Coping with Exam Panic Attacks?

UniGirlBot asks: "I am a distinction / high distinction student who normally doesn't have any major levels of stress during exams. Today I managed to have a major panic attack during an exam on databases and ended up leaving the room in tears about halfway through a 3-hour paper. This panic attack was an absolute first for me and I now have to begin the special consideration procedure, which I am grateful exists. For the record, I did study enough and the course was something I enjoyed doing. Does anyone out there have any advice on what I could do stop this from happening again, please?" If you've been in this position, how did you recover?

Comments

Emotional Detachment

[PrivateDonut]

Simply stop caring.

Re:Emotional Detachment

[drhlx]

Once your at the exam, even the night before, there's nothing you can do that is going to increase your knowledge

I disagree. For the vast majority of undergrad CS subjects, a day or two of revision was plenty. For the 'soft' subjects (management, etc.) a few hours was more than enough to memorise the buzzwords. Sure, it requires having been to the classes and knowing what's going on, but don't underestimate the marginal benefit of a few hours of targeted revision right before the exam. Particularly when lecturers set exams that are all-too-similar to the tutorial questions, past exams or textbook questions. If you're talking process-based subjects (e.g. differential calculus), a few hours may not help you. But a higher-level subject on project management? A few hours of dedicated study is all you often need.

Re:Emotional Detachment

[Fyz]

That's a good philosophy for any student. But telling a person that has panic attacks to stop caring is like telling a clinically depressed person to cheer up.

In fact, it can make the problem worse if they suppress their nervousness under a superficial shell and then crack completely under the real pressure of an exam, especially one you're not sure of passing. I thought all my life that I don't have this problem, that I could always keep my cool, but then I realized that this was just a front I brought up for the examinators, though under this surface I was a nervous wreck.

Now, knowing that I actually have a jumpy nerves, I can work on them using some of the techniques others in this discussion have mentioned.

Though if you have a real problem, the solution is very simple: take a beta blocker in the morning of the exam. Trust me, works like a charm.

Re:Emotional Detachment

[SanityInAnarchy]

That's a good philosophy for any student. But telling a person that has panic attacks to stop caring is like telling a clinically depressed person to cheer up.

It's a start, though.

Trust me, I know plenty of people who were suicidal. I learned some things. I learned that they don't really want to do it, or they would've succeeded already. I try not to tell them that, but it keeps me calm.

I also learned that, while it takes a certain amount of finesse, and the most effective approach differs from person to person. But no matter what the approach, the most important thing is to try. It's amazing how thoroughly these people convince themselves that nobody cares, and a real, serious, up-at-2-am-on-the-phone attempt to talk them out of it and keep them alive proves that someone cares.

So, in other words, telling a depressed person to cheer up may not fix the problem for life, but it will help at least now, at least for today, if done with consideration (not in a snarky slashdot post).

So, the trick would be to tell this person to stop caring, but not in an arrogant-Slashdotter way. Get their parents to tell them to stop caring, to tell them that it doesn't matter. Parents want you to succeed, but good parents will forgive you and help you when you fail (even literally).

Deep Breathing...

[thepropain]

with closed eyes. If possible, "step outside yourself" and see the silliness of it. Of course, im my book ain't nuthin' wrong with a shot and a beer before the test...

Shifting Gears

[FirmWarez]

When I was in the last couple of years of my undergrad -- computer engineering -- the way I'd deal with hard core tests (Calculus IV, control systems, etc) was by completely shifting gears right before the test.

Guys would always be cramming that last hour or so before the test. Look, if you don't understand how to do a Laplace transform you ain't gonna learn it 30 minutes before the test. To freak out then ya gotta be fracking crazy.

I have a lot of non-technical interests, and a big one is sports cars and sports car racing. I'd take a couple of car porn mags and read about sports car restoration or racing skillz in the common areas while watching every one else act like nut cases. It really calmed me down, and reminded me that I knew this stuff.

There's a saying in the world of professional soldiers -- you fight like you train. Same about tests. If you know the material and are comfortable with it you will test like you train.

Re:Pressure is a bitch

[aprilsound]

Agreed, but make that psychiatrist, not psychologist. There are physiological factors that contribute to panic attacks, and having an MD explain them to you can do wonders.

Plus, like the parent said, there are probably diet and exercise considerations that will help you out.

People can say "You shouldn't worry so much" and that sort of thing, but if that is all you needed, then you probably wouldn't be here in the first place.

At the very least, if you talk to a doctor, you'll be able to understand it better, and he/she'll probably tell you things you can do. Being able to do something will also make you feel better.

