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[00:00:00]

I'm John Horn, host of the podcast Hollywood, the sequel. In each episode, we're asking actors, producers and directors to tell us how they'd fix the industry's long standing problems like equity at all levels for people of color. Here's actor Kerry Washington.

[00:00:17]

It's not enough to just not be racist. We have to be actively anti-racist. Listen to Hollywood, the sequel on the I Heart radio app, Apple podcast, or wherever you get your podcasts. Everybody has a podcast. All right. Every celebrity, every what you do in college, there are literally hundreds of thousands of podcasts out there.

[00:00:40]

And, yeah, it's a bit of a mess. I'm Nick Klaw and my new show, Servant of Pot. We'll give you the most interesting and important stories of podcasting. And I'll tell you why you should care to listen to serve in a pod on the I Heart radio app, Apple podcasts or wherever you get your podcasts. Hi, everyone, from October to 2014, my Saturday select pick for the week is how panic attacks work. And this is very sad and serious stuff, everybody.

[00:01:11]

Panic attacks are terrifying. They are real deal stuff. I've never had one. I've had friends and family members that have had them, and it's tough stuff. So if you suffer from them or have friends or family that do, why don't you give it a listen? And maybe this will help out or at least bring a better understanding about how panic attacks work. Welcome to Step, you should know a production of ancient radios, HowStuffWorks. Hey, and welcome to the podcast, I'm Josh Clark.

[00:01:48]

There's Charles be Chuck Bright, Gerri. So it's stuff you should know. Yep. Widespread panic. Did you see that video? No. Which one? There was a dude. This is just like two days ago that went up on stage and attacked the band. Oh, no, I didn't see that. Yeah. And they've got the whole thing. And it was during one of the really repetitive droning parts of a song. And I haven't seen an explanation, but there was I went to the widespread panic Facebook thing because there was a big thread about people talking about it.

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And I just said, Hiro, did you really hate people? Gang violence, me?

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Good hero, dangerous.

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I thought it was pretty funny he attacked the members of the band. Yeah, like physically. And I couldn't quite attack the drummer and he was upset and wow. I don't know if that part of the song made him snap, but it was definitely one of those repetitive. Thank thank thank. Over and over and over. Yeah. He's like, stop.

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But he was at the show so there'd be weird unless he went there to attack them. Yeah. Was probably the bath salts. Maybe so. So we're not talking about that kind of panic.

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It's more a psychotic break and this is not widespread at all.

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It's very individualized panic. It is. But it turns out people suffering from this is kind of widespread. How about that? So if it's a little bit sure instead what we're talking about panic attacks and the combination of panic attacks or the combination of panic attacks, they can lead to something called panic disorder. Yeah, and it is a sucky. Mental condition? Yeah, that about 2.8 percent of Americans, which is a pretty significant amount of people.

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Yeah, that's that's more than bipolar, which we've covered in schizophrenia and OCD, which we. Well, we've covered all three of those. Yeah. So that's a pretty significant amount of people who suffer from panic disorder. Right. But that's different than just plain old panic attacks. Even though to have panic disorder, you have to have panic attacks. But if you have panic attacks, you don't necessarily have panic disorder. Right, exactly. And I've had two experiences which I'll talk about at some point through the show.

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Not personally, but Emily had a panic attack once and a friend in college had a panic attack. A roommate. Yeah. And neither one of them had panic disorders. It was just an isolated incident. Yeah.

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So apparently that's I don't know if Commins the right word. Yeah. But people do have panic attacks and they but they, they that might be the only one they ever have for their entire lives. I hope so. Which makes the whole thing kind of mysterious.

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And we should say like science does not know what exactly is going on here.

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They have some theories. Yeah. But there's there's no there's no way to predict what's happening. They don't even know if it's genetic or what environmental.

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Well, they finally isolated a gene last year, I guess, and go and talk about that now.

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In December 2013, they isolated the gene in you know, genes are always so boring with their names unless it's Simmons'.

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That's right. The Enquirer three, uh, they think may be responsible, um, because its presence appears to cause an overestimation of fear and danger and an over activation of the hippocampus and amygdala. So basically, if you have this gene, you're going to exaggerate your fear overall.

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OK, but it's not like they're saying they prove that's the cause. Right. But that is a good step in scientifically in the right direction.

