Dear Maria,

welcome! You’re saying you’re leading a calm and happy life, and have a great job which doesn’t give you any stress. The first panic attack happened when you were resting with your husband.

You took up fitness and started eating healthy about 1.5 months ago. The only possible cause you can think of is the neck exercises a day earlier which were hard for you.

What comes to me is that perhaps the neck exercises, which were difficult for you, awakened a memory (perhaps not even a conscious one) of some difficulty and pain you’re suppressing. You otherwise live what seems to be a perfect life, and now, with fitness and healthy eating, you’re making it even more perfect. But what if there’s something underneath the surface that is calling for your attention?

I know this is a wild guess, but do you feel there might be something to it? Is there something you’d need to deal with, which you’re refusing to?

Dear Maria:

You are welcome. You wrote in your original post: “On fitness, we do some exercises for the neck. And the first panic attack happened right after. What if it’s the problem that gives me the PA?”

In your original post you also wrote: “My life is really calm and happy”, and in your second post: “About my perfect life- it’s not perfect, of course. But it’s improved since the last year as I started caring a bit more about myself”

Maybe you suffered from elevated anxiety in the recent year, only less than in the previous year, so in comparison, you felt calm in the recent year.

There is a connection between neck discomfort/ pain and anxiety. Calm clinic. com/ anxiety/ symptoms/ neck pain (no spaces), Anxiety and Neck Pain: Causes and Solutions reads:

“Neck pain is a frequent and common anxiety symptom.. Anxiety often causes the pain itself through muscle tension.. For some, neck pain may also be a cause of anxiety, fueling health fears or distress…

“When you suffer from anxiety, you constantly put your body through long-term stress.. it generally means it is releasing stress hormones (especially adrenaline and cortisol) that create muscle tension…

“Neck pain is one of the most common physical symptom of persistent anxiety… anxiety can cause people to fixate more on negative sensations unintentionally. This can make the neck pain feel more severe than it would to someone without anxiety… those with anxiety may be more prone to having greater degrees of neck discomfort than those without anxiety”.

Psychology today. com/ when panic attacks are pain in the neck, reads: “Panic attacks can be understood as catastrophic misinterpretations of physical sensations… Devon Hinton’s ‘A unique panic disorder presentation among Khmer refuges: The sore neck syndrome’… In short, attention is drawn to the neck and neck sensations are particularly concerning..”

As I understand it, it happens this way: (1) an anxious person feels a new discomfort or pain or some other unpleasant sensation in the neck, (2) the person’s attention is focused on the sensation, (3) the person is alarmed and thinks: what is this? what is happening? will it get worse? etc., (4) the person’s neck discomfort or pain feels more severe because of the focus and worry, (5) the person experiences additional discomfort outside the neck area: shallow breathing, muscles tightening, etc., (6) the person’s anxiety elevates further, culminating in a panic attack.

All this applies to me because I too focus on unpleasant sensations in a certain area of my body. When I am very engaged in a social activity, I am not at all aware of sensations in that area. When not engaged, it takes me effort and patience to remove my focus away from that area again and again, and yet again.

anita