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Panic attacks - emotional or physical?

The lessons I learned

Last week I was interviewed on a local radio station about publishing my book. One of the questions I was asked was how difficult it is to be so honest about my illness. I explained that it can be hard, because remembering the times when I felt so ill can stir up many unhappy memories, but it is also a good thing to feel, because by being honest with myself, I am also being honest with my readers. Anyone who is experiencing symptoms of M.E. or chronic fatigue syndrome needs to feel understood and they also need to be able to trust those who are providing information to help them towards recovery.

One of the symptoms which affected me quite severely, particularly in the early stages of the condition, was panic attacks. I had never experienced them before and, when they did appear, it was totally out of the blue. While trying to get out of the house early on, what struck me was how disabling and frightening they were, I felt alone and vulnerable as I tried desperately to catch my breath, every step feeling as though my feet were made of lead. One of the reasons I avoided going out was because the attacks became more and more frequent along with the muscle pain, which I described in one of my earlier blogs; it became a vicious circle, the attacks led to the pain which led to more attacks. I have since discovered that emotions can play a large part in the causation of panic attacks. They cause extreme physical symptoms, such as tightness in the chest, a pounding heart beat, sweating and then the inability to move. It is no wonder that M.E. is often referred to as a physiological condition; a psychological cause with physical symptoms. I noticed also that these attacks became more frequent if I was struggling with my emotions or, if I had been trying to do too much on a particular day.

I recall one particular event once I had started treatment with my psychiatrist. I was making my way on one of my graded exercise sessions and had just crossed a busy road. There were quite a few people about and, whether that startled me being out after so long in the house, I am not sure, but I was suddenly struck with a panic attack. I couldn't catch my breath and was unable to move. I was terrified by these symptoms again but I did finally manage to regain my composure by using the exercises given to me. These then allowed me to restore my breathing to a regular pattern.

Although the attacks seem a lifetime away now, at the time they were very frightening. What I now know though is that they were another lesson for me to listen to my body. I didn’t stop, so my body did whatever it could to stop me, even if that meant forcing me to a halt on the side of a busy road. It took time for me to understand the why these attacks were happening, because at the time I was too absorbed by the symptoms to understand the root cause. Looking back at my diary from the early years of my condition, I notice they tended to occur at times when I had forgotten to pace myself either physically or emotionally. I was trying to get to where I wanted to be too quickly. I needed to slow down for better performance by stepping back and seeing the bigger picture, I now know I always had time, I just didn't realise it then.

There is actually a misconception about panic attacks, or hyperventilation, that they are caused by too little oxygen. In fact, the opposite is true. They are caused by having too much oxygen in the body and too little carbon dioxide (CO2). The body uses carbon dioxide to extract oxygen from the blood and, with panic attacks, the body exhales too much carbon dioxide meaning the body cannot use the oxygen which is there. It therefore feels as though there isn't enough air when actually there is too much. One of the ways we have all heard of to restore the CO2 levels in the blood is to breathe into a brown paper bag. This allows the CO2 in the bag to be inhaled back in to the body therefore restoring the balance between CO2 and oxygen. At the time of my initial diagnosis, I was actually diagnosed with chronic hyperventilation, so it is little wonder at the occurrence of so many panic attacks.

Thinking about the brown paper bag led me to my recipe for this week's blog. I remembered that these brown bags are often used for american kids to take their lunch to school, and a favourite lunch choice for many is the bagel. This recipe is from Serious Eats by Adam Kuban and originally comes from a famous restaurant in Le Marais Jewish quarter of Paris. (

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I cannot recommend these bagels highly enough. They are nothing like the ones available in supermarkets in the UK. They are soft on the inside and crunchy on the outside and the malt extract used to poach them before baking gives them a deep, yet sweet flavour. I recommend you give them a go!

Home made bagels

3½ cups bread flour

2½ teaspoons instant dry yeast

2 tablespoons sugar

1 tablespoon salt

1½ cups, hot water about 50℃

1½ tablespoons malt syrup (for the boiling water; alternatively, you can use 1½ tablespoons sugar)

Add all the dry ingredients to the bowl of a food processor (with a dough blade if possible), keep the salt and yeast separated so as not to retard the yeast, then add the water.  Mix until the dough becomes soft and elastic - about 2-3 minutes.  

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Transfer the ball of dough to a lightly oiled bowl, cover with cling-film and leave to rise for about an hour.  I put mine in my airing cupboard to ensure a constantly warm temperature, but anywhere which is warm will suffice. 

Bring 6 litres of water to the boil and preheat oven to 200℃ (180℃ fan).

After the dough has risen to about double its original size, lightly flour your work surface and turn the dough out.  I tend to weigh the dough at this point and then split it into 10 equal portions by weight. 

Take each portion of dough, roll it into a rope shape and then wrap each rope around the back of your hand, bring the two ends together and then seal.  The dough doesn't need any water to stick, as this is quite a sticky dough. 

Place each bagel on lined baking sheets, cover with a tea towel on each and allow to rise for about another 10 minutes while your water comes to the boil.  

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When the water has boiled, add the malt extract to it for it to disperse.  

Plop each bagel into the boiling water (up to 3 at a time) and simmer for 1 minute (turning over half way). I plop them in with my hand, turn them with tongs and then remove them with a slotted spoon.

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As they are removed from the water, place them on a wire rack with kitchen towel underneath.  Pat dry.

Place the bagels on prepared baking sheets. Bake them for about 15-20 minutes, until they are light brown.  Turn them over, and bake until the reverse side is golden-brown and shiny, about 10 minutes more.

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Leave to cool on a wire rack.

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