Weird attack - what the hell happened?

[terrified321]

Just sitting in taxi having just had a weird attack when speaking to my therapist (anxiety and depression). She said she thinks it’s dissociation - mind went completely blank, couldn’t speak, couldn’t get a clear thought and everything went numb/‘swirly’ and couldn’t get my breath - like breath holding. Put my head down for 2-3 mins, therapist told me to take a few big deep breaths and glass of water.

I haven’t eaten anything or drank very much - didn’t eat much at all yesterday either.

I’m also on several meds all of which can cause low BP.

Therapist (she is medically trained - NHS) said I don’t need A&E, she’s happy it’s just some combination of all the above and the last appointment having been very difficult too, so very panicked about coming down to see her.

I’m not sure and a bit thrown (and still feel weird!). It has happened before but I’ve usually made my way to A&E where I’ve either passed out or thrown up or both.

Been told to go home and get a decent meal and see how I get on but I’m a bit knocked and scared of it happening again.

Sorry this happened. DS has anxiety and has had dissociative episodes. They are always when he hasn't eaten. Would you be able to carry some cereal bars and small packets of nuts around with you, with a small bottle of water, so that you can eat something every few hours.

Mental Health nurse here. Sounds like stress related vasovagal response to me. Basically, it’s a sudden drop in blood pressure and heart rate due to being in a very stressful or emotional situation. This can also be made worse by not eating and drinking properly; dehydration in particular increases the chances significantly. I would just try and take care of yourself for the next few days. Kindly, when did you last have a glass of water?

Wow sounds so scary. Definitely just go home and try and relax. It’s not an accident or an emergency but very scary nonetheless x

I get these.

I carry a bottle of iced tea (high sugar) and emergency chocolate with me. If I eat and drink when I feel one coming on I can stop it.

I now eat every 4 hours.

Being honest, last night! I’ve had a McDonald’s now and feeling a bit more normal. Made it back home Ok thankfully - exhausted but a bit more with it than I was.

I’d got myself really panicked about going down then when I got there the place smells like a GP surgery/hospital which is very triggering, then it was just as we were finishing she was saying to me ‘right tell me what your homework is for next week’ and I couldn’t answer her, could just feel myself very distant and everything tensing up/feeling weird.

Sounds more like a pre syncopal attack due to stress and not E&D and meds. Can you check your BP?

Yes sounds like a combination of emotional response, dehydration and not eating. When I'm dehydrated I sit down and find it very hard to get up again like I'm stuck in place and not eating can make me feel faint. Going to see your therapist does sound very triggering, do you need to go there or could you have the appointments on Zoom?

I do need to go there yeah, they’d say if I don’t go I’m avoiding things. It’s just because I had such a bad session the last time, hyperventilating, that I just froze walking in today and thought oh God, oh God I don’t want to do this again. It is helping but it’s so bloody hard. I got the whole way through the session by deliberately holding back as much as possible, and then at the end I just couldn’t cope any longer and that was the result.

I absolutely get like this when my BP drops (I have a medical condition that causes this) but that doesn't mean to say that anxiety doesn't play a part. Shutting down when things are very difficult is a normal (albeit not very nice if you are the one experiencing it) response, our brain is trying to protect us from that thing.

I'd try monitoring your BP for a few days, home arm monitors are pretty cheap - do an AM and PM reading and any time you feel funny. That way if anything shows up outside a normal range you can show your GP if needs be and discuss what can be done - a review of the meds causing it and so on.

I would write a letter/email to your therapist (always easier) and explain what is going on here if you haven't and that it's causing you to hold back in sessions to avoid displaying feelings and can you work on that together and work to identify what's triggering this and take a different or slower approach.