The Panic Experience
This experience has many names such as the panic attack
(or habit or disorder or reaction), anxiety attacks (or disorder or reaction), acute stress disorder, etc. Some people equate
it with agoraphobia or social phobia.
The term `panic attack' is used to describe a uncomfortable and upwardly spiraling
state of anxiety, fear, and intense mental and physical arousal coupled with an intense fear of the state itself.
If
you experience panics it is important to remember that it is a learned behavioural habit and not a ' personality disorder
' nor a reflection of some inherent character weakness. And because it is a learned behaviour it can be 'unlearned' and replaced.
This takes a little time and quite a bit of dedication - but it can be done.
How the panic habit begins
The 'panic' habit often begins with an unexpected and apparently unexplainable
surge in adrenaline - an 'anxiety rush'. Because we do not understand what is going on or why it is occurring we `panic'.
We loose confidence in our ability to manage the situation. And this causes more adrenaline to be released which causes even
more fear. And so the state becomes more and more intense.
After our first `panic' we become more aware of, and
apprehensive of, our body sensations and begin to carefully monitor ourselves for any feelings of excitement. This increased
attention soon produces the evidence that it dreads - sensations of arousal. Our fear of another `panic' is maintaining the
pattern.
The connection with agoraphobia or social phobiaThe panic habit is not the
same as agoraphobia or social phobia. However unless we deal with this ways of reacting to stressful situations it can develop
into agoraphobia or social phobia.
This tends to occur when we repeatedly experience panic in certain situations, particularly
when we are not at home, and then begin to fear these situations because we believe that they are responsible for our panics.
In
reality the anxiety reaction can be provoked by just about any situation that is a little unusual or challenging. Trying to
avoid such situations rather than deal with the thinking and feeling pattern the produces the panic misses the point.
More
significantly if you begin trying to avoid such situations you could end up fearing any unfamiliar situation - and then you
are into the agoraphobia or social phobia pattern. It is more useful to deal with the internal way in which the panic occurs
rather than the multitude of eternal stimuli that provoke the internal activity.
Why the panic habit beginsBecause panics commonly begin for no apparent reason
the question Why is this happening? is a common initial response to them. Understanding how and why they begin certainly helps
in dealing with them because we then have a rationale for their occurrence.
Panic - a delayed reactionPanics
commonly begin as a delayed response to how we have been living our lives in recent months or years - how we have been responding
to everyday stressors, adjusting to significant life changes, and dealing with our emotions.
The reactions can
occur during the period of stress but they often occur quite some time afterwards, just when we thought we had put it all
behind us.
This is can be extremely disquieting because there is no apparent connection between the reaction
and what is currently, or has recently been, occurring in our lives. So recognising that they are frequently a delayed reaction
explains the apparent lack of cause.
How long can this delay be? As long as a few months or as little as a few days.
For example, when assisting someone in resolving the panic habit I generally ask them about life events in the six to twelve
months prior to the onset of the reactions.
A delayed reaction to...The follow are three of the more common categories
of contributory causes
1. Everyday stressorsHow we deal with life's challenges and hassles affects our feelings towards life, towards
other people and towards ourselves. If we have not been handling things effectively this can cause a lowering of confidence
and self esteem and a buildup of underlying mental and physical tension
2. Life ChangesMajor changes in our living patterns require us to re-adjust to new situations. The more common
changes include moving house, financial pressure, serious illness or operation, setbacks or alterations in working life, relationships
ending or beginning, problems in a relationship, bereavement, accident, etc.
This readjustment calls for considerable
mental and behavioural flexibility, rather than a conservative attitude that wants things to remain as they were. Such flexibility
is common in children and teenagers but frequently diminishes as we progress into adulthood.
Lacking this flexibility
we may find these life changes extremely stressful - even if the symptoms do not immediately appear. Often, in the midst of
the crisis or upheaval, we can appear to be managing effectively, because we have things to do. This doesn't just fool others
it also fools ourselves and afterwards, when things settle down again, we experience our delayed response.
Panics - Dealing with themTo effectively replace the panic habit with more normal
ways of thinking, feeling, and reacting takes a little time. And a little determination.
Even more importantly it takes
a decision - that you will do it. Whatever it takes.
There's no quick fixIt also requires you to recognise that there is no simple 3-step solution. And that, even
with really effective counselling, you are the one who will have to face the issues, work your way through the adrenaline
rushes, and continuously experiment to discover what works best for you.
