Coping with panic attacks - What to do to help yourself or a loved one calm down

Your heart is pounding, your vision is blurring and your breathing is rapid... You feel like you are dying...

If you've ever had a panic attack, you know how terrifying they can be. If you have never had the experience, consider yourself lucky.

Panic attacks typically are self-limiting and short in duration. The usually develop and peak suddenly, their intensity reaching the highest level within ten minutes and then abating. Someone experiencing a panic attack may feel their heart bouncing around in their chest (palpitations); may feel sweaty or shaky; might feel like they are choking or can't breathe; and may feel disoriented or dizzy as well as an intense amount of fear¹.

Today a friend of mine had a panic attack unexpectedly (as they usually are "out-of-the-blue") and I happened to catch it and help them calm down. I want to offer some tips to those of you who experience panic attacks or have loved ones who do.

Generally the first thing you want to do is control your breathing, as calming your physical self down will help to short-circuit any of the "fight-or-flight" responses occurring in your body. If you are having a panic attack (or your friend or family member is), get into a comfortable position and relax the body and focus on proper breathing. I quickly knelt by my friend and got them to a chair. I told them to focus on their breathing and breathe in through their nose and out their mouth using only their belly. I kept eye contact with them and held their hand and breathed with them.  It is hard to think during a panic attack so if you can be the guide for breathing, it is much easier for the other person to follow; also, if you are helping someone else, it is important to keep calm yourself.

If you are alone when panicking, it may help you to call a friend/family member to help you breathe or talk through what you are feeling while focusing on breathing (but be safe! If you are panicking while driving, pull over and make the call or use a hands-free device). If you can't call anyone find a comfortable spot and begin your breathing exercise. Distraction works well in this case - video games, movie, music, writing. Anything to get your mind off the feeling of fear or the physical symptoms you're experiencing. If you continue to breathe correctly your anxiety should subside. If it doesn't, there are help-lines to call and the operators will be able to assist you.

Once you've regained control of your breathing and are in a safe place to relax, you can work on progressive muscle relaxation (PMR) exercises (especially if you are prone to panicking before bedtime). This will bring the anxiety level down even farther. The slow and controlled breathing is an important first step and might help you come completely out of an attack or might just bring you back to a manageable level of anxiety; but the PMR exercises can really help you get centered again, especially after a panic attack. It all depends on your base-line anxiety levels.

If you are noticing that you are having many anxiety attacks in a short period of time or that they are getting worse or your work/school/relationships are suffering you should speak with your doctor. There are many helpful therapy programs (CBT especially) as well as medications that can help you manage your anxiety. It is not a weakness to reach out for help when you need it.


List of crisis lines*:

https://www.lifeline.org.au/  (Australia)
http://suicideprevention.ca/thinking-about-suicide/find-a-crisis-centre/ (Canada)
National Suicide Prevention Lifeline toll-free at 800-273-8255. (USA)

*if your country is not listed, a quick Google search should help you find one in your area.




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Other topics you may be interested in:

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Staying motivated when depressed. 5 ways to fight the sludge of depression/anxiety!

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¹  Kessler RC, Chiu WT, Jin R, Ruscio AM, Shear K, Walters EE: The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication.
Arch Gen Psychiatry 2006, 63:415-424. PubMed Abstract | Publisher Full Text | PubMed Central Full Text 

Driving Anxiety: How to cope when you're going over 100km/h!

We all know driving is dangerous, but we casually get into our cars and drive everyday without thinking more than once about safety - putting on our seatbelts, checking mirrors, and we're off to work, or school, etc.

Until you feel that sense of uneasiness welling up from your stomach, or the fog and pressure building in your head.... Maybe you feel too hot, or cold.... Maybe your vision starts blurring and you start sensing the worst.... And then you end up in a full-blown panic attack, speeding down the highway in a giant metal weapon.

Having panic attacks is extremely rough and having them while in control of a vehicle is monumentally worse.

I have some tips for those of you conquering this issue in your life right now:

1) Deep-breathing techniques

If you perform some deep-breathing you might find that your physiological response tones down enough that you can actually reduce the panic feeling and retreat from the edge of the full-blown panic attack.
If not, at least you will be able to calm yourself sufficiently to pull over.

2) Distracting yourself:
-by adding numbers on license plates you see
-really focusing on what other people in their cars are doing
-talking to yourself, or using a hands-free device to call your friends or parents (or if you are secretive about your panic, your local crisis line). Sometimes just talking with someone, about anything or your particular situation, is extremely helpful for distracting you from the physical or mental stimulation that was pushing your anxiety.

3) Have some snacks and water on hand. Eating a few bites of apple or some popcorn or veggies might help you to refocus yourself, while giving you a bit of nutrition.

4) Track your panic - see if you can find a root cause or causes. If it happens around the same time of day or on the same stretch of road, try to prepare yourself by knowing that it will likely be rough but because you have made it through before, you will again, and again. Gradually, through exposure, and pure Conqueror-spirit, you will be able to drive through those tough spots.

5) Are there other things in your life that you are ignoring or repressing? Relationship or school/work issues? These may be making themselves known in the form of panic attacks in stressful (ie: driving) situations. If you haven't already, talk to a close friend or relative about what's going on for you. If that doesn't help, or doesn't help sufficiently enough to reduce your anxiety, see your doctor or a local counselor.

6) Finally, if these practical approach tips aren't working for you, speak with a local counselor or your doctor about other ways you can manage your anxiety while driving. It may be helpful for you to try some herbal or pharmaceutical anti-anxiety medications.

