Panic attacks can be very intense
and make you feel like death
is just around the corner.
And that feeling can intensify
your anxiety even more,
making the panic get worse and worse.
But can it get so bad
that you just die,
like from a heart attack?
The short answer is no.
People don't die from panic attacks.
If you want to know more about why, stick around.
I'm Dr. Tracey Marks, a psychiatrist,
and I make mental health education videos.
This topic is based on a viewer question from Sal.
Sal says, "Dr. Marks,
"A few days ago,
"my friend let me try her vape pen.
"I took a puff and a few minutes later,
"it felt like my throat was closing in on me.
"My arms felt really weak
"and I thought I was going to fall.
"My mom took me to the emergency room
"and while I was waiting,
"my arms and legs were jerking.
"I thought I was going to have a seizure.
"They put me in a room and I passed out.
"When I woke up, I felt better,
"but my throat still felt like
"it was slow to open and close.
"They told me I was high and anxious.
"Okay, so what if it was anxiety?
"I'm still scared
"if I do it again,
"I may completely stop breathing.
"Can the anxiety kill me?"
Thanks Sal, for your question
and I'm sorry you had that experience.
There's actually more to unpack here
than it would seem.
First, let me tell you how this situation
can be potentially threatening.
Vaping through e-cigarettes is associated
with constricting your blood vessels
regardless of what you inhale.
Vasoconstriction is where your blood vessels narrow
and you get less blood flow,
and therefore less oxygen to your tissues.
The damage that comes from vasoconstriction
doesn't happen after one use.
It's multiple uses,
but you can get temporary reversible
constriction that may go unnoticed by some.
But for people prone to anxiety,
that constriction can trigger a panic attack.
Then there's cells jerking.
Vaping is associated with an increased risk of seizures.
The FDA posted a warning on their website about this
and that reference is in the description
along with other article
references I use to make this video.
But not all jerking is seizures.
One easy way to tell is
if your arms and legs are jerking
on both sides of your body
and you're still conscious, it's not a seizure.
Seizures result from abnormal and disorganized
electrical activity in your brain.
That disorganized firing of nerves
can make your limbs jerk.
If the jerking happens on one side of your body,
it's called a focal seizure and you can remain awake.
But once the disorganized nerve firing crosses over
to the other side of your brain and affects both sides
of your body, you lose consciousness.
That's called a generalized seizure.
So let's assume Sal didn't have a seizure.
Constricting vessels can also trigger
muscle contractions.
Have you heard of the term
the claw hand in reference to anxiety?
The claw hand is an example of a muscle contraction
due to hyperventilation causing muscular contractions.
So sometimes a person in the throes
of a panic attack who is hyperventilating
can get contracted limbs
that make them believe
they're having some kind
of neurological problem instead of it being anxiety.
That kind of jerking
or muscle contraction is not life threatening,
but scary nonetheless.
So back to Sal's experience of throat closing.
Panic attacks can be experienced in a variety of ways.
There's the classic increased heart rate
and hyperventilation,
but sometimes there are
stranger symptoms like feeling a lump in your throat,
feeling numbness and tingling in your limbs.
The numbness and tingling
is not a reflection of impending paralysis.
You lose the ability to move your limbs
or become paralyzed when you have damage to your nerves.
Panic attacks don't cause that kind of damage.
What could be going on is hyperventilation
and muscular contraction that stimulates your nerves.
You feel the nerve stimulation as numbness and tingling,
and we call this paresthesias.
It's a weird activation of your nerves,
but it's not nerve death or damage.
It's actually evidence that your nerves are active.
Then there's the throat closing issue.
Real throat closing happens when the tissues
around your throat get inflamed and swell.
This is usually associated
with an extreme allergic reaction called anaphylaxis.
That process has nothing to do with anxiety.
Feeling anxious can cause contraction of the muscles
around your throat,
which gives you the sensation of a lump.
Now, there are other reasons you can have a lump
in your throat, like gastroesophageal reflux disease,
but a lump from anxiety is merely a sensation
and does not cause narrowing of your throat
to the extent that you won't be able to breathe.
So if Sal has another panic attack for any reason,
the lump doesn't just keep getting bigger and bigger
until it eventually closes off your breathing.
It doesn't work like that.
It's just merely a sensation due to the contraction
of the muscles in your throat or around your throat.
The last issue that Sal mentioned that could make them feel
like they could die the next time is passing out.
Most likely, the intoxication from the drug
they vaped made them feel drowsy and fall asleep.
But your breathing is controlled
by both the involuntary system
of your autonomic nervous system
and a voluntary system.
You don't have to stay awake to make yourself breathe
even if you have a lump in your throat.
If something makes you lose consciousness,
your autonomic nervous system will take over
and breathe for you.
Then the lump would probably go away
as your muscles relax.
So remember, an allergic reaction that causes
swelling in your throat
is what causes your throat to get blocked,
not the sensation of a lump from muscle contractions.
So no doubt, panic attacks are very frightening
because of all these physical symptoms that you can have
and many people think that they are dying.
Often a person with panic attacks will make several trips
to the emergency room
before they finally get help for anxiety.
A 2017 study found that 50%
of people with panic disorder
made six or more trips to the emergency room.
That's a lot of trips, but it happens
because even if someone tells you once or twice
that you don't have a serious condition
and you're not going to die,
each time you have another attack,
it can feel like this time is different.
It's like Groundhog Day.
You keep having these attacks,
but each time, you don't remember
how the last time it was anxiety.
You still think that this time
you have something more serious.
I hope, Sal, this put your mind at ease
at least just a little bit.
And you too, if you've suffered with this
or know someone who's had this very
scary experience of panic attacks.
Watch this video for more on
how to use your vagus nerve to calm yourself.
Thanks for watching.
See you next time.