First steps for overcoming Panic and AnxietyLast Modified 2009-10-03 15:42:10
You've arrived at this site generally because you are looking for help for yourself or a loved one to help in the recovery from anxiety or panic attacks.
There is an enormous amount of information on the home pages of this site that has all been written either by Nicola or site members who have personal experience of having anxiety and panic.
This is an initial guide for those who are acutely suffering and looking for immediate help and information.
Firstly, welcome to a site where everyone knows what its like and how absolutely awful it feels.
I would like to reassure you that there is absolutely no secret in overcoming anxiety and panic.
Do not take any notice of websites that promise to show/sell you the 'secret'. The secret does not exist - it is a marketing ploy.
Recovery from this is a learning process and needs a lot of persistence and it will slowly get better. You need to learn which path to take and be shown along it a little way until you feel able to continue your journey alone.
Panic or anxiety may restrict your life at present if it has already got a hold on you, but it will not harm you despite everything your body symptoms are telling you.
Panic originates in several ways.
The most common way, but not the most obvious way, is through your thought processes. If you are a negative or over dramatizing thinker then eventually your central nervous system will respond in kind.
Often these people will report panic attacks coming out of the blue but on careful reflection afterwards they can usually trace back their thoughts to a downward spiralling effect of 'what if's', and over escalating events negatively, imagining all the possible outcomes and dwelling on the most scary but improbable ones.
A simple chemical source such as caffeine, low glucose or the after effects of alcohol can cause anxiety and panic attacks.
These days increasingly complex chemical imbalances caused by recreational drugs are also causes of real spontaneous panic attacks.
Once you stop the source, the panics will go in time and of their own accord but in the meantime people get taken up with the revolving fear cycle so can turn into obsessive worriers and become anxious.
Some medications can also over stimulate the CNS system which may lead to spontaneous anxiety or panic. Just ask if you think this may be you. It is rare but not unheard of.
There is a soft genetic link. You may be prone to anxiety courtesy of relatives but you don't have to be stuck with it forever.
Most people dearly want their panic to be spontaneous and attributable to a treatable physical illness and not of their own making, but the reality is that the majority are home grown and it can be a bitter pill to swallow. It may take several weeks until you can trace a pattern of thoughts and how this eventually had such a profound effect on you.
The symptoms may be completely overwhelming and terrifying and vary varied in their manifestation. Please see the home pages (Symptoms) for a list of the most common ones.
The scariest symptoms
Many people with panic don't feel real or feel that they are in a goldfish bowl. This is depersonalization and that they are not real (derealization) and is thought that this is just what the brain does when it's truly overwhelmed and is not a sign that you're going mad. It passes as the stresses pass.
The disease process of severe mental illness is completely different to that of anxiety and panic - anxiety does not lead to madness.
A racing, thumping heart rate is not a sure sign of a heart attack or cardiac arrest. Just as chest pain during panic does not mean you're having a heart attack.
Shortness of breath is not a sure sign of stopping breathing.
Dizziness is not a sure sign of an imminent faint.
The secrets to getting better are
- To look after yourself better - make any lifestyle changes necessary.
- Learn to accept, manage and control the symptoms.
- Check and work on your thought processes.
- Build up your confidence and anxiety threshold.
- Learn skills so you do not have continued panic attacks.
Do this in very small manageable steps. Break a task down into the smallest steps and work your way through those at your own speed- so for some, it may be opening the front door for 5 minutes, for others it's getting up and making that presentation. Reward yourself for achievements - however small they may seem.
To your memory system, it's a very important part of retraining it.
I personally do not recommend the throwing in at the deep end method as people always survive and achieve the objective somehow, but it doesn't allow or encourage your confidence to grow or anchor the activity as a positive learning experience as the task was such a horrendous blur.
There are steps that you can take to help yourself with these panics although they are not 'cures' in the traditional way as taking an antibiotic and the infection goes away completely.
Have a medical check up. It is seldom that anxiety is purely the result of a medical condition but it is possible.
Tests you can expect routinely for anxiety are an ECG - electrical tracing of the heart and blood tests that include urea and electrolytes, haematology screen and thyroid function.
Make a list of questions when you see your doctor and don't leave until you're happy you have been heard. Discuss every option of treatment open to you. Ask about referral to a counsellor/community psychiatric team.
- Beta blockers (Beta Blockers) are very helpful to reduce the symptoms and are not mood altering drugs and are not sedatives - they are used in anxiety to reduce the racing heart beat and associated spiralling physical symptoms. NOT for asthmatics though.
- Sedatives - medications such as Valium (Tranquilisers) and its family can be brilliant in helping with the worst moments. However, they are addictive so do not take regularly for more than 2 weeks.
