Can one go to the ER with a panic attack?

[Joules]

I'll delete later so don't quote, but if someone is having a panic attack, does it make sense to take them to the ER on a Sunday morning or wait until they can get an appointment next week?  I guess it is not life-threatening, but very, very bad.

[MedicMom]

People do it all the time. In all honesty, though, there isn't much they will do for it.

[Daria]

In my experience, which is limited, the E.R. has 2 things to offer during a psychiatric emergency.  One is admissions, and the criteria are very strict, and the other is a faded photocopied list of mental health providers that is so old that many of the providers are dead.

 

In our area, we have a service called "mobile crisis" that will come to your house.  I have had somewhat better results with them. 

[Joules]

Thanks, I'm still concerned that it might have a medical component, but I was figuring a trip was worthless.

[Lawana]

Have you considered calling a crisis line?

[J-rap]

Can you call your local ER and ask them?  They might have other ideas too.

[displace]

People go to the ER with panic attacks all the time. If there is no diagnosis yet, they will make sure it's not due to the heart, lungs, drugs, etc, as much as possible. If it is a panic attack, they may or may not be able to give a small trial of meds to help. They will be super unlikely to admit, even if you go to a hospital with psychiatric admissions, as panic attacks are not usually admissible (unless severe).

Edited August 6, 2017 by displace

[Daria]

Thanks, I'm still concerned that it might have a medical component, but I was figuring a trip was worthless.

 

If you haven't ruled out another issue causing racing heartbeat, etc . . . then that would totally change my answer.

[JFSinIL]

If naught else, the ER (if they get the person into a room asap, not stuck in the waiting area) can be a safe place to wait out the attack...unless hospital itself adds to the panic. Can the person having the attack articulate if they want to be taken to ER?

[Night Elf]

I think it depends on the symptoms. I had an especially bad attack once that had some symptoms last for days. When I finally decided to go in, not realizing it was anxiety, it was during office hours so I just saw my regular doctor. She ran tests to rule out other things like asthma. Then she referred me to a cardiology office where they did some more testing. It all came back negative and my doctor suggested I talk to my psychiatrist because she knew I had an anxiety disorder. My psychiatrist gave me anxiety medicine and the symptoms went away.

 

I have always used a long hot bath to try to calm down from anxiety attacks. Now I bought a weighed blanket and that helps tremendously.

 

Anxiety attacks can be debilitating. I'm sorry you know someone who is suffering. I have Kaiser Permanente and they suggest if someone is having a serious medical or behavioral health problem, they call 911 or get to a hospital. Surely there is a psychiatrist on staff at an ER but I don't know if they would give medication.

[ktgrok]

There are physical things that can mimic a panic attack, so if it is bad and there is no prior diagnosis I'd go. Thyroid storm, heart palpitations, high blood pressure, etc. 

[MedicMom]

I think it depends on the symptoms. I had an especially bad attack once that had some symptoms last for days. When I finally decided to go in, not realizing it was anxiety, it was during office hours so I just saw my regular doctor. She ran tests to rule out other things like asthma. Then she referred me to a cardiology office where they did some more testing. It all came back negative and my doctor suggested I talk to my psychiatrist because she knew I had an anxiety disorder. My psychiatrist gave me anxiety medicine and the symptoms went away.

 

I have always used a long hot bath to try to calm down from anxiety attacks. Now I bought a weighed blanket and that helps tremendously.

 

Anxiety attacks can be debilitating. I'm sorry you know someone who is suffering. I have Kaiser Permanente and they suggest if someone is having a serious medical or behavioral health problem, they call 911 or get to a hospital. Surely there is a psychiatrist on staff at an ER but I don't know if they would give medication.

It depends on the ER. Our local ERs don't have a psychiatrist on call, except the hospital that has a psych unit. I've taken a lot of people in with panic attacks and basically if there's a diagnosis they do nothing but let it pass and tell the patient not to hyperventilate.

