How to deal with panic attacks in S&T/IBD?

BOBBERT's picture
Rank: Senior Monkey | 90

I didn't realize I was stressed... I thought I was just tired till one day I hit the ground in full panic and haven't been the same since. I'm scared its going to happen again. Im young and fit, this shouldn't be happening to me, but it is. I need advice to get through these panic attacks. I'm on meds now and I dont feel like myself. How do you all cope?

Mental health is in the shitter right now. Im depressed and anxious.... Advice from anyone who has had a panic attack before would be appreciated. Thanks

Comments (32)

Most Controversial
Jun 29, 2019

never had a panic attack before but i'm sorry that this has happened and good luck getting back into better shape

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Most Helpful
Jun 29, 2019

Okay, I am sure you are not the only one. I hope you get better and it was just a one-time thing.

On another note, I hate to be THAT guy but at some point this career path cannot be worth a huge sacrifice on your health. I have heard many stories from this forum about people suffering from some weird stuff that doesn't seem normal for people between 20 and 25 years old.

It is very likely that people exaggerate in an attempt to get others to feel sorry for them and I have considered that possibility. With that said, if people start experiencing things like panic attacks so young, I can't help to think it's a sign to change something.

I haven't had experience in this field, so I may be completely off. If that is the case, please someone tell me.

My point is that this is just a job and no job is worth significantly deteriorating your health. Life is way too short for that.

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Jun 30, 2019

Have you spoken to someone who is a therapist? Personally, I think it would be very beneficial. To be straight forward, talking to someone about issues regarding what makes you panic or stress out will be very rewarding. Going forward, finding someone who will listen to you and acknowledge what is going on with you and give you advice will be the greatest self-help that I can recommend. It has been legitimately the most beneficial help I have ever had in my life.

"It's okay, I'll see you on the other side"

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Jun 30, 2019

I would focus on your health first over anything. This work might not be for you if you do have severe anxiety. There's nothing wrong with that and you can always move into somewhere else in finance.

Keep in mind if you don't make real lifestyle changes soon you'll end up making your health problem worse in all likelihood.

I ran into bad health issues (severe spinal stenosis) when I was young and ended up taking the most roundabout way into PE, maybe it will work out that way for you too.

Jun 30, 2019

Hey, first off being young and fit and having panic attacks have nothing to do with each other. I consider myself very physically fit and that doesn't stop occasional panic attacks from happening, especially when I'm already feeling off, so don't beat yourself up over it. Some immediate things you can do are (1) figure out if there's something that specifically triggers these so at least you have a little warning and (2) work on breathing techniques to counter hyperventilating and to give you something to ground yourself when you feel yourself starting to panic. There are lots of meditation apps and websites that can give you exercises to work on.

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Jun 30, 2019

Happened to me first year on the desk, and took me like 2-3 months to get completely back to normal. What you need to focus on is visualizing in your mind that everything's going to be alright. Go to the pool after work, relax, drink tons of water, and eat really healthy. Make sure you're going to sleep at good times 930-10 PM. If you don't do those motions, your physical health is going to seriously deteriorate. What a lot of people don't realize is that the stress you experience your first year on the desk is EXTREME, especially if you're at a shop that has even a half way decent franchise. You'll get used to it, it's just going to take some time.

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Jul 2, 2019

Not sure how an IBD analyst is going to be sleeping at 10PM...

Array

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Jul 2, 2019

Why are we assuming he's an IB Analyst...his tag shows ST.

Jun 30, 2019

Been there before. Palpitations, severe stomach pain all the time, panic attacks (short and intense or long with the slight feeling of suffocation for a few hours.), big ups and downs, dissociation, etc. Music performance is hell when it's serious; I'm glad to be out now.

