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 What Exactly Is Happening to My Body during a Panic Attack
By Lindsay Kiriakos, M.D.
Panic attacks
are very uncomfortable, but they are not dangerous. They are produced by a firing of your body’s “fight or flight”
response system, also known as the sympathetic nervous system. This response is supposed to happen when you are confronted
by a lion or a bear. In fact, if you were confronted by a lion or a bear, you wouldn’t even notice you were having a
panic attack, because you’d be more concerned about escaping. But because your body is firing off this response when
there is not a lion or a bear around, your mind jumps to the false conclusion that you must be dying or going crazy. (Most
people don’t know about panic attacks, so it makes sense that they would initially make this mistake).
Despite
the intense discomfort, panic attacks are actually not harmful. In fact, during a panic attack you are at your peak ability
to fight or run away. When you think about it, all of the panic attack symptoms make sense in this context. Your heart beats
fast so you can pump more blood to your muscles and brain. You start breathing fast to you can get more oxygen to your muscles
and brain. Your muscles tense up in preparation for you to use them. You start sweating to cool down your body. Your pupils
dilate to get in more light, which can be perceived as spots in your vision. In addition, all of your non-essential organ
systems power down so you can focus on running or fighting. In particular, your gastrointestinal system (throat, stomach,
and intestines) powers down – which can lead to nausea, a choking sensation/lump in the throat (also known as globus),
abdominal pains, constipation, and/or diarrhea. For a fair number of patients, these gastrointestinal symptoms, which are
just side effects of powering down, are actually the main symptoms they experience during a panic attack.
All of this
stuff is meant to get you ready to fight or run away. But if you don’t fight or run away, you will get even more symptoms
which are still not harmful, but can be even more uncomfortable. For example, if you don’t use up your increased muscle
tension, your body will start to shake. In addition, if you hyperventilate (breathe fast) for too long, without using up the
extra oxygen, you will get rid of so much carbon dioxide that you will get tingling/numbness in the fingertips, a feeling
of dizziness or lightheadedness, and the sensation of depersonalization (where your body feels like it’s not your own)
or derealization (where the world seems like it’s not real).
The hyperventilation
is usually unnoticeable while you’re anxious because it can be quite subtle and takes a few minutes to build up. Of
note, there is nothing actually dangerous about this hyperventilation or these symptoms. In fact, oyster hunters hyperventilate
on purpose before they go underwater, because once they get the tingling/lightheaded symptoms, they can usually hold their
breath for 2-5 minutes.
Oddly enough, when you measure the vital signs of a person who is actually having a panic attack,
their heart rate and blood pressure do not change very much, despite the intense feelings. For example, their heart rate on
average usually just rises by 5 beats per minute, and their blood pressure usually just rises 5 millimeters of mercury on
average for both systolic and diastolic blood pressure. These are all relatively mild changes. So, your body is getting ready
to fight or run away, and it feels like it’s fully active, but it’s actually not even nearly as active as if you
fought or ran away for real.
Panic Attacks: This Truth Will Set You Free
By Dr Jeannette Kavanagh
Unlike far too many people on the Internet, I don’t claim to have discovered
THE CURE for panic attacks & other anxiety states. I do offer you a beautifully simple insight into panic which will change
your reaction to it. Immediately you’ll start you on the path to calm. The insight?
“Accept your panic
symptoms & ….they’ll go. Fight them & they’ll intensify.”
Look at that word ‘INTENSify’.
It’s about TENSing up. Becoming worried & even more panicky about….what? Your feelings of panic. Once you
really genuinely realize that they’re only feelings, you’ll also come to accept that feeling alone can’t
harm you.
Yes, I know you don’t want them.
Yes, I know that they're frightening & uncomfortable.
But
tell me this, my sweet one, “in the past, has tensing up & worrying even more about feeling panicky helped those
feelings to dissipate?” Your answer? I know it’s NO.
Just so you’re very clear: tensing up &
fighting your symptoms of panic help didn't help in the past. It'll NOT HELP YOU today. Tensing up & worrying will not
help you in the future.
One person selling his e-book on the Internet claims that that 'float with your panic' insight
is his unique discovery to send panic away. The truth? The truth is that we’ve known for decades that instead of fighting
panic & tensing up, you must do the opposite.
