I suspect you've landed here because you’re terrified of doing anything or going anywhere in case you have a panic attack.
I totally understand how very frightening anxiety attacks can be. So I want to reassure you right away: panic attacks are common, can happen to anybody and are not a sign that you're going mad.
As a registered (licensed) therapist with 24 years’ experience, I’ve treated many people who suffered with anxiety and panic attacks. I know what's likely to work and what won't.
But ultimately, you are the expert on you, here. That means you’ll be able to figure out which strategies are most likely to work for you.
It's really important that you also read my articles on anxiety for no reason, signs and symptoms of a nervous breakdown and how to recover from a mental breakdown! These articles will help you to put these sudden and severe onslaughts on your peace of mind into context.
When you experienced your first period of high anxiety, or your first anxiety attack, your brain registered the environment around you. It made a note of things like smells, tastes, sights, sounds and touch.
Normally, all that kind of information would be stored in separate places in your brain. However, because the information was gathered during a time of high anxiety, your brain has neatly filed it all together in one place. Your brain identified potential danger, so it stored the information in a way that can be made available to you again within a split second.
Your brain uses that information to warn you, even ahead of time, of 'impending danger'. It prepares you for fight or flight without you having any idea that it’s happening. Should you be anywhere near a situation remotely similar to that of the original anxiety episode, your brain knows how to instruct the rest of your body to keep you safe.
For example, if your panic attack took place in train station A, you need not be surprised if it also happens in train station B. If it happened in the lift in a shopping centre, it may also happen in any other lift you take. If there's someone standing close to you wearing a particular perfume whilst you had a panic attack that same perfume on someone else could trigger a panic attack somewhere else. And so the anxiety spreads.
That’s why it might seem as though your attacks happen out of nowhere, but in reality they generally all have an identifiable origin. You might have thought you were starting to get attacks in new places. But, to your brain, the place wasn't new at all. It recognised a familiar smell, sight or sound which you then experience as that horrible feeling of anxiety. That is, in a scientific sense, the beauty of the whole process: had you really been in danger, your brain would have ensured you'd get out in time.
But for the most part, the danger your brain anticipates isn’t life-threatening. And your brain’s overreaction is simply leading to your developing a more generalised fear of activities and situations, and potentially even agoraphobia. You might even have started to wonder if you’re going mad.
So let me reassure you right away: you are not going crazy! And I hope the above has helped you to understand that your symptoms aren't random at all.
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I’m not surprised if your anxiety attacks are causing you to worry about having a heart attack.
During a panic attack, your heart does what’s expected of it under the circumstances. It's under the direction of your brain which is convinced you’re in a life-threatening situation. Your heart is instructed to speed up to pump extra blood through your body to provide your major muscle groups (legs and arms) with extra nutrients.
Any chest pain that you experience during a panic attack is most likely to be the result of overbreathing. Your chest muscles tighten up as you try to catch your breath, tire and cause you pain as a result.
An anxiety attack itself cannot damage your heart. However, I trust you will have seen your physician.
During a panic attack you’ll struggle to catch your breath and you might become dizzy. But you won't faint. People faint when their blood pressure drops. Your blood pressure is far more likely to rise during an anxiety attack.
Your body-mind always automatically adjusts any external and internal changes. So, the moment it perceives a danger in the environment, real or imagined, it ensures you're prepared to tackle whatever comes your way. Therefore, you don’t need to feel, as some people do, that you’re a freak and that your body’s letting you down.
Remind yourself often: your body and mind are responding normally to what they perceive as abnormal circumstances. You are healthy and safe.
I'd like you to practise the following breathing exercise several times a day. Learning how to control your breathing in a safe environment means it’ll be much easier to keep calmer when you feel a panic attack coming on.
This symptom is simply due to the reduced blood flow to your brain on account of shallow breathing. Blood carries oxygen and nutrients which your brain needs to function optimally.
Your doctor may talk to you about depersonalisation and derealisation.
You may be telling yourself that you're going crazy.
I am telling you that it's a 'normal' symptom of a panic or anxiety attack. Rephrame this symptom as your brain disconnecting you from the full impact of the feared situation.
Here's the way to stop it...
Will panic attacks kill you? No, they won't.
Yet, you're probably worried that you're very ill and that you could die at any moment, anywhere. I totally get that when you're having such strange and often severe symptoms.