Specifically on the panic attacks: When it comes to being short of breath, you actually aren't. It feels like hell for a minute, but making yourself breathe very slow, medium breaths that don't feel like near enough can help things reset. I'd also really suggest guided meditation. I use the headspace app every day. It really helps with acknowledging and noting things rather than just trying to avoid them. Basically accept that you're thinking this or feeling that and kinda letting it pass. For example, accept that you are anxious and even anxious at the fact that you are anxious in the first place. I've found this to be very effective.

Regarding the meds: I really think they should be temporary last resorts for these problems, something to alleviate symptoms while you sort out the underlying problems. I won't get into details because I'm not really that anonymous on here, but I witnessed an entire side of my family controlled by an illness for which they took all sorts of pills. I promised myself I would conquer it without being a slave to medication and I did. That's not what I publicly recommend for anyone though. If something is giving you an edge with minimal downside/dependency and you're in a bind, certainly take advantage of what's available. I've just seen too many people with shit lives trying to fix them with an eleventh pill to take every day. It doesn't work.

It's ok to be stressed and anxious and have panic attacks and whatever else. Your concern for it can exacerbate the problem. Have some faith in yourself that you are going to get more sorted out in the long term. I could probably write a volume on this thread, so I'll cut it here. You can pm me about any of this.

JUST DO IT. Don't let your memes be dreams.

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Jun 30, 2019
BOBBERT:

I'm on meds now and I dont feel like myself. How do you all cope?

If you're on Benzodiazepines, you should feel relatively normal. Its not like they gave you Oxy or something. If you don't feel normal on Benzos, it may be psychological to the extent that you think its messing with you when the drug is not. You legitimately may have an issue with the drug, but it is probably unlikely.

I'd say to be well aware of your behavior patterns and when you do things like catastrophize (thinking the worst thing will happen), you can catch yourself before you lead to a full blown panic attack. Even if you get there to full panic mode and the voices start to get louder and louder around you and you feel like everything is caving in at the same time, you can still resort to deep breathing. Change scenery. Take a walk.

But, the mind is like a forest of neural pathways. Every time you let yourself walk down that path to a panic attack, the more likely you are to take that path again in the future. So calm yourself down and do an activity if needed to take your mind off of things. I think Xanax is prescribed in particular for panic attacks, so talk to your psychiatrist on what they feel is the best for your situation and dosage recommendations.

Having a circadian rhythm and getting a good night of sleep and hydration and good nutrition are going to be the basics of good mental health. We can feed our brain shit for nutrition and be dehydrated and then if we are stressed, it could lead to increased anxiety. Be aware of the basics of your life health for avoiding a buildup anxiety. If you skipped a meal and are dehydrated running around in a panic - sure it will increase the likelihood of clinical anxiety. Drink water like a boss. Buy La Croix. Everything helps.

I would also emphasize working out until you feel like you're dying a few times a week. It will clear out that anxiety no prob.

"If you always put limits on everything you do, physical or anything else, it will spread into your work and into your life. There are no limits. There are only plateaus, and you must not stay there, you must go beyond them." - Bruce Lee

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Jul 1, 2019

Start seeing a therapist - I notice you are on meds, so i'm guessing you saw someone, but do not simply rely on medication or just yourself. I'm very serious about this - just do it. There's a huge stigma to men, especially, getting help and it's bullshit. I started about two or three months ago - I was having the same issues. All the normal issues related to stress induced anxiety, primarily a lot of stress my body was internalizing and I didn't realize it. Start working on yourself and you will not regret it.

A few other tips:

  • Dial back on the caffeine. I used to drink a ton of coffee, now a cup here and there will do it for me. It simply amps up any anxiety you are having creating an awful feedback loop. Until you can control and/or handle your anxiety try it out.
  • Exercise more, I've found first thing in the AM helps. Running, oddly, especially helps. Just 30 minutes and a few miles does the trick - anymore is a bonus (especially if your schedule is rough).
  • If you find yourself having some anxiety, get up and walk away. Obviously don't take five hours and/or abandon your job - just walk around, deep breathing (a few second in, a few second out) will help as well. The other advice I will give you is simply focus on positive reinforcement - that you will be fine, it's happened before and you are still fine.
  • Alcohol. I like to drink, I don't avoid it and don't plan to stop - however if you are having anxiety and/or simply trying to figure out how to cope with it, I would cut back as much as possible. It, like caffeine, can exacerbate it and create a fucking awful feedback loop. Again... YMMV.