More than 3 decades ago, the Australian General Practitioner the late Dr Claire Weekes advised people that instead
of fighting panic & tensing up, they should float into their panic & welcome it like an old friend.
From my
counselling practice, I know that you know there’s nothing to fear. At a rational level. At an emotional level, you
still feel overwhelmed. For many of you, the fact that you can’t explain why you feel so terrified is often the most
upsetting.
FEAR OF FEAR ITSELF
Once you accept that there is no real danger, you’ll see that your real &
lingering fear IS THE FEAR OF THE PANICKY FEELINGS. If you let those inappropriate messages of fear come & do their worst,
you’d learn how to send those fears packing.
So to summarize: When your pulse races, your heart pounds, do the
opposite of what you normally do. Do this:
STOP !
SMILE…
even though you mightn’t want
to
B R E A T H E… D E E P L Y…
O B S E R V E…
OBSERVE YOUR FEAR…. FLOATING AWAY…
MIMIC MOTHER NATURE - FLOW WITH THE HURRICANE
Just as the grass and the trees sway with the wind, rather than rigidly resist it, let your fear feelings come. Then,
just observe what happens as if watching a science experiment.
You might want to practice that simple approach at home
a few times. You’ll soon see how well it works. I know you can make yourself feel great fear. Bring back those memories
of your last panic episode. Right now. Recall every detail. Feel those fear symptoms & now…. just accept them.
That’s
right. I’m not saying TRY to do anything. I’m not saying try to relax. I’m not saying try to divert yourself
from your fear-filled thoughts.
I am saying – do absolutely nothing. Accept your feelings.
USE OF DIVERSION
If
you normally use various tricks to divert you from the intense feelings of fear, please reconsider that tactic. It may help
in the short term, but all those tactics (counting backwards, counting bricks, etc), keep you imprisoned in what Dr R Reid
Wilson calls ‘the panic cycle’.
They can become habits, and as difficult to break as the panic cycle itself. Please visit Dr Wilson’s wonderful
website for more information: anxieties.com
When you recognise your role in your own panic episodes, you’re
90% closer to the solution, to a life without panic attacks. Next time you feel the first fluttering of fear & panic follow
the simple steps above.
If you’ve been experiencing anxiety & panic for a while, I have to let you know
that it’s your fear of the fear-filled symptoms that feed your panic. You are a major part of your problem. But you’re
also the total solution.
IT'S ALL IN THE MIND - YOUR MIND
As I point out in my self help e-kit Calming Words, if
you feel terrified standing in that queue at the supermarket, or sitting in the middle of the row at the cinema, the feelings
you feel are fine. They’re a perfect reaction to…danger. Where none exists.
Your mind sent the wrong message
“danger, danger” to your body. Your body has then had the right reaction to that danger message – it’s
sent the adrenaline surging to get you out of danger. To end with the good news: those messages can be rewritten, re-learned.
That’s why I wrote Calming Words (www.calmingwords.com)!
Panic Disorder...
kathleen howe
I added the above article for one reason only. The "truth" will set you free from Panic Disorder, Anxiety Disorder, Depression & most other mental illnesses. For it's our pain
relived over & over again that originated from some sort of deception, deliberate untruth or misunderstanding that causes
these illnesses. Pain. We can't bear it. Internally we are worn down, we are tried over and over in our grief at the expectations
of those who aren't compassionate, empathetic and understanding. It is unrelenting pain that causes our basic chemical balance
to become uneven, unbalanced and deteriorates our perfectly designed systems to become broken beyond repair.
Nothing is as freeing & liberating than the truth. Fear can be left at the wayside; doubt, uncertainty
& unfaithfulness can be excluded from our minds completely. All we need is truth to set our minds and our heart free from
the control of others, pain, and irreversible damage. In my own personal growth & recovery efforts, my goal has become
to live a life based in truth. For from that point, in all truthfulness, everything else will naturally be guided into its
rightful place.
What's easier to guide your way
by? If you live by truth - you live by healthfulness for it's truthfully the only way to live. If you live by truth, you live to give to others & receive your rewards thereof. If you live by truth you can see what's good & what's evil. If you live by truth, you can be who you need to be truthfully. It's the utmost shining example of what we can be - being truthful - that is.
