menopause and panic attacks

Of the many symptoms associated with perimenopause and menopause, one that few women know about or experience is panic attacks, which may or may not be accompanied by panic disorder. Let's explore this symptom a little closer.

What are panic attacks and panic disorder?

A panic attack is characterized by a sudden and relatively short-lived feeling of fear and anxiety in response to an ordinary, nonthreatening event or situation. The emotional response is typically accompanied by excessive sweating, racing heart, and trouble breathing. Some people say they feel like they are having a heart attack. Other symptoms can include chills, chest pain, choking, nausea, tingling or numbness in fingers or toes, and shaking. Symptoms are usually worse within 10 minutes after an attack starts and disappear soon after.

One thing to rule out first. A panic attack and a heart problem can feel identical from the inside, and women's heart attack symptoms often do not look like the crushing chest pain we see on television. They are more often breathlessness, nausea, cold sweats, or pain in the jaw, neck, back, or arm (Mehta LS and colleagues, American Heart Association scientific statement, Circulation, 2016). So the first time you get chest pain, breathlessness, or a racing heart, treat it as something to be checked rather than something to explain away, and ask your doctor to rule out a cardiac cause. Once panic disorder has actually been diagnosed, recognizing an attack for what it is becomes part of managing it, and you will not be starting from scratch every time.

Panic disorder can develop when someone worries too much about experiencing more panic attacks or changes their behavior to avoid them. The Cleveland Clinic notes that every year, up to 11 percent of Americans have a panic attack, and that about 2 to 3 percent of them then go on to develop panic disorder.

Generally, the exact cause of panic attacks is uncertain. Panic disorders tend to run in families, and individuals with depression or other mental health issues are more prone to develop them. Drug abuse and alcoholism also can increase the risk. They are also more common among postmenopausal women who have a history of emphysema, cardiovascular disease, migraine, and depression.

Read about how your microbiome affects mood and mental health

How are panic attacks associated with perimenopause and menopause?

When estrogen and progesterone levels fluctuate, they can cause depression and anxiety. For some women, these feelings escalate into panic attacks. Having one or just a few panic attacks doesn't mean you have panic disorder. However, a more consistent pattern can.

Any woman can develop panic attacks during menopause, but those who have a history of anxiety or postpartum depression may be more likely to have them. Because panic attacks have some of the same symptoms that affect many women in perimenopause and menopause, it may be difficult to diagnose.

How can you manage panic attacks naturally?

To help ward off panic attacks, you may want to make a few lifestyle changes. For example:

Read about 9 foods that calm your nerves (and mind)

• If you need someone to talk to, seek help from a counselor or psychologist who is familiar with panic attacks. It's helpful to identify the source of your panic, which may include health problems, stressful life events, and physical issues.
• Control your breathing by counting to 5 as you inhale and exhaling to a count of 5 as well. Humming also can help.
• Maintain a healthy diet that avoids processed foods and focuses on whole, natural fruits and vegetables, lean protein, seeds, nuts, legumes, and whole grains.
• Exercise regularly, at least 4 to 5 days a week for a total of 150 minutes. Pick activities that aren't intense because this can mimic a stressful situation.
• Adopt a fun hobby or volunteer for a cause you believe in. These activities can give you a sense of purpose.
• Consider taking natural supplements as suggested by your physician to help develop a sense of calm. This may include L-theanine, magnesium, chamomile, valerian, ashwagandha, lavender, and passionflower. Our Morphus Sleepus, combines Lactium, L-theanine, magnesium, and melatonin to help calm your nervous system and help you sleep better which can go a long way helping to cope with anxiety, panic, and stress.

A correction we owe you. This page used to list kava kava among the calming supplements to consider. We have taken it out. In March 2002 the FDA issued a consumer advisory about the potential risk of severe liver injury, including liver failure requiring a transplant, associated with kava-containing dietary supplements. If you have been taking kava, stop and tell your doctor or pharmacist, and go sooner rather than later if you notice yellowing of the skin or eyes, dark urine, unusual tiredness, or pain in your upper right side.

when you should contact your doctor

If you are experiencing panic attacks or anxiety at levels that are disrupting your work, schooling, or family life, then you should seek help. It's also time to talk to your doctor if you have suicidal thoughts or feelings (please call 988 in the US), you don't have anyone you can confide in, or if you have persistent negative thoughts and feelings for more than two weeks.

bottom line

Panic attacks and panic disorder can occur in a small percentage of women in menopause and postmenopause. Several lifestyle changes and natural remedies can help manage these symptoms.