8 Things To Understand About Panic Attacks & How To Deal With Them

 

I remember my first panic attack in more detail than I remember losing my virginity or the first time I drove a car by myself. (I guess vivid terror of suddenly not being able to breathe really ingrains itself into your psyche.) It was 1998 and I was watching the “Psycho” remake with my family’s French exchange student. During the infamous shower scene, my throat and lungs tightened inside me like a figure eight knot.  I got up and paced around the movie theater, unable to control my body and wondering if I was having a heart attack. I’ve had panic attacks periodically since then, probably due to a combination of biology and circumstance. I’ve made an effort to lessen the conditions that they occur in and for the most part, I live a pretty calm life. My anxiety only spikes in extreme circumstances, such as the rare times I’ve gotten temporarily stuck in a subway underground (I’m claustrophobic).

After a couple of years without anxiety attacks in my everyday life, I’ve started having them again. The stress is related to old stuff resurfacing in my life and the anxiety is pretty much the same, too: my chest tightens, my heart beats too fast, I can’t breathe, and I feel like I’m having a heart attack. (Or, you know, what I assume a heart attack feels like.) I’m 30 now. Panic attacks are still shitty and frustrating, but all the experience I’ve had coaxing myself through them over the years actually does makes them less intense and quicker to get over.

These are my thoughts on what panic attacks are like, how to deal with them, and what I hope other people could understand if they’re trying to help:

1. Panic attacks are really fucking scary. If a person is panic attack virgin, his or her mind naturally goes to an Oh my God I’m dying I need to get the ER!!! place.  That’s … a bad place. Yet, it’s a deeply-ingrained reaction to feeling physically out of control. (Google “flight or fight response.”) All you’re feeling while you’re having one is that you would give anything to feel normal again — panic attacks are so scary that I used to have panic attacks because I was worried about having panic attacks!

The reality is that after the person calms down and starts breathing normally again, he or see will feel better soon. “Better,” of course, is relative, but what I mean is that when she calms down, she’ll be able to see that she’s not immediately at risk. In the moment, though, her focus is on her inability to breathe, tense muscles, dizziness, trembling and her wildly-beating heart. She feels like she could be dying and is rightfully terrified.

So, if someone you know is having an anxiety attack, be sensitive. It’s an enormously scary thing to go through. Make them feel safe and keep calm yourself.

2. Anxiety isn’t necessarily rational, so explaining why not to panic isn’t helpful. Conquering an anxiety attack is a matter of “mind over body,” but that doesn’t mean the panic is just going to shut itself off when the person hyperventilating into a paper bag hears a really good argument. People mean well. I get it. But something that always frustrates me is when my family or friends try to rationalize why I shouldn’t be having an anxiety attack. Like, I’m in therapy, I’m an self-reflective person, I know I shouldn’t be hyperventilating over XYZ problem. Alas, my anxiety doesn’t respond to logic — it responds to feelings. So, in the throes of a panic attack, try not to address their problems. Instead, focus on making this person feel safe and staying calm. (By all means, address their problems later, though.)  

3. A panic attack might be tipped off to something specific, but it usually has been built up over time. Here are a few things that have caused me to have panic attacks:

- a combinatronics test

-an email from my mother

- the death scene in documentary about John Lennon

Were those really the stressors that made me have an anxiety attack? No, of course not. They were just what triggered a well of worry and anxiety to rise up and spill over. This is part of the reason why I say that anxiety isn’t rational; coaxing a person to respond to the immediate trigger is sort of useless. Stress is much wider and deeper than it seems on the visible surface.

4.  Medication generally works for me, but dealing with anxiety has a lot more to do with practicing self-care. I have a prescription for Lexapro and also Xanax. So, yes, I am an advocate  of addressing generalized anxiety disorder (GAD) and depression through proper medication. That being said, there are no quick fixes. I believe what has really helped me the best — the real reason that I went several years without large panic attacks — was because I made well-rounded self-care my #1 priority. What does that mean? I get eight to 10 hours of sleep every night. I don’t over-commit myself to plans or responsibilities. I use the word “no.” I try to eat healthy-ish. I go to the gym a couple times a week. I don’t take hard drugs and I barely drink. And I stay as far away from stress-producing assholes and energy vampires as possible. (I’m personally not a fan of the “just meditate!” or “just do yoga!” schools of anxiety remediation, but lots of people say that works for them.)

