Panic is the kind of word that strikes fear in most of us.  Unless you have had an actual panic attack there is no way to describe the storm that is unleased during panic. 

Believing and Believing In

This blog posting is dedicated to a client who stuck with me as her counsellor even though at that time I had no idea what a panic attack looked or felt like.  I did not get it until one day she had a panic attack in my office.  My immediate response was to call 911 because as a witness I was 100% certain that she was having a heart attack.  That was one of my most humbling experiences as a counsellor.   I knew then that I needed to learn more, respect more and honour the clients who stuck with me as a counsellor even though I knew only the tiniest bit of what they were experiencing.  This client also taught me that she was not overreacting and that my job was to both  believe her and believe in her

I have included a video at the end of this blog about panic.  That You Tube video only begins to touch the surface of the experience of living with panic.  Watch it only if you can handle seeing someone in distress.

The Brain on Panic:

Think of a flood, a really big flood, that you can not escape or control once it has started. The best you can hope for is survival. You are about to get hit with not just a wall of water but water with a lot of debris in it that you have to try and avoid. Hopelessness and powerlessness are all consuming

 A panic attack occurs suddenly and typically reaches its peak within 10 minutes before slowly ebbing away. Once it starts panic is impossible to control. However we can prepare for the next one.

Physical and Emotional Symptoms of Panic:

Sweating, Palpitation, Shortness of breath,  Dizziness, Chest pain,   Tingling in arms and or legs, trembling or shaking nausea and abdominal pain, chills, hot flashes, fear of dying, embarrassment, shame, anger these are all symptoms of panic.

Panic Disorder:

Panic disorder, on the other hand, is diagnosed when panic attacks are recurrent and unpredictable. Because they seem to occur out of nowhere, people begin to live with fear that they will happen again with no warning.

Fear becomes magnified so that the person begins to be afraid of feeling fear in case it triggers panic. Because we are all our own experiential  scientists the person starts to try and understand what is causing the panic. For example if you have a panic attack at the bank you may start to avoid the bank, then if the next panic attack happens in a grocery store you may avoid the grocery store. Eventually your world becomes smaller all because your brain is weary from the attacks.

What to do: Planning Ahead for your Worst Nightmare while Still Living Your Life

Planning ahead for what to do when you feel totally out of control sounds like an oxymoron. It is in fact a brave act because you first have to admit that panic is indeed the issue which is totally counterintuitive to what you body and your brain are telling you So here are a few tips that we can teach you about practicing for panic before it happens.

1. Practice Having the Frightening Sensations

I don’t usually start with this skill because it requires a lot of courage as well as trust in me as your counsellor.

Begin by telling yourself that your symptoms of panic, the pounding hear, dry mouth, and so on are not actually dangerous.

• I invite you to imagine a time when you have had those very symptoms and been happy about it. for example working out at the gym.

• Then you try to bring on the very symptoms you’re afraid of. You practice having them outside the context of the panic attack.

• You stop defining these symptoms as life threatening.

• When you practice controlling your own symptoms you begin to tell yourself a different story about the symptoms. Or as Dr. Weekes said ‘there is that old panic again’.

Here are a few ways to bring on one or two of the symptoms of panic outside of a panic attack. If you’re worried about a pounding heart, hop on the treadmill.  Terrified of feeling dizzy?  Sit in an office chair and spin around and around. Shortness of breath?  Breathe through a coffee stirrer.  Lightheadedness?  Crouch for a minute and then stand up quickly. Be creative about controlling and bringing on the symptoms. I personally think that is when people go sky diving or bungee jumping they have learned to like the adrenalin rush that can also be part of panic.

2. You are not the Panic so Challenge it as if it were a Bully

This sounds weird, but with panic disorder, a little reverse psychology works.  When you start to worry about panic or feel that first twinge, tell yourself “Hey body, I want more.  Bring it on!  Hit me with your best shot.”   The way we deal with bullies is to stand up to them and that’s what we need to do with panic.

