 Good morning. It is early on a Tuesday morning here in New York in August 2021. It's a little before 5 a.m I have to record podcast episode number 168, which is entitled the panic attack hangover And I thought I would try something new since I generally don't pay much attention on YouTube or the video platforms Well, I'm gonna record myself recording this podcast You guys can sort of watch it be be produced and you can watch it right here and you'll see me record the podcast Something a little different and then in this episode. I promise I will pop on over here to YouTube and I will pay attention to the comments I know I generally do not on YouTube, but for this episode we will do a little bit of a experiment And we'll see how it goes on YouTube So this is a way to listen to this episode of the podcast or watch this episode of the podcast without having just a still Image in the silly audiogram thing. We'll see how this works out if it works out, okay Then I'll make it a regular thing Anywho this is what it looks like when I record a podcast episode especially early in the morning Which is when I tend to do these things. I literally have rolled out of bed. I made myself a cup of tea got it right here Rectory mineral under the weather the last couple of days So my nose is a little stuffed up and my throat is a little more scratchy So my voice is a little scratchier than normal forgive me for that. No, you don't have COVID-19. I promise But anyway, this is what it looks like I tend to just keep the lights off and record that way and I wing these as I go So you'll see how it works out, but you'll hear all the stuff your whole theme music and all that stuff So maybe it'll be interesting who knows all right Let's get going. This is what it looks like when we record a podcast. So here we go Dudes and dudettes welcome back to the anxious truth. This is episode number 168 168 welcome back to the show Today's podcast episode is called the panic attack hangover We're gonna talk about that sort of the aftershocks the after effects of panic What happens after you have a panic attack and it sort of lingers for some people It will linger for a half hour for some people it will linger for a couple of hours and for some people especially when they feel like they have Not they've been doing really great. Like I haven't had any panic in a long time It's been a week or two or a month and then I had a panic attack Sometimes the panic attack hangover those after effects will last for days or even a week So this topic was suggested by a friend in Australia. It's a really good topic I cannot believe that I haven't talked about it before but I haven't so here I am talking about it this week For show notes on this episode. You can go to the anxious truth comm slash one six eight I'll have them up all on the website along with a bunch of other interesting links to like my books and all that stuff So let's get into it the panic attack hangover and by the way for the record This one is going to be less than 20 minutes because I could see by my analytics that after 20 minutes even in my most Interesting and most popular podcast episodes. Ooh, the listenership falls right off So I you have spoken and I have heard you I will keep these shorter So what is the panic attack hangover? All right, let's talk about a panic attack We all know what this is if you've been listening to the podcast for any length of time and following along Clearly you've heard me talk about panic attacks many many many times and you talked her probably heard of a zillion other people Talk about panic attacks. You know what they are. You know what it feels like you may have had a zillion of them yourself So you have a panic attack which we have always defined as this is a physiological event Right panic is panic is a physical event. That's true You feel panic in your body and it has a beginning a middle and an end if we do it right or we have a good relationship with panic and anxiety It starts it builds it peaks it comes back down and in many instances when you get really good at this That all can happen in the space of under 10 minutes If you're not really good at it yet and you're learning and you're practicing and this is all kind of new to you Then that's okay If you don't if you can't get through it in 10 minutes That takes time and repetition and practice and all of that stuff and learning how to Navigate through sort of float through except through surrender to the panic and just let it happen and let it come back down And it always ends right it always ends. So you guys have heard me talk about this about a zillion times There's a zillion other podcast episodes where I talk about the mechanics of panic and it's in my books and all that stuff So what happens after the panic attack? Excuse me So what happens after the panic attack? That's the question for today. That's the question that we're addressing now What is the panic attack hangover those after effects? So about two or three months ago It was around 10 10 30 at night and I experienced panic for the first time in a very long time And it can happen to me now and then a couple times a year maybe maybe not and I tried to document it on Instagram But the whole episode in terms of the actual panic itself probably less than less than five or six minutes So by the time I sort of stumbled across the house back into the office and got the lights on for the cameras and everything It was already over but I did document it. It's on my Instagram stories Where I stayed up I stayed up for about an hour afterwards and I just let people ask me questions about what it felt like And in the beginning of that series of Instagram stories, you'll see that I actually looked different for the first Maybe five minutes or so You could tell like I didn't look the way I usually look I was definitely breathing a little more heavily I was a little shakey or you could see that but at that point I would have absolutely told you that the panic was over it had peaked and it had come back down It was it was done nonetheless I was still experiencing some of those like physiological sort of aftershocks So panic attack hangover has what I think are really three