“It is a strange thing, but when you are dreading something, and would give anything to slow down time, it has a disobliging habit of speeding up.”
~ J.K. Rowling, Harry Potter and the Goblet of Fire
Joe had his first panic attack while on an airplane headed for his freshman year of college. He had no idea what was happening to him; he didn’t understand why his chest felt so tight and why his mind wouldn’t stop racing. He worried that he’d have to ask the pilot to make an emergency landing because he thought he might be having a heart attack. To his relief, the symptoms passed after about forty minutes. He dismissed what had happened and soon forgot all about it.
Several years later, while in his first semester of medical school and waiting for the birth of his first child, Joe woke up in the middle of the night with the same uncomfortable symptoms he had felt on the airplane.
Convinced he was having a heart attack, he nudged his sleeping wife and asked her to take him to the emergency room. When the diagnosis came back as a panic attack, Joe was both embarrassed and confused. He’d always felt like he was a strong guy with his life under control. He was excited about becoming a father and starting medical school, so the panic didn’t seem to make sense.
The panic attacks became more frequent after that. Moreover, they seemed to come out of nowhere, without warning. Joe soon became terrified of having another attack. He lost confidence about doing anything in public, especially participating in classroom discussions. “What if I have an attack in front of the class? What if my classmates find out I am falling apart?” His fears began to rule his life. He even considered dropping out of school and ending his lifelong dream of becoming a physician. Luckily, he found Empowered Life Solutions instead. With help, Joe came to understand his own contribution to his panic attacks. He learned the skills to manage his anxiety and curtail the frequency and intensity of the panic attacks.
Though not as common as anxiety and depression, panic affects a huge percentage of the American population. At least 20% of adults (60 million people) have suffered from panic attacks at some point in their lives. The National Institute for Mental Health suggests that as many as six million Americans have full-blown panic disorders.
How Panic Feels
Panic is strikingly different from other types of anxiety. While anxiety is an intense feeling of worry, panic attacks are seemingly unprovoked feelings of terror that strike without warning. These episodes can occur at any time, including nocturnally, when a person wakes suddenly in a state of fear or dread. A person experiencing a panic attack may believe that he/she is having a heart attack, that he/she is going crazy, or that death is imminent.
Most people with panic attacks experience several of the following symptoms:
Feeling weak, faint, or dizzy
Tingling or numbness in the hands and fingers
Sense of terror, impending doom, or death
Feeling sweaty or having chills
Feeling a loss of control
Panic attacks are usually brief. They can be anywhere from ten minutes to two hours in duration, but they generally last about 45 minutes. Although uncommon, panic attacks can occasionally piggyback one on top of another in what seems like one long, continuous panic attack. Regardless of how long it lasts, however, panic has the ability to feel like it will go on forever. Irrational thoughts seem completely rational in the moment. You experience something called cognitive narrowing, or tunnel vision, where the only thing you can attend to emotionally, behaviorally, and psychologically is the panic. It is as if nothing else exists–just you and the panic.
Why Does my Body Feel this Way?
When your body senses danger, whether real or imagined, it releases adrenaline. This is called the “fight or flight” response. This response is important, even life-saving, if you need to jump out of the path of a speeding car or fight away an attacker; but if there is no actual physical danger–as in the case of a panic attack–the adrenaline can make you feel completely out of control. While the symptoms feel horrendous and dangerous, your body is actually reacting naturally and healthily to a perceived danger.
For example, let’s say you are hiking in a canyon when it begins to rain. As a child you repeatedly heard a story about a relative being caught in a flash flood while hiking. At this point, there isn’t a flash flood or even a legitimate threat of one, but you start thinking about getting caught in one anyway. Your body responds to the possibility of danger with the “fight or flight” instinct. Adrenaline is released into your body, causing an increased heart rate and elevated blood pressure. Your hands and legs begin to go numb because blood is being pumped to your legs for running and to your arms for fighting. Even though there isn’t any actual danger, your body reacts to your thoughts as if they are real.