- Anti anxiety - Some of the SSRI category of medication better known as antidepressants (Anti Depressants), are now licensed for anxiety too so in suggesting them, your GP's does not automatically think you're depressed.
They are mood altering drugs and they can help to give you a break from the panic cycle.
However unless you use this time on them wisely, when you come off the medication and the original issues still remain, the panic can reoccur.
They are not miracle drugs, they give you a breathing space they do not cure you of your problems.
All drugs have side effects and initially you may take a few days to settle onto them- your panic and anxiety may become more pronounced whilst you are settling onto them.
Never stop these suddenly - reduce the dose slowly.
Try to have the medication discussion with your doctor with an open mind.
Other avenues that do help include
Breathing- Learn to breathe from your diaphragm, your tummy should rise and fall with your breath as well as your chest. Ensure your out breath is longer than the in one. A count of 4 in - 6 out is great. Use this as soon as you feel panic rising. Alternatively, if you find this difficult hold your breath for a few seconds. This resolves the dizzy feeling.
Distraction- As soon as you feel the anxiety soaring and you get afraid - do something different. Really different. Change your environment, talk to someone, do something to distract yourself.
Immerse yourself in something that takes your whole attention and needs detailed thinking. Plan a party, write an article, learn a new hobby - something right brained is particularly effective such as a musical instrument or creative design, photography, dressmaking, art, singing, sport, research for a project.
See how much better you feel when your full attention is elsewhere. Learn and be confident that you can overcome anxiety by distraction. Later on you will learn to stop anxiety before getting to this stage but for now take comfort in knowing you can control it.
It's often enough to dissipate the panic. Some folk like company during these frightening events, others prefer to be quiet and alone. Its goes along with their personality usually.
Comfort yourself - be totally positive with yourself but do allow yourself to go with it. Don't fight panic, it makes it worse. Keep giving yourself positive messages that this will pass naturally and cannot harm you - breath and distract.
Keep a journal. Initially get a blank book and just write whatever comes into your mind about who you are, how you got here, how you're feeling today.
Going forward resolve to write in it every day.
Sometimes there may only be the bare facts of what you ate, where you went and that there were no issues but initially and on some days you may have lots to say.
Certainly in the initial stages track food, drink and sleep patterns, what your fears are, how they manifest themselves, what small task you set yourself to do, how it went and so forth. For ladies it is also worth tracking menstrual cycles.. As we move through stages in our female life it is possible that you may get PMS sysmptoms that you didn't have a few years ago.
There is really relief in writing plus it gives a massive boost to your confidence when you see progress in the making. When we're anxious we forget easily and have poor concentration and only a few days later you may not recall just how you were on a certain day or even what you did.
Regular exercise - uses the adrenaline/noradrenaline and the cortisol that are secreted when panic sets in and enhances endorphins (happy chemical) production. Walking or swimming are good places to start if you've not exercised for a long time.
Relaxation classes - good if you've got continual whirring thoughts: Tai' chi, Yoga or meditation promotes complete relaxation as well as stretching. This has a cumulative effect so try it regularly. The meditation part also helps learn to still the mind and cumulatively is a very effective exercise to learn to use during panic. Brings you back down to a 'normal' stress level.
Relaxation CD's are extremely useful. Find one you like and stick to it. Play it every day whether you are stressed or not and soon whenever you feel anxious just putting it on will relieve that tension.
Massage- Good for headaches and unexplained pains in upper body or legs. It releases the tension that builds up in your tissues. Often with anxiety we store it in major muscle groups apart from the usual chronic shoulders and neck so leg muscles etc can go into spasm.
Intestinal disturbances - Reaction from the guts are extremely common, you may find you get wild disturbances. Adrenaline causes the guts to race so you may have diarrhoea as a primary symptom. IBS is often diagnosed if you report it to your doctor and get it investigated. When you learn to control anxiety, it usually subsides completely. Dietary changes are often helpful.
A churny tummy with or without nausea can usually be relieved by tonic or soda water leading to a good big burp or two.
Bach remedies - will take the edge off panic and anxiety. These are flower essences, are completely safe and have no sideeffects. A couple of squirts in a bottle of water and sip liberally all day or 2 drops on tongue in a crisis. Rescue remedy is the main one used which is a combination of 5 essences. Additionally I used Aspen for fear, Cherry plum for terror and Rock rose for fear of losing control.
Nutritional supplements - Having panic and anxiety is extremely draining on your body resources. A strong 50 mg Vit B complex supplement is highly recommended as is Omega 3 oil ,Vitamin C and extra calcium and magnesium.
Unless you're intolerant, warm milk at night contains tryptophan which promotes sleep and relaxation.Turkey breast also contains tryptophan.