 

I sympathize. I've had anxiety attacks the last few years and it's terrible.

[Seasider]

IME with two people I know, their panic attacks generated a full on cardiac response, because the hospital has to rule out a life threatening medical event. However, that full attention response was apparently comforting enough in itself (i.e., "Phew, I'm NOT dying!") to squelch the panic attack.

[Butter]

People go to the ER with panic attacks often, but usually because they don't know for sure that it is a panic attack.  Panic attacks are not a true emergency most of the time, but they can mimic signs of things that are emergencies like heart attacks so the ER will rule out physical causes for the symptoms.  They will not do much for the panic attack itself other than to tell you you are having a panic attack and to see the doctor.

[gstharr]

The people I know who have panic attacks always have attacks.  The Er should be used for real emergencies.  Anyway, the ER bill might put them back in panic.

[ondreeuh]

In the midst of a bad panic attack I would take some Benadryl and a small glass of wine, put on some relaxing music, and try to play Solitaire until I was ready to go to bed. Or have someone wrap me up in a blanket. Or take a hot bath with epsom salts. Basically I would take something to knock me out and try to cope until I could sleep. I would then ask my doctor for a prescription of as-needed meds to take in the future.

 

The ER is there to figure out if you're dying, and to stop you from dying. Once they determine you are medically stable, they release you even if you don't fell well. They aren't going to treat anxiety unless you are a danger to yourself or someone else.

Edited August 6, 2017 by ondreeuh

[displace]

Urgent care may be able to help too, if you want to avoid the ER.

[G5052]

My experience is that ER's do very little if anything for psychiatric issues. They'll check for a physical issue and send you home with a recommendation to see your primarily and/or a psychiatrist.

[Granny_Weatherwax]

My actions would depend on whether or not the individual is diagnosed with anxiety and has had previous anxiety attacks or if this is something novel and an anxiety attack is only suspected not confirmed.

 

If the person has a known history of anxiety attacks, I would have that person follow the protocol given by the person's counselor. Using relaxation techniques, stepping away from the current situation, etc.

 

If this is new, I would seriously consider the ER just to make sure there are no cardiac complications.

 

I am surprised at how many people are saying the ER will do nothing. When I had a panic attack, I was given a nice dose of Ativan and monitored for a couple of hours. When I was released I had a temporary prescription for a sleep aid and an emergency dose of Ativan to get me through until I could schedule an appointment with a counselor. Our city is too small to have a psychiatrist on cal (that would have required an hour drive to the city) but I feel I was well treated.

Edited August 6, 2017 by Scoutermom

[SparklyUnicorn]

 

 

If the person has a known history of anxiety attacks, I would have that person follow the protocol given by the person's counselor. Using relaxation techniques, stepping away from the current situation, etc.

 

 

Is this really what they tell people to do for a panic attack? 

[Guest]

Is this really what they tell people to do for a panic attack? 

 

Yes.

 

As if it is a matter of just taking a chill pill. Not a literal pill. A chill pill :mellow:. Gee wish, why didn't I think to relax when my body tells me death is immediately imminent?! Such a silly goose.

 

OP, a person certainly CAN go to the ER with a panic attack, but it's frightfully expensive depending on insurance. However, if you get a sympathetic Dr, they can help expedite follow-up care because you'll leave with paperwork stating that while you don't need to be admitted, you have an emergent mental health crisis.

 

It just depends on how things are in your area, and I guess there's no way to know until you actually go through it.

[Guest]

People here are using anxiety attack and panic attack interchangeably, but they are different things.

 

 

[SparklyUnicorn]

Yes.

 

As if it is a matter of just taking a chill pill. Not a literal pill. A chill pill :mellow:. Gee wish, why didn't I think to relax when my body tells me death is immediately imminent?! Such a silly goose.