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That's a huge step. Yeah, because, I mean, that does sound very much like what a panic attack is.

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A panic attack is where you experience a very pronounced sense of fear and basically your fight or flight symptoms response. And really, from what I can understand, your flight response. Yeah. Like you're not in a position to fight or freeze because, you know, now these days it's fight, flight or freeze. Oh, really? Yeah. I don't think any of that. Yeah. There's a third option now.

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Um, like drop and roll. Kind of. Yeah. Oh no wait. Those aren't options.

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That's a sequence. Right. This is, these are options.

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Yeah. When you're confronted with danger Nick then our buddy, the comedian dude have you seen his Honda ads.

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Yeah. Those are awesome. Yeah. I was like, that's Nick Funen. He's on like Miss America. Yeah. The first thing I always think about is good for you.

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Cash those checks, baby. Yeah, he is that funny. Bit on stop, drop and roll and like they needed to continue that like keep rolling. He's like that's kind of key. Don't stop, drop and roll because you'll be consumed by fire. You need to keep rolling right. Until you get to a door.

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Yeah. It's very funny stuff. So this is a little different fight. Flight or freeze. Yeah, it was. So how does Free's factor in, like you just freeze up and toast? It's yeah. That's beneficial of all of the these adaptations to danger. But basically when you're when you're confronted with danger, you can either fight or flight or freeze. That makes total sense.

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I don't know why I freeze. Was never in there to begin with. Yeah. Because so many people freeze. They just all on the last couple of years I think I'm a flier or freezer for sure.

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It depends. I don't know. Do you think there's a personality type? Oh boy, I don't know. Um, you know, don't you think it's possibly like just what your body chemistry happens to be doing right then?

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No, I think some people are more inclined to fight for sure.

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OK, well, with panic attacks, you're flying. Yeah, that's your only that's your gym right there. Yeah. And you're experiencing it in the exact same way that somebody is coming to mug you. Right. Or has pulled the knife on you and you're running away or there's a lion chasing you. Except and this is the key to panic attack.

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There is no lion. There is no mugger. Yeah. There's no knife. There's no discernible reason for you to be experiencing this sudden onset of crippling fear, but you're experiencing it nonetheless.

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That's right. Now, no tangible thing happening right in that moment. Right. So when you come out of it and these things, can they peak within about ten minutes, but the symptoms can last for an hour or more. When you come out of it, you're like, I don't ever want that to happen again. Yeah, the place that this just happened. So the park I'm never going back to because now I associated with this because what you're doing when you experience fear, you're learning to stay away from something.

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Yeah. So whether you want to or not, you've just been conditioned to fear the place that you just were. Sure. Because you had a panic attack. And then lastly, you think possibly you're crazy, yeah, or having a heart attack. Yeah, that's both both of the my wife and my friend both thought they were having heart attacks. Yeah. Which is super scary. And we'll get to the difference later on. But I guess we should talk about just some of the initial symptoms of a panic attack.

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The old DSM Diagnostic and Statistical Manual of Mental Disorders lists, it looks like about 10 symptoms. And if you have at least four of these, you may be having a panic attack, which is heart pounding, shaking, dizziness, sweating, choking, feeling nausea, shallow or short breath, chest pain, numbness or tingling, chills and hot flashes, a feeling of unreality, a feeling like you're going crazy or feeling like you're about to die.

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Yeah, you got four of those. You're having a panic attack. Yes. And if you have four panic attacks within four weeks. Yeah. Or you have one panic attack and then fear having another panic attack for about a month or so. Yeah. Then you can be diagnosed with what's called panic disorder.

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So if you listen to our fear podcast, which was a really good one, it's kind of the same as a panic attack. We covered your your autonomic nervous system is what maintains all the functions in your body, the involuntary functions in your body, that is. And it's going to take signals from your central nervous system. It's going to regulate your organs. That's why you don't have to tell your heart to beat your kidneys to work.

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Yeah, it's all your pancreas to secrete stuff. That's right. It's your autonomic nervous system. And it has two parts, the sympathetic and parasympathetic and your parasympathetic controls. Like I said, you're your heartbeat and stuff like that.