Panic is the fight or flight response gone haywire, so when you try to fight panic it actually makes it worse. When you welcome in the sensations of fear, your body has no reason to fight or flee. The panic is not you… it is a bully and we don’t give in to bullies. I found this he

3. Putting Panic into perspective

Panic is all in the interpretation.  Think of it this way: It’s 3am and the phone rings.  What happened?  Well, it could mean bad news but it could also be good news or even a wrong number.  Until you pick up the phone, the reason for the call is a product of your interpretation.  

So before you react have a little think about what it could be instead. This is only panic. you have felt this feeling before and survived. A true panic attack actually only lasts about 10 minutes but the aftershocks of panic can last longer. Tell yourself …oh my goodness this is annoying but my fears and anxious thoughts are not who I am.

4. Talk Back to Panic

The thoughts that go through our heads - What if i am wrong this time and I actually am dying. I’m going crazy, I’m going to pass out, ’m going to throw up.

So when you feel panic starting to rise, talk back to your thoughts in a new way. Sometimes people say I’ve got this. or Oh for goodness sakes this is annoying. You don’t have to be polite, say whatever makes you feel strong and powerful! You may not remember these empowering words during a panic attack so write them down and pin them on your fridge, computer or somewhere where you will see them.  I know someone who made a recording of their own voice telling them powerful statements that gave them comfort and stamina.

5. Avoidance Feeds Panic: Endurance is the answer

Think of a situation that makes you panicky - I’ll bet you white-knuckle it until you can’t stand it anymore, and then quit, which makes you feel better.  But consider this: While quitting does make you feel better in the short-term, it  also reinforces the idea that what you’re doing is dangerous.  The goal here is not to avoid the situations that trigger panic but to endure them. Do not run away from the panic.

Try it out.  Your brain will get bored, but you have to let it get over the hump. Then you can move on to the next step.  As you master more and more situations, even the things you thought would be 9s or 10s will start to look easier.   The point of this endurance exercise is to extend the time you spend being uncomfortable. You also begin to tell yourself that being uncomfortable is tolerable. Then you begin to tell yourself that panic is only uncomfortable and that you are good at tolerating discomfort.

Note to the reader:

I know that some of my suggestions sound and feel scary and that it will require bravery to practice. But, know this,, every single person who has ever come in to see someone like me is showing courage in one way or another. We can extend that courage by practicing small steps towards bravery

 Living with someone who has panic attacks: a note to families and friends

Panic attacks are scary to experience but they are also scary to witness.  Family members can become frustrated, angry and resentful towards the person who is experiencing panic or anxiety.  Many of us think that if the person just tried harder they could stop the panic.   The snap out of it kind of thinking does not work. When family members feel helpless that sense of helplessness can overwhelm them as the person they love withdraws into panic.  What does work is; witnessing, honouring their experience as real. It is a sensitive topic for the person with anxiety because they do feel like they have no control.

• What also works is planning with the person who experiences panic what they need you to do.

• Make sure you write down several options such as sitting with them, getting the person to drink a glass of water, help them do a grounding exercise, and wait… for the panic to pass. I have included a link to an easy to remember grounding exercise at the end of this blog

• Please do not try to get the person who is experiencing the panic to be logical or insightful at the time.

• Do not minimize the panic for the person who is experiencing it.

• Help them with their own self talk but don’t do it for them.

• Reassurance and support work. Just because someone who has panic experiences such intense experiences does not mean that they are incompetent.

• After it is over perhaps in a day of two each of you can sit down and talk about what worked and what you would like to differently.

• If you live with someone with ongoing anxiety or panic disorder, get some support yourself. What we often don’t talk about is that caring for someone who has panic disorder can take a toll on you too. So…get your own support system.

Deborah

“If you are depressed you are living in the past, if you are anxious you are living in the future, if you are at peace, you are living in the present.”  —Lao Tzu

Endnotes

https://www.healthline.com/health/grounding-techniques This is a link to some easy and practical grounding techniques

https://www.youtube.com/watch?v=x0p5lbt-wd8 This is a video of a person actually having a panic attack when he was not aware that he was being filmed. Do not watch this if you are easily triggered.

This is a Ted Talk called: What is a Panic Attack and how to you prevent them by : Cindy J Aranason: https://www.youtube.com/watch?v=IzFObkVRSV0.

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