Overall, my point is to take care of yourself. Take stock of where you are, what you need to do and start moving there.

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Jul 3, 2019

Walking helps. I've been there too on panic attacks. Short of breath, chest pain, hyperventilation. You end up having too much O2 and too little CO2 so you end up feeling like you're having a stroke... terrifying feeling. I also get esophageal spasms from time to time on uppers which feels the same as a heart attack.

Need to tell your body that it's non-cardiac related and you need to expel CO2 so any activity helps as that burns up the excess molecules and brings respiratory system back into balance.

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Jul 1, 2019

I suggest you just don't worry about it.

It happened to me once, I eventually realised what it was, accepted that there was no rational reason to have one, and never had one again. For me the scary thing about a panic attack is not knowing what is happening, so being armed with this knowledge stopped me worrying about it happening again in future.

A friend experienced panic attacks too. He kept worrying about having panic attacks. Eventually he was put on medication to stop him having panic attacks. The medication usage instructions stated that side effects could include death... which then gave him a panic attack. Possibly the most ironic thing I've ever heard of.

I don't know if it's actually helpful, but all I can suggest is to just chill out.

Jul 1, 2019

Hi @BOBBERT, The best remedy for panic attacks is always trying to make yourself happy by doing any of the simple recreational activities. Meet new people of your same interests and try to keep yourself engaged. Talk to any of the one people whom you TRUST about the stress issues that pushing you down. Unless you are suffering from multiple panic attacks in a day or week, you need not think about consulting a doctor. Hope you get back to normal!

Jul 1, 2019

I started using Headspace when they became a little more frequent, it's not a cure but it at least helps me go from feeling like I'm about to die to just an anxious disaster.

Jul 1, 2019

There is a short practice for in the moment of panic attacks called "grounding". It has to do with finding 5 objects in the room you can see, then 4 things you can touch, three things you can hear, and so on. It's more about distraction. Look into it, it's helpful to me in the actual heat of an episode.

Jul 1, 2019

Never had a panic attack but have certainly been very stressed before. More by the atmosphere and people rather than my PnL.

That said. There is some good advice in this thread but a few things I have not noticed being mentioned.

  1. This is all a game. It's not reality. Try to remember that. Our jobs in finance especially markets are fantasy and we are lucky to participate. That said it's still a game.
  2. Have you thought of yoga/meditation? Different things, I know. But someone else mentioned breathing techniques. It may be worth your time and dollars to explore some of these things and hire someone/join a class or read up and try to practice on your own. Perhaps in the morning before work and then before bed again.

Good Luck

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Jul 1, 2019

Hey, I didn't read all comments above, so sorry if some things are repeated, and also everything I'm about to say is from personal experience, we may have different experiences.

First I just want to say you are not going crazy, that was a big issue for me, once this low lingered for awhile I thought it was a deeper issue (schizophrenia, brain tumour , etc.)

Second, before I go into helping deal with the issue in the moment, the most important thing is to prevent these feelings in the first place. The best way to do this is to take care of your physical health. You say you are active, but have you been slacking in some aspect of your life? Are you going to the gym, are you eating healthy, are you cutting back on alcohol/drug use, are you giving yourself mental breaks, I.e hanging out with friends or meditating? The big thing for me when I'm in these low moments is to cut back on alcohol and caffeine and get back into the gym.

Third, regardless of how healthy you are there will be times where the stress in your life momentarily takes over. Everyone handles it their own way but for me it's first take a step back, go to the washroom or somewhere semi-private and just focus on breathing and nothing else for a couple minutes. Once you calm down realize whatever your stressed about isn't life or death, you brain is exaggerating the issue, bring it back to earth (easier said then done). Finally for me drinking water helps 1000x, once you've settled down drink some water and slowly get back at tackling the issue.