 

If this is the usual advice from therapists, I guess I haven't been missing out on anything useful.  :glare:

[Guest]

If this is the usual advice from therapists, I guess I haven't been missing out on anything useful.  :glare:

 

I meant that's what they'll tell you at the ER and it's what most pcm's say as well.

 

Of course I've met some half-assed therapists too, that in particular don't know the difference between panic attacks and GAD....

[SparklyUnicorn]

I meant that's what they'll tell you at the ER and it's what most pcm's say as well.

 

Of course I've met some half-assed therapists too, that in particular don't know the difference between panic attacks and GAD....

 

I've heard them used interchangeably (unfortunately).

[Daria]

People here are using anxiety attack and panic attack interchangeably, but they are different things.

 

I was about to post the same thing.

[Night Elf]

It depends on the ER. Our local ERs don't have a psychiatrist on call, except the hospital that has a psych unit. I've taken a lot of people in with panic attacks and basically if there's a diagnosis they do nothing but let it pass and tell the patient not to hyperventilate.

 

I sympathize. I've had anxiety attacks the last few years and it's terrible.

 

Weird, I've been in a hospital that has a psychiatrist on staff but no psych unit.

[gardenmom5]

 .

 

The ER is there to figure out if you're dying, and to stop you from dying. Once they determine you are medically stable, they release you even if you don't fell well. They aren't going to treat anxiety unless you are a danger to yourself or someone else.

 

the ER is there to treat immediate medical crises that can't (shouldn't) wait until morning - that may or may NOT be life threatening,  many aren't.

 

emergent medical situations that are beyond a dr's office equipment, etc.

 

in my experience -  sometimes during the day - drs offices do NOT take things as seriously as they should.

 

even UC aren't open at night. . . . . or take things as seriously as they should - or have the staff to get accurate diagnosies.

[Guest]

I've heard them used interchangeably (unfortunately).

I've heard a lot of things used interchangably. One Dr told me outright that there's no such thing as PTSD, and everyone who thinks they have it has bipolar disorder. This gem of a dude also aid depression is anxiety and panic also, obviously, is anxiety... All of which is really--you guessed it-- bipolar!

 

But we can be so much better that that guy here on the board.

[Guest]

the ER is there to treat immediate medical crises that can't (shouldn't) wait until morning - that may or may NOT be life threatening, many aren't.

 

emergent medical situations that are beyond a dr's office equipment, etc.

 

in my experience - sometimes during the day - drs offices do NOT take things as seriously as they should.

 

even UC aren't open at night. . . . . or take things as seriously as they should - or have the staff to get accurate diagnosies.

One of the ER s I took my son to here has a sign up that they have no obligation outside of stabilizing an individual. I asked the nurse and she said if they're swamped they triage and send anyone who will live til morning home.

[scrapbookbuzz]

Yes, you can and I have. My sympoms mimic cardiac issues so, when I go and I am always 99.999% sure it's NOT heart-related, it's because 

there is that VERY RARE chance it MIGHT be. One thing I've found to help that might also help in your case are the following:

*even though there is the feeling of not being able to breathe, and maybe intense pressure in the chest, I make myself take a couple of deep breaths.

So far, each time, I HAVE been able to take those deep breaths, and thus, I know it's panic/anxiety and not cardiac-related

*my symptoms sometimes also mimic heartburn so when it does that I take a couple of antacids (chewable)

*the last time (just a few weeks ago) I was in the ER with similar symptoms, I felt like my throat was closing up while I was talking to the ER nurse. As 

she stated, "Well, you're talking to me so I know that is not really happening." Although I felt like slapping her, she was not trying to be rude or imply

that I was lying. She was pointing out that if my throat really was closing up, then I wouldn't have been able to talk. As you probably know by now, there

are multiple things you can do to alleviate symptoms on your own, but it is DANG HARD to do so when you're in the thick of it!

 

Also, I understand, if you have symptoms that can be concerning like mine, it is a good idea to go to the ER. Just GO. I find I stress out more if I sit there,

in the midst of my symptoms, and contemplate "do I go or do I wait?" ten thousand times than if I just make the decision and GO.

