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Psoriatic Arthritis and Panic Attacks

I’ve experienced quite a few changes in my life since psoriatic arthritis made its grand entrance. Many of which include anywhere from moderate to severe emotional side effects. I’ve struggled with anxiety, depression, and brain fog just to name a few. But it wasn’t until now that I’ve had a run in with panic attacks. Acute and emotional overwhelm of which it is nearly impossible to rationalize my way out of.

The first one took me by surprise and woke me in the middle of the night. My chest felt tight and I couldn’t catch my breath. It was hard to distinguish if some type of physical thing was going on, like a heart attack, or if it was caused by emotions.

I sat there, my arms wrapped around my legs as I struggled to calm my breathing and racing heart. I couldn’t think straight. My heart felt like it was going to pound right out of my chest and my stomach was in knots. My brain shouted the same thing over and over again.

What is going on? What is going on? What is going on?

I had no answers

I must have sat there for 20 minutes, trying to calm myself down. Trying to remind myself to just breathe. In and out. In and out. Every sound had me on edge. And every movement made my muscles tense. Without even knowing it, tears were streaming down my face.

What is going on?

Realizing what was happening

I never did make it back to sleep, but I was able to eventually calm myself. But that feeling, that panicked, anxiety driven feeling has yet to completely leave me. And I fear that it never will.

Since that first panic attack, I’ve had three more at different times of the day. Luckily, my children have never been around to witness Mommy have a panic attack. I’ve yet to come up with a plan to deal with it if they do.

I’ve racked my brain, trying to logically figure out what has changed that would cause such a level of panic and anxiety. I tried to use reason to rationalize what was going on. Every thought, every attempt at an explanation just didn’t seem to make any sense.

But I guess that is what panic is. Illogical. Unreasonable. Irrational.

The best I can figure is that it started when I began a new medication. It was added to my already lengthy list of medications and I had managed to titrate all the way up to two pills in the morning and two pills in the evening without any issues at all. Or so I thought.

I spoke with my doctor, thinking it was the introduction of the sulfasalazine to my treatment regimen that had prompted the panic attacks. She hadn’t had any other patients report a similar experience, but she took what I told her seriously. She thought that perhaps others may have experienced it, but didn’t feel comfortable telling her. In that light, how could she possibly warn me of that potential side effect? I even Googled the relationship between these drugs and panic attacks, but came up with no solid proof of a relationship.

If you’ve experienced panic attacks, you are not alone

Please know, this experience was, and is, deeply personal. I share it with you so that if you ever have this experience, you might feel less alone. So that you know, you can have panic attacks with psoriatic arthritis and still be a perfectly “normal” person. They are nothing to be ashamed of and certainly nothing to hide. If you experience a panic attack, be sure to speak with your doctor, they need to know all aspects of life with this disease, not just swelling joints and overwhelming fatigue.

I wish I could say that I had some great “tips and tricks” to help manage PsA related panic attacks. I suppose I’m still working on developing those for myself. But when it comes down to it, in that moment, when your mind races, trying to figure out what is going on, all you can really do is breathe. In through your nose. Out through your mouth. Hold on to reality as best you can until it passes.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Rackmani
    8 months ago

    Interesting. I’m also taking sulfasalazine and suffered a few ‘panic attacks’ last summer which I’d never had in my life before. I was pretty stressed at the time but had recently increased the dose from 1g/day to 1.5g at the time.
    I’m now taking 2g a day without issue.

  • WoodchuckR
    9 months ago

    First, fantastic job on this article. The personal and authenticity factor superb.

    Decades before PsA I had my first full-blown, hyperventilating panic attack in a doctor’s office. The good doc did not recognize what had happened. But, since then it’s my mission to read and research trauma, panic, and anxiety. Not to mention, live and not be held prisoner to anxiety and out-of-the-blue panic attacks.

    Somehow this had led to so many coincidence meetings with other suffers. Which is highly unusual since most of us expend vast amounts of energy keeping it hidden. This article carries that stress relieving factor of not being alone. Job well done.

    I love the look of relief when I meet someone and they are able to let their guard down for the first time outside of their immediate family. Just knowing, really knowing, with your heart and head, that you are not alone can be transformative. Sometimes the best therapy comes from regular Joe’s and Jane’s who’ve been seasoned from experience. Not as a substitute, but as a helpful addition to counseling and possibly medication.

    Usually, the central concern and focus of those I’ve worked with have been how to shed the ‘out-of-the-blue’ ball & chain. Without going into too much detail on a Comment, I lay the foundation that they are not capricious or without reason. However, in our effort to “fix” ourselves, by ourselves, find it highly frustrating and adding to our already taxed anxiety. I mention that we tend to throw hardware at a software problem, by rationalization of cause and effect. After all, that is how our universe works. So, why would it not apply here? I share that it does, but there is more to the equation. Yes, hope is found in this simple, but not easy, formula. And that is where the healing begins. With hope. If you’re reading this and feel overwhelmed please know that there is h o p e! I would like to write more but first, want to abide by the rules of this forum. If permitted and asked, I will gladly pen more.

  • WoodchuckR
    9 months ago

    Please forgive the run-on sentences and other typing haphazards that go along with getting thoughts to screen.

  • VickiN moderator
    10 months ago

    @leanned, I’m so sorry! Thank you for sharing your story. The first time I had a panic attack I also awoke in the middle of the night and thought that I was dying. Incredibly frightening for sure 🙁
    If anyone out there is interested, I found the material by Jon-Kabat Zinn to be very helpful (the first book I bought after my onset of panic attacks was “Calming your anxious mind.”)
    Hugs to all!
    -Victoria, Community Moderator

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