What are the Signs of Panic Attacks in Anxiety?

This is my anxious face!

What are the signs of panic attacks in anxiety?

Here is a story:

Julie, I was feeling ok this morning and decided to work on my latest work project when I get to the office. It is due next week and I’ve had such a hard time getting it done. My boss is understanding, but she really can’t cover for me any more. I’ve never gone through such a tough time work wise. Never.

This morning, I got up feeling ok. I drove to work with a smile on my face. Nothing was wrong. Nothing. I am not sick. I like my work. In about five minutes, my heart started pounding. I could feel it. Not one thing had changed from the moment I left my house. I am not depressed. I am not manic. Just this pounding heart.

Then, I had trouble breathing. Like something was stuck in my throat. If fells like cotton. My chest then gets tight. Like someone is pressing on me. I feel an intense pressure on my sternum. All of this happens in seconds. SECONDS!

Then, I sob. A grown man. I sob! It’s a cry out- like grief. But I’m not sad! Nothing is wrong! Julie! As I get closer to work, I can hear my heart beating in my ears and a feeling of dread comes over me and then I hear the thoughts.

You will never finish this project. This project is doomed. You will never feel better.

These thoughts are physical. They combine with the shortness of breath, the beating hear, the ringing in the ears, the fear, the idea that something is wrong.

Nothing is wrong damn it!

I have to finish this project. This is my life and my job and nothing is wrong with me except that everything feels wrong and I can’t breath and I’m crying as I drive to work.


Well. Rob has entered a world I know well. He has perfectly described an anxiety panic attack. They come out of NO WHERE. They are not necessarily tied to an event- yes, Rob has a project due, but nothing is happening with the project or at work that would justify this kind of reaction just driving to work. His bipolar is under control. He is not depressed or manic. He is not angry or using drugs. He has a stable relationship and people who care about him.

This is ANXIETY and it’s a @#$@#$%@#$#@$#@$%@#$%!

Anxiety is treated separately from bipolar disorder. In my experience, those of us with mania can’t take anti depressants at anxiety levels due to our mania, so that treatment path is not for us. Benzodiazepines such as Ativan in very small amounts can help in the moment, but they do not address the real issues of panic attacks. And please, know that many people including myself use Benzos without getting addicted.

This is a physical illness. It needs to be treated with physical activity, breathing, cognitive behavior therapy and medications if needed. It is serious. Tell me about your anxiety and what you do about it?


You can always pull over or go to a quiet place and use this video to calm things down so that you can at least think of what you need.

PS: Please know that this kind of anxiety is NOT a part of bipolar disorder unless you are manic or depressed at the same time. Rob is stable, so this anxiety is separate. I have this kind of anxiety from a head injury.

I use the ideas in my book Get it Done When You’re Depressed for much of my anxiety management. It works for anxiety as well as depression.

Bipolar and Cannabis: Thoughts on THC

My next book is for couples. In one chapter, I talk about herbs and bipolar. Here are my thoughts on cannabis and bipolar disorder.

…….There are 113 cannabinoids in cannabis. Two of them concern us.  Cannabidiol, also known as CBD and tertrohydocannibinol also known as THC.  CBD is relatively benign and in a pure form,  it rarely causes mania and psychosis. It is used around the world for anxiety.  But as you know, the bipolar brain is not about one symptom. Our symptoms are mixed.

What works for anxiety and even depression is not the same as working for our bipolar brains.

My beef is not with CBD, but I am passionate about educating people with bipolar about the dangers of THC. If you have bipolar disorder and use THC, please know that the risk of increasing mania and psychosis is so high, you might as well smoke  crack. Yes, it is that bad. I know from personal experience, so please stick with me here. THC is a hallucinogenic. Study after study shows that THC increases our risk of psychosis around 500%.  But what about mania? When I used medical marijuana after my 2012 biking accident for pain, my bipolar mania went through the roof and it wasn’t the fun kind. THC often leads to dysphoric mania. I was prepared for the psychosis, but mania?

It may be because THC is the stimulating part of the cannabis plant. It may be that our bipolar brains convert THC into mania due to our genetics. Whatever the reason, you will find that I’m more passionate about our not using THC than I am about cocaine.  People who use cocaine know exactly what they’re doing. When people use cannabis, often for the right reasons, they are rarely educated on the psychotic and manic properties of THC. Now you know.

I don’t recommend the use of any marijuana product until more studies have come out about the safety of today’s CBD weed.  Until then, I will not be in the same room as cannabis. If you choose to use marijuana, please get a CBD only product that is tested in a lab. Then you can test it for psychosis and mania. My testing showed me that much of the CBD labeled pure is not. THC is hard to remove. Use your noggin. THC is not your friend.


Julie, How do I get my partner to read your books?

Julie, how do I get my partner to read your books? Help me!
Hello to all partners out there who write me and ask how they can get a partner to read my books- use the Health Cards, take care of themselves and get better in general.
My answer to this question might surprise you. If you are one of my clients, the answer will not surprise you!
Answer: You can’t get someone to do something they do not want to do. That is not your job as a partner. It is not your job to manage someone’s bipolar disorder. It is not your job to beg and cajole and bargain.
Instead, it is your job to take care of yourself and learn how to be a parter of a person with bipolar disorder. You do this by using the ideas in my book when you interact with your partner. For example, you absolutely can learn to avoid the Bipolar Conversation as I teach in Take Charge of Bipolar Disorder. That is completely up to you.
You can use the Health Cards and learn the signs that your partner is getting manic and protect your own money. You can learn that your partner does this and does that when depressed and see the signs at the very beginning.
You can get clear on your needs and set boundaries. If you need your partner to read my books or any book in order for you to stay in the relationship, then this is about you. Not about your partner. If you want someone to change for their own benefit, it will NEVER work. If you ask for someone to change in order to help you feel safe in a loving and stable relationship, then it is a choice they have to make.
We don’t change other people. We change and ask them to join us. If they don’t join us, we then decide if we want to stay. This is FREEDOM and believe it or not, this is when the partner who has bipolar gets interested in getting better.


