Do panic attacks happen when you feel relaxed?

[Arethesepanic]

Short version - can panic attacks happen when you think you're relaxed?

I've been having episodes of faintness after a period of intense stress and a nasty virus.

I also have benign ectopic heartbeats which are disconcerting but cardiologist has assured me are safe.
After one particularly worrying faintness spell, a 111 call ended up with me being taken to A&E where I had a load of tests and was sent home with the assurance that all was okay but with a referral back to cardiology - that appointment is next month.

My BP was very high when the paramedics tested it, but came down and has been fine when tested at home.

They told me to go back to A&E if it happened again - it did, same result, lots of blood tests, ECG for several hours and told nothing detected, go home, carry on as normal including exercise.

But the faintness episodes have continued and are sometimes while I'm sitting down chatting to friends. I'm wondering if they're in fact panic attacks - but do panic attacks just come out of the blue like that when you feel you're otherwise relaxed?

The ectopic heartbeats have been more noticeable recently but they come on more if I'm tired, have had a virus or if I'm stressed - and obviously I'm stressed about the faintness episodes. I haven't actually passed out, but need to sit with my head between my legs.

Thanks for any advice, especially if you've had this yourself.

OP this is a useful reference for symptoms of panic attacks:

https://www.priorygroup.com/mental-health/panic-attack-treatment

As you'll see, faintness isn't listed. That's not to say that your feeling faint doesn't indicate a panic attack, but it could be helpful for you to consider some of the other listed symptoms and notice if you have any of those along with feeling faint.

I'm afraid I couldn't say categorically that you can have a panic attack while feeling relaxed, but in my experience one of two things causes my panic attacks. Either I'm feeling stressed to the point of being caught in fearful thoughts and physical anxiety symptoms, and that develops into a full blown panic episode, or I'm in an environment that triggers anxiety at some point and brings on a panic attack. In the second example, I mightn't have realised before the panic sets in that the environment could be a trigger for me, so it can feel like it comes out of the blue. (I've experienced a similar onset at times around certain people, or while watching/reading something disturbing.)

If you're breathing is affected during a panic attack, you can feel faint.

As for your question, I have had 'random' panic attacks lately as I'm going through a lot of stress. I mentioned this to my therapist, and she said it's completely normal and common for panic attacks just to spring themselves on you, unfortunately.

Thank you both, that's reassuring.

No-one has suggested it's panic attacks but I do have past trauma and the symptoms add up to that.

I had what I believe was a panic attack when I was totally relaxed. I was sat reading my son his bedtime story as I do every night and then suddenly felt like my heart was racing, very faint feeling and when I measured my BP it was sky high, I was terrified I was dying and just had this overwhelming feeling that something was really wrong with me. The Dr at A&E was very reassuring and not dismissive at all, he said that panic attacks do produce very real symptoms like high BP, racing heart and feeling faint. He advised me that if it happened again to breathe into a paper bag to help calm myself down (the idea is to breathe in your exhaled carbon dioxide - but not so much you faint!). After the initial panic attack I had a couple of days of feeling not right, BP still a bit high and just feeling very anxious. I found the breathing into a bag did help calm me (I just used a plastic bag as I didn't have any paper ones).

For a few weeks after the panic attack I occasionally had the feeling start to come over me again (often when I was in the same situation - reading the bed time story) but, as I was confident that it was "just" a panic attack, the feeling dissipated quickly with deep breathing. The paper bag trick would have probably been better but it usually happened when my kids were around and I didn't want them to see me doing that.

There was really nothing that precipitated it. I had recently been diagnosed with an ovarian cyst that was giving me a fair amount of pain so that was stressing me out a bit but it wasn't on my mind at the time of the attack and I've dealt with other more distressing things and not reacted like this. I've never had a panic attack before or since (other than the start of the same feelings that I mentioned above).

I spoke to my mum about it and she told me that she once had a "funny turn" when I was little. She felt like she couldn't breathe properly and had the Dr come out to her. He said it was almost certainly stress/anxiety related. It hasn't happend to her since.