 

Honestly, if you believe there may be an underlying physical medical issue (even if there turns out not to be), just GO. HTH!

[zoobie]

First option would be to call the person's mental health care provider's number and hope there is an after hours emergency line. Second would be to call the nurse line if your insurance has one and get advice. I personally wouldn't go unless I thought it could be a heart attack or another immediately life-threatening condition because of the cost and concern insurance wouldn't cover it. If the nurse line tells you to go, with my insurance anyway, the visit would be covered. (But our deductible is so ridiculous that it would be entirely out of pocket unless it cost more than $6K, so...)

[nixpix5]

I would try and wait until you can get to a regular doctor. Many people go to the ER with a panic attack but usually because they are convinced something serious is happening to them. There is an element of hypochondriasis that can occur because once a doctor runs tests and give them a clean bill of health the panic attacks may subside for a little while. Often people worry they are having a heart attack. One of the best ways to treat panic attacks is convincing the person that it is a panic attack. A panic attack kicks in "fight or flight" chemicals often at random which can be quite upsetting since our bodies want a rationale as to why we are feeling panicky so it starts to create one. Not knowing the age of the person but if they are older often times visiting panic attack forums to read through other people's experiences with them can be helpful in this situation.

 

Sorry to hear they are suffering with them. I had a bought of panic attacks from 14 yo-16yo. I thought I was dying. It was terrible.

[gardenmom5]

One of the ER s I took my son to here has a sign up that they have no obligation outside of stabilizing an individual. I asked the nurse and she said if they're swamped they triage and send anyone who will live til morning home.

 

 

do they have people die in the waiting room?  and yes - that DOES happen due to how they were triaged.

 

we had an acquaintance with a compound fracture - they loaded her with pain killers and sent them off to a bigger city with a better equipped and staffed ER in their car.

[SparklyUnicorn]

I've heard a lot of things used interchangably. One Dr told me outright that there's no such thing as PTSD, and everyone who thinks they have it has bipolar disorder. This gem of a dude also aid depression is anxiety and panic also, obviously, is anxiety... All of which is really--you guessed it-- bipolar!

 

But we can be so much better that that guy here on the board.

 

No bleeping way is PTSD bipolar disorder!

[Guest]

No bleeping way is PTSD bipolar disorder!

He was insane in the old use of the term. In. Sane.

Edited August 6, 2017 by OKBud

[Pen]

Yes.

 

And sometimes it is physical.  I had a friend die following what she thought was a panic attack, but turned out to be a serious breathing problem.

[SparklyUnicorn]

Yes.

 

And sometimes it is physical.  I had a friend die following what she thought was a panic attack, but turned out to be a serious breathing problem.

 

Yeah that is the difficulty.  It feels like something is seriously physically wrong.  And even if turns out it is a panic attack, a person who has them regularly probably needs some sort of medical intervention/help. 

 

People with mental disorders often get dismissed for them though because people cannot SEE the disorder.  And then the people who suffer from these things often begin to dismiss themselves.  My mother said she felt like something was seriously wrong with her, but she was afraid to go to a doctor and have them tell her it was all in her head (she did have a mental illness).  We encouraged her to go, but she was still too afraid.  So then she went for a routine check up at the GYN doc some time after that and they felt tumors.  Turned out something WAS seriously wrong. She had stage 4 ovarian cancer.  She didn't live much longer after that.  But she KNEW something was off long before that point.

[Granny_Weatherwax]

Is this really what they tell people to do for a panic attack? 

Sorry, I got lost in the posts and went with anxiety attack. And, yes, there are ways to redirect cognition and fend off an anxiety attack but it takes practice, knowing the triggers, and having established relaxation methods. It's part of what is known as Cognitive Behavioral Therapy. That's why I said if the person has been diagnosed. If this is new, medical care should be sought.