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The normal aspect. Yeah, just like your homeostasis, right? Yeah. That balance that we all seek that we don't know we're seeking. And then the sympathetic is if you have that fight or flight or if you become excited in any way, really, that's when that's going to kick in. Yeah.

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It's like normal gear and then high gear. Yeah. But it's not always fear, you know, just any kind of excitement. Right.

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You could be super happy. It could be sexual arousal. That's all your sympathetic nervous system.

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Right. In those two components make up the autonomic nervous system which kind of switches from one to the other depending on your state of arousal, right? That's right. But when fear has aroused you, your sympathetic nervous system kicks into high gear and adrenaline is released, which is a huge factor in causing the symptoms of a panic attack. You start breathing very heavily and shallowly your pupils dilate you. We always used to say if you're digesting food, you stop doing that.

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Oh, yeah, that's right. Basically, all of your energy is transferred over to either fighting or flying. And in the case of a panic attack, it's transferred over to get you to be able to run away as fast as possible.

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Yeah, which can be a little scary. But in a real fear situation, if you're in danger, your parasympathetic nervous system is going to kick in and calm you down.

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But that is not what happens in the case of a panic attack, which is really perplexing.

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So let's recap this. A panic attack is when you experienced this incredibly intense fear, so much so that you run away, but there's nothing there to be afraid of. And then and then to make everything a million times worse, your parasympathetic nervous system doesn't kick in and calm you down like it would under normal circumstances. So you get to experience this horrible thing even longer. That's right.

[00:12:24]

Over the years, host Erin Manque and the team behind law, unobscured and cabinet of curiosities have scoured the globe to bring you tales from the past with a hint of darkness, from superstitions and folklore to the curious and the bizarre. But now it's time to bring that journey home, because while America's history books are filled with people, places and events that sit on lofty pedestals, there's a whole other world of American history that waits for us in the shadows tales of unlikely heroes, world changing tragedies and legends that are unique to the American spirit stories that we call American shadows.

[00:13:00]

Each episode is handcrafted by the Greyman mild team and narrated by me, Lauren Vogel bomb. And while we might be traveling some dark and lonely roads, you're also bound to learn a thing or two along the way. Get ready for a tour of American history unlike any other. Get ready for American Shadows. Catch new episodes of American Shadows every other Thursday. Listen on Apple podcasts, diet radio app or wherever you get your podcasts. What if we reimagine the word citizen not as a weapon to divide us, but as a verb, inviting us all to wield our collective power pretty dull Ponte in this time of pandemic and revolution, you may find yourself frustrated at high levels of corruption and inequality, at our inability to get basic things done at the persistence of systemic racism.

[00:13:51]

You are not alone. I'm Baratunde Thurston. I've produced for The Daily Show, advised the Obama White House and screamed way too much at my screen.

[00:14:01]

Now I've made a show for us. In it we highlight people mobilizing their communities, having an impact on some of the biggest challenges we face. We offer you ways to get involved and we remind you that we, the people, have the collective power to change how our society works and for whom. Listen to how does Citizen with Baratunde on the I Heart radio at Apple podcast or wherever you listen to podcast.

[00:14:37]

All right, so like I said before, breaking news from December of last year, they think they've isolated a gene previous to that. They've got some research that said it could be genetic because identical twins experience it more than fraternal twins. But it's always been sort of up in the air.

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There've been contradictions as well of a genetic basis.

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They think it's also possibly epigenetic or environmental. Like apparently one study found that a lot of people who have panic disorder had some sort of traumatic incident happen in their childhood. My friend from college did. Is that right? So they're thinking like possibly it had some sort of effect and set up like a time bomb for later on in life.

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Yeah, the stored feelings that maybe you've never dealt with about some traumatic event are going to they're going to rear their head at some point in your life in some way. Yeah.

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Or it just rearrange the the neural output in your brain so that one day you're just set up when everything is just right. Yeah. That chemistry is flooding your brain in a certain way and then bam, it comes out of nowhere. You have a panic attack.

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Yeah. Another theory is that they think if you have an over active fear system like you basically have been scared too much in life or you're scared person, then it's just going to make it a hair trigger for something to set it off. Right. Which makes a lot of sense. I think it could be a combo of a lot of things. Yeah, as usual. Yeah.

