I have severe panic disorder that often manifests in my shutting down and having a pseudo-seizure which makes me appear catatonic. Even when I come out of it, I am mute (selective mutism).

I take medicine to reduce the severity and am seeing all the right doctors. I am taking care of myself and am getting excellent medical care.

Occasionally, I will have one of these episodes and people, understandably, are upset by it. My SO wants to be helpful but doesn't know what to do to help me when these happen (fortunately it's rare, but they still do happen).

How do I communicate that these episodes are just stress, that I do come out of them and that medical assistance isn't needed?

This is hard for me, as the mutism often strikes during these times and I cannot speak.

Any suggestions on how I can communicate prior and/or during an episode?

NOTE: I cannot always realize when these attacks are coming on. I even took my medicine before the last one, but it didn't take in time.

Edited to add: When I can move again, I can write, but the mutism persists for a while. I am cognizant and fully aware of what is going on, I just cannot move. First, I tend to regain movement in my thumb, then my hand, then it spreads.

  • Is written or nonverbal communication an option during the selective mutism stage of the episode?
    – apaul
    Dec 18, 2017 at 16:42
  • During the episodes, are you cogent? (For example, can you gesture, control facial expressions, etc?) Dec 18, 2017 at 17:09
  • 1
    "Shutting down and having a pseudo-seizure which makes me appear catatonic" is not my understanding of the word cogent.
    – paparazzo
    Dec 18, 2017 at 18:22
  • cognizant @Paparazzi but the point was taken regardless.
    – user4548
    Dec 18, 2017 at 18:46
  • Do you feel it coming or are you always 'too late' to signal anything?
    – user10085
    Dec 19, 2017 at 14:39

3 Answers 3


In a moment when you are not having these episodes, take whoever needs to know aside and explain to them what it is.

For example, with your SO, talk to them about it when you both have free time and you aren't having this issue.

Start by mentioning that you know they want to help and aren't sure how, then explain (if you haven't already) what this condition is. Then, or if you have already, set out a list of what exactly happens (to the best of your ability) and what, if anything, they can do to make sure this doesn't turn dangerous (like hitting your head on something, if that's possible).

Is there a chance that something happens and these attacks get worse at some point? If there is, explain what the signs you do need medical assistance are if you know them. If you don't know them or aren't sure if one of these could end with you needing a trip to the ER, consider asking your doctor.

Make sure that your tone is (relatively) relaxed while discussing this, so that you show that you know these aren't as big a deal as they may seem.

Also consider a discussion about stress itself. Someone, especially your SO, might have a few ideas to try to help remove some stress from you, or might be able to see when you're getting very stressed and try to take steps to help if possible.

Then, perhaps work out some signal you might be able to give at the start of one of these attacks, if you have just enough time to. For example, give a thumbs up or something similar to signal that you'll be fine through your episode.

If you can't make a signal like this at the very start of an episode, it may be impossible to communicate in any way during the episode. However, you can, after your discussion, just inform whomever is present and knows that an episode is about to start for the times when you do feel them coming on. This will at least give them some warning as to what is about to happen. You can also, as you have indicated you regain movement in your thumbs/hands first, give a thumbs up at the end of the episode to indicate you'll be just fine.


I think you'll need different strategies for communicating this to people who are close to you vs strangers or casual acquaintances.

For people who are close to you, such as your SO,

1) Tell them what you have explain (as you have here) that your getting help, and that while it looks scary it is not harmful.

2) Explain what happens so that they are prepared and not as surprised when it actually happens. Make sure to include how long they can expect you to not be able to move and how long until you will be able to talk.

3) Give them something they can do to help. For example, get help moving you out of other peoples way (or just keep other people from walking over you, which ever is best), sitting by you to keep you company, or putting a pillow under your head to make you comfortable. Anything really - if they feel like they are doing something helpful it should mitigate their fears.

Be specific and be prepared to answer questions. Even those who know you well will probably have some.

For people you don't know that well. This one is much tougher, They best think I can think of, is to wear a dog tag somewhere visible, that has large letters on one side saying,

"If I pass out"

and on the back side in smaller letters a really short version of how long the attack will last and what people can do to help. Something like,

"I'm ok , it usually lasts between x to y hours/minutes. Pleas make sure no one walks on me and I'll be awake soon."

If the mutism persist much for a long time after you regain full movement of your body you could simply write out a thank you on your phone or a notepad. Telling people "Thank you, I hope I didn't scare you, I'm fine now, I'll be able to talk in xHours. I can see myself home, to work, etc. . ."

  • 2
    With strangers, chances are someone will call an ambulance or medic anyway... Just to be on the safe side. No one wants to be the guy called out on the news for checking a passed out person and not calling for help if something really wrong happens... Otherwise, totally agree.
    – Kendra
    Dec 18, 2017 at 22:16
  • 1
    @Kendra: good point, but carrying a more descriptive written note (Dan's is rather vague).would help the emergency services when they arrive figure out what [not] to do. Dec 20, 2017 at 3:47
  • @Kendra ya having a note is of questionable efficacy. But when your passed out and don't know who will be around you it's about all you can do. Dec 23, 2017 at 16:47

While the other answers have some good points, I wanted to add one or two ideas. They aren't IPS really but it was too long to comment on an existing answer so i post one myself.

If your SO or someone else who you have already told about your illness is around when the seizures strike, you can instruct them to inform other bystanders that everything is ok and no further help is needed (no ambulance etc.)
This means that you have to fill in your SO beforehand, in a moment where you are alone and you aren't suffering an attack.

If noone you know is around, you could have a small sign prepared that says "I'm OK! No help needed.". You can keep this sign in an easily accessible location and put it beside you before incoming seizures. Of course this only works if you have some time to act before incoming attacks. This way, any bystander will know not to call unneeded help like an ambulance.

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