kind of three components to it That's what I want to talk about today Number one is the physical component and that happens after the peak of panic physiologically and it starts to come back down You are still going to feel it physically adrenaline does what it does right? It's pretty predictable We know what it does. We know how what it feels like and we know how it acts in the body This is not not news for us So after the peak of a panic attack when it's when it comes back down and it's kind of over You could say okay, the panic is over and you all know what that that feels like that moment when you begin to feel better And then it sort of falls off and then it's over So the panic itself is over but physiologically you will experience a hangover for a little while For me that probably lasted maybe 10 15 maybe 20 minutes at the outside I think for most people probably fall in that category I'm talking about purely the physical hangover the physical aftershocks the physical physiological after effects of panic Which is you'll still feel a little shaky, right? Your muscle tone has been altered So you have that a little bit of shakiness. You just don't feel like you're on you know, you're on solid ground yet Takes a little while for that to come back Your legs might feel a little weak just in general you might feel have that weak sort of shaky feeling You're just not feeling very strong physically Your heart rate may continue to be elevated Now, maybe it's not elevated to the point of 130 or 140 beats per minute where it was at the peak of the panic But it's also not at 55, right? So your elevated heart rate will remain for a little while It takes a while for that to fall off and go back to your normal resting heart rate. That's just physiology That's just the way it goes You may experience Increase in respiration rate that doesn't go back down to your base level And you may continue to be aware of your breathing for a little while longer And I think you could see that if you look go back and look at the instagram story that I saved It's in my highlights on my instagram account Um, you'll see that my breathing was still a little ragged for for a little while as I was answering questions on instagram that night after panic So you may continue to feel a little sweaty a little clammy Uh, you've probably if you're like many people you've sweated profusely throughout your panic that happens Uh, and that's just that's a cooling mechanism So you might feel a little cooled and you might feel a little warm So you feel changes in in in temperature in your body and and the level of perspiration We could probably list 10 different very subtle physiological things. Your stomach may still be upset You may feel a need to get to the bathroom. You may have to Uh, you know, you may still feel a little lightheaded a little dizzy a little disoriented So the aftershocks once the panic itself like the the key part of the panic is over Then you're still going to feel some physiological effects of adrenaline because it's not like it's a valve It doesn't just turn off and then there's none It actually your drenals will stop firing and stop adding adrenaline But it's still in your bloodstream and it takes a while for that to be metabolized, right taken out of your bloodstream So as the concentration of adrenaline or norepinephrine, whatever you're going to call it Is still higher in your bloodstream you're going to feel the effects and as it gets metabolized out There's less and less of it and those effects will dissipate, but they're still there so cardiac Heart heart related effects increase heart rate increase respiration perspiration muscle tone all of the things that adrenaline does Your vision might still not be perfect. Uh, and you just might have that little sort of disoriented feeling. That's normal Those are the physiological that's the physical part of the panic attack hangover. That's the shortest part of it That's the shortest part of it So that will go on for like I said anywhere from probably 10 to 20 minutes now If you're still new to this and you're not really good at surrendering to panic and passing through it and letting it happen Naturally without fighting it Then you may find that your panic attacks look like roller coasters You'll say that well, I panic for hours and hours on end. Well, you really don't you just panic again and again It's not one continuous panic attack. But when it starts to come down We're gonna talk about sort of the psychological hangover of a panic attack and how you're reacting afterwards and behaviorally You can in fact feel another one that is possible So you may have that rolling or undulating panic where it comes and goes and comes and goes For long periods of time that that was my first panic attack looked like that And for many years they sort of looked like that So that's possible, right? It is possible if you're new to this and you haven't learned these skills yet and you're still getting into it You're still getting putting your brain around this and you haven't had enough time and experience to get good at moving through a Panic attack Then yes, that can happen and some of this may not necessarily apply to you but but it will so keep listening So that's why I say the physiological after effects of panic are generally over 15 20 minutes, maybe 25 minutes if you're really good at it, you're not you're just not afraid of it Which means you're not adding additional adrenaline or fear 15 20 minutes and those things are pretty much over and your body is back to its base state So that's the physical part of panic attack hangover sort of the after effect The second part of panic attack hangover is what I would call the mental Right. So this one is tricky. This one is definitely tricky The mental after effect of a hangover will leave you feeling shaken vulnerable weak mentally susceptible um afraid Maybe a little bit unsure of yourself like this is all super common. It'll rattle you mentally And again as you get better and better at this process you get less and less rattled So for me Honestly after many many years of this and a lot of practice when the panic attack is over Well, you know, I'm not really rattled