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Panic Attacks and the Emergency Room

by Dr. Blumberg on February 20, 2011

*Emergency Room Panic Attacks

What fuels the powerful surges of heart pounding, dizziness, shortness of breath, weakness and rubbery legs that drive panic attack sufferers to the Emergency Room every day? Emergency Room panic attacks are what I call Fused Panic.

The Two Parts of Panic

Part One-Physical Sensations

There are two parts to a panic attack.   Part One (physical feelings): you feel a sudden intense surge of bodily sensations “Out of the Blue”…..heart pounding, dizziness, shortness of breath, rubbery legs, weakness, jelly legs, numbness in the hands, feet and face, tingling throughout your body, hot/cold flashes, heaviness in the arms and legs, heavy head, heaviness in the chest, like an elephant is sitting on your chest, off balance feeling, blurred vision, tunnel vision, butterflies in the stomach or even bats in the stomach, nausea and queasiness, inner trembling, there/not there, disorientation, unreality, out of body experience, to name a few.

Part Two-Worry Thoughts

Then, instantaneously, comes the second Part, Part Two (Worry thoughts): When physical feelings strike for no apparent reason, without warning, you ask “Why am I feeling this way? What is happening to me?”  You mind races to the worst…..heart attack, die, suffocate, stroke, paralysis, brain tumor, seizure, faint, serious undetected illness, collapse, fall down, lose my mind, nervous breakdown, go insane, go beserk, lose control, snap, go crazy, fall apart, never come out this, I won’t know who I am or where I am, locked up in a mental ward.

Fused Panic-Emergency Room Panic

In fused panic, the two parts of panic are fused and seem like one impending catastrophe.  The physical feeling, jelly legs (Part One) and the worry thought, “legs will give out from under me” (Part Two) seem like one terrifying experience…and you say I feel like my legs won’t hold me up and walk around waiting to drop, holding on for dear life.  But you never fall down!  You body tricks you. When you say you feel like you are going down, you make the idea you are “going down” believable and set up off the vicious cycle of emergency room panic. The more you think you are about to drop, the more you set off the alarm in the brain which releases adrenaline.  Jelly legs drinks adrenaline for breakfast. Adrenaline fuels the jelly legs. The more your legs feel like jelly, the more you believe you are closer to falling down.  The more you believe you are about to fall, the more rubbery your legs feel. You can go through this cycle 50 times in 50 seconds.  Each time you are sending a stronger signal of alarm to the brain, producing more adrenaline and feeding the rubbery leg feeling you fear most.

Major Panic Attacks-The Mother of All Fears

The cardinal feature of panic disorder is the fear of bodily sensations and the vicious “fear of fear” cycle.  When you fear a dog, your fearful reaction to the dog does not cause the dog to turn in to 10 dogs with more massive, sharper teeth, getting closer and closer to your throat. When you fear rubbery legs, the fear of rubbery legs produces more adrenaline. This increase adrenaline production causes the rubbery legs to intensity.  The vicious cycle of panic is the mother of all fears.  The level of adrenaline and fear produced is comparable to you showing alarm to one tiger and the one tiger multiplies into ten tigers. You signal a stronger alarm to ten tigers which multiplies into 100 tigers. You signal an even stronger alarm to 100 tigers, which turns into a 1000 tigers with sharper and sharper teeth, getting closer and closer to your throat…all in the span of 50 seconds…and you are never harmed.

Panic Dissection

I urge you to dissect your panic attack into two parts:

Part One, Symptoms, the natural normal bodily sensations of adrenaline that are part of life

Part Two, Enemy thinking, the false catastrophic worry thoughts about where the symptoms will lead

Dissecting a panic attack into their two parts lays the foundation for taking control.

The ideas in this blog are developed from Dr. Blumberg’s panicLINK Program.  PanicLINK is a comprehensive, twelve session, four phase, multi-media educational program on panic disorder. The material in this Blog and the panicLINK Program are copyright protected by Out of the Blue Network, LLC. No permission is granted to reproduce this blog for commercial purposes. For more information about the panicLINK Program, connect at

* This educational information should always be used in consultation with your doctor to confirm a diagnosis and review available treatments for panic disorder.

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