It also helps to have someone to talk to whether that's professionally, family member or friend. It's a battle for sure but focus on taking care of yourself physically and the battle will be a lot simpler. If you have any questions let me know, I've experienced many of the side effects of anxiety and can probably relate on many levels.

Jul 2, 2019

Panic attacks can happen for a lot of reasons, including anxiety, depression, and chronic stress.

Going to get very holistic here, but it helps to have a broader perspective of the world and your role in it. It is so easy to get caught up in the minutia of Investment Banking when every detail of your work is so important. You lose sight of a whole world that goes on outside of Microsoft Office and conference calls.

Couple things that help me keep an even keel in turgid corporate waters:
1.) My mornings are mine: I wake up around 5:30 am and use that time to work out, read the newspaper, blog, make a big breakfast, or just breath. I stay away from anything work-related until around 8:00 am. (Obviously pending fire drills or whatever)

2.) Change the Routine: I'll change up my routine throughout the week, maybe I'll drive a different route to work, take the scenic walk to the office, go out to lunch by myself at a nice restaurant, or call a friend to catch up during the day.

3.) Smell the Roses: Take enjoyment in all the little things that happen in life. If it's a sunny day, maybe take a long walk into the office. If there's a beautiful sunset outside, find a conference room with a good vantage point to make your next call.

4.) Laugh off and learn from your mistakes: John Wooden has two poignant quotes on the matter 1 - "Success is never final, and failure is never fatal" 2 - "If you're not making mistakes, you're not doing anything. I'm confident a doer makes mistakes."

5.) Leave early for meetings: No one is perfect, but rushing to your next responsibility will cause you unwanted stress. Leave enough time to take your time.

6.) Go Home: Get out of your work clothes, put the phone away, pick up a book, and unwind. Spend time with the people you love. Do whatever you need to do to mentally get ready for work the next day.

Don't forget to enjoy yourself, and that you are the only one who controls your emotions. Hope this helps, good luck with everything!

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Jul 2, 2019

Panic attacks? On medications now?
I am saying this for your own good - get out now and find something more 'holistic' or whatever or find a way to rise above it without medication or a shrink.
I hope you decide the latter, because I did.
First you need to figure out what is causing the stress.
If its the work and the pressure of the work, then you need to get out because uncertainty and being in a pressure cooker is what it is. It is NOT going to change to accommodate your mental health issues.
If you are surrounded by loser a$$holes looking to stab you in the back and undermine and demoralise and demotivate you every single day you need to fight back and stand your ground instead of internalising it. Walk away and join a different firm if you can., where you can start afresh.

  1. Find what your problem is. Only YOU can do this.
  2. Decide what options you have. eg. leave. stay. find another position. industry.
  3. Focus on the solution, not the problem. You will feel more in control.
  4. Decide on what you are going to do and then commit to it and never think of this time in your life ever again. Youre better than that.
    Good luck
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Jul 2, 2019

First of all you must focus on your mental health. There are no shortcuts when it comes to your psyche. I've seen it first hand when people on the trading floor and in investment banking get to the point where their life just falls apart due to a shitty boss or stressful job.

It's always stressful at the beginning but by picking a position where you actually enjoy the work is huge.
Changing from a clearly insane boss who makes your life miserable to a great boss will make going to work every morning a pure pleasure. You will be motivated and excited for the next challenge.

You can do it but you must be willing to make some changes/adjustments to your current status quo.

Good luck and stay strong @BOBBERT !

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Jul 2, 2019

Have experienced exactly this and can agree it is terrifying! All of these posters are spot on; while I am still struggling myself giving the IB lifestyle is relentless, however giving up caffeine, eating healthier, starting yoga and doing breathing exercises has helped me! Also CBD!

