Panic Attack!! Is it Real? Does It Feel Like You’re Going Crazy?

panic attack, worried young manPatrick Pomfrey, Psy.D., is a doctor of clinical psychology in Fairfield,Iowa. If you’d like to submit a question, please email

Dear Dr. Pomfrey,
For the past 53 years I have lived a good life. For 26 of those years I have eaten a vegetarian diet, mostly vegan, and I have placed a lot of importance on my spiritual life. I have two healthy grown children (last son just left home) and my wife and I are completing plans for our dream house. However, for the past few months, I have been waking up around 3 to 4 a.m. with anxiety over just about everything. Two nights ago when my wife was out of town, my anxiety got so bad that I woke up crying and gasping for air—I thought I was having a heart attack or going crazy—I just don’t know if I can take it anymore. Am I going crazy? —Living the Good Life

Dear Good Life,
You feel like you’re going crazy, but you’re not. You are likely experiencing an extreme form of anxiety known as a panic attack. The words are descriptive of the experience. You likely experienced a state of absolute terror and perhaps felt as if you were under attack from some unseen internal invader. Maybe you even felt death was imminent.

Typically, panic attacks have a sudden onset and build rapidly to a peak. They rarely exceed ten minutes in length, but can include palpitations, accelerated heart beat, sweating, trembling, shortness of breath, depersonalization, and bodily sensations such as hot flashes, chest pain, numbness, and dizziness. Fears of dying or going crazy are common. Not fun stuff.

There are different types of panic attacks. From what you’ve told me, it sounds as if you had what is diagnostically characterized as an unexpected panic attack. And now you’re wondering, “What in the world happened to me?” Panic attacks are believed to have many sources. Here are a few angles on it.

The number one cause of panic attacks is toxic language. What we say to ourselves affects our brain chemistry in a profound way. Thoughts are chemical reactions that have the potential to stimulate the release of other elements into our body. Catastrophic thinking and “what if” scenarios are a primary source of anxiety. When you start to feel the first sign of anxiety, stop and ask yourself, “Am I in any danger?” Because that’s what the mind really wants to know. Recognize the truth. You are not in danger.

What is a panic attack? It’s a flood of adrenalin into the body. It’s actually energy and power. It’s just there at the wrong time. Still, I would advise you to check with your physician to make sure that the panic attack does not have a physiological basis, e.g., a heart problem.

Also, I’ve never treated a person that has had panic attacks who didn’t have unresolved underlying emotional issues. You mentioned your last child “just left home.” For many parents, this is an experience that causes inner conflict. Consciously, you may be happy to have more freedom and less day-to-day responsibilities. On the other hand, you may be grieving the loss and experiencing (consciously or unconsciously) feelings of abandonment, aging, or a sense that “it’s all over.”

A second issue to consider is that your anxiety swelled into a panic attack while your wife was absent for a couple days. I’m unaware of the details of your marriage, but I wonder if there are unresolved emotional issues between you that are causing underlying anxiety. The empty nest syndrome also means, “It’s just you and me, honey.” Perhaps you are concerned about the depth, stability, and meaning of your marriage now that your children have left home.

Also, anyone who is building a home or is in the process of preparing to build usually experiences the bliss-anxiety seesaw. Make sure this is something you really want and can comfortably afford.

Another red flag for anxiety is a vegetarian diet, especially vegan diets. The absence of meat, dairy, and eggs, etc., may impact the amount of nutrition your body receives. In my practice, I often find profound absences or excesses of a particular nutrient that can lead to mental instability. A good multi-mineral and multi-vitamin are important. In addition, consider a B complex and this time of year supplementing with vitamin D3. Talk to your health care provider about healthy dosages.

I also recommend that you pursue therapy. If you’ve had one panic attack, you will likely have another. Find a good therapist that specializes in Cognitive Behavioral Therapy. And don’t worry—the right psychotherapy is very effective in eliminating this disorder.