My severe IBS was triggered many years ago by a panic attack.Article by Sian
"The first distant rumbles of thunder which heralded the approach of IBS began with fear and panic."
Suddenly I could see no faces, simply a mass of things with legs, crowding me. I could not see the way back to the car park, it was hidden by this heaving forest of beings. Noises began to echo queerly in my head, I broke out in a sweat, and needed to run. I remember gasping out, " I don't want to go down there, and I don't want to go down there either! " " What? " My mother was bewildered. " I want to go back to the car! " She gave me her keys and I ran. Fortunately I knew little short cuts through stores and behind them. I ran, dodging through the crowds, which seemed to me to be strange mushrooms, faceless and threatening, trying deliberately to impede my progress. Saliva sprang in my mouth, and I was sure I was going to be sick, publicly and horrifyingly. I could not take a deep breath, a band was squeezing my lungs and my heartbeat was drumming in my ears. 
I don't know how I got back to the car, but once I was there, locked in, in a quiet place and alone, slowly the fear ebbed, leaving me shaken and exhausted.Not long after, I experienced severe nausea, and stomach cramps, and went through several days of a bad stomach, an effect of the fear, I believe. My first panic attack, but not my last, and the world, that in my younger days, had promised travel to see wonders I had only read of, became a place I could not set foot. If panic attacks had any warning, they might be rather terms " panic events ", but there seems to be very little warning, which is why the term " attack " is very apt. It does feel as if one is being mugged by terror. The symptoms are abrupt and intense, involving symptoms such as shortness of breath, pains in the chest, dizziness, an inability to breathe, sweating and nausea among others. Some of the people who have emailed me have called an ambulance, so sure were they that they were experiencing a heart attack of stroke. All of the symptoms below I have experienced myself.
These can be so acute that it is little wonder we believe we are having a heart attack, and the fear of that only exacerbates the out-of-control fear we experience. Tingling sensations, also hot or cold flashes, and a feeling of burning or scorching in the face or neck. Shortness of breath, when in fact we are hyperventilating ( over-breathing ) Hyperventilation, causing too much oxygen in the blood, can lead to the feelings of dizziness, tingling, light-headedness and nausea.The doctor suggested to me breathing in and out into a brown paper bag, but at times I had to create a small * cave * under the bed-covers and breathe there, resulting in breathing in more carbon dioxide. Derealization - a strange feeling that nothing around one is real. I believe I experienced that in my first panic attack, when the crowds became something like faceless ambulatory mushrooms. Nausea, tingling, vertigo. These are often a result of hyperventilating.
Alcohol, nicotine, marijuana and caffeine may act as triggers , and most SSRI's ( a type of anti-depressant, known as Selective Serotonin Re-uptake Inhibitors ) have been shown to increase the likelihood of anxiety in the first few weeks of usage. There can be biological causes to panic or anxiety disorders which hospital tests would bring to light. Some may be related to the thyroid gland, or a deficiency of Vitamin B ( also possibly Magnesium which the western diet is highly deficient in ).
This leads to a greatly increased heart rate and sweating, to aid heat loss. Were we in fact to run, or fight, these symptoms would be useful, since we rarely do, this * energy * has nowhere to expend itself, thus the carbon dioxide in our blood and lungs drops, leading to dizziness, tingling and, a burning sensation or numbness. Likewise the adrenal surge causes a lessening of blood-flow to the head, and the light-headedness we feel. The blood sugar is directed from our brain to our major muscles, in preparation for our " fight or flight " - which rarely happens.
I realize that avoidance of crowds has lead to a severe social phobia, and had curtailed my life almost wholly, since - for instance - the thought of being on a plane and not being able to get away from my fellow passengers seems a nightmare scenario. At one point in my life I used alcohol as a cushion against panic, before going to any public place. Naturally this is not a good thing, and I stopped. Riding out a panic attack leaves one limp and drained, it is an enormous struggle, but knowing the symptoms and what they are is, I have found a great help. I have carried mints with me to suck, to stop myself feeling sick, carried lavender oil on handkerchiefs to calm me, tried Bach Rescue Remedy ( which I found surprisingly effective ) and taken very small baby steps, such as getting on a bus to one or two stops further on and then walking home. The greatest relief to me was to be told, many years ago, that panic attacks seems to follow a " sine wave " pattern, that is they have peaks and troughs, and do seem to die away naturally. I found this to be true, and it is also something to remember when one is in the throes of such an attack. They will not last in the acute stage forever.
Panic Attacks, Stress and IBS. Long term stress is apparently a very common cause of IBS. Sometimes it is not recognized, since many people are under stress these days, a low-grade and perpetual worry, which is so much a part of their lives that they simply live with it. I have come to recognize the links between panic attacks, stress and IBS in my own life. Scenario 1) After a panic attack I would enter a few days of nausea which would become stomach cramps and diarrhea. This could last as long as eight days. Scenario 2) After a shock, or upset, an argument, IBS would literally punch me in the gut, resulting in my curled up in pure agony, with painkillers, a hot water bottle and Pepto Bismol. This would lead to again, days of nausea, extremely bad gas, causing me to belch, diarrhea and abdominal pain. It came to the point that I could count down the time from becoming upset or angry to the time IBS would hit me. Scenario 3 ) Long term stress or worry, for example, when my grandmother was in her last illness, or when my stepfather was dying. IBS would manifest itself in a feeling that I was wearing a wide band of iron about my lower stomach and back which was gradually tightening unbearably. This could continue for weeks, with bouts of diarrhea, nausea and gas. I would have mornings where the first thing I drank, a sip of tea, or water, would " jump start " my bowels, sending me rushing to the bathroom and remaining there for quite some time.
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...The main pedestrian area through the shops of the town centre was called the Parade with reason, and on that Saturday it was heaving with shoppers. 
Panic attack - causes.
How to manage panic attacks.