PS: This was originally a post on The Stable Bed page on Facebook. This page is for partners of people with bipolar disorder and schizoaffective disorder. Please join me if you are a partner. If you are a parent or care giver, The Stable Table on Facebook is for you. If you have the illness, please visit my Julie A. Fast page for my strategies.

Music Tracking and Obsessive Thoughts in Bipolar Disorder.

The following is my blog from Bp Magazine. It starts like this….

My brain has an extra groove when I’m depressed.  This mood swing opens a channel where music and conversations are recorded and played back over and over and over again. I then fly back to my past and dwell on what went wrong and feel an incredible sadness.

My latest depression happened while I was revisiting the original Broadway cast recording of Evita with Patti Lupone and Mandy Patinkin. I am not saying this caused my depression (haha), but it was in my ears when the down swing hit.

One line from one song got stuck in my head: “It doesn’t matter what the morons say….” It started to loop. I heard bits of the music and then the words, then the music and then the words.

As the depression progressed, my brain took me back to my failed relationship with my first husband that was ended by my bipolar disorder. Normally, when I think of this wonderful man it is with a tinge of sadness, but nothing overwhelming. When depressed, it’s a fresh wound. Then, my brain, my out of whack depressed brain took me back to my first boyfriend whom I met when 19. At the time, I was manic and then was dumped for being too emotional and young. This was the start of my first serious depression. I looked up his picture on the internet. What a mess.

Why am I telling you this? Because I DO NOT have these thoughts nor do I dwell on the past when stable. Music isn’t looping and I don’t cry all of the time.  These are depression symptoms. If I let myself get too into the music or the thoughts, I will loose my mind and the depression will take hold of my life as it did in the past.

Music is always a part of my depression. I hear the notes differently when depressed. All of the minor keys stick out and I find myself thinking of sad movies like Brokeback Mountain and the music that accompanied the sad scenes. It’s obsessive. I hate it.

So I fight it. I know my depression very well. It has been my companion for over 30 years. It is not a friend. Maybe it is a teacher, but it is not allowed to stick around.

Sometimes it’s so severe, I feel that I am buried in mud. But this is not a depressing post.

This is a positive story to show you how I fight this monster and stop the music looping—and the insane dwelling on my past loves. This is what I do every minute that I can when the depression strikes:

And then I give you ideas on how you can stop these symptoms as well! Julie

Click here to read Music Tracking and Obsessive Thoughts in Bipolar Disorder from the Bp Magazine Website. 



Ask Julie Fast: I Can’t Get My Lamictal Regulated! What is Wrong with Me!

Julie, I just can’t seem to get my Lamictal regulated. It’s ridiculous. I’ve been taking this drug for three years! Why on earth would I suddenly have dosage problems? It was working so well and now I am getting a bit sick and this is terrible! What is wrong with me?


Hello Janna,

There is nothing wrong with you. I would say this is actually a good sign. Your body is changing and it means the way the medication metabolizes will change as well. Few people stay on the same meds with the same outcome for a life time. It is completely NORMAL for meds to work and then not work and then work again.  Sometimes we have to change the mediations and I know how hard this can be.

Our bodies also change with stress.  Lamcital is lamotrogine, an anti epilepsy drug that has been quite a miracle for those of us with bipolar depression. Yes, it’s big pharma, but out of all of the drugs for depression, this is the one that rarely causes mania, so if it has helped in the past, I suggest working with your prescriber to get it regulated.

Also, I have always had trouble staying on track with my meds. If there is a chance you have not been taking the meds at the right dosage at the same time, this can change the way the Laminal works. Also, have any new meds been added? That can change things.

It’s hard to have an illness that needs profolactic (preventative) medication. The meds do not cure us. They hold down the symptoms. This is why the symptoms can bubble up even when we are on meds.

I’m glad that you are very aware of your body and you are thinking of what you need to do to stay stable. Keep trying to get this regulated. Work on a management plan that might allow you to use less meds. Focus on trigger management.

Good luck!


How I Manage Bipolar Disorder Mood Swings

When I have a lot of mood swings, as I’m having now- managing bipolar disorder becomes my job. Everything I do has to be examined- will this help me get better? Will this make me more ill?

It’s hard. I just want to be a person who gets up, works, sees friends and family, has fun and goes to bed. That is my dream! I have lived it a few times, but bipolar always returns.

When the bipolar shows up, I have to be ready for it. I can work on prevention all day long and the mood swings will still sneak in. It is an illness.

This afternoon, I saw a nice looking woman who was in her 50’s walking down the street. She was beautifully dressed. The well part of me thought, “Wow, those are great shoes!” The sick part of me thought, “What is the point of even looking at her shoes, we will all be dead eventually.”   This illness is up and down and our thoughts will be up and down depending on our mood swings.

It takes a lot of work to prevent thoughts like these from taking over your life- you have to know what is real and what is ridiculous!  Managing bipolar is my job when I’m sick. I do it 24 hours a day until I’m better.

Find a way to manage this illness. Use a plan like the one in Take Charge of Bipolar Disorder or the Health Cards to learn your symptoms.  You can get better.