Panic attacks?

Do you ever have panic attacks?

I just started researching the link between panic disorders and diabetes.

I had a bad one last night, and two really bad ones (requiring medical attention) last fall.


Panic attacks can mimic episodes of hypoglycemia (low blood sugar), so we need a better understanding of how the two conditions are related

I know that I can find myself on the verge of a panic attack when I go hypo. What seemed like an insigificant issue before the hypo turns into a major life issue during a hypo. After I correct, away it goes.

I can tell you that PD has been the worst thing to happen to me over the last year. Let me give you some advice:

If your life is comprimised in any way by panic attacks, seek help. The best therapy is Cognitive Behavioural Therapy. It is freakin expensive, but what I did was go to the university and get my help there.

Another thing, if your diabetes is not in control, it seems to excaserbate the panic. Especially if you have huge swings. Getting control over your numbers will help immensly.

One trick I can give you is the actual panic cycle, if it helps you at all.

Symptom <- Symptom | | Fear (OMG, WHat was that??) -> Checking or Worrying

I hope that makes a good enough s=circle. LOL

Thanks. I have been diagnosed by three different doctors over the decades as having PTSD (as a result of assault/abuse, not war-related -- unless we count the war on children and young adults by vicious perverts to be an actual war.)

However, I also have adrenal hyperplasia -- supposedly "benign" growths in my adrenals. But how "benign" are they when my 24-hour output of adrenal hormones (metanephrine, a metabolite of epinephrine aka adrenaline, our "fight or flight" hormone) tests out at being about four times the normal amount?

I have often wondered which caused which? Did the abuse cause my adrenals to become over-stimulated resulting in the hyperplasia and recurring panic issues? Or was the adrenal hyperplasia already there (developmental/genetic) causing my reaction to the abuse to be extra-strong, hard to heal/overcome and life-altering?

Now I'm finding that there is some kind of correlation between poor diabetes control and panic disorders, which makes sense but is...well, distressing.

You're right, however. This is the hand I've been dealt, and it makes perfect sense that improving my diabetes control will help with the panic disorder and getting (more!) help with the panic disorder will improve my diabetes control. Our hormones don't operate in silos; they are more like a symphony.

Of course, it doesn't help that I was assaulted AGAIN two years ago. The idiot kids in that gang have no idea what kind of destructive dominoes they sent crashing through my life when they randomly picked me as a target of their momentary "fun". No idea.

I'm sorry you have to deal with PTSD. My mom has been diagnosed with PTSD from a bad auto accident that led to a stroke. She recovered physically from the stroke but the PTSD has been life altering for her.

I've had a few bouts with panic attacks but never until I started with the menopause symptoms. My CDE actually told me that the name of the hysterectomy procedure came from "to remove the hysteria".

Yup... I have them regularly actually. It's all because of the glucose levels. They are internal though. Nothing physical. Just a total state of despair. But the scientific community doesn't seem to see that as a complication. They only seem concerned about body parts falling off and probably mainly because it costs our health-care system money. I think feeling like hell mentally and physically is a pretty severe complication from least in my case.

From the Wiki: Diagnostic criteria

DSM-IV Diagnostic Criteria for Panic Attack

A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

-- Palpitations, or accelerated heart rate
-- Sweating
-- Trembling or shaking
-- Sensations of shortness of breath or smothering
-- Feeling of choking
-- Chest pain or discomfort
-- Nausea or abdominal distress
-- Feeling dizzy, unsteady, lightheaded, or faint
-- De-realization (feelings of unreality) or depersonalization (being detached from oneself)
-- Fear of losing control or going insane
-- Sense of impending death
-- Paresthesias (numbness or tingling sensations)
-- Chills or hot flashes

Note that while the DSM-IV-TR only lists the 13 specific symptoms above, it has been proposed that culture-specific symptoms (e.g., tinnitus, neck soreness, headache, and uncontrollable screaming or crying) be added to the DSM-V diagnostic criteria for a panic attack.


