Panic Attacks:

Many people suffering from PTSD experience panic attacks.

      Panic Attacks are episodes of intense fear or apprehension that are of sudden onset and of relatively brief duration. Panic attacks usually begin abruptly, reach a peak within 10 minutes, and are mainly over within 30 minutes. Panic attacks can be as short as 15 seconds, or can be cyclic, lasting for an extended period, sometimes hours. Often those afflicted will experience significant anticipatory anxiety and limited symptom attacks in between attacks, in situations where attacks have previously occurred.

     The effects of a panic attack vary. Some, notably first-time sufferers, may call for emergency services. Many who experience a panic attack, mostly for the first time, fear they are having a heart attack or a nervous breakdown. Experiencing a panic attack has been said to be one of the most intensely frightening, upsetting and uncomfortable experiences of a person's life.

     Sufferers of panic attacks often report a fear or sense of dying, "going crazy," or experiencing a heart attack or "flashing vision," feeling faint or nauseated, a numb sensation throughout the body, heavy breathing (and almost always, hyperventilation), or losing control of themselves. Some people also suffer from tunnel vision, mostly due to blood flow leaving the head to more critical parts of the body in defense. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the sympathetic "fight-or-flight response") in which the hormone which causes this response is released in significant amounts. This response floods the body with hormones, particularly epinephrine (adrenaline), that aid it in defending against harm.

A panic attack is a response of the sympathetic nervous system (SNS). The most common symptoms may include trembling, dyspnea (shortness of breath), heart palpitations, chest pain (or chest tightness), hot flashes, cold flashes, burning sensations (particularly in the facial or neck area), sweating, nausea, dizziness (or slight vertigo), light-headedness, hyperventilation, paresthesias (tingling sensations), sensations of choking or smothering, and derealization. These physical symptoms are interpreted with alarm in people prone to panic attacks. This results in increased anxiety, and forms a positive feedback loop.

Often the onset of shortness of breath and chest pain are the predominant symptoms; the sufferer incorrectly appraises this as a sign or symptom of a heart attack. This can result in the person experiencing a panic attack seeking treatment in an emergency room.

Panic attacks are distinguished from other forms of anxiety by their intensity and their sudden, episodic nature. They are often experienced in conjunction with anxiety disorders and other psychological conditions, although panic attacks are not usually indicative of a mental disorder.

PTSD & Substance Abuse Triggers:

Triggers are extremely dangerious.The PTSD & Substance Abuse Program  devotes a full week to

the topic.

PTSD Triggers: Anything that brings about a symptom of PTSD. For example, a news story about the Iraq War may cause a veteran with PTSD to have thoughts and memories about the war. Triggers may include people, places, sounds, words, and/or smells.

Substance Abuse Triggers: They come in many forms.

• Fights with your spouse.
• Getting together with old drinking buddies. 
• Driving by a favorite bar.
• Payday.
• Somebody’s birthday.

Substance Abuse Triggers can be about a good or bad situations. PTSD & Substance Abuse Triggers can be very interactive. The two problems can feed off each other giving them a dangerous synergy. 

Note from DonP:

     A really surprising trigger I had to deal with, early in my recovery, was that after a VA PTSD meeting I would drive straight to a liquor store. I had to realize that I was dealing with many suppressed Vietnam Memories during the meetings. This was making me nervous and I jumped straight into self medication. Once I understood this trigger I was able to deal with it and I didn’t allow this to continue. I had to make smart choices. The more I did this the easier it became.

Coping With Triggers:

     Stay far away from triggers. The safest plan is to stay away from triggers whenever possible.Don’t watch the upsetting TV show.Don’t go near the bar. “Avoid avoidable suffering” by protecting yourself from triggers ahead of time.

     Never “test’ yourself with triggers. This is a mistake some people make early in the recovery process.

They may think “I’ll go to the party tonight to see if I’m strong enough!”

Don’t do it! 

     It is hard enough without setting yourself up

     Hopefully your good friends will want to help you. If not you may need to stay away from them until you are strong in your recovery. You will find that you don’t need friends that don’t support you. This may be really hard at first but a good friend will support you and they are worth a thousand of the ones that won’t!.

Worry Stones: Some people carry them as a reminder to stay grounded

     They are smooth, polished gemstones usually in the shape of an oval with a thumb-sized indentation. They are also known as thumb stones or palm stones. They originated in Ancient Greece. Held between the index finger and thumb, rubbing them is believed to lessen one's worries. This action is a type of stim which can often create feelings of calmness and reduce stress levels.

      Anything that reminds you of good things or a good time in your life can help. A family photo in your wallet or even a pendant on a chain worn in the open or under a garment can remind you to stay grounded.