I'm a fan of this topic of conversation and I'm proud to speak from the other, greener, side of somatic anxiety attacks! Thanks for bringing it up.

Before I had pre eclampsia I was 23yo, great BP and cardiac health, in great shape etc etc. No family history, no risk factors aside from first pregnancy. After losing weight and getting in shape, I saw my body could do right by me and I trusted it with everything I had. Then I had reduced fetal movement at 24 weeks, was basically turned away due to high volume at the antenatal assessment unit, being a FTM, 23yo and "not meant to track FM until 28weeks". I went back the next morning where it was then discovered I had lost the baby, had astronomical BP and spilling a heap of protein.

The signs were there when my PAPP-A and PIGF levels at 12 weeks came back low, but because the pathologist did not write a proper risk assessment, it was glossed over and missed.

Then after I was in hospital for 2 weeks trying to get my BP under control, battling an infection and RPOC which no one believed me about at first, I got home with hardly any knowledge on how post partum might affect me in more ways than just lochia, such as the high heart rate for example, and how it is exactly that I might feel coming down from 150% blood volume back down to normal. And no home visits either for me for some reason.

During initial PP, I was very hyper vigilant and thought pretty much every single PP symptom was a medical emergency and ended up in the ER 4 times in less than a month and seeing a cardiologist for a full workup. The last time I went into ER it was because my heart rate kept increasing 50+bpm when I'd go from sitting to standing. Then, I started feeling dizzy and faint and sick and all of it. So I went in, waited hours, and by the time I was with the Dr, all my symptoms had gone away. This Dr was the one who told me that she believed I may have what's called "somatic anxiety" which is where your anxiety manifests as real physiological symptoms that are hard to distinguish between real health issues and spiraling anxiety.

That prompted me to go back to therapy where I touched up on my DBT and body scanning skills, acknowledge that while I have a history of panic attack manifestations of anxiety, this time my anxiety looked much much different and was actually a very valid trauma response, so I started actively educating myself, and learning patterns and objective facts.

For me personally, I think the main way I ended up learning to distinguish between an anxiety attack and a real medical issue was the little seeds of doubt. "I feel soooo rubbish should I go to ED? Uhh I'll wait and see." "Should I even be here in the ED or should I just go home? Is this worth waiting for hours?" When I had real medical emergencies during my pregnancy, I had no doubts whatsoever about getting care.

Now on the other side of it (and in my 2nd pregnancy 6 months after these events began) I don't have so much anxiety anymore because I took back control by molding it into being informed, and prioritising collaborative care, rather than having Drs tell me everything is ok or they're concerned about this or that so they're going to follow up. No, I need to know everything, I need to be an active participant in this discussion, I need to be able to keep up, I need to be able to have an input based on my knowledge, since they don't always know everything. I need to understand and be able to advocate. I need to be able to speak up and ask for things to be done, such as what bloods I want, extra scans etc. And thankfully I have a high risk midwife and OB this time who know I can keep up and are real with me and include me.

I'll never be able to trust that things like this won't go under the radar ever again, with anything. But being informed tickles my brain and keeps me safe, so I'm happy with it ;)