Hypoglycemic symptoms and manifestations can be divided into those produced by the counterregulatory hormones (epinephrine/adrenaline and glucagon) triggered by the falling glucose, and the neuroglycopenic effects produced by the reduced brain sugar.

Adrenergic manifestations
-- Shakiness, anxiety, nervousness
-- Palpitations, tachycardia
-- Sweating, feeling of warmth (although sweat glands have muscarinic receptors, thus "adrenergic manifestations" is not entirely accurate)
-- Pallor, coldness, clamminess
-- Dilated pupils (mydriasis)
-- Feeling of numbness "pins and needles" (paresthesia)

Glucagon manifestations
-- Hunger, borborygmus
-- Nausea, vomiting, abdominal discomfort
-- Headache

Neuroglycopenic manifestations
-- Abnormal mentation, impaired judgment
-- Nonspecific dysphoria, moodiness, depression, crying, exaggerated concerns
-- Negativism, irritability, belligerence, combativeness, rage
-- Personality change, emotional lability
-- Fatigue, weakness, apathy, lethargy, daydreaming, sleep
-- Confusion, amnesia, dizziness, delirium
-- Staring, "glassy" look, blurred vision, double vision
-- Flashes of light in the field of vision
-- Automatic behavior, also known as automatism
-- Difficulty speaking, slurred speech
-- Ataxia, incoordination, sometimes mistaken for "drunkenness"
-- Focal or general motor deficit, paralysis, hemiparesis
-- Paresthesia, headache
-- Stupor, coma, abnormal breathing
-- Generalized or focal seizures

I have them, sometimes. I also have PTSD. I feel much better now that I live very far away from my ex-husband who was very abusive emotionally and psychologically during our marriage. His abusive behaviour escalated dramatically after we separated including abducting our children and engaging in a lengthy campaign to alienate them from me. He was successful with our daughter; I've seen her for a total of about six hours in the last decade.

Panic attacks do feel like hypos, for sure! Fortunately, for me, at least, I have a good understanding of the things that trigger me and I'm usually able to identify them and choose to avoid or confront them appropriately.

I'm very sorry that you're dealing with panic, Jean. It's debilitating and exhausting on so many levels! I hope you have some people in your life who understand and support you when things get rough.

Nonspecific dysphoria, moodiness, depression, crying, exaggerated concerns Negativism, irritability, belligerence, combativeness, rage
Personality change, emotional lability
Hunger, borborygmus

This is me in a nutshell ^

Gary, curious, have you looked into getting treatment for this yet?

I have an appointment with a new endo in about a month. I'm not expecting much but I'd like someone else's perspective. I'll probably get yelled at for not testing all day but I just can't seem to come to terms with that aspect of the management. I really despise everything about diabetes but other then feeling horrible I hate the testing most. I do look forward to non invasive which I believe will be a reality in the somewhat near future which will be a help at least until I get some kind of transplant.

I am a type 2 and was on januvia 100 and lipitor 80 lisinopril 40 and metformin 2000. My doc wanted to get real aggressive on treating my diabetes. Turns out some of the hidden side effects of those pills are panic attacks. I have a couple that cost me some serious money on emergency visit costs. As I lower the drugs or stop taking some of the pills my panic attacks were less severe. It was a crazy year for me. I am now better and the panic attacks have gotten better. One thing I learned from all this is that the pills that are supposed to make us better are actually making my mind worse.

I love how people link things to diabetes but fail to mention that half of the pills they give us cause the problems.

Then it’s not “diabetes” fault, it’s “not testing’s” fault?

Yes, sometimes it seems like the drugs that are supposed to help us are...not very helpful, eh?

I have tried seven or eight different antidepressants over the years, and all of them had bad side-effects for me. Three of them MADE me suicidal (to the point of making plans), several gave me serious gut issues, most of them made me feel like I'd had a bucket of margaritas -- without the lovely salt and lime flavor, or the salsa music -- no fair!!! It's kind of hard to drive, work and live your life with you're always impaired. No thanks!

One of the older ones (not one of the new SSRI's) pretty much killed my good judgement for about six months, resulting in a relationship with a dishonest, shallow and borderline abusive man who I can't even think of now without cringing (what was I thinking?!?) It was like the part of my brain that evaluates behaviors as "good idea, let's do that" vs. "bad idea, no way am I doing that" had been anesthetized for half a year.