It's by truth that you can feel safety. It's by truth you can realize if you've found the right person to be life long companions with. It's by truth that we don't delude ourselves into impossibility thinking. It all comes so basically & easily if you just take your life by the sword of truthfulness.
Everything can be basic & simple in your life. No more panic attacks, anxiety & chaos. Truth doesn't contain chaos. It contains only itself. It's glorious to say, "This is a truth..." for how else can you be confident, sure & quick of mind?
If you want to hold no worry, hold only the truth. You'll never worry again. There is no confusion in truth. There's no deception in truth. There's no guessing in truth. It's simply the truth. Once you're only concerned with what's true, you have so much more time & energy for good & positive things to transpire in your life.
Okay, how to get there? That's your journey! That's your own personal
journey, down your own personal road to health, wisdom & truth. You'll know it when you get it. You'll see people remove themselves from your friend list. You'll see how many people adhere
to truthfulness. You'll see that it isn't an easy road, it's a truthful road. No one can tell you how to get there, you must do what it takes to get there.
But ohhhhh, what a glorious world we'd all enjoy if it were lived by all
its people in truth.
Every person in my life
who had any significance has been likely affected. I've found thru 5 years of diligent recovery & personal growth work that everything bad revolved around negativity & personal pain.
How can one understand the importance of the truth without an honest example?
If you think hard about it all - there aren't many people that you know in your daily life - who are completely honest people over half of the time. Just think if you only knew people who accepted truth, lived in truth & perpetuated a life to be ruled in truth.... how simple & safe that is. I believe it's clean, it's safe & it's true happiness.
How I long to meet one person that I can be truthful with 100% of the time, I thought some years back, in the beginning of my recovery process. Five years into it, I see this - I'm the only person that I can be truthful with 100% of the time. It's me & me alone.
For who is to say that others are being 100% truthful with you 100% of the time? It doesn't matter if I'm being 100% truthful with my own self. Is it possible to be that? Always true? It's a goal we need to set & learn more every day what we can
do to accomplish that goal.
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What To Do When You Feel a Panic Attack Coming - Great tips for when you need it the most
By Dr. Lindsay Kiriakos
Notice: The following is presented for informational purposes only. Assessment
& treatment should always be directed thru 1-on-1 consultation with a trained professional.
This is one of my favorite questions & obviously one of the most important ones for people who are trying
to gain mastery over panic.
There are basically 2 options
for what to do when you feel a panic attack coming on.
The 2nd is to do an exposure.
And yes, I'll explain what coping techniques & exposures are! But first, let’s start off with my favorite analogy:
The Demon
Analogy
Panic disorder can be thought of as a demon. There are 2 ways to fight this particular demon.
The
1st way is to:
-
-
leaving
the situation for a while to calm down
-
-
Below I'll describe these coping techniques in detail including their pros & cons. But apart from your shield, there's also a 2nd way to fight this particular demon
- it turns out that every time you face the demon head on, he gets weaker.
Each time you challenge him, he gets smaller. That is where exposures come in to play. Exposures
involve turning the tables on the demon by jumping him, challenging him, and saying “Bring it on. Is that all you’ve
got?”
Initially, most coping techniques alone are actually not strong enough
to stop a panic attack . For example, you may try relaxation to stop a panic attack but it’s just not working. The demon is so large, that he just swipes your “shield”
aside.
However, usually after 1 to 2 months of starting to face the demon (i.e.
doing exposures), the demon become so small that the shield techniques finally start working! And after several months
of exposures, the demon typically becomes so tiny that he stops coming around at all & eventually dies.
These combined tactics of using your shield & periodically facing the demon head on will help you gain mastery
over panic once & for all. If you learn these techniques (in a type of therapy known as Cognitive Behavioral Therapy)
it's very likely that you can eventually enjoy going out with your friends, driving your car, flying overseas & enjoying
a sunny day at the beach without having to worry about panic any more.
The Shield (i.e. Coping Techiqnues):
Benzodiazepines
(ie Xanax, Ativan, Klonopin, Valium): These are usually the most immediately powerful of all of the coping techniques. It
usually takes about 20 minutes for benzodiazepines to kick in, and they strong enough to stop and even full blown panic attack.
