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Night Time Attack

For some reason I have most of my anxiety attacks at night. I am (was?) having one right now. I don’t know why they always hit me at night – usually waking me up from my sleep. It used to be that I would have them on the nights before I was on call and I assumed it was because I was anxious about the upcoming shift and, likely, the possibility that I would get nauseous while at work. The last few attacks I’ve had, however, haven’t been associated with a call shift.

I’m not really sure what’s been going on. I know that one of the hallmarks of my anxiety attacks is nausea. The whole emetophobia thing is something I’ve been working on with my new psychologist. But, I’m not so sure my anxiety is related to the nausea as much as its a cause of my nausea. Why do I think this? Well, despite my best efforts, I still feel nauseous most days. Fortunately, I haven’t been having anxiety attacks every day that I am nauseous. My nausea has also improved so much that I hardly take any medications to help with it. There have been nights where I have been quite nauseous and needed to take medication again, yet I wouldn’t have an attack. Tonight, much like the last time I had an anxiety attack, I had very little nausea up until I actually started the attack.

Tonight I fell asleep right after the end of my headspace meditation (ironically I am in the midst of a series of anxiety meditations). I woke up very suddenly in the same position that I fell asleep in and realized I hadn’t yet taken my anxiety medication. So I got out of bed, went to the bathroom, and took a sip of water with my pill. Right after I swallowed the pill, I felt just a little bit “off.” I got back into bed, turned off my lamp, and got comfortable. Very soon after that, though, I felt the panic attack start. After awaking suddenly, it almost always starts with a feeling of nausea, and then a flushing sensation over my whole body. I did feel some slight nausea and flushing and thought to myself, “gee that’s not as bad as it usually is.” I tried the technique I’ve been learning in my meditations that involves “noting” the feeling, labelling it as anxiety, and trying to observe it rather than experience it. Unfortunately, the feeling came back again, but only stronger. And then a third time. At this point, I had to get out of bed because the nausea was so bad. I went to the washroom and did my usual “routine” that I do when I’m feeling very nauseous: I take some gravol vaginally – yes, you can do that – and then I sit on the toilet (sometimes I find when I’m nauseous, the other end of my GI system gets excited too). After a 4th round of intense nausea and flushing, I moved to the next stage of the attack: chills and shivers. Usually this marks the winding down of the attack. Occasionally it will repeat itself another time, but I find that if I get to the shivering phase “successfully,” I know I can make it to the end of the attack.

At this point, I climbed back into bed with the pillows propped up against my headboard. I pulled up the blankets, and stayed sitting to let the attack resolve enough to go back to sleep. I tried to think about my day and the events of the evening that could have precipitated this panic attack. I know my kids drove me crazy and we ran a lot of errands, but I remember thinking one prominent thought right before I got into bed the first time: I was having a really great weekend without call or the stress of crazy work hours. I was thinking about how much more enjoyable my life would be if I wasn’t in such a stressful residency program. I’m not sure if that thought is what precipitated my attack, but I just thought it was an interesting “coincidence.”

I know I have been struggling a lot lately with feeling unhappy with my life choices and not being able to tell if it’s the choices or the exhaustion making me unhappy. This was a topic of discussion in psychotherapy this week and I thought I realized that it was mostly the exhaustion. I really do like my job – I just hate how hard I have to work right now. I also haven’t been feeling “great” for the last week or so – like I’m coming down with a chest cold that just won’t actually come… There have also been other stressors, like my nanny situation, feeling lonely, still adjusting to my new life… Just to name a few.

I just wonder, why do these attacks always happen to me at night? At a time when I need to be getting rest. A time when I am alone and have no one to talk to. A time when I really just feel isolated and helpless. I thought maybe blogging would help me to reflect on the attack, let it pass, and give the gravol time to kick in (both for the anti-nauseant and the drowsiness). I’m not sure if writing it down has changed anything or made me feel any better. I know I didn’t make any major or profound discoveries about my anxiety, but this is the first time I’ve done writing during (or at the tail end of an attack) and hopefully that is part of the next step to overcoming this anxiety.

11 thoughts on “Night Time Attack

  1. You probably already have, but look at the differential diagnosis of flushing. What you are describing does not sound like it is psychosomatic. Sleep apnea is another thought. It is not always in the traditional patients. Anyway, this sounds miserable. I am sure I would not be able to function. Best of luck!

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    1. Thanks! It is a very atypical type I anxiety attack, but I still get the heart racing – it just seems to be predominately the nausea and flushing sensation. The first time I thought it was strictly because I was sick and I wasn’t letting myself vomit. But now it seems to start off with the mild flushing feeling, then everything else. But, it does get me thinking that maybe I should get some bloodwork and a physical exam!

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        1. I realized that I should clarify that these “flushing” episodes are not like drenching night sweats or fever nyd… It’s more like I wake up suddenly wide awake for no reason and then I start feeling a flushing sensation and nausea. The best I can describe is that warmness feeling from iv contrast dye…

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        2. Seriously, you need to book an appointment with the smartest, most compassionate primary care physician you know and get this worked up pronto. As for the depression and disappointment… God/life puts us where we are supposed to be. You have a job to do there: lives to touch and lessons to learn that could not come to you anywhere else. Grieving is fine for a time but do not allow it to consume you or you will miss the important things you are meant to see. Consider yourself hugged. You are stronger than you give yourself credit for.

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  2. Anxiety during the day is already torture, I am sorry you have to deal with this at night now too. I hope you find some answers sooner than later…you definitely deserve to get a break by now. ((hugs))

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  3. I’m sorry, this sounds so crappy, especially on top of everything else going on in your life. What I hope for you is what Victo Dolore mentioned – a really compassionate family doctor who will help you work this up, just to make sure something else isn’t going on.

    I only have mild anxiety, and even that can be unmanageable when it gets bad – I can’t imagine how awful it must be to have anxiety attacks. It sounds really tough. 😦

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