A couple years ago (June 13 2013, to be exact), I had a massive panic attack. Unfortunately, due to my good physical condition due in large part to biking at my aerobic limit almost every day at that time, I didn't pass out like a lot of people would have. Instead, I spent a solid hour suffering through symptoms that most people normally only experience when running for their lives from an angry predator, before finally calling 911 because whatever was happening to me clearly wasn't ending on its own. By the time I got to the ER I was so wound-up that it took two injections of intravenous Ativan just to calm down my nervous system enough that my pulse didn't double every time I inhaled. (it's normal for your pulse to increase when you inhale, but my nervous system was overreacting to *everything*.) Having talked to a couple current and former ER nurses, the amount of Ativan they gave me should've made me fall asleep within a couple minutes, and the people I talked to were rather shocked that I didn't -- that should give you an idea of how bad my panic attack was.

Two years later, I'm still mixed up. I'd like to be able to ride, but the trauma of that first panic attack (and the subsequent 4-5 that I had in the following year before I got things under control) seared into my mind that an elevated pulse is absolutely, indisputably a sign of an impending panic attack. When I get on my bike and I start riding, my pulse increases for obvious reasons, and I have to fight like crazy to keep that "uh oh, here comes another panic attack" phobia under control until things stabilize and I stop feeling my heartbeat again. After that I'm fine, but it's a hell of an initial hurdle to get over.

Biking was one of my main outlets of stress. I've had to come up with others, which in fairness has caused me to grow my personality a bit, but I still don't bike very much. This year the most I've ridden is a few laps around a looping street near my apartment complex, and then over a bridge into the wooded side of a local park to go sit next to a creek and relax. I miss being able to just hop on my bike and feel good about feeling my body come close to "redline". I'm not as sad about it as I used to be, but I still feel broken.

Work stress, relationship stress, financial stress, burying myself under piles of work to keep my mind occupied, and riding as hard as I possibly could 4-5 days a week, resulting in physical burnout too. One of the biggest problems was that I'd never even heard of anything called a "panic attack" until after I got to the ER, so in addition to the immediate symptoms I also became convinced that I was dying, or at least suffering some kind of severe cardiovascular malfunction. So, rational fear of what seemed like my impending death, combined with a massively amplified sensitivity to fear and terror in all forms.

After the first panic attack I felt like my skin was on fire for the next week. Imagine taking a bath in hot sauce. That's how hypersensitive my nervous system was afterwards.

I screwed myself up good.

Hi Fyrestormer,
I'm really sorry to hear that you suffered so much at the time and still apparently, do.
I assume that you have had / are having counselling?
If not, I'd highly recommend that you seek some, as I would hope that it would help you, both physically and mentally.
Whilst it seems easy to self-diagnose the causes, they may well just be more symptoms rather than the real underlying causes and triggers.
Here in the UK, you would see your local GP (Doctor) and describe your symptoms and then they would quite likely refer you to a specialist. I also know that voluntary free services like this exist.
If even only some of the causes are work related, your employer surely has a duty of care to provide some assistance. I can understand if you want to keep things confidential and away from work, but please don't just suffer this alone and without professional assistance.
PM me if you want to chat off-line.

Col.

Oh yeah, I got counseling. Still am. I tried to solve it on my own for the first year, but whatever "broke" during the first panic attack made me much more susceptible to being overwhelmed by my emotions, and after the second round of crushing depression I got a shrink. Where I live, most shrinks are out-of-network for insurance purposes, because nobody wants their counseling to be reported to insurance companies because then it will get reported to the people who oversee their security clearances. (this despite the fact that the government *specifically says* they encourage people to get counseling and it will never affect clearance eligibility. Oh well.) So I'm paying out the ass for the guy's help because my insurance company won't cover out-of-network bills until I've spent $2600 out of pocket, but he has helped.

I haven't kept it a secret at work either; the worst thing you can do with a psychiatric problem is keep it a secret, but even if that weren't a factor, I was so messed-up for the first couple weeks after my first panic attack that there was no way to hide it at work. One of my coworkers later told me I *looked* mentally ill during that time; that's how severe my symptoms were at the time.

One of the more useful things my shrink helped me figure out is that I'm not having panic attacks, I'm having anger attacks -- but I'm so good at restraining expressions of anger that it leaks out as other negative emotions. Unfortunately, while that is a very helpful revelation, it can't undo the PTSD about the functioning of my cardiovascular system, and obviously the shrink can't reach in and rewire anything. All he can do besides help me talk about stuff is prescribe medications, and psychiatric medications are about 75 years less sophisticated than other types of medications. I've cobbled together a regimen of small doses of several medications and nutritional supplements that cumulatively have the effect I need, but strenuous exercise has all the same physical "symptoms" of a panic attack -- increased pulse, increased blood pressure, increased oxygenation, increased muscle tension, etc., and that's when the PTSD starts screwing with my head all over again. All the medications that directly treat PTSD symptoms just make me lazy, so they're no use in that scenario.

So basically my 756 leans against the walls and I check the tire pressure once a month or so, and rotate the bearings to keep the lube from solidifying. I have a large collection of remote-control trucks now, and an airplane coming soon, but as much fun as it is to hear a tiny engine screaming at 30,000rpm, it is of course not exactly the same as riding and feeling the power coming from within my own body. I miss it.

PTSD, oh how familiar that is to me.  Stayed hyper-occupied to avoid thinking too much for 30+ years after Vietnam.  Fortunately I finally crashed my way into the VA before going nuclear.

be patient, rebuild slowly and don't over commit.  Easy to say.

that's a nasty catch-22 :-(

You forgot one: Start something *and* finish it, and then after admiring your handiwork, realize that now you have to find something else to do, which means starting another project and having the burden of unfinished work hanging over your head all over again.

That's one of the things I really liked about riding; I could "get it over with" in a half-hour and move on to something else, but I could also know that I could do it all again the next day instead of having to find something totally new to occupy my time. In that respect it was like meditation for me, even down to the measured-breathing, but unfortunately I "meditated" so hard I gave myself athletic burnout, and didn't even deal with the root-cause of my stress in the process. If it had at least solved something, I could've felt better about it. All it did was postpone my inevitable meltdown -- but that's how my mind has always worked, distracting myself has never actually made me feel less-bad about whatever's bothering me. And that, in turn, has played its part in making my recovery much, much harder. I probably would've spent ten thousand dollars on medical tests over the past couple years to confirm that there really is nothing physically wrong with me, were it not for really good insurance.

"All of a man's problems stem from his inability to sit quietly in a room alone." ― Blaise Pascal, Pensées