Sorry that was long. It's interesting to hear of someone having the same though. I think people sometimes misuse the word "panic attack". If you'd asked me a couple of months ago I'd have said I had a panic attack whenever I got on a plane but after experiencing a true panic attack I think my response to being on planes is more phobia/stress response. Hyperventilating, crying, feeling very scared. Not to diminish how horrible that is but it is very much situation triggered which a panic attack doesn't necessarily have to be, in my experience.

@RainbowRedPanda Thank you for sharing that.
It definitely does sound like my symptoms are panic attacks, brought on by stress. I think they then set off the ectopic heartbeats, which makes me more stressed...
Back to regular yoga and meditation which I've neglected in the past few months, but which will help!

The term panic attack is really unhelpful because it makes it sound like hysteria.

I’ve been sat cuddling and reading stories with my dc, completely relaxed, and my heart just raced for a couple of seconds and I felt a terrible dread that just wasn’t connected to any other thought or anything in my environment.

My gp was completely dismissive of my suggestion that the feeling was caused by my heart racing rather than the other way round (and prescribed relaxation exercises) but I’ve had anxiety induced panic attacks in my twenties and this was something entirely different.

This is perfectly put. I preferred my mum's "funny turn" euphemism to panic attack tbh, it felt more descriptive of the experience I had.

I was really, really lucky with the Dr I saw.

@Theothername its interesting you mentioned the heart racing as well. The Dr I saw took the opposite view to your GP and said possibly it was the racing heart that precipitated the whole thing, so my heart had a little palpatation and my brain for whatever reason totally overreacted to that sensation and sent my body into action stations.

Yes they do, when you’re relaxed or not busy your subconscious wanders to the traumas or stress that you’re burying or trying to ignore and the panic can creep in.

Not every symptom is anxiety or panic. But your GP will probably convince you it is. It could just be harmless tachycardia following the virus which will hopefully just resolve. Lots of people have POTS like symptoms after a virus that will then calm down.

I've woken up in the middle of night with them so yes they can appear at random times! I've also had one when feeling really relaxed, watching a film and dozing off. It's really just a massive dump of adrenaline out of nowhere. For me it's linked to past trauma and ongoing stress.

I'd agree. I've had them when there's no stress and I'm feeling relaxed and they leave me wondering 'where the heck did THAT come from?'

Hmmm what virus? I have been having really incredible anxiety and panic and racing heart after a virus. Since reading the COVID posts I see others are too so wonder if I had covid and this is a COVID after party. I took myself to a and e too as was feeling like was dying...

Peri-menopause often causes massive anxiety/panic attack issues, and the attacks can come out of nowhere. You can even wake up in a panic attack in the middle of the night due to hormonal fluctuations.

Came to say this.

While I more often have them with an identifiable trigger, where I can feel the panic building, and know what it is and why (not that that helps particularly!) on one particular occasion I was fast asleep and suddenly lurched awake with heart racing, sweating, felt sick and like my skin had pins and needles. I had been worrying about something for a while and for some reason it just erupted in the middle of the night.

The first panic attack I ever had, I was lying on the sofa, half dozing and reading a book. I was about 17 and genuinely thought I was having a heart attack. It was for no reason at all as far as I could work out.

This is the main reason for school refusal and you can see why. Imagine having a full blown panic attack in the middle of a classroom, zero privacy and no escape.

@shewolfmum It could well have been Covid, I didn't test.

@Aquamarine1029 I'm well into menopause and not on HRT, so that's a distinct possibility.

Thanks for all the replies, it's been very helpful.

It might be worth reading up about chronic hyperventiltion. If you are already hyperventilting in a small way all the time then it can be very easy to tip over into being symptomatic. Doctors often don't think of chronic hyperventiltion. If they test your blood oxygen during an episode and it is 100% I think it would be worth asking them about chronic hyperventilation syndrome. Also try holding your breath. If you struggle to hold if for more than 25 seconds, that is a clue. Another good test is to think of something extremely stressful and see if your breathing markedly increases.

I'm not hyperventilating and can hold my breath for extended periods, thank you though!