Don't stress, get sleep

[scdeimos]

YMMV, but as a survivor of several panic attacks over the years I have found that they've usually been brought on by combinations of stress and lack of sleep. My suggestions:

• Learn to compartmentalize: keep work/school worries at work/school, don't bring them home with you.
• Realize you what can and can't do: There will always be some things beyond your control, so don't worry about them.
• Don't lose sleep: If you're feeling tired during your days at work/school, go to bed earlier at night, try taking (natural) things to help you get to sleep like warm milk, valerian extract, whatever works for you.

Re:I KInda Disagree

[Anonymous Coward]

>1) Cut out on sugary drinks completely. They're empty carbs that make you jittery during the day and mess up your teeth ...
> 3) Orange juice good

Make up your mind. Orange juice is sugar water with a vitamin C tablet. There's about at much sugar in OJ as in Coke. (checking fridge) 36 grams/12 oz (OJ), 39 grams/12 oz Coke.

Point 1 is correct.

Or realize it's always fixable...

[vistic]

Well you can always adopt the attitude of "well, i'll die someday and this test won't matter in the long run, the world will forget about me, and then the world itself will end someday... in the grand scheme of things i am not that important, let alone this stupid test..."

Ok maybe that's not good advice...

But seriously... I was a Physics major... couldn't handle it and dropped out. I was working full time and slowly downgraded my plans for my future. I was resigning myself to be content with mediocre jobs and low pay, and decided that friends were what would really make me happy.

But then I snapped out of it and realized I was settling for less. I went back, switched to Computer Science and it's all been good. I even had some REALLY bad semesters, but the thing is that I know now that (at least academically, if not in other areas of life such as love...) no matter how bad you screw things up, you can always recover from it, if you're willing to put in some extra work and get determined.

So when you're doing an exam... just remember that if you do bad, it probably isn't determining your entire grade for the class (if you're doing college in the USA), and even if you do bad in the class you can probably retake it... or take a minor hit in your GPA and make up for the loss with another class you do well in.

I know failure can seem daunting and horrible. But some people like me who have done it enough times (failed at things in life) know that it's not the end of the world, and you might end up learning something from it, or get to know yourself better... so it's not a total loss. It's life experience.

It's hard to explain this to people who only get A's their entire life and SERIOUSLY think they're life will end if they get a B. In the end, you're better off being kind to yourself.

Re:Or realize it's always fixable...

[Glonoinha]

Quite a few of the responses here are focusing on a particular symptom (the panic attack during the exam) and overlooking the context of the issue (the entire semester.)
Perhaps it isn't that he is being too hard on himself, but that he isn't being hard enough on himself (but doing it constructively.)

In the military there is a saying : "Train hard, fight easy."

What this means is - if you can condition yourself via repeated very difficult exercises to be able to operate and function in those difficult situations, you will be able to function under pressure. If your training (studying) is even more difficult than the situation you will encounter when it counts (battle, or the exam) then your exam will be easier (less stress, less pressure, easier questions) than you have been experiencing during training (studying) and you will breeze through it.

When I was a competitive swimmer (years ago) the longest race I ever swam was 200 meters - on competition day I might even swim less than that for the entire day : a 100m and a 50m.
But every day during practice I would swim upwards of 3200m over the course of an hour. The coach would yell at us, push us harder, have us swim laps with only our legs (arms behind our backs), have us hold folding chairs over our heads in the deep end while we used only our legs to keep our head, arms, shoulders (and the chairs) out of the water for ten minutes at a time. After a month or two of high intensity training, race day was something we looked forward to - not only to compete, but because it was the easiest day of the swim season.

Same thing with military guys. The guys that are calm and can function reliably when someone is shooting at them - they are calm because the ONLY thing they have to deal with is someone shooting at them. During training someone was shooting at them, a gunny was screaming in their face, they were doing push-ups / sit-ups until they puked, they were carrying around telephone poles as a team through pounding surf in the ocean, they were living on three hours or less of sleep per night for weeks at a time, and they were doing it all while eating grubs and worms and whatever crap the can find or kill or catch with no way to prepare it (under nourished.) Compared to how they trained, fighting on the battlefield is a cake-walk.

