Stuff You Should Know - SYSK Selects: How Panic Attacks Work

Episode Date: August 22, 2020

Almost three percent of Americans suffer from a debilitating disorder that causes them to suffer intense fear seemingly without reason and science hasn’t yet figured out what causes it. Join Josh and Chuck in this classic episode as they get to the bottom of panic attacks. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

On the podcast, Hey Dude, the 90s called, David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.

We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass

and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye.

Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. Hi, everyone, from October 2, 2014, my Saturday select pick for the week is how panic attacks work. This is very sad and serious stuff, everybody. Panic attacks are terrifying.

They are real deal stuff. I've never had one. I've had friends and family members that have had them. And it's tough stuff. So if you suffer from them or have friends or family that do, why don't you give it a listen, and maybe this will help out,

or at least bring a better understanding about how panic attacks work. Welcome to Stuff You Should Know, a production of iHeart Radio's How Stuff Works. Hey, and welcome to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant and Jerry. So it's Stuff You Should Know, yep.

Widespread Panic, did you see that video? No, which one? There was a dude, this was just like two days ago, that went up on stage and attacked the band. Oh, no, I didn't see that. Yeah, and they've got the whole thing, and it was during one of the really repetitive droning parts of a song.

And I haven't seen an explanation, but I went to the Widespread Panic Facebook thing because there was a big thread about people talking about it, and I just said, hero. Did you really? Yeah, people gang-filing me, going, hero, that's hilarious, he's troll. I thought it was pretty funny.

He attacked the members of the band. Yeah, like physically, and I couldn't quite, he attacked the drummer, and he was upset, and I don't know if that part of the song made him snap, but it was definitely one of those repetitive thunk, thank, thunk, thank, over and over and over, yeah. He was like, stop. But he was at the show, so that'd be weird

unless he went there to attack them. Yeah, that was probably the bath salts. Maybe so. So we're not talking about that kind of panic, that's more of a psychotic break. And this is not widespread at all, it's very individualized panic. It is, but it turns out people suffering from this

is kind of widespread. How about that? So it fits a little bit. Sure. Instead, we're talking about panic attacks and the combination of panic attacks or the culmination of panic attacks that can lead to something called panic disorder.

And it is a sucky mental condition that about 2.8% of Americans, which is a pretty significant amount of people. Yeah, that's more than bipolar, which we've covered in schizophrenia. Yeah, and OCD, which we've covered all three of those. Yeah. So that's a pretty significant amount of people

who suffer from panic disorder. Right. But that's different than just plain old panic attacks. Even though to have panic disorder, you have to have panic attacks, but if you have panic attacks, you don't necessarily have panic disorder, right? Right, exactly.

And I've had two experiences, which I'll talk about at some point through the show, not personally, but Emily had a panic attack once. And a friend in college had a panic attack, a roommate. And neither one of them have panic disorders. It was just an isolated incident. Yeah, so apparently that's, I don't know if common's the right word,

but people do have panic attacks, but that might be the only one they ever have for their entire lives. I hope so. Which makes the whole thing kind of mysterious. And we should say like science does not know what exactly is going on here. They have some theories,

but there's no way to predict what's happening. They don't even know if it's genetic or what, or environmental. Well, they finally isolated a gene last year. I guess I can go and talk about that now. In December, 2013, they isolated the gene, and you know genes are always so boring with their names. Unless it's Simmons.

That's right. The NKRT-3, they think may be responsible because its presence appears to cause an over-estimation of fear and danger, and an over-activation of the hippocampus and amygdala. So basically, if you have this gene, you're gonna exaggerate your fear overall. Okay.

But it's not like they're saying they prove that's the cause, but that is a good step in scientifically in the right direction. That's a huge step, because I mean, that does sound very much like what a panic attack is. A panic attack is where you experience a very pronounced sense of fear, and basically your fight or flight symptoms

response, and really from what I can understand, your flight response. Like you're not in a position to fight or freeze, cause you know now these days it's fight, flight, or freeze. Oh really? Yeah. I don't think I knew that. Yeah, there's a third option now.

