What Are Exhaustion-induced Panic Attacks?

People took notice when Jennifer Lopez talked about how a lack of sleep left her ‘paralyzed’ with stress. In this InStyle article, Mindpath Health’s Kiana Shelton, LCSW, explains why our bodies shut down when we try to do too much.

Jennifer Lopez — whoops, we mean Affleck — might be reveling in newlywed bliss right now, but the talented entertainer recently got real about a time in her life when she was suffering mentally — and, in turn, physically. In her “On the JLo” email newsletter, Lopez opened up about experiencing an exhaustion-induced panic attack when she was in her late 20s.

The incident occurred during a time when she was feeling “invincible,” and she’d sleep for just three to five hours a night. “I’d be on set all day and in the studio all night and doing junkets and filming videos on the weekends,” she recalled.

The multi-hyphenate performer recounted how she was sitting in her trailer and “all the work and stress it brought with it, coupled with not enough sleep to recuperate mentally” caught up with her, and she felt “paralyzed.”

“I couldn’t see clearly and then the physical symptoms I was having started to scare me and the fear compounded itself,” she wrote. “Now I know it was a classic panic attack brought on by exhaustion, but I had never even heard the term at the time.”

J.Lo’s experience has left many women wondering how they can minimize their risk. We spoke to leading experts to break it all down.

What is an exhaustion-induced panic attack?

Annually, up to 11% of Americans experience panic attacks, and another study found that as many as 1 in 4 Americans have experienced at least one.

These sudden episodes of fear and distress usually go hand-in-hand with physical sensations, says Sarah Gupta, M.D., licensed physician, and board-certified psychiatrist with GoodRx. A few of those symptoms, according to Dr. Gupta: trouble breathing, racing heartbeat, chest pain, trembling, and dizziness.

“Many people worry that they’re dying, losing control, or going crazy,” Dr. Gupta explains. “The attack usually fades away within a half hour, but while it’s happening, the symptoms can be completely overwhelming.”

It also bears noting that panic attacks can come out of the blue, even when you’re feeling calm and rested, according to Dr. Gupta.

From simply being genetically predisposed to anxiety and panic or contending with particularly stressful or traumatic events, there are a variety of panic attack triggers, but exhaustion is a biggie, points out Lyndsay Volpe-Bertram, PsyD, a licensed clinical psychologist at Spectrum Health in Grand Rapids, Michigan. “A person may be more likely to experience panic attacks if they are not getting sufficient sleep, overworking, not eating healthily, not drinking enough water, or having too much caffeine,” she explains.

Compared to regular panic attacks, the main trigger for an exhaustion-induced panic attack is missing out on sleep, notes Elizabeth Fedrick, PhD, a licensed professional counselor in Arizona. In short, there are two parts of the brain that are affected by not getting enough z’s and can lead to a panic attack. First: the amygdala, which is the emotional center of the brain and alerts our fight-or-flight response to perceived threats. The second: the prefrontal cortex, the part of the brain that is responsible for logic and reasoning, says Fedrick.

During the third stage of non-REM sleep — often referred to as deep sleep or slow-wave sleep — the prefrontal cortex is restored so it can be more effective for managing emotions and threat responses. “Thus, when an individual is exhausted or sleep deprived, they are more likely to not only experience an increase in anxiety, but are also unable to manage it as effectively, because the prefrontal mechanisms of the brain have not been properly restored,” says Fedrick.

Potentially making matters worse is the fact that if you suffer from anxiety, it can be tough to fall or stay asleep, which only serves to exacerbate the problem, she notes.

Are these kinds of panic attacks on the rise?

Yes. Kiana Shelton, licensed clinical social worker with Mindpath Health, says more people are having exhaustion-induced panic attacks — not to mention panic attacks in general — since the start of the pandemic.

“Panic attacks generally derive out of anticipatory stress,” she explains. “Many people today — and particularly women — are still juggling to balance their careers and children, with little separation of home life and work life. For more than two years now, many have been burning the candle on both ends. As a result, the fear of the body shutting down from exhaustion — i.e., getting sick — increases that anxiousness and can activate a panic attack.”

How can you prevent exhaustion-induced panic attacks?

In her newsletter, Lopez wrote that following her panic attack, her doctor told her that she’d need to step up her efforts to take care of herself mentally and physically if she was going to continue to work as much as she had been. “[The doctor] said, ‘You need sleep … get 7 to 9 hours of sleep per night, don’t drink caffeine, and make sure you get your workouts in,'” Lopez recalled. “I realized how serious the consequences could be of ignoring what my body and mind needed to be healthy.”

The National Sleep Foundation’s recommendation on how many hours of sleep the average adult should get per night echoes Lopez’s doctor: 7 to 9 is best for optimal physical and cognitive functioning. “It is also suggested that this amount of sleep is most conducive to the prefrontal mechanisms being restored,” adds Fedrick.

A few other pro-tips to avoid exhaustion-induced panic attacks:

Limit caffeine.

“Caffeine leads to a release of some of the biochemicals that are also released during the fight-or-flight response,” says Fedrick. “Thus, if you are already prone to this part of your brain being easily activated, adding caffeine to this will increase symptoms of anxiety.”

Set boundaries.

“When we feel like we must do it all, chances are there are opportunities to say ‘no’ that we are ignoring,” points out Shelton. She recommends making a list of everything you feel responsible for and then a list of items that cause you undue stress that can be removed or adjusted.

Redefine self-care.

Although self-care might bring to mind thoughts of massages, vacations, or shopping, it can really just be a walk or a 10-minute meditation, says Shelton.

Fedrick adds, “Regular meditation, mindfulness, and deep breathing exercises can be highly beneficial for keeping the nervous system regulated, and therefore reducing the occurrence of panic attacks.”

And if you’re experiencing a panic attack, try these tips.

Shelton notes that a symptom of a panic attack might be feeling detached from the present. “To help, look at five separate objects, listen for four distinct sounds, touch three objects, identify two different smells, and taste one thing,” she advises.

You might also try intentionally taking deep, long breaths, which your brain will associate with a sense of safety and an absence of threat, explains Fedrick who likes box breathing aka square breathing, a method of deep breathing that assists with increased regulation and calmness.

To try it, gently exhale all the air in your lungs and then slowly breathe in as you count to four (focusing on the sensation of your breath entering your nose and your lungs). Hold the inhalation at the top for a count of four, then slowly exhale for a count of four (remaining aware of the sensation of your breath exiting your mouth and your lungs). Repeat for at least 4-5 rounds.

Take a tip from JLo and see a pro.

Because it can be hard to differentiate panic attack symptoms from other health concerns, Shelton advises always seeing a medical professional to rule out other potential causes. And don’t hesitate to connect with a mental health care provider to discuss the factors leading to stress and exhaustion and find healthy ways to cope.

Read the full InStyle article with sources.