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I wonder, though, what I will end up being, though, if we'll find that there is one thing that that leads to this predictably like like things built up.

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But then there's the actual trigger, right. Yeah.

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And that's another thing too is they don't know what triggers these things. They do know that a panic attack, being worried about having a panic attack can actually trigger a panic attack.

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Yeah, absolutely. I feel so bad for people. Panic disorder. This is like a terrible affliction. Yeah.

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Because you do become very much afraid that you're going to have another panic attack. So that can set off a panic attack, but it also can set off a comorbidity called agoraphobia. Sure. Where you are afraid to leave your house. Yeah. But you're also afraid to be alone. And I read this this article that was from the 80s, 1987, and they were saying, like the the Freud Nest's, the Freud ESTs followers of Sigmund Freud. Yeah.

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We're saying, oh, well, clearly, if you're an agoraphobic, you don't want to go outside because that's where sexual desire is. Yeah. And you don't want to be alone because you're worried that you will, like, abuse yourself. Right.

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So agoraphobia and everybody want to sit down and shut up. Freud is. Yeah. And so nowadays they they have realized that agoraphobia is almost almost exclusively the result of panic disorder. Oh really. Yeah.

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And it's because you you you fear the place that you had a panic attack.

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So you don't want to go there again. Yeah. And then maybe it happened again at the grocery store. So you don't want to go there and happen. You don't want to be alone, but you don't want to be around strangers. So you cling to your family members. Yeah. And all of a sudden you're not living your life anymore. Yeah. You're developing phobias because of your panic attacks and your association with them.

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Like if you're on an elevator and you have a panic attack, you're not getting on an elevator again. Right.

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You've just developed a phobia for elevators. And so all of a sudden you're not going to be working at a place where you might normally work because you have to take the elevator to to get there or you develop a love of stairs.

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Right.

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But then what if you're you don't like confined spaces at all? Like a stairwell. Yeah. Yeah. You ever been locked in the stairwell here at the building. Yeah. I mean, you just walk down however many flights.

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So you're at the lobby. Yeah. You can get out down there. Yes. OK. Yeah. Yeah.

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You're not actually locked in. You just have to walk all the way down to usually just call you and say let me.

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Yeah. Uh another theory is that when you're super tired and overworked was when a lot of times when these are set off, your brain is producing sodium lactate or CO2. And when those levels increase, your brain says, you know what, I think you're suffocating. And so I'm going to send the signal to get you a lot more oxygen. And I found this really sad case of this woman, a university student who died from a severe asthma attack.

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Like three days ago, and she had had a history of asthma and then told the medics that she was going through like final exams and she had been having panic attacks in the weeks proceeding. So breathing is a huge part of panic attacks. And as evidenced by her, if you have asthma, it's can be deadly, which is super, super scary and sad.

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So, yeah, um, then one other, I guess there's a neurological basis, they believe for people who have panic attacks, people who suffer from panic disorder tend to have fewer serotonin receptors. Yeah. And apparently also gabb, which helps us get to sleep.

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It's called the gamma immuno butyric acid.

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Let's call it Gabba Gabba. Um, those two have some sort of role in, um, panic disorder. Like you don't have enough serotonin in your body's not producing enough gabb. You may be prone to panic disorder. Uh, you know, there isn't like a specific type of person that necessarily gets a panic attack. It can happen to anyone, but usually it happens if you're in your 20s. Mm hmm. Although they say kids can get it as well.

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Have a panic attack or a disorder. Twice as many women have a panic disorder develop on as men, which is pretty interesting. And like you said, just the fear, like having had one before, that fear can lead to more.

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So it's very cyclical. Yes. And you know that one paper from eighty seven, I can't tell if it was arguing in favor of panic disorder being like an evolutionary adaptation. Yeah. And like possibly beneficial. Or if they were saying like some people think this can you believe this. But they were one of the points that this guy made was well twice as many women have panic disorders as men. Right. So clearly it's an evolutionary adaptation because women wouldn't have had to have gone as far away from camp while they were gathering food as in.

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Yeah, sure. Men couldn't stand to have a panic attack or they couldn't. It wouldn't be an adaptation for men, right? It would be for women. Plus, women can't run as fast when they have kids to carry, so they need to be on alert a little more. Gotcha. It's just smelled like bonke. Yeah. 1987 bunk that there was a big year for bunk.