Like stop, drop and roll? Kind of, yeah. I don't know, wait, those aren't options, that's a sequence. Right, these are options. Yeah. So when you're confronted with danger. Nick Thune, our buddy, the comedian. Dude, have you seen his Honda Fit ads?

Yeah. Those are awesome. Yeah. I was like, that's Nick Thune, and he's on Miss America. Yeah, the first thing I always think about is, good for you, cash those checks, baby. Yeah, he has that funny bit on stop, drop and roll, and like they needed to continue that, like keep rolling.

He's like, that's kind of key. Don't stop, drop and roll, because you'll be consumed by fire. You need to keep rolling. Right. Until you get to a door. Yeah. It's very funny stuff. So this is a little different, fight, flight, or freeze.

Yeah, so how does freeze factor in? Like you just freeze up and toast. Oh, yeah, that makes sense. It's the least beneficial of all of these adaptations to danger, but basically, when you're confronted with danger, you can either fight, fly, or freeze. That makes total sense, I don't know why freeze was never in there to begin with,

because so many people freeze. They just added on in the last couple of years. I think I'm a flyer or a freezer for sure. It depends, I don't know if, do you think there's a personality type? Oh boy, I don't know. You know, don't you think it's possibly like just what your body chemistry happens to be doing right then?

No, I think some people are more inclined to fight for sure. Okay, well with panic attacks, you're flying. Yeah. Like that's your only, that's your jam right there. Yeah. And you're experiencing it in the exact same way that somebody's coming to mug you, or has pulled a knife on you, and you're running away,

or there's a lion chasing you, except, this is the key to panic attack. There is no lion, there is no mugger, there's no knife, there's no discernible reason for you to be experiencing the sudden onset of crippling fear, but you're experiencing it nonetheless. That's right, no tangible thing happening right in that moment.

Right, so when you come out of it, and these things can, they peak within about 10 minutes, but these symptoms can last for an hour or more. When you come out of it, you're like, I don't ever want that to happen again. Yeah. The place that this just happened, say the park, I'm never going back to, because now I associated with this,

because what you're doing when you experience fear, you're learning to stay away from something. So whether you want to or not, you've just been conditioned to fear the place that you just were, because you had a panic attack. And then lastly, you think possibly you're crazy. Yeah, or having a heart attack. Yeah.

Both of my wife and my friend, both thought they were having heart attacks, which is super scary, and we'll get to the difference later on, but I guess we should talk about just some of the initial symptoms of a panic attack, the old DSM, Diagnostic and Statistical Manual of Mental Disorders, lists, looks like about 10 symptoms. And if you have at least four of these,

you may be having a panic attack, which is heart pounding, shaking, dizziness, sweating, choking feeling, nausea, shallow, or short breath, chest pain, numbness, or tingling, chills and hot flashes, feeling of unreality, feeling like you're going crazy, or feeling like you're about to die. Yeah.

You got four of those, you're having a panic attack. Yes. And if you have four panic attacks within four weeks, or you have one panic attack, and then fear having another panic attack for about a month or so, then you can be diagnosed with what's called panic disorder. So if you listen to our fear podcast,

which was a really good one, it's kind of the same as a panic attack. We covered your autonomic nervous system is what maintains all the functions in your body, the involuntary functions in your body that is. And it's gonna take signals from your central nervous system. It's gonna regulate your organs. That's why you don't have to tell your heart to beat,

or your kidneys to work. Yeah, or your pancreas to secrete stuff. That's right. It's your autonomic nervous system, and it has two parts, the sympathetic and parasympathetic. And your parasympathetic controls, like I said, your heartbeat and stuff like that. The normal aspect.

Yeah, just like your organs. It keeps you at home of a stasis, right? Yeah, that balance that we all seek, that we don't know we're seeking. And then the sympathetic is if you have that fight or flight, or if you become excited in any way, really, that's when that's gonna kick in. Yeah, it's like normal gear and then high gear.