afterwards That is over within minutes for me because I just I just don't care about the panic attack And I know that sounds crazy if you're new to this but you could get there too many many people do But for most who have not had the opportunity to practice as much as I have or maybe you're still working on this stuff Then the mental after effects the mental and even emotional to a certain extent after effects Are real that's a real thing the panic attack hangover from a mental emotional standpoint is a real thing And it can be lasting So you will feel all the things that I just talked about vulnerable afraid unsure uncertain Weak in some instances you may have feelings of failure Or despondency like I'm never going to fix this. This is always this is this this panic is going to come and get me Forever I can't get away from it and Beneath all of those things there's certainly a matter of anger and frustration for sure Being upset that it happened Maybe feeling that you're failing especially after you've had a really good run of I don't know It's it's been weeks I haven't had a panic attack in weeks and then I had a really bad panic attack and a right back to square one That's a very common Part of the the mental and emotional panic attack hangover For many people, especially in the earlier stages early and mid stages of recovery Which is you will declare it a failure like oh no, I slid back to square one You will forget that your job is not to never panic your job is to get better when you do panic right better at moving through it That's the measure of success But it's easy to forget that because it's a jarring event and it is frightening that fear is real We're talking about that all the time So the underneath all of those sort of emotional and mental aspects of the panic attack hangover Are really two things number one is is sometimes a feeling of failure that you did it wrong Like I did it wrong somehow I did it wrong if panic actually happened. It means I I made a mistake I made a recovery mistake and I allowed panic. That's not true Right. That's not true at all But that's that's one of the more common underlying currents and the second underlying comment Which is probably really the base underlying current is I'm afraid that that might happen again So the thing that fuels all of those things the the vulnerability the unsure feeling this the unsafe feeling The shaky feeling you may lose your confidence will be rattled And that's going to last for a little while it's all based on the idea that What if it happens again? Right, so everybody kind of gets in that mode where it's you know What if it happens again and that really is the basis of all of this all of this is the fear of the panic itself We talk about this over and over and over And panic disorder and agoraphobia and anything that involves panic attacks The problem where it becomes a disorder is when you become afraid of the panic itself And you are afraid of the next time it happens you are deathly afraid of the next time it happens So the psychological and mental and emotional part of the panic attack hangover and air quotes Is that it's those feelings? It leaves you rattled and it feels it leaves you unsure Mainly it may make you feel like well, what did I do wrong? I need to analyze this to see what I did wrong and how that I allowed this panic to happen That shouldn't have happened and I am afraid that it's going to happen again Right so you can bring it back to the analogy that I use all the time Which is being bitten by a dog if you are bitten by a dog And that dog is still in the room with you You will likely psychologically mentally emotionally remain afraid for a very long time while that dog is still there Because you think you're afraid that he might bite you again And in this situation the panic attack is the dog like you could still feel it right So the physio the physiological panic attack hangover is still there for 15 20 minutes It's over but yet it doesn't feel physically all over yet It's still like completely over it's still lingering And those 10 or 15 or 20 minutes where your body is still coming back down to its its base level Can absolutely fuel and light the fire of the the mental The mental psychological emotional panic attack hangover which is I still feel it It's still here, which means it's not really gone and is oh my god Is it going to come back and what did I do wrong in the first place? So that's sort of the psychological Panic attack hangover the mentally emotional panic attack hangover you may feel sad some people cry after panic So people get really angry that they even let it happen But those are real effects afterwards those are real and especially if you're in the the beginning stages and middle stages of recovery Those could be really amplified. It's okay and expected and normal to have Sorry I have to keep hitting the mute button. I've been under the weather the last couple of days So I don't want to cough at you But it's normal and expected and it's okay to have those Those emotional and sort of mental You know hangover components. How long do those last? well That leads us to the third thing which is the behavioral component of the the panic attack hangover and this is probably the most important one Because you don't have to not be human We're not trying to get to the point where you're just saying well I you know I'm not going to have any sort of emotions or mental effects of panic Of course you are you're human. I have them too. I I don't pay them much mind But like even though I'm really good at this. It's it's not I don't it's not like oh great. I had a panic attack I'm not skipping and like You know, it's not sunshine or rainbows because I had a panic because I don't like it either So it certainly affects me from an emotional and mental standpoint to make me feel a little tired I'll make that you will make me maybe reevaluate. I should go to bed early tonight I need to back up a little bit to take care of myself all those things. It's normal So it's not so much that you have The emotional mental psychological panic attack hangover that may last for an hour or two hours or The rest of the night or even feel at the next day. So