5. Avoiding anxiety triggers is also important. The phrase “trigger warning” gets used a lot in feminist activism and academia (lately, often times in a denigrating way). Personally, I don’t go around telling other people what they shouldn’t expose me to and instead worry about what I expose me to. I know I’m not awesome in tiny, compact spaces, such as airplanes. I get really anxious when people are murdered in movies. A few years ago, I stumbled across a man domestically abusing a woman on my street and, quite understandably, I had a panic attack. So, when I can control it, I try not to expose myself to stressful triggers. (Conversely, if I start to feel panicky, I’ll do things that have proven to make myself calmer, like going outside for fresh air or giving my husband a call.)

6.  Panic attacks are embarrassing.  Everyone experiences stress. But anxiety attacks really are a physical manifestation of how you’re feeling inside and, to be frank, that can feel like you’re weak and whiny. Most people don’t want to think that way about themselves. And it’s really hard for some people to admit weakness, especially if they put up a front of toughness. It took me years — like almost a decade — to get past my denial and embarrassment over feeling depressed and anxious. I prided myself on being successful and put-together; I didn’t want my peers to think I was weak or “crazy.” I thought if I hid how I felt, eventually it would change on its own. Well … if anything was crazy, it was that idea.

7.  A lot of times anxiety goes hand-in-hand with depression.  A lot of people, especially women, experience anxiety and depression together. Just like I take care of my anxiety, I have to take care of my depression, too. Again, it’s not really a big deal in my life because I generally take care of it well.  I try to make smart choices for my life while keeping everything in mind — for example, I don’t drink much, because alcohol is a depressant.

8. Some medical professionals really fucking suck at helping with anxiety. I once saw an (old, white, male) GP who advised me to cope with my anxiety attacks by keeping a paper bag in my purse and breathing into it. The doctor meant well. But his “advice”? It was crap. He made me feel like I had been overreacting and just being silly. This was during one of my worst bouts of panic attacks  during college, which eventually lead me to getting prescribed Lexapro and seeing my therapist again.  I wish I had gotten a second opinion, because I suffered for something like seven or eight months absolutely vicious panic attacks until I actually got help. All that time was wasted just because I didn’t have someone who knew what he was talking about.  So try to be as patient as you can. You deserve good help. When you’ve gotten it, your anxiety will become manageable and your life become enjoyable again. Not to co-opt It Gets Better but … it does get better.

http://www.thefrisky.com/2014-06-25/8-things-to-understand-about-panic-attacks-how-to-deal-with-them/

Panic Disorder Symptoms

People with panic disorder have feelings of terror that strike suddenly and repeatedly, most often with no warning. They usually can’t predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. In between times there is a persistent, lingering worry that another attack could come any minute.

When a panic attack strikes, most likely your heart pounds and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control. You may genuinely believe you’re having a heart attack or stroke, losing your mind, or on the verge of death. Attacks can occur any time, even during nondream sleep. In the United States, this type of panic attack has been estimated to occur at least one time in roughly one-quarter to one-third of individuals with panic disorder, of whom the majority also have daytime panic attacks. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more.

Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men. It can appear at any age–in children or in the elderly–but most often it begins in young adults. Not everyone who experiences panic attacks will develop panic disorder– for example, many people have one attack but never have another. For those who do have panic disorder, though, it’s important to seek treatment. Untreated, the disorder can become very disabling.

In the United States and Europe, approximately one-half of individuals with panic disorder have expected panic attacks as well as unexpected panic attacks. Thus, as a recent change made to the criteria in the 2013 DSM-5, presence of expected panic attacks no longer prevents the diagnosis of panic disorder. This change acknowledges that oftentimes a panic attack arises out of an already-anxious state (e.g., the person is worried about having a panic attack in a store and low-and-behold has one). Clinicians now make the decision whether a person’s expected panic attacks will count towards their client’s panic disorder diagnosis. Now, they will usually classify expected panic attacks under panic disorder as long as the person’s concerns accompanying their panic attacks are centered around fears of the panic sensations themselves, their consequences (e.g., “I could have died or gone crazy”), and of having them again in the future (e.g., the person makes special efforts to avoid returning to the place where that attack occurred).