Effective studying in college isn't reading a book by yourself in the quiet library until your eyes glaze over.
Effective studying is creating an environment where you are mentally challenged by forcing yourself to demonstrate an understanding - a MASTERY of the material. Sit round robin with a few other students from class and go through the chapter, subject by subject, and have each person be the 'target' - the others ask him a question on the topic and he has to answer it, demonstrate his knowledge on the subject. Do not allow anyone to pass (skip a question,) force him to read the material until he understands it and can explain it to the satisfaction to the others. Let the questions get harder and harder, and pile on the peer pressure. Let the only response to 'I don't know' be 'well motherfucker you better figure it out now with the book in your hands and people here to help you learn it, because it is going to be on the exam.' The harder you are on each other during those study sessions, the easier the exam will be - for two reasons : during the exam it is quiet time without your peers putting the pressure on you (just you and the pencil and the paper), and also because you will have already worked through the thought processes in order to come up with the correct answers, not only for the questions you had to answer but for all the questions all the others had to answer - in watching them get it right or wrong, you will have seen several different perspectives and approaches on the problem, learning not only the correct answer, but the correct approach to get the answer. In doing so, you will have developed a mastery of the material and it will be obvious when you exhibit that mastery

Break it down

[Alicat1194]

Another post mentioned the 'fight or flight' response that is triggered during panic attacks. I've been experiencing panic attacks since the 2nd grade (hereditary, thanks Dad!), and have found that once I have an 'exit strategy' of sorts worked out, it helps to calm everything down.

Basically, assuming you can't head the attack off at the pass, once it's in full swing, just tell yourself '5 more minutes (or questions), and then I'll leave'. Once the five minutes is up, reassess and see if you can hack another 5, and so on.

(It can also help if you make sure you sit in a seat with decent airflow around it. The fresh air helps to get enough oxygen where it's needed, which makes you feel a lot better)

Gee thanks

[HalAtWork]

Get a girlfriend (or boyfriend depending on your preferance), drink some beers, wine or whatever you like and enjoy college, this is your LAST chance. The real world is a lot tougher and a lot less fun until you become a billionare or die :)

My school teachers had always been telling students that elementary school is easy compared to junior/high school and that we had better enjoy it while we can because it was about to get a lot tougher. So I started dreading high school. Then in high school they started saying the same thing about college, and that college was as close as the real world could get in school, and that we had better work hard to get into the right one and do the right thing because our life depends on it, otherwise we'll be working at gas stations. So I started dreading college. Then in college they stopped holding our hand or putting guns to our heads to come to school and do assignments, so since I dreaded college and its assignments so much, to stop being stressed out I simply didn't pay attention to it because I couldn't handle the dread and pressure. Then I dropped out of college. Saying shit like "It's your last chance, it'll get a lot tougher!" is not going to make someone do something better, it'll simply impede them like it did me. Now I'm having a hell of a time.

Advice from a PA sufferer

[Anonymous Coward]

Some good advice so far on the thread, I'll throw my own in the mix..

Not that it makes me an authority on the matter, but I've had some really first class panic attacks. The first one sent me to the hospital (I walked there) thinking that I had a major blood sugar problem. My heart rate and blood pressure were both over 200, I felt like I was walking along a tightrope with insanity beneath and a strong wind blowing. When the nurse brought me in to sit me down my whole body was visibly palpitating like I'd just drank a thousand cups of coffee. The skinny on the situation, looking back at it all, was that I was in a boring job as a sysadmin that I knew was ending in six months so, being a young male, I decided I'd party for the remainder of tenure. Each night was a tour of the bars and each morning the hangover was treated with a few bong hits followed by a cup of coffee on an empty stomache. Off I went to work with the headphones cranking, thinking I was the coolest kid in town. It really should be no surprise that one day my physiology finally went bankrupt the way it did.

You might be thinking, "what a loser, I've nothing to learn from this guy." but the truth is that regardless of how your first PA was triggered, the anxiety cycle is similar for everyone. It's great that you know what you're dealing with after your first attack. I spent weeks in an unbearable state of despair thinking that I'd done "permanent brain damage." I went to a psychiatrist for numerous sessions, read books on the matter, participated in online communities, and now, a couple years later, I feel like I'm finally comfortable back in my own skin.

My advice:

- The fear of another PA is often what kicks people into a vicious anxiety loop right after their first PA. The moment your heart rate ticks up in a stressful situation you think "oh no, here it is again" and sure enough your fear of the fear sets off a PA. Breaking that cycle is not easy and there has been some good advice so far. Learning to meditate is important as is making sure you're eating well (get rid of caffeine and sugary foods), getting enough protein, etc. Exercise goes a long way to stabilizing emotions and will make you feel comfortable with your body operating in a high gear. Once you learn to flow *with* the current of anxiety and accept that it is not dangerous to you then you will treat its arrival with more of a "blah, I have to hang out with this stupid thing for 5 minutes, then it will go" rather than seizing on it and thinking "anything but this!!!"