Yeah, but it's not always fear, you know, just any kind of excitement. Right. You could be super happy. It could be sexual arousal. That's all your sympathetic nervous system. Right, and those two components make up the autonomic nervous system,

which it kind of switches from one to the other, depending on your state of arousal, right? That's right. But when fear has aroused you, your sympathetic nervous system kicks into high gear. And adrenaline is released, which is a huge factor in causing the symptoms of a panic attack.

Like you start breathing very heavily and shallowly. Your pupils dilate. We always used to say if you're digesting food, you stop doing that. Oh yeah, that's right. Basically all of your energy is transferred over to either fighting or flying, and in the case of a panic attack,

it's transferred over to get you to be able to run away as fast as possible. Yeah, which can be a little scary, but in a real fear situation, if you're in danger, your parasympathetic nervous system's gonna kick in and calm you down. But that is not what happens in the case of a panic attack, which is really perplexing.

So let's recap this. A panic attack is when you experience this incredibly intense fear. So much so that you run away, but there's nothing there to be afraid of. And then, and then to make everything a million times worse, your parasympathetic nervous system doesn't kick in and calm you down like it would under normal circumstances.

So you get to experience this horrible thing even longer. That's right. ["Stuff You Should Know"] ["Stuff You Should Know"] On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses

and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends, and non-stop references

to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist?

So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to Hey Dude, the 90s called

on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough, or you're at the end of the road. Ah, okay, I see what you're doing.

Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place, because I'm here to help. This, I promise you. Oh, God. Seriously, I swear.

And you won't have to send an SOS, because I'll be there for you. Oh, man. And so will my husband, Michael. Um, hey, that's me. Yep, we know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you through life, step by step.

Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen. So we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass

on the iHeart radio app, Apple podcast, or wherever you listen to podcasts. All right, so like I said before, breaking news from December of last year, they think they've isolated a gene. Previous to that, some research has said it could be genetic, because identical twins experience it more than fraternal twins.

But it's always been sort of up in the air. There have been contradictions as well on a genetic basis. They think it's also possibly epigenetic or environmental. Like apparently one study found that a lot of people who have panic disorder had some sort of traumatic incident happen in their childhood. My friend from college did. Is that right?

Yep. So they're thinking like possibly it had some sort of effect and set up like a time bomb for later on in life. Yeah, the stored feelings that maybe you've never dealt with about some traumatic event are going to rear their head at some point in your life in some way. Yeah, or it just rearranged the neural output in your brain

so that one day you're just set up when everything is just right, that chemistry is flooding your brain in a certain way, and then bam, it comes out of nowhere. You have a panic attack. Yeah, another theory is that they think if you have an overactive fear system, like you basically have been scared too much in life, or you're a scared person, then it's

just going to make it a hair trigger for something to set it off, which makes a lot of sense. I think it could be a combo of a lot of things, as usual. Yeah, I wonder though what it will end up being, though, if we'll find that there is one thing that leads to this predictably. Like there's things built up, but then there's the actual trigger.

Right. And that's another thing, too, is they don't know what triggers these things. They do know that a panic attack being worried about having a panic attack can actually trigger a panic attack. Yeah, absolutely. I feel so bad for people with panic disorder.

This is like a terrible affliction, because you do become very much afraid that you're going to have another panic attack. So that can set off a panic attack, but it also can set off a co-morbidity called agoraphobia, where you are afraid to leave your house, but you're also afraid to be alone. And I read this article that was from the 80s, 1987,

and they were saying like the Freudists, followers of Sigmund Freud, were saying, oh, well, clearly, if you're an agoraphobic, you don't want to go outside, because that's where sexual desire is. And you don't want to be alone, because you're worried that you will abuse yourself. So agoraphobia, and everybody went boo, sit down, shut up. Freudists.