those things can linger for sure But they won't linger forever because in the on on their own because in the end your body does come back to a natural state And this is where the third component the behavioral component comes in because like I believe in my opinion That this is really what fuels that hangover Right. So the physical part of the hangover is just adrenaline dissipating Normal can avoid that supposed to happen. You're human the mental and emotional parts of the hangover That might last for an hour two hours a few hours the rest of the night Again, you're human. You're allowed to have mental and emotional responses to events like panic. That's that's okay The issue here is the behavioral part So the panic attack hangover in my opinion Is fueled predominantly and when people say well, I had sort of a panic attack hangover I'm I feel like I'm back to square one. I'm shaky now everything. I'm back. I'm right back to the beginning. I'm afraid again I don't know Generally is fueled by behavior Which is now you are feeling you had this event your body still feels weird for 20 minutes afterwards Mentally you're shaken for an hour or two a few hours afterwards and then you begin to behave accordingly So in this situation when the panic attack is over in my case the best it was later on at night, right? So I did stayed up for a while on instagram asked questions First of all behaviorally, what did I do? I did not retreat back and like rock in the corner because I had had a panic attack I did not ruminate on it. I did a thing that I do often Which was for me I tried to use it as a teaching tool and I went online and I interacted with people and I tried to document What it was like for to have a panic attack now in that situation Yes, I was talking about panic and anxiety But I could have been answering questions about about hockey or playing the guitar Like I could have been talking about anything But I was I was behaving in a very normal I could have done that any guys have seen me live on instagram a zillion times in my stories and videos and Like this is what I do So I just did a normal thing it just it was related to that panic attack, but I did a normal thing I behaved normally I was not behaving like a person who had just had a panic attack And that and then the next morning I posted a picture that is extremely rare for me Which was I was I was in the home gym and I posted a picture that I was lifting the very next morning And I did that to illustrate exactly this point So my response to the panic attack hangover was I'm going to act like I would normally act I'm not going to change my behavior I'm going to go right back into the same routine that I would normally have which was the next morning I got up and I was in the gym early and I was lifting and I posted a picture of that Which I will rarely ever do because honestly that's a No, I'm not going to get into the rant, but I don't like that But I did it to illustrate a point So the panic attack hangover that then you say is going to last for days or a week Like I was I felt like I was in the aftershocks for you know days afterwards. It took me days to get back in my feet I believe really strongly that you are making a choice to not get back on your feet Right, so you felt a thing It felt really nasty and icky and and terrifying and uncomfortable like we all know it does it lingered for an hour Half hour so afterwards mentally you're really shaken for the rest of the day or the rest of the night And then you start to fall back into bad behavioral habits You retreat you start to protect and guard and brace and modify your behavior So if you are victim to the panic attack hangover after you have a panic attack You feel like it ruins the entire rest of the next three or four days or a week or more You really have to sit down and say well, what do I do? What do I actually do what's my behavior when that panic attack is over? And you you get time to you know to come down afterwards That's okay. I'm not saying at the very minute the panic ends you got to run out and climb a mountain That's not what I'm saying at all And some people do take that extreme approach you could nothing would stop you from doing that But you don't have to do that. You're allowed to kind of come down from it That's normal and you totally expect and you play that by ear each panic attack may be different But in terms of the context that it's in but you have to really look at that and say okay after You know an hour or so has passed. What can I do now? I got to get back into my normal routine I mean the old cliche is I got to get back on the horse. I fell off the horse I got to get back right back on the horse and that is a hundred percent true So if you have decided after a panic attack that you are a failure You're back to square one none of the supplies and you literally stop doing the things that you know You should be doing or that you like to do you stop living your life And you go back into retreat mode from a behavioral standpoint if you do not get back on that horse Then yes, there's a really good chance that you are literally creating that day's long panic attack hangover So the panic attack hangover is largely fueled by the change in behavior or the reversion for me You know you revert back to the things that you used to do either before recovery or early on in your recovery Or if you're in the beginning of your recovery journey, then you recognize that you're probably doing This is just the way you live your life now when you panic you retreat You feel like you have to take it easy you have to rest you have to be careful You know kids shouldn't do too much because you might trigger it again This is all based on the idea that what if I trigger it again that underlying fear that that that is the underlying the fear of the fear That drives these disorders panic based disorders That's so insidious. What if it happens to me again? You know, so I have to make sure that I behave differently to protect myself so I don't trigger it I don't know what caused that panic attack last night, but I certainly don't want to do it again It's all I need to back up. I need to take it easy. I need to do all of