The Panic Attack Cycle
What causes a panic attack? The answer may surprise you. Simply put, you cause your panic. Of course, there may be other contributing factors, but panic usually runs in a very predictable cycle–beginning first with your thoughts. Managing your panic starts with understanding this cycle.
1. REGULAR STRESS OR ANXIETY
Stress and anxiety come from either a real event in your life or your thoughts about your circumstances. For example, when Joe experienced panic attacks his stress was about becoming a new father and attending medical school.
2. YOUR SELF-TALK SAYS THAT YOU ARE IN DANGER
The circumstances in your life do not create panic, but your thoughts and self-talk about the circumstances do. These thoughts are often about being rejected, mocked, inadequate, or trapped. The fears can also be about specific situations like crossing a bridge, speaking in public, or flying on an airplane. Joe’s fearful self-talk said, “What if I can’t do medical school and be a dad at the same time? I have so many people depending on me, and I can’t do it.” His thoughts created a situation that felt too big to handle. Consequently, his body sensed danger.
3. FIGHT OR FLIGHT- ADRENALINE IS RELEASED IN YOUR BODY
When your body feels threatened, powerful chemicals are released from your adrenal glands. These chemicals include adrenaline, sodium lactate, and cortisol. Once these chemicals are released into your system, you experience a full panic attack. Your body does not distinguish the difference between real danger or perceived danger–it just reacts. (See Empowered Life Solutions article Anxiety – “Anxious Thinking”)
4. BODILY SYMPTOMS
During panic, your breath becomes shallow. It feels like things are closing in on you. You feel trapped, confused, or fearful. At that moment, nothing else exists but the panic. You feel like you will lose control.
5. ANXIETY ABOUT FUTURE PANIC
Once you experience a panic attack, the symptoms are so overwhelming you begin feeling anxiety about having another panic attack, and then the cycle repeats itself.
The Truth About Panic
The extreme terror of a panic attack is not proportionate to the true situation at hand. Joe had been successful in his schooling before. He had secured adequate funding through a scholarship, parental support, personal savings, and student loans. His wife was in good health, and all was well with the pregnancy. Even though his situation was stressful, there was no real danger. Only his self-talk told him that life was out of his control.
|YOU WON’T LOSE CONTROL|
|YOU WON’T DIE|
|YOU ARE NOT GOING CRAZY|
|YOUR SYMPTOMS WILL PASS|
|YOU ARE GOING TO BE OKAY|
When you experience the symptoms, you know what is happening. It is a panic attack. You are not dying and, even though it feels like it, there is nothing wrong with your body. What’s more, the panic will not last. The mind and body can only maintain this heightened state for a certain period of time–usually around 45 minutes. Once the chemicals are released in your body, however, they must run their course.
Now That I Understand My Panic, What Can I DO?
Empowered Life Solutions provides a six step approach for managing a panic attack.
1. BREATHE – The first step for dealing with panic is focusing on a slow, sustained breathing pattern. The 333 breathing technique (Taught in Empowered Life Solutions “Let’s Get Started” article and instructional video) allows the mind to concentrate on something besides the panic. Remember to move the breath to the abdomen. Breathe in for three counts — hold the breath for three counts — breathe out for three counts. Do it three times.
2. GO WITH THE PANIC; IT WILL PASS – Recognize that you are not going to die or lose control. The adrenaline in your body will soon run its course. While waiting for this to happen, accept what your body is doing and don’t fight against the symptoms. Manage your panic by soothing self-talk and distracting activities. After the panic has passed, allow yourself to rest. You will feel fatigued. The level of adrenaline that has just gone through your body is about the same as if you ran a marathon.
3. MANAGE YOUR SELF-TALK – Your internal dialogue about what is happening is what perpetuates the panic. If your mind says that you are in danger, your body responds accordingly. It is your job to understand how panic works and to apply that knowledge by managing your internal dialogue. Tell yourself things like, “I am okay. This will pass. This is only panic.”