Yeah, and so nowadays, they have realized that agoraphobia is almost exclusively the result of panic disorder. Oh, really? Yeah, and it's because you fear the place that you had a panic attack. So you don't want to go there again, and then maybe it happened again at the grocery store,

so you don't want to go there. And it happened, but you don't want to be alone, but you don't want to be around strangers, so you cling to your family members, and now all of a sudden, you're not living your life anymore. You're developing phobias because of your panic attacks and your association with them. Like if you're on an elevator and you have a panic attack,

you're not getting on an elevator again. You've just developed a phobia for elevators, and so all of a sudden, you're not going to be working at a place where you might normally work, because you have to take the elevator to get there. Or you develop a love of stairs. Right. But then what if you don't like confined spaces at all,

like a stairwell either? Yeah. You ever been locked in the stairwell here at the building? Yeah, I mean, you just walk down, however many flights. So you're at the lobby? Yeah. Oh, you can get out down there? Yes.

Oh, OK. Yeah, yeah. You're not actually locked in. You just have to walk all the way down to it. I usually just call you and say, let me in. Another theory is that when you're super tired and overworked, it was a lot of times when these are set off, your brain is producing sodium lactate or CO2.

And when those levels increase, your brain says, you know what? I think you're suffocating. And so I'm going to send the signal to get you a lot more oxygen. And I found this really sad case of this woman, a university student who died from a severe asthma attack like three days ago, and she had had a history of asthma and then told the medics that she was going through

like final exams, and she had been having panic attacks in the weeks, like proceeding. So breathing is a huge part of panic attacks. And as evidenced by her, if you have asthma, it can be deadly, which is super, super scary and sad. I would say. Yeah. Then one other, I guess there's a neurological basis,

they believe, for people who have panic attacks, people who suffer from panic disorder tend to have fewer serotonin receptors. And apparently also GABA, which helps us get to sleep, it's called a gamma immunobutyric acid. Let's call it GABA. Yo, GABA. Those two have some sort of role in panic disorder.

Like you don't have enough serotonin, and your body's not producing enough GABA, you may be prone to panic disorder. There isn't like a specific type of person that necessarily gets a panic attack. It can happen to anyone. But usually it happens if you're in your 20s, although they say kids can get it as well,

have a panic attack or a disorder. Twice as many women have a panic disorder develop on as men, which is pretty interesting. And like you said, just the fear, like having had one before, that fear can lead to more. So it's very cyclical. Yes. And you know that one paper from 87,

I can't tell if it was arguing in favor of panic disorder being like an evolutionary adaptation and like possibly beneficial. Or if they were saying like, some people think this, can you believe this? But one of the points that this guy made was, well, twice as many women have panic disorders as men. So clearly it's an evolutionary adaptation

because women wouldn't have had to have gone as far away from camp while they were gathering food as men, so men couldn't stand to have a panic attack or they couldn't, it wouldn't be an adaptation for men. It would be for women, plus women can't run as fast when they have kids to carry. So they need to be on alert a little more. Gotcha.

It's just smelled like bunk. Yeah. 1987 bunk. Yeah, that was a big year for bunk. Yeah. If you do have a panic disorder, you may have a hard time getting your family to understand it.

Sometimes they overreact and think it's like way more severe than it is. Sometimes they underreact and say, you know, it's all in your head. Right. And then they come down, but either way saying, boy, you're nuts or you just need to relax.

Neither one of those is going to help out a loved one. Chill out. There's no lion. Yeah, one thing I've learned in arguments and fights with my wife is, and I'm boy, I learned this early on, is saying, telling someone to relax never causes someone to relax. No, it does not.

It's like the worst thing you can do if something's heated is to say, just relax. It is true. It's just going to ramp it up. Yes. So that's my advice for couples out there in any relationship, really. That's good advice, Chuck.

Thank you. There is a silver lining to all this in that panic disorder is actually highly treatable. The treatments that they've come up with are pretty successful, and we will talk about those treatments right after this. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor,

stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it.

It's a podcast packed with interviews, co-stars, friends, and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal? No, it was hair.

Do you remember AOL Instant Messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in

as we take you back to the 90s. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough,

or you're at the end of the road. Ah, okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. This, I promise you.