Jul 2, 2019

you said you're on meds. what are you taking?

i used to have panic attacks at least twice a week following a bad accident (chest pain, mood swings, palpitations, stomach pain, chills, you name it). went to the therapist once a week, didn't help at all. ended up waking up at 2-3am & having full-blown panic attacks and calling 911 on a regular basis because I thought I was gonna die

same as you, i didn't realize i was off... i'm young & fit & active too and very high-functioning during the day, so i didn't suspect anything. most of my panic attacks were at night so i thought these were minor sleep issues. my PCP & close friends & parents all kept nudging me to see a psychiatrist but i was very defensive about it and insisted i didn't have any issues, even though looking back i clearly did. finally went to see a psychiatrist 3 months later, told me i had ptsd, prescribed me some benzos, and BOOM all the physical symptoms literally just flew right out of the window & never came back again.

if you're having panic attacks, what i found that worked for me was to grab someone you trust and talk to them and let them know what you're physically experiencing and anything you're concerned about (for me it was difficulty breathing = imminent death) and ask for their understanding. once you let it out & they sympathesize or laugh it off it alleviates the symptoms a bit. if you feel like crying, go somewhere safe and just let it out. then open the timer app on your phone, set the timer to 1 minute, and measure your pulse rate - you'd want a low pulse rate so you reallllly gotta take deep breaths. do the full minute & you'll see your pulse rate is actually not that high which means everything is fine. distract yourself for a minute or two and then measure your pulse rate again. rinse & repeat. might sound silly, but for me this was the fastest way to calm myself down, staring at the timer and taking deep breaths and counting heartbeats.

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Jul 3, 2019

Talking to people takes your mind off yourself. Agree with this. I've never felt so connected to a thread on WSO in my life. Thanks for sharing.

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Jul 3, 2019

Panic attacks are the absolute worst, I've gone in meetings and thought my throat was closing up... It's the most uncomfortable, stressful thing I've ever had to deal with.... That being said I always just try to keep a room temp bottle of water with me and focus on my breathing, generally that does the trick... Also, I know this is hard but try to focus on anything but your panic attack lol

Jul 3, 2019

A lot of good advice on here already but wanted to chime in to reiterate you're not alone in this. I struggled with panic attacks/anxiety in college and am still in banking. There are a lot of ways to deal as others have mentioned: meditation, breathing exercises (#1 thing you should try - when you get anxious your heart beats rapidly, which stirs up your other symptoms like panic/brain fog, so if you can control your breath, you can reduce or prevent panic), visualization and rationalization (thinking to yourself what's the worst that can happen? i die? okay then i have nothing to worry about. I lose my job? cool i get a chill 9-5 corp fin or something, i'll figure it out and have people i can lean on), and also therapy should also be an option.
A few/couple years ago I was having a major panic attack probably every month (before that more frequently) and no one can understand how it feels without going through it. You think you're dying, hopeless, and once its gone you're not the same, your body is still in fight or flight mode leading to brain fog and heightened anxiety for days or weeks or more. Trust me, it gets better. Stay the course and work on breathing techniques (xhalr.com), meditation, and rationalization. Give it time, and if you feel like nothing's helping, consider a change of lifestyle/career, but first try these techniques and remember my advice and that of others. Also, I feel like distraction is a good thing for those with anxiety, and getting lost in my work sometimes helps me just forget about any anxious thoughts I was feeling as the urgency of the work puts my mind in focus, so try to be present and urgent in your work as much as possible, and maybe you'll also find your anxiety on the backburner or gone by the time you're done. Message me if you need any extra advice.

"We must all suffer from one of two pains: the pain of discipline or the pain of regret. The difference is discipline weighs ounces while regret weighs tons."

