  As usual, it’s what you DO.  So go forward with recovery, and with life.  Do your best to treat your panic attack like a non-event, even when you want to make it into a huge event.  With time and experience, this changes things, even in long term recovery.

See you next week!