Oh, God. Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh, man. And so will my husband, Michael. Um, hey, that's me. Yeah, we know that, Michael.

And a different hot, sexy teen crush boy bander each week to guide you through life, step by step. Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody, about my new podcast and make sure to listen

so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with a Lance Bass on the iHeart Radio app, Apple podcast, or wherever you listen to podcasts. All right, so you mentioned that they are treatable. They have found success rates through medication and therapy, which seem to be about the same as far as how effective they are between 60% and 90% of the time.

That's pretty good. Yeah, that's not bad at all. So that's the good news. So there's three typical methods of treatment. Antidepressants, anti-anxiety pills, and therapy. And you might use them independent of one another in conjunction with one another. I also saw beta blockers.

Some people use beta blockers to treat them, but they're not quite sure what's going on with that. I've used those before live performances. Those are the ones I read about that. You gave me one, and I was like a useless worm. Yeah, it didn't affect me like that. I just totally lost my personality. I wasn't nervous, but I didn't do anything.

Well, I've gotten used to live performing now, so I don't need them anymore. But I got that tip from apparently a bunch of musicians and symphonies and stuff use them. I was like, well, if a first chair violinist, if it's good enough for them, then give me some beta blockers. But it worked for me. But like I said, overall that.

I enjoy being on stage now. So with SSRIs, which is what you moved on to from beta blockers, right? No, I'm not on anything. So with SSRIs, those are selective serotonin reuptake inhibitors, and they do exactly what they sound like. You've got a bunch of serotonin receptors in your brain. If you have panic disorder, you may have fewer serotonin

receptors in your brain. Serotonin is a neurotransmitter that helps basically stabilize your mood by either causing a neuron to fire or inhibiting a neuron to fire in this really beautiful, perfectly balanced chemical reaction. So if you have fewer of these receptors than normal, you're going to be comparatively out of balance.

What an SSRI and antidepressant does is it allows the serotonin to stay in your synapses a little longer than is normal so that you are releasing a little more serotonin than you would under normal circumstances. And it's proven pretty effective for panic disorder. Yeah, I mean, they work wonders for a lot of people for a lot of reasons, but not everyone. And they can cause a lot of negative side effects.

So obviously, work with your doctor on a program. And it takes them a little while, like two to four weeks to begin working. For a panic attack, an anti-anxiety drug like Xanax might be a little more effective because that is immediately hits you. It is a tranquilizer. Benzodiazepine, right?

Yeah, and it's Xanax is going to help chill you out immediately, but you can get hooked on those things. Pretty quick. Yeah, and they're dangerous to quit cold turkey. And it's not the best thing to go to Xanax a lot. Well, yeah, they say that you should basically, if you undertake an SSRI regimen, you can conceivably stay on it for years.

If you undertake anti-anxiety or benzodiazepine regimen, it shouldn't last for more than a couple weeks or month, from what I understand, because of the dependency. And again, you want to really do all of this with a qualified, competent doctor's assistance. Sure, not a doctor's assistant. Doctor's assistant. It depends if it's a qualified, competent doctor's

assistant who can write prescriptions who you trust. Go for it. That's true. And then there's therapy, of course, the old CBT, Cognitive Behavioral Therapy, which we've talked about a bunch. But that is they're going to, sort of the process is going to play out like this. They're going to teach you about your panic disorder, which

is a big step if you understand something. You can overcome it more easily, I think. They're going to monitor you, and you're going to self-monitor and record your symptoms, and when they happen and why they happen, what the circumstance was. Breathing, like we mentioned, is a huge part of it. Anything from meditation to just regular breathing exercises,

which we'll give you some tips on that in a minute, too, are going to help you out. And then the old exposure to situations. And this is once you've rethought what your approach is going to be like, here's your new outlook, and now here's a situation that might give you a panic attack. How do you feel? Yeah, or like if you had a panic attack in an elevator,

like they may tell you to imagine you're in an elevator, your therapy might progress until you're actually in an elevator and you're chilling out. And the hope is that if you can undergo exposure therapy to that degree, it will get you over your panic attacks in general. Another aspect of it, Chuck, is rethinking. And that is basically accepting the fact

that you have panic attacks. Apparently, if you can say I'm having a panic attack or I have panic attacks and you acknowledge it to yourself and to other people, it immediately turns down the volume on the whole thing. Yeah, I noticed some similarities in someone guiding someone through an LSD trip and guiding someone through a panic attack.

