Anxiety and Panic Attacks After a Difficult Childhood

A racing heart in a work meeting. The feeling that you can't get enough air in the grocery store. Dread about driving too far from home. Many people who grew up in difficult homes reach adulthood with anxiety or panic attacks, and for years they don't understand why. "I don't even live there anymore. Why do I still feel like this?"

This article covers what research says about the link between adverse childhood experiences and anxiety, what actually helps, and when it's time to see a professional. The good news comes first: anxiety and panic attacks are treatable.

A quick note: this is general information. Only a health professional can diagnose an anxiety or panic disorder. And some panic symptoms, like chest pain, overlap with other medical problems, so a checkup is always worth it.

What adverse childhood experiences are

The U.S. Centers for Disease Control and Prevention (CDC) defines adverse childhood experiences (ACEs) as potentially traumatic events that happen between ages 0 and 17. They include, for example:

• Violence, abuse or neglect.
• Witnessing violence at home or in the community.
• Growing up with a parent who misuses alcohol or drugs.
• Growing up with a parent with untreated mental health problems.
• Family instability, like separation or a parent's incarceration.

Emotional abuse, meaning humiliation, threats or constant contempt, is among the most common ACEs the CDC reports.

The term comes from the original study by Felitti and colleagues, published in 1998, which found a link between the number of adverse experiences in childhood and a range of health problems in adulthood. Since then, hundreds of studies have explored that connection.

How common they are

Far more common than we tend to think. According to the CDC, in a survey of U.S. high school students, three in four reported at least one ACE, and one in five reported four or more. The CDC also estimates that preventing ACEs could substantially reduce cases of adult depression.

This doesn't mean everyone who went through something hard will develop anxiety. Some people with many ACEs do well, and some with few struggle a lot. But it does help you understand that your anxiety didn't come out of nowhere.

Why childhood can leave your body on alert

When a child grows up in an unpredictable home, their nervous system learns to scan: Dad's tone of voice when he walks in, Mom's silence at dinner, footsteps in the hallway. That vigilance makes sense in childhood. The problem is that it can stay switched on in adulthood, long after the danger is gone.

Cleveland Clinic lists adverse childhood experiences among the factors that can contribute to panic disorder, along with family history and other mental health conditions. We go deeper into this, including complex PTSD, in healing after narcissistic parents.

I tell this story on video, too

I lived with panic attacks for twenty years, and in the end it turned out I'd been on the wrong medication all along. I tell the whole story here (in Spanish):

If this story speaks to you, subscribe to La Oveja Negra on YouTube. That's where we keep this conversation going.

What a panic attack feels like

The National Institute of Mental Health (NIMH) describes symptoms like a pounding or racing heart, sweating, trembling, trouble breathing, chest pain and nausea, together with intense fear and a sense of losing control. According to Cleveland Clinic, a panic attack usually lasts 5 to 20 minutes, though some people experience longer episodes.

Something that helps a lot to know: as awful as it feels, a panic attack on its own isn't dangerous, and it always ends.

What you can do during an attack

1. Name it. "This is a panic attack. It's really uncomfortable, but it will pass."
2. Breathe slowly. Breathe in through your nose for a count of four, pause, and breathe out through your mouth more slowly than you breathed in. A long exhale helps calm the body.
3. Ground yourself in the present. Name five things you can see, four you can touch, three you can hear. Feel your feet on the floor.
4. Release your muscles. Clench your fists for a few seconds, then let go. Do the same with your shoulders.
5. Stay if you can. Escaping brings relief in the moment, but over time it teaches your brain that the place is dangerous. If you can, stay until it passes.

What helps in the long run

• Cognitive behavioral therapy (CBT). NIMH describes it as the gold-standard psychotherapy for panic disorder. It includes learning to understand your symptoms and gradually facing what you fear.
• Trauma-focused therapy. If your anxiety has roots in childhood, a therapist experienced with trauma can help you work on both.
• Medication, when a doctor recommends it. There are effective options. Some take weeks to work. Never change or stop a medication without your doctor.
• Reviewing your treatment. If you've gone years without improvement, asking for a second opinion is reasonable.
• Habits that calm the body. Sleep, movement, less caffeine and alcohol. They won't cure anxiety on their own, but they help.
• Safe relationships. People you don't have to stay on guard around. Your nervous system learns there are places where it can rest.

When to get help

• Right away (911): chest pain, severe trouble breathing or fainting, especially the first time. It's better to rule out a heart problem.
• Soon: if attacks keep coming back, if you've started avoiding places or activities, or if anxiety is keeping you from sleeping or working.
• Always: if you're having thoughts of harming yourself. Call or text 988.

Asking for help isn't a lack of faith or strength. Your anxiety has a history, and that history can heal. You're not alone, and you're not crazy.

Sources

• CDC. About Adverse Childhood Experiences.
• Felitti, V. J., Anda, R. F., Nordenberg, D., et al. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245-258.
• NIMH. Panic Disorder: What You Need to Know.
• Cleveland Clinic. Panic Attacks & Panic Disorder.

If you'd like to hear my full story, subscribe to La Oveja Negra on YouTube (videos in Spanish).

If you're going through a hard time, you don't have to carry it alone. In the U.S., call or text 988 (Suicide & Crisis Lifeline, free, 24/7). If you're in immediate danger, call 911. In Mexico, you can call Línea de la Vida at 800 911 2000. This blog shares personal experience and general information and is not a substitute for professional help.