The main drawbacks of these medications are that if you take too much, they can make you tired, and if you take them everyday,
you might get used to them after 1-3 months (i.e. they might stop working). In addition, people with a history of addiction
problems can get addicted to these medications (although in general, they produce a pretty weak high, so it’s exceedingly
rare for a non-addict to become addicted to these drugs). I prescribe benzodiazepines to my patients while they are learning
the other coping techniques and starting the exposures. I typically recommend using benzodiazepines on an emergency basis
to stop panic attacks, and occasionally I even recommend using benzodiazepines on a regular daily basis for people who are
in a chronic state of panic / high anxiety. Although benzodiazepines will not cure panic disorder, they can provide relief
while you are engaged in a more definitive treatment (such as Cognitive Behavioral Therapy) to help you gain complete mastery
over panic.
Leaving the Situation: This is one of the strongest coping techniques, but also can eventually lead to
problems. Leaving a crowd, pulling over on the side of the road while driving, or avoiding vigorous exercise are examples
of leaving the situation. These are effective coping techniques because they can frequently avert a panic attack. However,
these techniques have the obvious drawback of encouraging agoraphobia (i.e. the avoidance of activities because of a fear
of panic). I would say that leaving a situation is useful, but only if you are also engaging in a definitive treatment to
help you gain mastery over your panic disorder.
Relaxation Techniques: It’s hard to stop thinking about something
“cold turkey.” It’s easier to stop thinking about something if you replace your thoughts with something
else. Relaxation and meditation techniques aim at getting you to stop thinking by giving you an effective distraction to replace
your thoughts with. For example, many Buddhist forms of meditation replace your thoughts with a focus on repeated sounds and/or
breathing. In addition, various visualization exercises replace your thoughts with vivid imagery. The relaxation techniques
I have found to be most effective for panic attacks are 11-muscle relaxation with Abdominal Breathing, Sensation Focusing,
and Permission Breath Counting. These are all cognitive-behavioral techniques and they can be found at PanicMastery.com. I never teach patients just one coping technique because different
techniques seem to work for different people. Relaxation techniques initially may not be strong enough to stop a panic attack,
but they become much more effective once you have started doing exposures.
Thought Restructuring: This coping technique
teaches you ways to stop your anxiety by talking back to it. Thought restructuring is a type of journaling done on paper for
10 minutes a day for 1-2 weeks. After 1-2 weeks, I usually encourage my patients to stop talking back to their thoughts on
paper and start doing it in their heads. Much like relaxation techniques, this is a cognitive behavioral therapy technique,
it gets better with practice, and it becomes much more effective once you have started exposures.
Thoughts restructuring
along with Relaxation Techniques eventually form the two most healthy and permanent parts of your “shield” because
they can be used extensively without having the drawbacks of avoiding situations or relying on medications. However, these
“shield” techniques are usually not strong enough alone to completely stop panic attacks, most patient need to
do exposures.
Facing the demon (i.e. Exposures)
Exposures involve voluntarily bringing on a mild to moderate
level of anxiety In other words, exposures show you ways to face the demon, challenge him head on, and kill him once and for
all. There are two keys to exposures: 1. They have to be voluntary (which means that you can’t do them all the time,
because you won’t always be in the mood) and 2. If you imagine your anxiety from a 0-8 (with 0 being calm and 8 being
a panic attack), you want to hit a 4 during any given exposure (because if you go above a 4, the anxiety might get ahead of
you and no longer be voluntary and under your control). Exposures are used to gain mastery over any phobia. They work for
panic disorder because the core of panic disorder is usually phobia as well: A phobia to certain physical sensations. Whether
it’s a racing heart, dizziness, nausea, a choking sensation, or a certain pain, every panic disorder patient has at
least one or two physical symptoms that trigger their panic cycle. Exposures show you how to experience these sensations in
such a way that you finally stop being triggered by them. After 1-2 months of exposures, most patients find that coping techniques
begin to be effective (i.e. the shield actually starts working). Once patient are good at exposures, they can often use them
to actually stop a panic attack that is coming on. In other words, once the demon appears, they can turn the tables on the
demon, challenge it, and get it to run scared with it’s tale between it’s legs. After several months of exposures,
most of my patients become completely panic free (and can usually be taken off on any panic-related medications they have
started). Exposures are at the heart of Cognitive Behavioral Therapy, and they are by far the most useful techniques for killing
the Demon and gaining mastery over panic once and for all.
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