It's interesting, a lot of it is like understanding, like I am having an acid trip. I am not having a good time. It's the same thing as I'm having a panic attack and this is no good. And if I understand that, then I can calm down more easily. Keeping it in just leads you to freak out more. Exactly.

So that's CBT, Cognitive Behavioral Therapy. And if you undergo therapy and you're still suffering from panic attacks, apparently being discouraged is a real problem with people with panic disorder. Because you can still suffer them even if you're doing everything right. And so a lot of people have learned to cope and there's some pretty common coping techniques

for panic disorder. And like you said, the heart of the whole thing is breathing. Like when you suffer a panic attack, you start breathing shallowly and quickly and you can hyperventilate. What you want to do is breathe from your diaphragm and that you can actually practice this in the times when you're not having a panic attack.

Yeah, if you're a singer, you know how to breathe with your diaphragm. But if you're not, what you can do is lie down on your back, put some pillows under your head and knees, and put a hand on your stomach and a hand on your chest, and then practice breathing and making your hand on your stomach move without the hand on your chest moving.

Right, and then tap the hand on your stomach while you make a circle with the hand on your chest when you're really advanced. Wow, that's pretty impressive. And then another thing you can do is just literally like put a weight on your stomach and make sure you- Nothing too heavy? No.

Like a book? Sure, like a nice atlas. Something that you can see going up and down when you're breathing with your diaphragm. That's right. And you want to just kind of breathe in the good, exhale the bad. Yeah, like I'm having a panic attack.

This will pass, you know this will subside. This is a temporary feeling, is what you should be saying to yourself. And if you're a person who's like out in public and you see somebody having a panic attack, you basically want to do the same thing that they're trying to do for themselves. You want to remain calm, you want to tell them

that it's going to be over with pretty soon, that everything's okay, they have nothing to fear. Yeah, you don't want to tell them to chill out though. No. Guiding someone through relaxation is different than saying chill out by the way, very different. They do recommend that you, if you have a problem with attacks in general, or if you have a disorder,

you should exercise a lot, you should practice. They don't call it meditation, but that's really what it is, is deep breathing and relaxation. It's called mindfulness these days, isn't it? I don't know. I think that's what they call it. Because meditation turns people off probably.

I guess. Interesting. Cut out the caffeine and sugar and nicotine. That's a big one. Yeah, that's not going to help you at all, doing all those things. And if this stuff is stuff that's building up inside of you, which it often is, learn how to express yourself

a little more and talk about your issues. I know that in both of my cases, my buddy in college, it was during finals week, and I had gone to bed and my roommate and another dude had worked out in the living room staying up, and one of them came and woke me up and he's like, dude, he's having a heart attack. He's having a heart attack.

And I didn't know anything about panic attacks, so we took him to the hospital, of course, and that's all it was. It was a panic attack. He calmed down. I think they might've given him something there, some sort of medication to calm him down. Probably benzodiazepine.

Yeah, probably like a good shot in the arm of that stuff. And he was like, oh, I'm fine. Right, with Emily's case, she had been under a lot of stress and was driving back from Akron, Ohio to Atlanta. I think she went to get some furniture or something, so she was in a truck, like a moving truck. Oh yeah, that's a stressful event.

Had been drinking caffeine like crazy, like she does, and basically started to have trouble breathing on the highway, going like 80 down the highway, and had to pull over, called me, and I calmed her down. I was like, all right, now let's get back on the road, see how you do. She got back on the highway

and immediately freaked out again. And I flew to Cincinnati and went to her hotel and drove her home. Nice. Yeah, I mean, there was really no choice at that point. You know, when it's your wife, plus it was a good opportunity to get on the white horse, you know, and ride in and save the day.