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Yeah. If you do have a panic disorder, you may have a hard time getting your family to understand it. Sometimes they overreact and think it's like way more severe than it is. Sometimes they underreact and say, you know, it's all in your head. Right. Like just calm down. But either way saying, boy, you're nuts or you just need to relax. Neither one of those is going to help out your loved one. Chill out.

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There's no lying.

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Yeah. One one thing I've learned in arguments and fights with my wife is in a boiler in this early on is saying telling someone to relax never causes someone to relax. No, it's like not the worst thing you can do if something's heated is to say just relax. It is true. That's just going to ramp it up. Yes. So that's my advice for couples out there in any relationship, really. It's good advice. Chuck, thank you.

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Um, there is a silver lining to all this in that panic disorder is actually highly treatable. It's the treatments that they've come up with are pretty successful.

[00:22:42]

And we will talk about those treatments right after this stuff. I'm John Horn, host of the podcast Hollywood, the sequel. On every episode, we're challenging producers, actors and directors to tell us what's broken in Hollywood and how they'd fix it. Here's producer Ava DuVernay on ending systemic racism.

[00:23:06]

It's is not enough a statement. It's not enough. One black executive is not enough to is not enough. Your company must look like the real world.

[00:23:16]

And we're tackling other problems, like keeping everybody safe on set and fixing Hollywood's broken gig economy. Here's Moolarben producer Jason Reid. The financial pressure to do less with more in terms of days running a crew 12 to 14 hours, six days a week wasn't a sustainable model before. And it's definitely not a sustainable model. Now, listen to Hollywood, the sequel on the I Heart radio app, Apple podcast, or wherever you get your podcast. My name is Langston Kerman, and I love black people.

[00:23:55]

I love them short, I love them tall. I love them thick. I forgive them when their booties are small. The only thing I love more than black people are the conspiracy theories that black people come up with.

[00:24:06]

So I, along with the beautiful oppressors that I heart, radio and big money players have a brand new podcast called My Mama Told Me where each week me in a special guests will explore all of the deep and twisted conspiracies that the white man doesn't want us to know about. We'll talk silly conspiracies. We'll talk crazy conspiracies. We'll talk those conspiracies. You learned from your uncle who used to wear jean shorts when he went swimming at the public pool. Anything from baby urine as anatomy treatment to lotion being a tool for government mind control and sterilization.

[00:24:41]

Ladies and gentlemen, I don't want to be your president, but if you want to hear where the president is hiding that AIDS vaccine, then listen to my mama told me available on the I Heart radio app, Apple podcast or anywhere else that pods are cast. All right, so you mentioned that they are treatable, they have found success rates through medication and therapy, which seem to be about the same as far as how effective they are between 60 and 90 percent of the time.

[00:25:23]

That's pretty good. Yeah, it's not bad at all. So that's the good news. So there's three there's three typical methods of treatment. Um, anti-depressants. Yeah. Antianxiety pills. Yeah. And therapy. Yeah. And you might use them, you know, independent of one another in conjunction with one another. I also saw beta blockers. Some people use beta blockers to treat them, but they're not quite sure what's going on with that. I've used those before live performances.

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Those are the ones I read about that gave me one.

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And I was like a useless worm. Yeah, it didn't affect me like that. I was just like totally lost my personality.

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I wasn't nervous, but I didn't do anything.

[00:26:04]

Well, I've gotten used to live performing now, so I don't need them anymore. But I got that tip from apparently a bunch of musicians like in symphonies and stuff use a mouse like, well, if a first chair violinist, if it's good for them, they give me some beta blockers. Yeah, but it worked for me. But like I said overall, that I enjoy being on stage now.

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So with SSRI. Yeah. Which is what you moved on to from beta blockers right now I'm not on it.

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So SSRI is those are selective serotonin reuptake inhibitors and they do exactly what they sound like. You've got a bunch of serotonin receptors in your brain. If you have panic disorder, you may have fewer serotonin receptors in your brain. Yeah, serotonin is a neurotransmitter that helps basically stabilize your mood by either causing a neuron to fire or inhibiting a neuron to fire in this really beautiful, perfectly balanced chemical reaction. Right? Yeah. So if you have fewer of these receptors than normal, you're going to be comparatively out of balance with an SSRI.