4. GROUND YOURSELF IN THE PRESENT MOMENT – Panic doesn’t stem from something happening in the present moment. It comes from worrying about a past event or what you think will happen in the future. When you ground yourself in the present moment, you find that you are okay. Life is not coming at you with more than you can handle. In the present moment, you can take action to deal with whatever situation is causing your panic (See article Anxiety – “Action Reduces Anxiety”).
Breathing is an excellent grounding activity because you are never taking a breath in the future and you are never taking a breath in the past. Your breath is always in the present moment. Breathe, slow things down, ground back to the present moment, take action, and problem solve. Wow! Suddenly you can handle what life brings. You then move to a place of hope and faith rather than fear. Follow the instructions and assignments in the Empowered Life Solutions premium content workbook to continue learning how to ground to the present moment.
5. PHYSICAL ACTIVITY AND DISTRACTION – While experiencing panic, exercise can channel the adrenaline into something positive. The exercise may be as simple as a brisk walk outside, but any physical activity can help.
Distracting yourself is another way to deal with a panic attack. Some ideas for distraction include doing puzzles, counting backwards from 100, coloring, singing a familiar song, or doodling. Distraction is also a good strategy to help prevent future panic attacks. Distract yourself if you catch your mind chatter going to unhealthy, fearful places.
6. SELF-CARE- Taking good care of yourself helps prevent and manage the intensity/frequency of panic attacks. In addition to the self-care described in Empowered Life Solutions’ Healthy Living section, there are some activities that are especially helpful for those experiencing panic.
- Regular exercise or Yoga provides an outlet for anxiety, thus reducing the risk of anxiety turning into panic.
- Regular practice of relaxation/guided imagery, and/or meditation gives you the ability to access your inner strength. Learning to quiet your mind will help you be more resilient. (See articles Anxiety – “Relaxation,” “Guided Imagery,” and Healthy Living – “Meditation”)
- Calming music helps bring a sense of peace back to the body. Lie down and let the music soothe you.
- Be kind to yourself. Anxiety is nurtured by the false belief that you are somehow flawed and inherently inadequate. Practice kind self-talk. Develop a more accepting attitude toward yourself and life. Genuine self-acceptance creates an inner sense of safety and lasting resiliency.
- Have a healthy respect for your panic. Be respectful of your personality. If you know public speaking is stressful for you, then don’t take a job as a public speaker. Of course, you don’t want to spend your life hiding from the anxiety/panic, but you don’t need to hit yourself over the head with it either.
- A healthy diet and reduced caffeine are vital in your overall anxiety management program. If you eat healthy, you feel healthy. It just makes sense. (See article Anxiety – “Healthy Diet and Exercise”)
- Learn to acknowledge and express your feelings, especially sadness and anger. (See articles Healthy Living – “Feel Your Feelings” and “Anger Management”)
In addition to these six steps, you may consider medication as a part of your overall anxiety management. Please consult your physician to see if medication could be helpful in your situation.
Let’s return back to Joe’s story for a moment. He arrived early to take his final medical exam. Just before the test, he felt his heart rate increase and his palms begin to sweat. His thoughts were, “What if I fail? What if I won’t be able to support my family?” Fortunately, Joe had learned the Empowered Life Solutions strategies for managing panic. He recognized that he could intervene and curtail a full-blown panic attack. He immediately started 333 breathing and recognized that he hadn’t failed the test, he hadn’t even taken it yet, and that this was just the panic talking. His slow breathing and positive self-talk grounded him back to the present moment. He then distracted himself by counting backwards from 100. After using these strategies, he was able to take the test with minimal bodily symptoms. He had successfully thwarted what could have been a full-blown panic attack. It is important to note that he passed his test with flying colors and is now practicing medicine.
Like Joe, the effects of anxiety and panic do not have to rule your life. Understanding how your panic works, and then applying the six solutions offered by Empowered Life Solutions, will give you the emotional strength to live life free of panic.