Oh, that white horse. I think everyone loves those opportunities, you know? Yeah, for sure. And I've always also wanted to run to the airport and say, like, give me a one-way ticket to somewhere. That's all I want. Out of my way. I have time for your body scans.

Pretty much, that's how it happened. So she checked herself into a hotel, and I went there, and I had some nice Cincinnati skyline chili. And then the next morning, we hit the road. Nice. Yeah, it was good. That's a good story.

And she hasn't had one since then. Thank goodness. Despite, like, you know, she has a lot of anxiety, just as a human. Yeah. No panic attacks. Yeah. So I definitely have seen the things I saw

in this article in both of them, whether it was during finals, like the things going on in her life at the time were super stressful. I think the trigger was she doesn't, like, see great at night or in the rain when she's driving. And I think all these things compounded and just played out to where she felt

like she was having a heart attack. Gotcha. And so did my friend. But I guess we should mention that there are some telltale signs of a heart attack. Yeah, that's a big, big one. Yeah, that you can recognize the difference. Because you don't want to actually be having

a heart attack and be like, oh, it's just a panic attack. Just breathe. Right. Just breathe while you're dying. Right. Here are a few tips from the American Heart Association. Pressure in the center of your chest that persists longer than a couple of minutes

or goes away than returns. Shortness of breath, pain in the arm or upper body. You might feel nauseous or faint. And of course, if you're ever in doubt, call 911. Because like you said, you don't want to be having a heart attack thinking it will subside. No, there will be egg on your face. Well, yeah.

To say the least. Exactly. If you want to know more about panic attacks and panic disorder, type either one of those sets of words into the search bar how stuff works. And it'll bring up this article. And since I said that, it's time for a listener mail. I'm going to call this basement fear.

Hey, guys, I know most listeners know your podcast is great for learning and entertainment, but I found another purpose. Distraction from stress-induced irrational fears. Oh, this sounds familiar. We were just talking about this kind of thing. Oh, yeah. And I didn't even realize it when I picked this out. How about that?

It's called serendipity. I grew up in a house with a creepy gross basement where we did laundry, and it never bothered me. My fiance, James, and I recently moved into a house with a non-creepy and non-gross basement. But I think the stress of planning a wedding is getting to me because when I need to go down into the basement to do laundry, I nearly have a panic attack, imagining a person lurking

in the basement. I started playing an episode of stuff you should know on my iPhone and carrying it in my pocket when I need to go down to the basement. Stay back, spirit. Exactly. So we literally accompany her into the basement, which I think is hysterical.

I am busy enough enjoying your humor and information that I don't get as overwhelmed by this irrational fear. I think it may even be waning now, so I continue to make myself go down into the basement and see that my fear is not really based in any reality at all. That's CBT. That's exposure therapy.

Yeah. Boom. Nice. Also, before this weird basement fear popped up, I long called you guys my cleaning crew because I listened to episodes while doing my chores. And that is from Kelsey in Kansas City, Kansas, not Kansas City, Missouri, Missouri.

And Kelsey, good luck with that. And just don't look behind that door over near the washing machine. That was very helpful. Just kidding, Kelsey. There's nothing down there. Just take us with you. We will protect you because spirits don't like us.

No. The podcast is coming from inside the house. If you want to get in touch with Chuck or me, you can tweet to us at S-Y-S-K Podcast. You can join us on facebook.com slash stuff you should know. You can send us an email to stuffpodcast.howstuffworks.com. And as always, join us at our home on the web, stuffyoushouldknow.com.

The stuff you should know is a production of iHeartRadio's How Stuff Works. For more podcasts from iHeartRadio, visit the iHeartRadio app. Apple podcasts are wherever you listen to your favorite shows. On the podcast, hey dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slipdresses

and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

Hey, I'm Lance Bass, host of the new iHeart Podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy, teen crush boy bander each week to guide you through life.

Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeartRadio app, Apple Podcasts, or wherever you listen to podcasts.