If you happened to have had a traumatic near-death experience, such as for example in a road traffic collision, then your present panic attacks and fear of dying are almost certainly connected with the original trauma. You're likely to suffer from post-traumatic stress symptoms.
Regardless of the origins of your fears, chances are people close to you are unlikely to understand or take your fear of dying seriously.
Your doctor, though, should understand. He/she may want to prescribe anti-anxiety and/or antidepressant medication.
Know that medication is not going to cure you, but may be helpful in the short-term. Unfortunately, they can also make matters worse, so be sure to inform yourself. It's up to you of course to discuss with your doctor.
When you're in the middle of what's called a flight/flight/freeze reaction, the logical part of your brain is cut out.
Trying to calculate your best mode of escape in a life-threatening situation takes too much time. So, your brain bypasses that route and instead goes for a black or white option - do or die. This means that talking logic is as effective as filling a bottle with a hole in the bottom of it.
You’ve learnt now why your heart is racing and why you can’t catch your breath. You'll hopefully understand that these are temporary physical reactions to a perceived threat and that you'll live another day!
Yes, they can! But, you'll have to work on it!
Your anxiety attacks are causing you to feel jumpy, easily startled and on edge all the time in case another attack strikes.
Therefore, we're going to work on your fear of further panic attacks. That's a really important part of your recovery.
Because that fear adds yet another layer to your suffering, and in many cases simply perpetuates the cycle of attacks.
The following is a really challenging exercise, I know.
Ideally I’d want you to work through it with a CBT therapist, or at the very least discuss it with an online licensed therapist (link opens in a new tab).
However, you may not be able to or not have access to therapy for any other reason.
So, here's the plan: you're going to have to put your brave shoes on and become determined to get rid of the attacks once and for all by yourself!
Commit to your recovery, and don’t let any setbacks or wobbles throw you off course.
That sounds scary, doesn't it?
So, why would I want you to do that? Read on...
Here's how you can stop panic attacks from happening:
The last step is really important!
Previously, during an attack, you probably fled the scene at a high state of anxiety. But now, I want you to experience that anxiety and feel it subside, which it will even when you stay where you are!
You have to give your brain time to discover that in fact it is safe there (assuming that you're not in a place infested with alligators or gun-toting drug dealers).
Since you leave in a somewhat calmer state (the pattern in your brain is updated), your next visit to this place is likely to be a little less challenging.
As you repeat the process again and again, each time you do it, it'll be a little less stressful. Until finally you can go to all of those places without batting an eyelid :-)
Any of the following can potentially undermine your courageous efforts, so at the very least, do take the suggested action:
As I've mentioned before anxiety attacks can happen wherever and whenever your brain perceives a similar situation to that which provoked your first panic episode.
However, you may have landed here with a more specific question in mind about when and how panic attacks are triggered. So, here are some other examples of when they can happen and what you can do to deal with them:
When you're pregnant
Ask for help from your doctor, midwife or other healthcare provider. The attacks won't directly harm your baby, but it is important that you feel as peaceful as possible. In particular, I want you to be able look forward to the actual birth of your baby.
Before your period
Speak to your healthcare provider. The problem could be hormonal.
During the menopause
Anxiety is a common symptom of the menopause, and can, unfortunately, lead to panic attacks.
Yes, some people suffer from them in the night. Calm yourself with the breathing exercises described earlier. Consider taking a natural remedy. Don't expect to go back to sleep, but don't watch your mobile to entertain yourself. Instead, why not try listening to an audio book/story or some calming music?
When you're suffering from PTSD
This is a big topic in its own right, so have a look at my article on PTSD symptoms.
While you're driving
Panic attacks in the car happen for the same reasons as all anxiety attacks.
You're likely to have been highly anxious once while you were driving, which provoked an attack the following time you found yourself in a similar situation.
To deal with these kinds of attacks, revisit the area by getting as close as is safely possible, and follow the steps in the action plan above until you’re able to restore a feeling of calm.
I really hope the information here on panic attacks has helped you to understand their causes. And I hope that by learning about your body’s automatic reactions I’ve managed to reassure you that you’re not going crazy.
I'd really like you to commit yourself to the steps set out in this article. In addition be kind to yourself, give yourself time and really work hard.
I know you can make those attacks a thing of the past. You don’t have to be held hostage by anxiety anymore. I know you can do it, I'm rooting for you. :-)
I really hope this article is of help to you. :-)
I frequently update my articles based on feedback, therefore I really value your vote.
Thank you so much in anticipation. :-)