Thursday, September 11, 2008

Panic attacks and menopausal women

The first time I had a panic attack, I assumed that my heart rhythm was abnormal, and that was why I felt like I would lose consciousness as I drove to Boulder. By the second panic attack, my educated guess was that a tumor was pressing on my trachea, and that was why I could not draw a deep breath and might have a seizure at the wheel. Needless to say, driving after my snowy day collision with a moving van became a bit of an ordeal. As a result of my experience, I know that panic attacks are not about an anxious fear that you might die but rather a strong bodily feeling that you will die.

I was interested, therefore, to read a study in last year's Archives of General Psychiatry about cardiovascular outcomes in postmenopausal women who suffer from panic attacks. Panic attacks are common among women in this age group (although mine occurred over a decade ago). Researchers collected data from nearly 3400 women who participated in the Women's Health Initiative Observational Study.* The women self-reported whether or not they'd experienced panic attacks over a 6-month period, then they were followed for the occurence of coronary heart disease (CHD), stroke, or death in the next 5 years.

A 6-month history of full-blown, real deal, I-can't-get-a-deep-breath or I'm-going-to-die sort of panic attacks was significantly correlated with both outcomes in a scary sort of way. The women demonstrated a 4.2 fold increased risk for CHD, a 3.08 increased risk for the combined outcome of CHD or stroke, and (yikes!) a 1.75 times increased risk that those subjects who ducked heart attack or stroke would die of any other thing.

No surprise, panic attacks are awful, and they simply are not good for you.
_____
*Participants in the WHIOS were those women who either were not eligible for the hormone portions of the WHI but agreed to provide investigators with other information about their lifestyles and health outcomes. This particular sub-study was the Myocardial Ischemia and Migrained Study.

7 comments:

Anonymous said...

Were these women who had untreated panic disorder? Any comment on panic attacks that are "stifled" by meds?

JeanMac said...

Gosh, sounds very scary. I've never had one.

Wendy said...

My "panic attacks" not the sweating, shortness of breath kind, but the kind where I just feel jittery and feel like there is something really wrong with me..... is always relieved with food.... well juice - I always drink some o.j. and eat some protein and it goes away. Mine is somehow related to low blood sugar.

Mauigirl said...

Well, that's kind of scary. Is it because people who have panic attacks actually do have something wrong with them and the body senses it? (I can believe that because I felt very panicky when I had appendicitis and so did my husband - before we knew we had it. It's a symptom that wasn't mentioned in any of the symptom lists for appendicitis).

Or is it that because they are nervous or have panic attacks that it actually causes the future illness?

femail doc said...

Anon: These were self-reported panic attacks, so presumably those whose attacks were stifled were not reporting them. Presumably, the outpouring of adrenalin that accompanies anxiety with panic attacks is what did these women in and treatment improved their longterm outlook.

Antidepressant/antianxiety med. use is known to be good for brainhealth, presumably good for heart health too.

Jean: Definitely an experience one can better live without. Literally.

Wendy: Hypoglycmic episodes feel very similar to panic, same sort of "I'm in danger" kind of feeling.

MG: I think panic in response to real bodily danger such as grave infection like appendicitis should have similar physiology to panic attacks without a true physical threat. If you have the latter, however, on a regular basis, then it would cause future cardiovascular disease.

Anonymous said...

Thank you. One less thing to get panicked about!

Anonymous said...

Here is a senerio, a person has a what is thought to be a 'panic attack'....emergency doctors tell them they are just mentally ill....when adverse reactions to antidepressants, and other drug sensativities are also a major causative factor.....years go by with increasing ill health, with doctors playing the mental health card,never ruling anything else out, when finally the patient has to learn enough medicine to diagnos the real problem, graves disease,(complicated with vertebrae problems) which was listed on their chart as familial , all along, and ask for the test.....confirmed.....then wonders how to rid oneself of missdiagnosis, the damage to self esteem, pocketbook, and the very real problems created out of missdiagnosis,doctors not believing them, etc,etc.......not to mention the original doctors dumped them the minute it was diagnosed as mental illness, further kicking them while down in essense.......... what kind of future do you suppose this person has left, and what doctors do you suppose would help them now? Thankfully a few better doctors. Graves and thyroid illneses are not 'easy' to treat in the right way, (many people eventually die from improperly treated thyroid illnesses...ie...so that it actually helps the patient).....few doctors know what to do with the side effects, few put the patient in the ideal TSH range for the individual,Testing TSI, fT3 and FT4, T3/T4, and eveen fewer understand that it will most likely take something besides western medicine to treat it properly. For more info on how to treat thyroid illnesses, please read info by Dr. Shames, Dr. Rind, Elaine Moore,Mary Shomon, and a doctor trying to sell his patented drug, but with an explanation for the depression and fatique as unique to thyroid issues, namely Dr. Cohen, I am not pushing his drug, I think people should explore alternatives, who have known these connections all along, but now that a psychiatrist finally useed a little common sense , motivated by trying to sell his patent......
Alternatives offer treatments to many things and that includes how to treat the antibodies. Only the USA offers the only treatments as RAI or antithyroids as the first and only treatment of graves disease....
Hypothyroid is also treatable, and 'cureaable'...but not with the methods taught in the usa. Personal opinion based in personal experience....