- I was totally against pills for a long time thinking that I'd be popping them for the rest of my life or that it was a way of cheating that wouldn't address the real underlying issue. But the fact of the matter is that they're a useful tool which, used judiciously with other techniques, can help you get back on your feet. Xanax helped me deal with flying again (the thought of having a PA on a plane would keep me awake at night) and I use a tiny dose of Propranolol, a heart medication that blocks the effects of adrenaline, when I have to present or, as was the case recently, when I was interviewed by the news. Note that I *rarely* take the xanax and will probably graduate from the propranolol at some point but just knowing I have my little pharmacy in my wallet makes me feel better.

- Keep a journal. Jot down how you felt that day, what you did, how you're feeling about tomorrow. Note your diet, sleeping pattern, etc.

- I'm guessing if you're in school you're still quite young but take the time to reflect on your life and what sort of framework you've established for yourself on the inside. Do you feel you have to be the best at everything? Are you constantly gnawing away at where life will take you next? Sometimes anxiety and panic are the result of internal or external pressures that are not being handled correctly.

- Finally, take it easy.. take time for yourself. You've been bruised and pampering yourself a little is in order.

Good luck, you'll get through.

We all panic

[gvc]

We all panic. Most of us are overwhelmed by it from time to time. Some people experience it daily and and are barely able to function in life because of it. Others are able to control it -- at least is most situations -- to the extent that it doesn't overtly affect their performance.

I suggest that first of all you accept that it will happen. Of course try to recognise the situations leading up to it and try to develop coping mechanisms. The coping mechanisms will have to be things you've worked out in advance because when you're in a state of panic you're not in any position to do so.

I think it is valuable to use your experience (and others') to develop understanding -- for others and for yourself. There's litte point in saying "I [they] should [should have] done this [that] instead" -- you [they] are [were] simply unable. Some people really are just as panicked as this every day of their lives, and equally unable to cope. This does not mean they are lazy or hopeless or even crazy. You're privileged -- you've made it to college and you're studying something you love. I assume that you're female, so you've done this in spite of a social environment that is not 100% inviting. Obviously you have all the necessary raw materials to be able to cope in stressful situations -- reflect on some such situations and try to figure out what you did.

What do I do? That's hard to articulate. I'm a big believer in exercise -- walking, running, swimming. Do it regularly and before you notice you are in a potentially panic-inducing situation. Even if you feel you don't have time because you have an assignment, cramming, etc. At least that's what I do. If I have a stressful event on the horizon and only get to bed at 2 a.m. I'm better off getting up at 6 instead of 7 and having a run. An extra hour's (fitful) sleep isn't going to do me the good that the exercise will. And maybe it'll translate into a much better hour's sleep the next night.

Others here have advocated drugs. Drugs can help in certain situations and for certain problems, but I would not advocate them as a first line of defense. Booze, valium, etc are just depressants. They are unlikely to be strong enough to overcome your angst, but they will certainly affect your performance. SSRIs -- Prozac, Effexor, etc -- can work remarkably well for anxiety. But they are not "pop one when you feel jittery" treatments. And they can have very bad effects. If you are bipolar, they may well exacerbate the problem a lot.

Enuring yourself to particular situations can help. Stage fright is a good example. Put yourself in speaking situations as opposed to avoiding them. Eventually things get better. I guess you can't replicate exam situations exactly but maybe try a programming contest or something that you wouldn't otherwise enjoy -- if you experience some of the same feelings, this might give you a sandbox in which to experiment with various strategies.

Sorry if this rambles. I think the theme is that you have to discover what works for you. By all means solicit and consider opinioons such as the ones that you receive here. Since your panic occurs in relatively rare situations it is tough to know exactly what is going to work. I am pretty sure that somebody else's solution applied on an ad hoc basis will not work.

panic attack solutions

[Anonymous Coward]

I've suffered panic attacks for years. The best remedy for instant results, is to shake up your reality tunnel: Go to the washroom, splash water on your face, do some mild stretches (even whilst sitting still in your chair), breathe slowly and deeply and calmly until your chest is relaxed, scrunch up your face muscles until you feel silly. Anything to break the tension of the "flight or fight" mechanism.

Good luck ;)

Hmm...

[ivan256]

Really, it couldn't hurt for you to get professional help. But in the meantime you may want to learn some things that change your mindset a bit...

I am a distinction / high distinction student

The fact that your question starts with that tells me that you really focus on that... Perhaps to the point of obscession. Once you get that diploma, no employer that you'll ever want to work for is likely to ask you about your GPA or any of that crap. Some other people here are, both jokingly or not, telling you to give up on caring... You don't have to do that, but you can realize that there's nothing to worry about. Exams aren't going to ruin your life, even if you fail them.

More than anything though, you should talk to a professional. Most people here, myself included, are talking out their asses. There could be some serious medical consequences that you're not going to find out about here.