No one can hold your hand - you are in there alone.
No amount of understanding, or support groups, or sympathy will absolve you from the tough work of finding your own solution.
Sounds a bit depressing?It could be. But it is the reality that, I believe, you must face before you can focus
yourself and go ahead and beat the habit.
Now the good newsThe good side to all of this is that it is immensely empowering. When you do beat it - and you
can - nothing will ever really scare you again. You have been there. You have stopped and faced your fears. You have figured
out your own solution (with or without professional help) and you have beaten it.
Your confidence and self esteem will
soar. And, because you will have done it yourself, you will know that should the pattern recur in the future you can handle
it.
So where's the catchThe only 'catch' is that you do have to work at it. Perhaps for a few weeks and more likely
for a few months. Even if you have professional help it still takes time.
But it's worth it.
Three stagesThere are two stages in eradicating the habit.
1. Immediate steps to reduce the intensity of the panic experience and to restore your confidence in your ability to be in
charge of you
2. Learn the lessons from having had the experience. What does it indicate about how you have been living your life? What
do you need to change.
3. Your on-going stress-reduction programme where you recognise the way in which everyday stress is contributing to the habit
Phases
2 and 3 are the long-term ones. (They will later be dealt with in these pages).
Your immediate priority is Phase
1 - learning to manage the experience and to rebuild your confidence and your self esteem
Panic AttacksThe first panic attack can be terrifying. It appears to come out
of the blue and we don't know what it is or why it is occurring. Understanding what is going on demystifies the panic habit
and provides a route to managing it.
Why panics occurThey start… usually as a delayed response to a period
of intense or prolonged stress: to how we have been handling everyday stressors, adjusting to significant life changes, and
dealing with our emotions. They often begin some months after the stressful period, just when we thought we had put it all
behind us.
Imagine a glass of water - half full - that's a typical person's stress-level. As long as it doesn't
overflow we feel we are coping - even if, in reality, the level is a bit too high. But when things happen too fast, one after
another, our coping ability gets a bit frayed and the 'glass' overflows. That's the panic experience.
They are
maintained… by our fear of them. Even when the cause of the glass 'overflowing' has passed our fear of another panic
prevents the level dropping - we're into the panic habit! The level of water is right up to the rim and is maintained there
by our fear of having a panic attack.
What to do about themRemain very clear about what is going on. Remind yourself
frequently that (1) they are a delayed response to a stressful period, (2) that fearing the next attack makes it more likely
to occur and (3) there's nothing wrong with you - panics are very common and can be eliminated by practical self-help methods.
Look
after your adrenal glands. Panics are largely a fear of the effects of excessive adrenaline!
Get some 'wins'
to boost your confidence in your ability to eliminate them. Panics are very undermining of self confidence so each little
success will boost your flagging self confidence.
Action Plan: 1. Eliminate caffeine. Each coffee, cola, or tea drink causes a release of adrenaline and adds to the anxiety and jittery
feelings. (Reduce caffeine very gradually over a period of about two weeks. Eliminating this powerful drug too quickly will
produce uncomfortable withdrawal symptoms.)
2. Reduce sugar-rich foods. They indirectly re-activate your adrenals. For the same reason eat small amounts of food frequently
and ensure you do not get hungry.
3. Sip water or eat small amounts of fruit to keep your mouth moist - a dry mouth sends a 'fear' signal to the brain.
4. Use relaxing breathing methods hourly. Panic is usually accompanied by mild to severe hyperventilation. The breathing
methods will help reduce this and will calm you.
5. Regain the ability to relax deeply. At first this will be a little difficult since you are likely to be like a coiled
spring so aim for three or four sessions of 3-5 minutes each. Get this up to about 10 minutes after a few weeks. (A good relaxation
tape will be helpful but listen to some of it before you buy as many of them sound dreadful.)
6. Sort out your thoughts. Use pen and paper to get your thoughts on paper at least once a day. Just get a few sheets of
paper and start writing. Keep the pen moving. Write everything down as it pops into your mind. When finished destroy the notes.
(This technique is fully explained here).
7. Keep physically active. Exercise such as swimming or brisk walking helps get rid of accumulated stress hormones and physical
tension.
8. Monitor your self-talk to avoid too much negativity. Some negative thinking is understandable - it's an uncomfortable
period you are going though. (More on self-talk)
9. Replace negative self talk with affirmations such as "little by little I am learning to manage these episodes and to get
myself back to normal".
