Student nurse - depression/panic attacks

Sage611 · Aug 23, 2016

I am entering into my third semester of nursing school. I love nursing and I know that my heart is in the right place. Since 13, I have dealt with depression, anxiety, and panic attacks. I have heard all of the comments; "Your health comes first", "how will you care for a patient if you cant care for yourself?" and they are hurtful because I know that being in the medical field is where I am going with my life.
I feel as if I have overcome depression. I was on 40mg of Prozac for 6 years then switched to 100mg of Zoloft after a recent incident. My anxiety isn't what most people would consider anxiety. I don't constantly worry. I just consider myself to have a low self esteem.
My "panic attacks" are the real problem. They are the most bizarre thing and cannot understand them. They happen in good and bad situations. A good example is the night before my vacation, I threw up twice and my heart was racing.
The bad example is where the real problem...
My first clinical day of first semester I got all of the symptoms: unsettled stomach, shaking, sweaty, my body is hard to hold up, feeling like the urge to vomit/defecate at the same time, then ultimately I black out. I got myself through the first episode and finished the semester fine.
On to second semester... The night before the first clinical day I ate dinner and took my rx xanax 0.25 mg and tried to sleep. The symptoms came and I jumped from my bed and my body just took over. 3 hours of vomiting and diarhhea, my mom gave up and said I am going to the ER. I messaged my instructor and went to the ER. I couldnt move a muscle in my body without vomiting. My HR was 132. I ended up having to appeal the school for missing clincal.
My last day of clinical....I had been doing breathing techniques all morning. I entered a patient's room and suddenly got hot and everything went black. I excused myself into the hallway. My instructor witnessed me collapse. Code MERT was called, BOP 50/30, HR 50, covered in sweat, and did not respond to sternal rubs. Went to the ER and labs were normal.
I know that science describes this as vasovagal syncope but I dont feel right about that. Im very nauseas in the mornings. My "anxiety" about having an episode is heightened in the early hours and late nights. Almost every time I am out of a routine.
Sorry this is long, I just want to get over this. I want to be a successful nurse. Has anyone had anything similar?
and please don't hate about me taking xanax, I know my body and I am not a danger to patients because I take one 0.25 mg as I need it. Please no negativity. thanks

I used to have debilitating anxiety and took SSRIs for years. I didn't get nauseated, but I would blush, which in turn embarrassed me, making me blush. I got so that the fear of anxiety initiated a panic response. I am now off all meds, because I think there are long-term consequences that are not known. I have some little tricks that may help you:

Concentrate on wiggling your toes in your shoe or wear a hair band and snap it...when you feel panic coming on. It will help you focus on a sensation and not your anxiety.

Talk yourself out of it. I would say, "Calmmmm," with the emphasis on the m. You can talk yourself into an attack, and you can equally talk yourself out of it.

Try to limit caffeine.

Tell someone, "Excuse me, but I'm experiencing acute anxiety right now. It will pass soon."

I know that sounds ridiculous, but when you share your fear, it loses power over you.

Realize that anxiety is a self-centered condition. Focus on other people. Live outward, not inward.

Try yoga to center yourself.

Hope this helps!

doodlebuttRN · Aug 24, 2016

You aren't alone. I had terrible anxiety and panic attacks when I was in nursing school. Once, I had a panic attack on the way to clinical. I couldn't stop crying and I lost my contact. I had to pull over, call my CI (who thankfully was very understanding) then call my mom and dad to come get me and drive my car back... that was the worst day. But I got past it, and went back, and made up the hours. Unfortunately, much of the anxiety didn't get any better once I graduated because I was working so hard in this new and overwhelming field. The best advice I can offer you is to talk with someone. It sounds like you have a psychiatrist, but have you thought about counseling? Sometimes just talking can help, especially to a therapist who can help you work through the anxiety and give you valuable tips to manage the panic attacks. Make sure you are eating and sleeping well, and remember that you will get through this. You can come out on the other side, as a nurse, intact.

Best of luck to you.

asrn2017 · Aug 27, 2016

I really love the wiggling toes thing, that is something I have never heard of. I will definitely try that. I think this semester will be different. I am starting with OB before med surg and I want to pursue OB in the future. It's more of excitement than fear.

I do have a question about telling people about your anxiety. I have always been told not to tell instructors because that gives them the impression that you are weak. I ended up spitting it out one day. But i do tell my close friend. Thanks for the response!

asrn2017 · Aug 27, 2016

I have seen about 3 therapists. Unfortunately it just isn't working for me. My anxiety is such an in the moment and overwhelming sensation. I have had a hard time explaining it to therapists. They don't seem to under stand the physical symptoms that I get.

chocolateQ2H · Aug 28, 2016

Hello asrn2017,

I'm so sorry that you're experiencing all of that, it must be frustrating. I have just finished my first week training on the floor as an ED Tech. I had the same exact experience that you described in your first quarter of clinical while watching my third blood draw of the day (weird--why wouldn't it be the first?). I walked out of the pt room at just about the last second before collapsing, and stumbled to the MSW desk to sit down. Fortunately all of the nurses around were supportive and so caring. I hope your peers were as uplifting!

The next day I watched a few staples being pulled (and then pulled the last five) and felt the sensation start coming back even though I was done, and darted out of the room as my trainer took back over cleaning and applying steristrips.

I did have a successful blood draw after the staple incident on the same day, and I did shake a little but I managed (what a relief when I saw the flash on the butterfly!!!). I originally chalked it up to both incidents happening around 1100, just before my lunch, and maybe having low blood sugar. I have also been waking up with really bad headaches and feeling nauseated-almost like a morning sickness, but I have three negative tests in the last three days :no: I HAD NO IDEA THAT ANY OF THIS WAS RELATED TO PANIC ATTACKS.

Have you tried any of the suggested techniques above? Do they work? I guess I should talk to my PCP or even charge nurse about what's happening and figuring out why I'm feeling near syncope so often. I am THRILLED to be on the floor, and I'm about to start nursing school, and I want this more than anything!!! I can relate to your frustration in wanting to be a successful nurse and I'm hopeful I can push through and get past these stupid hiccups.

We'll get through this!

-chocolateQ2H

Diane Banks · Jun 25, 2023

I just want to start by saying you are absolutely not alone and you are not crazy. I never really had severe anxiety or panic attacks until nursing school. I was not sleeping and would have pain in my chest and numb arms from anxiety. I thought I could never make it through but I did and I am telling you the only reason I am where I am is through prayer. Knowing that God was with me and that battle belonged to Him took so much pressure off of me. I would just talk to Him like a friend. I was taking klonopin to help with the anxiety which helped but it didn't always work. Reading scripture from the Bible about anxiety and listening to worship music helped me a lot too. I'll be saying prayers for you. Believe me you are never alone. Hang in there.