Panic disorder is often accompanied by other conditions such as depression or alcohol/drug use to cope with or prevent symptoms, and may spawn phobias, which can develop in places or situations where panic attacks have occurred. For example, if a panic attack strikes while you’re riding an elevator, you may develop a fear of elevators and perhaps start avoiding them.

Some people’s lives become greatly restricted — they avoid normal, everyday activities such as grocery shopping, driving, or in some cases even leaving the house. Or, they may be able to confront a feared situation only if accompanied by a spouse or other trusted person. Basically, they avoid any situation they fear would make them feel helpless if a panic attack occurs. When people’s lives become so restricted by the disorder, as happens in about one-third of all people with panic disorder, the condition is called agoraphobia. A tendency toward panic disorder and agoraphobia runs in families. Nevertheless, early treatment of panic disorder can often stop the progression to agoraphobia.

Specific Symptoms of Panic Disorder:

A person with panic disorder experiences recurrent either expected or unexpected Panic Attacks and at least one of the attacks has been followed by 1 month (or more) of one or more of the following:

• Persistent concern about about the implications of the attack, such as its consequences (e.g., losing control, having a heart attack, “going crazy”) or fears of having additional attacks
• A significant change in behavior related to the attacks (e.g., avoid exercise or unfamiliar situations)

The Panic Attacks may not be due to the direct physiological effects of use or abuse of a substance (alcohol, drugs, medications) or a general medical condition (e.g., hyperthyroidism).

Though panic attacks can occur in other mental disorders (most often anxiety-related disorders), the panic attacks in Panic Disorder itself cannot occur exclusive to symptoms in another disorder. In other words, attacks in Panic Disorder cannot be better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations),Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination),Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).

Panic disorder is associated with high levels of social, occupational, and physical disability; considerable economic costs; and the highest number of medical visits among the anxiety disorders, although the effects are strongest with the presence of agoraphobia. Though Agoraphobia may also be present, it isn’t required in order to diagnose panic disorder.

http://psychcentral.com/disorders/panic-disorder-symptoms/

HOW TO STOP A PANIC ATTACK

Posed by model

1) Recognise your feelings of panic early on — by becoming more aware of your feelings of anxiety, you can take action before you have a full-blown panic attack.

Enquire into your feelings by asking: ‘What are my feelings telling me about what I might be needing right now?’ Then take action to give yourself what you are needing. This could be to go for a walk, relax, or doing the 7/11 breathing technique described below.

2) Think positive thoughts — when negative thoughts like ‘I’m losing control’, ‘I’m going to die’, ‘I can’t cope with these feelings’ come up during a panic attack, focus on a positive reassuring thought instead.

For instance: ‘I will be OK’, ‘these feelings will pass’, ‘I can cope with these feelings’. Whilst negative thoughts will tend to escalate your feelings of panic, thinking positive thoughts will help you to reduce your feelings of panic.

3) Take action to restore calm — focus your attention on  your breathing using the 7/11 breathing technique. It will help you overcome the physical symptoms of hyperventilation, including choking, shallow and difficult breathing.

It is a good idea to practice the 7/11 breathing technique a few times so that you are familiar with it and feel comfortable using it when you have a panic attack. This technique slows down your breathing and encourages you to take longer, deeper breaths into your belly. It works on the sympathetic nervous system as you inhale and on the parasympathetic nervous system as you exhale, relaxing your mind and body.

The 7/11 breathing technique

Practice this technique whilst sat and with your feet firmly placed on the ground and place your hands lightly on your belly.

Close your eyes or look down at a focused point on the ground.

Breathe in through your nose for two counts, then breathe out through your nose for two counts. Repeat this a few times.

Lengthen and deepen your breath then by breathing into your belly for five counts, then exhaling for nine counts. Repeat this for a few minutes.

Breathe in through your nose for seven counts, then exhale for 11 counts. Repeat this until you feel calm.

4) Accept your feelings and the physical symptoms of panic — you might want to avoid your feelings of panic. However, this only serves to keep you stuck in the vicious cycle of feeling afraid of these feelings.

By accepting that it is natural and OK for you to feel feelings of panic, you can begin to lessen your fear and the accompanying physical symptoms. The more comfortable you are being in contact with these feelings, the less they will affect you when you feel them.

http://www.eveningecho.ie/2014/05/28/stop-panic-attack/

Dealing with Panic Attacks & Anxiety | Zoella