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An antidepressant does is it allows the serotonin to kind of stay in your synapses a little longer than is normal so that you are releasing a little more serotonin than you would under normal circumstances. And it's proven pretty effective for for panic disorder. Yeah, I mean, they work wonders for a lot of people for a lot of reasons, but not everyone. And they can cause a lot of negative side effects. So obviously, you know, work with your doctor on a program and it takes them a little while, like two to four weeks to begin working right.

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For a panic attack.

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An anti anxiety drug like Xanax might be a little more effective because that is immediately hits you. It is a tranquilizer benzodiazepine, right? Yeah. And it's you know, it's Xanax is going to help chill you out immediately, but you can get hooked on those things pretty quick.

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Yeah. And they're dangerous to quit cold turkey. And yeah, it's not the best thing to go to Xanax a lot.

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Well, yeah, they say that you should um basically if you if you undertaken SSRI regimen, you can conceivably stay on it for years. Yeah. If you undertake antianxiety or benzodiazepine regimen like it shouldn't last for more than a couple of weeks or month. Yeah. From what I understand. Yeah. Because of the dependency. And again, you want to like really do all of this with like a um qualified competent doctors assistants.

[00:28:43]

Sure. Not a doctor's assistant. Doctor's assistants.

[00:28:47]

It depends if it's a qualified, competent doctor's assistant who can write prescriptions. Yeah. Just go for that's true.

[00:28:54]

Uh and then there's therapy of course the old CBT cognitive behavioral therapy, which we've talked about a bunch.

[00:29:00]

But, um, that is they're going to sort of the process is going to play out like this. They're going to teach you about your panic disorder. Right. Which is a big step. If you understand something, you can overcome it more easily. I think they're going to monitor you and you're going to self monitor and record your symptoms. And when they happen and why they happen, what the circumstance was breathing, like we mentioned, is a huge part of it.

[00:29:27]

Anything from meditation to just regular breathing exercises, which will give you some tips on that in a minute, too. Yeah. Are going to help you out. And then the old exposure to situations and this is once you've rethought your what your approach is going to be like, here's your new outlook. And now here's a situation that might give you a panic attack. How do you feel? Yeah.

[00:29:49]

Or like if you had a panic attack in an elevator, like, I may tell you to imagine you're in an elevator, your therapy might progress until you're actually in an elevator. You're chilling out. And the hope is that if you can undergo exposure therapy to that degree, it will get you over your panic attacks in general. Another aspect of it, Chuck, is rethinking. Yeah, and that is basically accepting the fact that you have panic attacks, apparently, if you can say I'm having a panic attack or I have panic attacks and you acknowledge it to yourself and other people, yeah, it immediately turns down the volume on the whole thing.

[00:30:27]

Yeah, I noticed some similarities in someone guiding someone through an LSD trip and getting someone through a panic attack. Yeah, it's interesting. A lot of it is like understanding, like I am having an acid trip. I am not having a good time. It's the same thing as I am having a panic attack. And this is no good. Right. And if I understand that, then I can calm down more easily and keeping it in just leads you to freak out more.

[00:30:53]

Exactly.

[00:30:54]

Um, so that's CBT, cognitive behavioral therapy. And, um, if you if you undergo therapy and you're still suffering from panic attacks, apparently being discouraged is a real problem with people with panic disorder. Yeah, because you can still suffer even if you're doing everything right. Um, and so a lot of people have learned to cope and there's some pretty common coping techniques for panic disorder. And like you said, at the heart of the whole thing is breathing.

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Like when you suffer a panic attack, you start breathing shallowly and quickly and you can hyperventilate. What you want to do is breathe from your diaphragm and you can actually practice this in the times when you're not having a panic attack. Yeah, if you're a singer, you know how to breathe with your diaphragm. But if you're not, what you can do is lie down on your back, put some pillows on your head and knees and put a hand on your stomach and a hand on your chest and then practice breathing and making your hand on your stomach, move without the hand on your chest, moving right.

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And then tap the hand on your stomach or you make a circle with the hand on your chest when you really advance. Wow, that's pretty impressive.

[00:32:10]

Uh, and then another thing you can do is just literally like put a weight on your stomach and make sure you have, you know, like a book.