Medications that mess with our minds are really in their infancy. According to one of my doctors, they're like "shooting a fly with a blunderbuss". There are all kinds of secondary and tertiary effects that are hard to predict and that can ricochet through our lives in destructive ways. I actually prefer being stone-cold sober all the time, but then I have to cope with the anxiety and depression on my own -- warm fuzzy blankets and the fetal position are my first line of defense, but sometimes I need more.

Never knew what a panic attack felt like until diabetic. My first bad lows were full fledged panic attacks. Still happens, but not as severe & I do my best to talk myself down with a mantra of--this will pass, breathe deep, you know what to do, this will pass. It's physiological for me. Soon as the low resolves, I'm fine. Does feel like it lasts longer than it acutally does. Time becomes warped.

Took my husband's Ativan (he uses it for fear of flying)once & it did nothing to alleviate the panic anxiety.

The fact is if the levels stayed in between 80 pre 120 post then its not likely I would have a problem. The fact that I don't test often enough doesn't help but even people that do test 6-10 times a day still have highs and lows. The testing is mainly to help make more accurate corrections. Honestly if I didn't have the sensitivity I do I'd probably test more because I'd have no idea what's going on. Last night I knew I was high but I tested because I couldn't tell how high I was. On the lows once I suspect I don't even bother testing because its rather simple to fix lows unless I go down in the 30's which rarely ever happens.

If you got to "last night" and were high but only decided to test because "you couldn't tell how high [you were]", if you had tested a couple of times "en route" to last night, perhaps you'd be able to achieve a better tactical solution than BG meter/ slot machining it?

I am not disagreeing with you but my reality is still if I don't come down low enough but not too low then I am not going to feel well. Sure I'd rather be 120 then 300 but honestly I probably won't feel any less disturbed and how I feel is far more important to me then where the actual sugar levels are. I know some diabetics actually feel low at normal levels and many diabetics actually feel good when they are high. If that were the case for me I'd sooner walk around high and feel good then have better numbers. As far as secondary complications, they are not guaranteed to happen despite horrible control so my attitude would be feel good now and hope for the best. Unfortunately I have virtually no window of range to not notice the sugar disturbance.

I know what you mean. I kicked the pills and wound up having drug withdrawal symptoms which I thought was not right. I stayed awake for three days and had insane headaches. I refused to take xanax to deal with the symptoms and crawled into a ball thinking happy thoughts clinging to good days past. I survived and since pushed meds away and go minimal.

Gary, you may not care if you're 120 vs 300, but your kidneys, eyes, brain, heart, feet and hands DO care. They care very, very much.

I think you're sailing on The Good Ship Denial towards a very ugly cliff if you honestly believe that "how I feel is far more important to me [than] where the actual sugar levels are".

Jesus wept, Gary. Google up some pictures of gangrenous feet or something. There may be "no guarantee" that complications will happen to someone who tries to maintain pretty tight control, but someone who doesn't care if they're over 300 or not -- who insists on using feelings to replace the hard data from a well-used meter -- is in for a RUDE awakening in the not too distant future. Really.

I'm not telling you anything that I haven't already told myself. Losing your feet, your ability to have an erection, your eyesight, the sensation in your fingertips, etc. is NOT where you want to spend the last twenty or thirty years of your life! Do you really want to have to rely on other people to pick out your clothes, read the newspaper to you or drive you anywhere you go? Do you want to go on dialysis? Really? Most of us want to put that kind of debility and dependency off for as long as possible -- I'm guessing that deep down, despite the tough talk, you feel the same way.

You should be testing eight or ten times a day and keeping a detailed log for at least the next three to six months -- that way you'll have HARD DATA for your endocrinologist and a sharp CDE and they can help you feel better. Otherwise? Relying on just your "feelings"? All of you will be flying blind and of course you won't get better. You said yourself the other day that you were at 165 and couldn't feel it. Get some data and see what's what in reality.