those things Right, so you have to be careful about that You can literally fuel the panic attack hangover if you're saying that it will last for days and days By reverting back to those old protective and defensive habits to try and keep that panic from reoccurring Which is exactly the opposite of what you have to do So if we're at 20 minutes, I'm going to wrap it up Like I said if in fact you are in a situation where the panic attack hangover is real for you You feel like yes, this is a thing and it happens to me at last for days sometimes I want you to understand the three components that I just went over Physiologically panic even when it's over will last for another 20 30 minutes The the adrenaline takes a while to get out of your body Mentally, you'll have some after effects psychologically emotionally You might cry be angry be frustrated all the things you're allowed to be human Those might last for an hour or a couple hours maybe the rest of the day You can try and shake that the best you can allow it to happen That's okay, but you don't have to allow yourself to go into an emotional fetal position and like it's over It's over. I'm a failure. I can't do that. Check that be careful about that And then finally how will you change your behavior in response to the physiology of panic and the emotional and mental and psychological After effects of the panic, that's the secret sauce right there Do not be careful and how you react behaviorally to the panic attack and its immediate after effects You can perpetuate that hangover by going into behavioral retreat mode and going back into the old avoidance habits You're afraid to trigger it again because you don't want that to happen again. So now I go back and retreat So in my situation after my last panic attack I went on instagram and I tried to teach and I interacted with people which is a very normal thing in my life to do So I didn't change anything based on that panic attack that had happened I went to bed I think I I think I watched like half a movie before I fell asleep And then literally the next morning I was up and in the gym and lifting the next morning You know, was it still a little bit in my head a little bit? I'm human. I really am. I'm not afraid that it was going to happen again I don't care. So that's what allows me to say. Well, I just got to get up and move on now I got to do what I got today was last night. It's over. It's done. Hopefully I was able to teach from it It's over and today. What do I have in my agenda? And the first thing on my agenda is I'm going to lift so I was in the gym Whatever your thing is I'm not saying you have to go to the gym But whatever your thing is what should my day look like for the rest of today? If you have panic attack in the morning, what was on my agenda for today? Do not cancel everything run home and lay on the sofa That would be a very bad idea You are literally creating a behavioral panic attack hangover when you do that If it's at the end of the day like well, I guess I'm going to wind down the way I usually do And I'm going to go to sleep the best that I can might not be perfect, but I'm not going to change my routine I'm not going to change my life So I'm not going to create protracted panic attack hangover by behavior really accommodating the fear of the fear I'm not doing that. So you have to really stay on top of that That's where panic attack hangover can go from like a couple hours afterwards. It feels a little shaky totally understandable That's where you can dig a hole and go sit in it for a couple of days afterwards now I'm not saying you choose to do that. I mean technically we do choose to do that. I used to choose to do that It's almost an automatic choice though. You're not choosing to suffer. Nobody is intentionally a victim here I'm not blaming you in any way. I used to do the same things But those are the instinctual things that say well, let me let me try and protect myself from this And we all know that most of recovery is kind of counter-intuitive and sort of runs against that instinct to to run away from the unpleasant stuff So excuse me So that is panic attack hangover in a nutshell 23 and a half minutes into this I hope it's been helpful and uh for those of you who are literally watching because I'm recording this for you to Show on youtube so you can watch me do the podcast If you have questions and comments, leave them below. I'd be happy to try to answer them I will pay attention to you guys on youtube this week I promise and as I end I'm going to ask you a favor like I always do Which is if you're listening on iTunes or any place where you can rate and review the podcast Leave a rating five stars would be awesome If you dig the podcast and then take another 30 seconds and maybe write a quick review of why you like the podcast Because then it helps other people find the podcast. That's why I do this to try and reach and help as many people as I can That is it. I will play you out with ben drakes afterglow as I always do You can find ben my friend and an awesome musician at ben drake music com Hope you enjoy his his song because I play it every week and that's it. I will see you guys in the next episode I appreciate your time and attention as always I will see you next week and remember this is the way Ask questions. If you got them, I'll answer them All around you you can breathe it in This is where your story begins You got the feeling that you're gonna win Yeah, you're doing There you go youtube that's what it looks like when I record a podcast at five o'clock in the morning Excuse me as I'm kind of half coughing up along you guys got to see me keep hitting the mute button I have a mute button on my little console here. I record Anywho, um, that's it. That's podcast episode 168 if you guys have questions or comments Put them down below you can find the show notes for the episode right at this url It's at the bottom of the screen the anxious truth.com so there's 168. I'll put them up there I appreciate you coming by if you guys dig this I will try and do it in every episode It's not the big deal. I turn on the camera while I record so Hope it worked out for you guys and I will see you in the next one