[00:32:19]

Sure. Yeah. Like a nice atlas.

[00:32:22]

Something that you can see going up and down with your breathing, with your diaphragm. That's right. And you want to just kind of breathe in the good. Exhale the bad. Yeah. Like I'm having a panic attack.

[00:32:32]

This will pass. You know, this will subside. This is a temporary feeling.

[00:32:37]

So you should be saying to yourself, and if you're a person who's like out in public and you see somebody having a panic attack, you basically want to do the same thing that they're trying to do for themselves. Do you want to remain calm? You want to tell them that it's going to be over with pretty soon, that everything's OK? They have nothing to fear.

[00:32:55]

Yeah. You don't want to tell them to chill out, though?

[00:32:58]

No.

[00:32:59]

Uh, guiding someone through relaxation is different than saying chill out, by the way. Right. Very different.

[00:33:05]

Uh, they do recommend that you if you have a problem with with attacks in general or if you have a disorder, you should exercise a lot. You should practice. They don't call it meditation, but that's really what it is, is deep breathing and relaxation. It's called mindfulness these days, isn't it? Oh, I don't know. I think that's what they call it, because meditation turns people off. Right. I guess. Interesting.

[00:33:28]

Uh, cut cut out the caffeine and sugar and nicotine. That's a big one. Yeah. That's not gonna help you at all doing all those things. And, you know, if this stuff is stuff that's building up inside of you, which it often is, learn how to express yourself a little more and and talk about your issues.

[00:33:47]

I know that in both of my cases, my buddy in college, it was during finals week and I had gone to bed and my roommate and another dude had were out in the living room staying up. And one of them came and woke me up. And he's like, dude, he's having a heart attack. He's having a heart attack. And I didn't know anything about panic attacks. So we took him to hospital, of course. And that's all it was.

[00:34:09]

It was a panic attack. He calm down. I think I think they might have given him something there, some sort of medication to calm him down. Probably benzodiazepine. Yeah, probably like a good shot in the arm of that stuff.

[00:34:21]

And he was like, oh, I'm fine. Right.

[00:34:24]

With Emily's case, she had been under a lot of stress and was and driving back from Akron, Ohio to Atlanta.

[00:34:32]

Uh, I think she went to get. I think she ought to get some furniture or something, so she was in a truck like a moving truck. Oh, yeah, that's a stressful event. Had been drinking caffeine like crazy like she does, and basically started to have trouble breathing on the highway, going like eighty down the highway and had to pull over. Called me and, you know, I calmed down.

[00:34:54]

I was like, all right, now let's get back on the road, see how you do. She got back on the highway and immediately freaked out again. And I flew to Cincinnati and went to our hotel and drove her home. Nice. Yeah. I mean, there was really no choice at that point. You know, when it's your wife, you plus it was a good opportunity to get on the white horse, you know, and ride in and save the day.

[00:35:17]

Oh, that horse. I think everyone loves those opportunities, you know. Yeah, for sure. And it's not. And I've always also wanted to run to the airport, say, like, give me a one way ticket to somewhere that's out of my way.

[00:35:28]

Yeah. I have time for your body scan. Pretty much. That's what happened. So she checked herself into a hotel and I went there and had some nice Cincinnati skyline chili. And then the next morning we hit the road.

[00:35:39]

I thought, yeah, it was good. And she hasn't had one since then, thank goodness. Despite, like, you know, she she has a lot of anxiety just as a human. Yeah, but no panic attacks. Yeah. So I definitely have seen the things I saw in this article and both of them, whether it was during finals, like the things going on in her life at the time, were super stressful. I think the trigger was she doesn't like C grade at night or in the rain when she's driving.

[00:36:06]

And I think all these things compounded and just played out to where she felt like she was having a heart attack and so did my friend.

[00:36:13]

But I guess we should mention that there are some telltale signs of a heart attack.

[00:36:18]

Yeah, that's a big, big one. Yeah.

[00:36:21]

That you can recognize the difference because you don't want to actually be having a heart attack now and be like, this is the panic attack.

[00:36:28]

Just breathe. Right?

