Seo In-young hid her panic disorder, too: telling heart-racing, breathlessness apart from workout symptoms [Their Health Aesthetics]

Singer Seo In-young has revealed that she hid the fact that she had panic disorder while undergoing intense military training for a past reality show. Panic attacks come with strong physical symptoms — a racing heart, shortness of breath and dizziness — that can be mistaken for the effects of intense exercise or other medical conditions. If someone actually collapses during exercise, this should not automatically be attributed to panic disorder without first ruling out other physical causes.

On her YouTube channel Gaegwacheonseon Seo In-young ("Turning Over a New Leaf"), Seo recently recalled appearing on a naval petty officer special for the reality show Jinjja Sanai ("Real Men"). The program put celebrities through military training.

Seo, who collapsed after completing a morning run and was taken to the medical unit at the time, said, "I really collapsed. I'm only talking about it now, but I really did collapse and was carried out on a stretcher. They gave me an emergency IV with fluids and sugar, and I suddenly came around a bit."

"That's when I first told the production staff that I have panic disorder," she added, revealing the circumstances only now. "I hadn't said anything before because I was afraid they wouldn't let me take part if they knew."

A panic attack is a sudden surge of intense fear or discomfort that can strike even without any clear danger present. According to the US National Institute of Mental Health (NIMH), symptoms can include a racing or pounding heart, sweating, trembling, difficulty breathing, chest pain, nausea, dizziness and tingling in the hands or feet. It can also come with an overwhelming fear of dying or losing control.

Most panic attacks intensify rapidly, peaking within minutes to dozens of minutes. Because the symptoms themselves are so severe, people experiencing one for the first time often mistake it for a heart or respiratory condition.

These symptoms overlap with the physical changes that occur during exercise. Running or intense training naturally speeds up the heart rate and breathing, and sweating and a rise in body temperature are normal responses. For someone with panic disorder, however, these very sensations can trigger memories of past panic attacks and heighten anxiety.

In fact, cognitive behavioral therapy, or CBT, a treatment used for panic disorder, sometimes includes interoceptive exposure — deliberately inducing physical sensations such as a racing heart or dizziness so patients learn that the feeling itself is not dangerous.

However, this does not mean intense exercise will necessarily trigger a panic attack. Regular exercise can, in fact, help reduce stress and tension. What matters is starting at an intensity suited to one's condition and understanding one's own symptom patterns before working out.

Seo said she actually lost consciousness after finishing the run. However, the information disclosed so far is not enough to attribute her fainting to panic disorder.

Dizziness or a feeling of being about to collapse can occur during a panic attack. But actual fainting during exercise can stem from a range of causes — dehydration, blood pressure changes, low blood sugar or heart problems — and needs to be evaluated separately.

Losing consciousness during exercise, in particular, calls for more careful evaluation. Britain's National Health Service advises that fainting during exercise, fainting accompanied by chest pain or heart palpitations, or a failure to quickly regain consciousness all warrant emergency assessment.

That is also why heart palpitations, breathlessness and dizziness should not automatically be assumed to be a panic attack. The NIMH likewise notes that diagnosing panic disorder involves ruling out other physical conditions that can cause similar symptoms.

Running for a long time in hot conditions, or exercising intensely without eating properly beforehand, can also bring on dehydration and energy depletion. That is why even someone previously diagnosed with panic disorder should not dismiss unusual chest pain, fainting or severe breathlessness during exercise simply as "the panic disorder acting up again."

Having panic disorder does not mean one must avoid all daily activities or exercise. With appropriate treatment, most people can manage their symptoms and continue with everyday life.

The main treatments are cognitive behavioral therapy and medication. The NIMH describes CBT as a well-studied treatment for panic disorder. It can involve changing how a patient responds to the thoughts and physical sensations that arise during panic, and gradually exposing them to situations they had been avoiding.

Medications can include antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Benzodiazepines can quickly ease symptoms but carry risks of tolerance and dependence, so doctors generally prescribe them only for short-term use.

Knowing one's own condition also matters when exercising. Before undertaking activities that are hard to pause midway, such as long-distance running or extreme-environment training, it helps to discuss current symptoms, treatment status and medications with a doctor. For programs that require preparation for emergencies, informing medical staff or safety personnel about one's medical history can also help ensure safety.

Avoiding exercise entirely out of fear of a panic attack whenever the heart rate rises even slightly can gradually shrink one's range of activity. On the other hand, ignoring symptoms and pushing through excessively high intensity is not advisable either. It is best to raise intensity gradually, in line with one's fitness and condition.

Seo's confession stands out less for the fact that she has panic disorder than for her admission that she stayed silent for fear of being excluded. Panic disorder is not a weakness to hide but a condition that can be treated and managed. Especially in environments expected to demand extreme physical exertion, it is more important to accurately understand one's own condition and find a way to participate safely than to conceal symptoms and simply push through.