You've probably seen one of those bad adventure movies where the explorer steps into quicksand and is quickly sucked under to a horrible death in spite of all his struggles to escape. The truth is, quicksand can occur almost anywhere and is just ordinary sand that has become so saturated with water that it becomes mushy and can no longer support weight. If you step into it, quicksand won't suck you down. However, the more you struggle the faster you'll sink.
The way to get out is to stop struggling, make slow movements, and lie on your back. You'll float to the surface and then you can use your arms to paddle to safety. Panic attacks work the same way. The harder we struggle to escape them, the worse they get. So let's look at some strategies that work.
In my last post I listed some important and reassuring points to remember about panic attacks. While terrifying, they're common and have a physiological reason for every sensation. And, most importantly, you won't die or go crazy from a panic attack. Managing panic attacks is simple but hard work and often involves doing things that seem illogical, uncomfortable or scary.
Usually our first impulse is to flee and leave the situation or location where the attack is occurring. This may provide immediate temporary relief, especially if we feel like we're going to totally lose it and freak out in line at Starbucks. One risk of this is associating location (Starbucks in this case) with the attack and then avoiding that place for fear of provoking another attack. There is nothing about Starbucks or any other place that brings on panic attacks.
By avoiding Starbucks, and thus future attacks, we've reinforced that connection. Anything that's rewarded (no attacks) is reinforced. Everything goes along fine for awhile and then we have an attack driving on the freeway. So now we avoid freeway driving and Starbucks. You can see how life can shrink very quickly as we avoid more and more places. So what do we do?
Well, very simply, we have to get back on the horse that just threw us. If we need to leave Starbucks or get off the freeway, do it. Sit in the car and practice some calming techniques (more on this later) and then remount. Go back in and stay as long as we can. If we have to leave again, OK. Keep doing this until we break or sufficiently weaken that association between place and panic.
Remember in a previous post I talked about the guy who overcame his fear about being there during his wife's labor and delivery? He kept gradually exposing himself to the place and event until he was able to be there for the delivery. It's called Exposure Response Prevention. Avoidance actually increases anxiety or panic. This is the simple but hard stuff about facing and overcoming fear.
So here are a couple of simple but helpful ways to get through a panic attack: Remind yourself that these are normal bodily functions happening at the wrong time and place and that they can't hurt you and will be over soon (They usually last 5 minutes to an hour, averaging about 20 minutes). Slow down your breathing by taking long, deep diaphragmatic breaths (your abdomen should swell as you breathe in). This restores normal breathing and chemical balances in the blood. It also focuses our attention on our breath rather than the panic sensations. Remember, what we focus on expands.
Get active by moving around or exercising. Remember that a panic attack is a release of adrenalin so moving around will burn off the adrenalin more quickly. What usually doesn't work is to try to sit down and relax. By the way, studies have shown that people who practice a regular exercise routine are less prone to panic attacks and bounce back faster in anxious situations.
These are just a few helpful tools for controlling panic. I'll share more in upcoming posts. See you then.
Next Time: GOING WITH THE FLOW
"Anxiety is like quicksand, the harder we struggle, the deeper we sink."
"We have met the enemy and he is us."--Pogo
In my last post I half-jokingly said that, looked at from a physiological point of view, panic attacks are quite interesting while absolutely terrifying for someone experiencing one.
So let's take a look at what's actually happening during a panic attack. Knowing what's happening and why it's happening can help relieve some of the fear and discomfort that they create and also open the door to some ways to deal with them.
To begin with, a panic attack can come on during a stressful, fearful situation (interestingly, they don't occur during life-threatening situations) or they can come just out of the blue when everything's going along OK. Some common sensations include chest tightness, rapid heart beat, numbness or tingling in the limbs, feeling hot and flushed or cold, feeling disconnected from ourselves or physical surroundings.
Accompanying and contributing to these sensations is a surge of adrenalin and increased blood flow to the muscles which increases alertness and strength. Energy is mobilized and directed towards fight or flight. The body is going through exactly the same physiological reaction as in a truly life-threatening situation but in the absence of any immediate or apparent danger. There's no saber-toothed tiger outside the cave.
So let's break down some of these sensations into simple physiology and chemistry:
*The pupils of the eyes dilate to improve vision.
*Hearing automatically becomes acutely sensitive to sound.
*Blood flow in the hands and feet decreases (the numbness or tingling sensation) and is
redirected to our deeper skeletal muscles. Blood also collects in the torso to provide
necessary nourishment to any vital organs in need during the emergency.
* Heart rate increases to get blood near vital organs, thereby increasing blood pressure.
* Our breathing accelerates to increase oxygen to rapidly circulating blood.
* Muscles in the arms, hands, legs and feet tense in readiness to fight or flee.
* Even the liver gets involved, releasing increased amounts of glucose (sugar) to fuel
muscles, brain and heart.
Now let's look at breathing for a minute, something we do naturally and without conscious thought. Normal breathing maintains a balance of oxygen and CO2 (carbon dioxide). With hyperventilation during panic that balance gets all out of whack, namely the drop in CO2 and rise in pH (don't worry about understanding the chemistry, I flunked it in college). This increases excitability of peripheral nerve endings, causing tingling around the mouth, fingers and toes.
Our pupils dilate, hands and feet begin to feel cold, the heart continues to race, lights seem brighter, sounds louder, Blood vessels in the brain constrict, decreasing oxygen flow which produces dizziness, faintness, vision distortion, difficulty concentrating and a sense of separateness from our body or surroundings. All of this is basically due to changes of the carbon dioxide in our blood. Most of these sensations develop rapidly, usually in less than a minute of hyperventilation as a result of our body's remarkable ability to defend itself.
WOW! Now that you know all this, don't you feel better? Yeah, right. Paradoxically, the body is operating at peak performance during a panic attack, utilizing its amazing resources necessary to maximize survival chances in the face of danger. But unfortunately, it's misdirected and unnecessary and can be destructive.
Understanding the physiology of what's going on during a panic attack is important and helpful as it can reduce a lot of fear and enable us to learn some useful tools for controlling and getting through an attack. More on that next time. See you then.
Next Time: TAKING CONTROL OVER PANIC
Hi and welcome to my blog. I’m Jeff Aronson, TheFearMonsterSlayer. In this and future blogs I’ll share some simple, effective and fun tools for managing fear and anxiety. So, welcome aboard!