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Jul 4, 2019

I used to do therapy but then I stopped. I do not believe in drugs as I see the marketing as predatory and ultimately deters people from finding real solutions to their problems. "I dont feel like myself" your exactly right! Thats what psychoactive drugs do. I have had some incredibly embarrassing public failures and emotionally painful moments in my life, but I have something very few other people have: Faith. One of the biggest epiphanies of my life was when I went to the church in my old grade school to pray and an old man walked up to me and said "your the only young person I have seen here in years...your wise beyond your years. the greatest gift in life is faith remember that." I respect everyones choices to not be religious or to have faith but I definitely think you should join some type of group

Jul 8, 2019

I was at an extremely high stress level job (Big 4 nightmare) and it wasn't doing my health any good (panic attacks, hair loss, you name it). Almost a year into the job I had managed to save up enough money and quit. I would have really liked to line up a new job instead of quitting, but with the massive amounts of overtime coupled with the high stress I was under, I knew job searching in that mindset would have led me to possibly ending up in a worse position than I already was or back to square one.

As far as coping with panic attacks, I did the following that slightly helped me... Taking short walks outside, eating a small snack, going in the break room and making small talk with people, telling yourself that these attacks are only temporary.

Medication for panic disorder can make you feel like a zombie, but for some people it works miracles.

Couple questions for you...are you sure these are indeed panic attacks? I only ask because a friend of mine never had panic attacks and suddenly was plagued by them. He went on medications specifically for panic attacks and they made him feel worse. This went on for months with no improvement in sight. He then went to another doctor and they diagnosed him with Lyme's Diseases and put him on the right meds. He's now 100% recovered with no panic type attacks.

Also, I hope you're seeing a therapist regularly to give you advice and help you cope. If things are or get that bad, see if you can take a short or prolonged leave of absence from work. No job is worth your health and well being. Hang in there, you're not alone.

Jul 8, 2019

TLDR:

go to a psychiatrist to discuss a short term fix like clonozopam while you strategize a long term fix.
start doing the breathing techniques in the book below.
take time for a mental break (any amount of time)
exercise to get rid of that cortezol
educate yourself on the topic so you don't beat yourself up and learn how to not let if effect your life

caeq is correct in that having panic attacks aren't really correlated with how physically fit you are (although regular exercise can help avoid them). They can happen to anyone at any point but some people are genetically predisposed; you can identify the marker in inexpensive testing. I had my first panic attack on vacation, after a long period of constant stress with no rest. I went a few months where I thought I had a brain tumor or something stupid; would have trouble walking, got nervous on the subway on the way to work to the point where I had to get off a couple times to calm down, would start seeing all black in the office and during meetings (not fun). The feeling started to stay with me 24/7; went to the emergency room when I thought I was having a heart attack. Turns out it was anxiety. I had an extremely difficult time admitting I had anxiety but finally went to a psychiatrist after 3 or 4 months of the aforementioned symptoms. It's hard to admit, especially when we think we are supposed to be tough and resilient to anything, and when whats happening is completely irrational and we are able to think about whats happening and try to rationalize it away. You have to just come to terms with it and start to deal with it; it is manageable. Strategies differ -- I currently take some meds, do breathing / mindfulness exercises and exercise physically 3 to 5 times per week. If I were you, I'd go see a psychiatrist asap for a short term fix like clonozopam. That will make you feel normal again and help you not f up at work. But that stuff is not a long term fix. Here are some resources that helped me:

Just learn the breathing teqnique here, don't bother with the hippy yoga nonsense, unless you want to! --
The Healing Power of the Breath
https://www.amazon.com/Healing-Power-Breath-Techni...
Also check out the authors, they teach this stuff to groups that have suffered really horrible expereinces and it works for them, including soldiers with PTSD. Navy SEALS do this stuff too so, don't feel like it makes you weak to have to do it.

Read this to understand that this crap happens to high-performers too and how to reshape the way you think about life -- Peak Performance

No one can stay in overdrive all the time and stay at max potential; we all have our breaking points. Just take care of your mind and body and everything else will follow.

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Jul 8, 2019
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