[00:36:29]

Just breathe while you're dying. All right. Um, here are a few tips from the American Heart Association. Pressure in the center of your chest to persist longer than a couple of minutes or goes away, then returns shortness of breath, pain in the arm or upper body. You might feel nauseous or faint. And, of course, if you're ever in doubt, call 911, because like you said, you don't want to be having a heart attack thinking it will subside.

[00:36:55]

No, there will be a gun in your face. Well, to say the least, exactly.

[00:37:02]

If you want to know more about panic attacks and panic disorder type, either one of those sets of words into the search bar HowStuffWorks. And it'll bring up this article. And I said that it's time for listener mail.

[00:37:17]

I call this basement fear. Hey, guys, I know most listeners know your podcast is great for learning and entertainment, but I found another purpose, distraction from stress induced irrational fears.

[00:37:29]

This sounds familiar. We were just talking about this kind of thing. Oh, yeah. And I didn't even realize it when I picked this out. How about that serendipity?

[00:37:37]

Um, I grew up in a house with a creepy gross basement where we did laundry and it never bothered me. My fiance James and I recently moved into a house with a non creepy and non gross basement. But I think the stress of planning a wedding is getting to me because when I need to go down into the basement to do laundry, I nearly have a panic attack imagining a person lurking in the basement. I started playing an episode of Stuff You Should Know on my iPhone and carrying it in my pocket when I need to go down to the basement.

[00:38:04]

Stay back, Spirit. Yeah, exactly. So we literally accompany her into the basement, which I think is hysterical. Yeah, I am busy enough. Enjoying your humor and information that I don't get is overwhelmed by this irrational fear. I think it may even be waning now. So I continue to make myself go down into the basement and see that my fear is not really based in any reality at all. That's CBT.

[00:38:26]

That's exposure therapy. Yeah. Boom. Nice. Also, before this weird basement floor popped up, I long called you guys my cleaning crew because I listen to episodes while doing my chores. And that is from Kelsey in Kansas City, Kansas, not Kansas City, Missouri.

[00:38:41]

Missouri. And Kelsey, good luck with that. And just don't look behind that door over near the washing machine.

[00:38:50]

That's very helpful. Just getting Kelsey, there's nothing down there.

[00:38:54]

Just take us with you. We will protect you. Yeah. The spirits don't like us. Know the podcast is coming from inside the house.

[00:39:03]

If you want to get in touch with Chuck or me, you can tweet to us. That? S Why Escape podcast. You can join us on Facebook dot com slash stuff. You should know you can send us an email to Stuff podcast at HowStuffWorks dot com. And as always, join us at our home on the web stuff. You should know Dotcom. Stuff you should know is a production of radios HowStuffWorks for more podcasts, my heart radio, the radio app, Apple podcasts or wherever you listen to your favorite shows.

[00:39:38]

I'm John Horn, host of the podcast Hollywood, the sequel. On every episode, we're challenging producers, actors and directors to tell us what's broken in Hollywood and how they'd fix it. Here's producer Ava DuVernay on ending systemic racism.

[00:39:53]

It's is not enough. A statement is not enough. One black executive is not enough to is not enough. Your company must look like the real world.

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And we're tackling other problems, like keeping everybody safe on set and fixing Hollywood's broken gig economy. Here's Moolarben producer Jason Reid. The financial pressure to do less with more in terms of days running a crew 12 to 14 hours, six days a week wasn't a sustainable model before. And it's definitely not a sustainable model. Now, listen to Hollywood, the sequel on the I Heart radio app, Apple podcast, or wherever you get your podcast. What if you can learn from hundred of the world's most inspiring women now you can.

[00:40:43]

Introducing Senecas One hundred women to hear a new podcast brought to you by Seneca Women and I Heart Radio in celebration of the 100th anniversary of American women getting the vote, we're bringing you the voices of a hundred groundbreaking and history making women. You need to hear women of the past, the present and women who are right now designing our future. Women who have broken barriers in outer space on the Supreme Court and on the playing fields. Through one hundred episodes, you'll get insight into not just what these women accomplished, but how they think about the world.

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You'll hear about their setbacks, their successes and what they learned along the way. I'm Kim Azorella, co-founder of Seneca Women and co-author of the best selling book Fast Forward. Listen to Senecas 100 women to hear on the radio, Apple podcasts or wherever you get your podcasts.