Aromatherapy oils - lavender, clary sage, Chamomile, vetiver. Just a sniff of lavender oil can be very helpful in getting you through a difficult situation.
Herbs - If you are really shaky passiflora/lemon balm/valerian root/ hops tinctures for instant help or you can take tablets regularly.
St Johns Wort can also help with depression but doesn't kick in for 3 weeks or so.
Kava Kava is brilliant for anxiety but is currently withdrawn from the market whilst investigations go on into possible liver side effects complicated by people often taking to alcohol for relief.
For constant insomnia melatonin is excellent. It's not available in the UK but widely available in the US where its main use is for jetlag.
With all of the herbs above if you are on any other medications at all then you must check it out carefully and ask for professional advice. SJW is a definite No if you're on the pill, immunosuppressants or anti coagulants.
Food and drink
It is worthwhile when acutely anxious, trying to eat little but often and keep to mainly protein and complex carbohydrates - nuts/seeds are a great choice, it's recommended to have a protein based breakfast when you get up and then a snack within 2 - 3 hours - avoid sugary things. This takes the strain off your adrenals glands and regulates your blood sugar.
Caffeine - reduce intake slowly if taken to excess. This is the Red Bull family and coke as well as tea and coffee.
Alcohol - many people do resort to a glass of wine or 2 to help them relax. Before they know it - it's 3-4 then day time drinking - then all day drinking. Do not go down this route. Alcohol is a popular and easily available 'sticking plaster' treatment for anxiety.
It is also a disaster waiting to happen. It promises much initially, but is always a disappointment later. It is a DEPRESSANT drug.
Many 'spontaneous' Panic attacks come shortly after alcohol and recreational drug intake.
Talking does help but unless it's an informal chat with friends, try to make the talks productive.
Think of the messages you're giving yourself every day.
Cognitive Behavioural Therapy is the main treatment of choice now which addresses how your thoughts affect you every minute of every day. With about 90% of panic attacks you can revise your self communication and stop these happening, you can also address your excessive worrying traits. It is not easy and takes time and patience but it is extremely successful.
It's all about restructuring the neural pathways in our minds. Once we have done something once or twice our minds learn the sequence so can help us perform better ie know the way to a specific location.
Once we've done it a couple of times it's an anchored route, the same with our fears. Once something has succeeded in frightening us twice then our minds automatically link the process and therefore almost automatically lead us to continued fear of certain things and then when it senses something similar it gives us a warning and asks whether this is to be avoided too. Thus the continuing list of growing fears where we had none previously. These neural pathways need to be broken and new ones built. This takes at least 30 - 45 days to anchor and is just a case of safe repetition. Drive over the bridge and you'll feel very frightened and feel all the awful symptoms but keep telling yourself positive messages. You survive - just!!
Next time do it again and you've even more positive messages to tell yourself as you've already survived once. You still feel awful and frightened but again you survive. Next time may already be a bit easier and once you've been doing it a month the fear will almost have dissipated - providing you are reinforcing the positive messages. Doing it with gritted teeth still visualizing all the possible way out troubles that could befall you will not help rid yourself of the fear.
Do watch out for your thought patterns , they can be very powerful in keeping you anxious and in panic mode.
Our thought process and what we actually do to ourselves ...
Take a minute : Is this following statement true ? ... When your mind is sexually aroused, the body responds in an unmistakable fashion.
This is also true for every other aspect of your thought process...
If you think thoughts that frighten you then you will feel fear. If you think despairing negative thoughts the body will respond by feeling worthless and depressed.
Your perception of events is of critical importance, not necessarily the events themselves. And by manipulating these perceptions, it becomes possible to diminish discomfort & pain.
Hypnosis (Hypnotherapy) is a successful, quick way of retraining yourself to think rationally. It is good combined with CBT.
Neuro Linguistic Programming (Therapy) and Kinesiology are also verified ways of dealing with anxiety that have a deeply suppressed emotional cause. You need to see qualified practitioners for this. They can be most helpful when you are struggling to see situations from any other viewpoint than the one causing the problems.
They are best explored once you are feeling a bit better having mastered distraction as they need some effort and input and if your concentration levels are still very low, you may not get the best effect from these therapies.
Do not allow yourself to start avoiding anything or anywhere. You are your own safe person and place. Where you are at the time may be a trigger but once you learn to not have panic any more it just doesn't matter.
Look after yourself emotionally, physically, spirituality and nutritionally and you will be making a head start in your recovery.
All these points are covered on the home pages so please look up anything that you need more information on. It's all there.
As time goes by, you may want to try other avenues. This guide is mainly for when you are acute just to give a brief guide.
You can overcome these.