Edited August 6, 2017 by Scoutermom

[Katy]

If the person has a history of diagnosed panic attacks (ie: they have been screened to rule out other causes), no, don't go to the ER.

 

If this is a new event, and the person has never had these symptoms screened before, have the person go to the ER.  Even if it seemed to be the result of an emotionally stressful situation. Stress--->High blood pressure--->Actual cardiac event.   I've seen patients who previously had a heart attack but didn't know it, or who wrote it off as stress alone. I've also had relatives drop dead from "sudden" cardiac events, but who had a history of writing off the feeling as stress, despite a family history of heart issues and never getting screened for heart issues.

 

Walking pneumonia can also cause sudden symptoms that mimic anxiety.

[SparklyUnicorn]

Sorry, I got lost in the posts and went with anxiety attack. And, yes, there are ways to redirect cognition and fend off an anxiety attack but it takes practice, knowing the triggers, and having established relaxation methods. It's part of what is known as Cognitive Behavioral Therapy. That's why I said if the person has been diagnosed. If this is new, medical care should be sought.

 

Maybe anxiety attack, but I'm trying to imagine this with a panic attack.

 

There are often no known triggers for one thing.

[PinkyandtheBrains.]

 

 

ER here will get you stable and send you home. On a rare occasion they might admit to the psych ward, but only if they really think you are a danger to yourself or others.

[nixpix5]

Maybe anxiety attack, but I'm trying to imagine this with a panic attack.

 

There are often no known triggers for one thing.

This.

 

Anxiety and Panic are two completely different things. Anxiety has a trigger and can be treated directly by addressing what is causing the anxiety. In generalized anxiety disorder CBT and medication is often best practices.

 

Panic is a whole other beast. The corticosteroid stress cycle and fight or flight system is completely out of whack. It can be due to an underlying illness so a full work up should happen if it just started. If they have had the work up and it is ongoing then it can be due to all sorts of things. Many times panic attacks can begin with puberty, sometimes after a hard life event, sometimes after strep, and sometimes for what appears to be no reason at all.

 

The difficult part is again, the body's desire to "make sense" of the activation of the stress/adrenaline system. This leads often to feeling like you are dying of something serious and nobody can figure it out. A need to keep the person away from looking up symptoms is important because it can lead to deep fear that retriggers the panic. It is a vicious cycle.

 

The system becomes so sensitive and primed that even a slight body sensation can alert the system that something is wrong which sets off the panic cycle. It can hit any time and anywhere. When I was a teen I often would have to run out of wherever I was to get out side. I would feel dizzy, I couldn't breathe, my chest would be tight and then I would feel pain in my left arm and so on. My body would mimic what felt like a heart issue. My was brought on by puberty and because my mom kept taking me in for my ailments it persisted. I finally had a doctor get clear with me about panic disorder and helped me get over it.

 

I have worked since with numerous panic attack sufferers. I feel so much empathy for them because it is just such a brutal disorder.

Edited August 6, 2017 by nixpix5

[Joules]

Thanks all for your thoughts, I've been busy handling it, but have been reading. Think things will be OK til tomorrow

[Joules]

And my apologies, *I* didn't know a panic attack and anxiety attack were different until today.

[Guest]

Thanks all for your thoughts, I've been busy handling it, but have been reading. Think things will be OK til tomorrow

(((())))

[ktgrok]

I read something recently about a woman who thought she was having panic attacks but it was a thyroid issue. 

[rdj2027]

With a panic attack I would absolutely go (and have gone myself several times) because I had no idea what I was dealing with.  I had the constant feeling of imminent death (never mind all the other symptoms) and honestly in my state I was sure they just overlooked something.  It took repeated visits to different doctors to convince my mind I was fine.

 

I had no stressors in my life, it came on very suddenly so the whole "Just relax" didn't work for me.  It took me years and several doctors to figure out what the problem was and deal with it.  Panic disorder is just plain horrible.