While you are working out what methods will work the best for you, you can always take the bus on days when it just absolutely won't work for you to drive. Try to find a carpool for your work or school; this will allow you to be more productive on the way to and from work, as well.

Note: I do not advocate avoiding anxiety-triggers, as that will only compound the problem; however, I do advocate remaining safe while figuring out what is best for yourself in these hard times.
If it is for you to carpool or bus while you practice driving at night or on the weekends, then do so.

Be safe, stay calm and Conquer on!



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Breathing

Most people never pay any attention to their breathing. It just happens.

"I’m still alive so there I go..."

But breathing is so much more important that many people realize, and breathing properly is something that has to be re-learned as adults a lot of times because we pick up bad breathing habits like shallow, chest-breathing instead of deep, belly-breathing.

I know this sounds bizarre, but trust me. Breathing is very important in order to attain and maintain a relaxed state.

It is especially effective when combined with progressive muscle relaxation.

In order to breathe “properly”, choose a quiet spot – preferably one where you can lie down. If you cannot lie down, sit comfortably in a chair of your choice.

Place one hand on your belly near your navel, and one on your chest near your sternum.

Close your eyes and inhale through your nose by expanding your belly, ensuring your chest doesn’t also rise – you can tell by whether your chest-hand moves up at all.

Exhale slowly out of your mouth, letting the air find its way out – do not force it out, just let your belly fall.

Concentrate on keeping your breaths even and slow – focus on the air moving through your nose and into your lungs, feel it energizing and calming your body, and feel the stress or anger flowing out with it as you exhale.

Practicing deep-breathing is important for calming yourselves during anxiety and panic, as well as re-energizing and relaxing after a long day. It is also helpful for centering oneself when spiraling into depression. It may not lift your mood but you will at least feel more centered after a breathing exercise.

I have underscored the importance of proper breathing a few times already without ever really explaining the mechanism behind why this is such a powerful tool to be using to reset ourselves during anxious periods. Please read the information in this article for more details about the systems behind why breathing helps calm us down during times of stress and anxiety.

Conquer on!

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Anxiety - What's It All About Anyways?

Many have felt the dark cloud of anxiety and depression in their lives. Usually they manifest during times of life change and stressful events. For anxiety, you may experience sweaty palms, a pounding heart, light-headed or feel even worse.  For depression you may feel low, down, heavy or just not-like-yourself. These are natural stress-reactions but if these symptoms of anxiety and depression seem overwhelming or are preventing you from doing what you’d like to be doing, or living your life the way you’d like to be living it, you might have an anxiety disorder or depression.

Today I am going to discuss anxiety. Depression and anxiety are often co-morbid disorders. This means that they usually present together, or as one after the other. I will explain in another article how depression is linked with anxiety, but for today, we will consider anxiety and panic attacks.

            Anxiety is a natural reaction of the body to perceived threats. Our minds and bodies are hardwired to understand the immediacy of escaping or fighting to protect ourselves... Unfortunately, in this day and age, we are no longer facing live-or-die type situations on a regular basis. Our hardwired anxiety machinery has nothing to fret about! So, we fret about traffic. We worry about money. We are scared of seemingly harmless things. This is because of our “fight-or-flight” system.

           

When a threat is perceived by a part of the brain known as the amygdala (the oldest portion of the brain) the sympathetic nervous system sparks into action, triggering cascades of hormones coursing throughout your brain and body. The adrenal glands (special glands atop the kidneys) release adrenaline. We’re all familiar with this hormone – the rush of excitement and fear when on a rollercoaster is due to adrenaline’s release into our bloodstream.

That same fear and buzz we get on the rollercoaster is what plagues most anxiety sufferers. Generally, it comes out of the blue. Suddenly the room begins to spin and you feel your heart pounding! Are you having a heart attack? Are you going crazy? No! this is an anxiety attack in the making!

Anyone who has ever experienced one of these will know that it’s a rough ride. You might even end up in emergency thinking you really are dying or going crazy! Don’t worry though no one has ever died from panic. It’s almost impossible.

            Now, after the panic attack is over, the frightening physical symptoms you’ve experienced will influence you to have thoughts about what just happened. These tend to be negative and future-based thoughts. You will definitely start thinking about how you’ll want to avoid another panic attack in the future! These thoughts can become more and more detailed and will ingrain themselves on your mind. You see, in the wild when we were foraging and fighting for our survival daily against large predators, we had to remember the situations in which we felt these fearful things – so that we could prevent it in the future to continue living.

            So our ancient little amygdala is only doing its job. Unfortunately for us, its software is a few thousand years outdated. 

            So we get ourselves worked up and negative thoughts begin to muddle and cloud our brains. This leads to us changing our behaviours in order to avoid these feelings and thoughts. However, this is not a practical solution for the long-term because it actually makes the anxiety worse! By trying to avoid the situations in which you’ve experienced anxiety you are feeding the anxiety. Your next panic attack may be worse, and will likely be in a place you’ve never experienced one – by the fact that you have been avoiding those previous places associated with panic.

The best way to deal with a panic attack is to: wait. That’s all. Breathe deeply through your nose and exhale through your mouth and wait. Panic attacks are short-lived – it’s the nature of the system. They may last up to thirty minutes but their intensity usually doesn’t exceed an hour or so. You may feel residually shaky for another few hours, but the brunt of the storm is usually over after 30 or so minutes.

Take a deep breath. Feel better?

Conquer on!