Why they happen and how to stop them
It is natural to feel a certain amount of anxiety about future events or even the future in general, but for the majority of people this is simply accepted as part of modern life.
Thousands of years ago it was very natural to feel intense fear and an overwhelming need to run when faced with an angry man eating animal, but these days things are very different.
Danger these days is often imagined in our minds, based on the two little words “what if?” Examples of this may be ‘what if I don’t get that job?, what if my partner’s having an affair?, what if I can’t afford the mortgage repayments?, what if I make a fool of myself?, what if people don’t like me?
If a person suffers a traumatic event, it is very natural to feel anxious, stressed and even depressed for some time afterwards. What is not healthy is to continually play the event over and over in our mind, because the brain knows no difference between reality and imagination, and will obligingly provide the physical feelings that were put in place at the time of the event, courtesy of the fight or flight response. In the preconscious part of the brain’s thought processes there is no such thing as time. As far as the brain is concerned, the event is happening now, and so the (in) appropriate responses are created. The fight or flight response is our natural survival mechanism, designed to keep us safe from real danger. If you were crossing a busy road and a lorry came around the corner at high speed, the fight or flight response would kick in immediately and there would be a massive release of adrenaline, which would enable you to get out of the way fast.
For a person who is prone to anxiety, the “what ifs” are attached to practically everything they do, and the bottom line is fear of the fear. As soon as we think “what if?” it puts our mind and body on alert to perceived danger, and the stress response is triggered. The resulting physical feelings can be numerous and very real, including feeling sweaty, feeling sick, dizziness, light headedness and feeling shaky as if you are going to pass out. The blood goes to our muscles, preparing our body for running away or fighting, we feel nauseous because our digestion stops ( you wouldn’t stop for a sandwich if you were faced with real danger!), the heart rate increases as more oxygen rich blood is transported to where it’s needed (the muscles), we feel lightheaded and faint because there is not enough blood in the head, and it can literally feel very frightening to experience these sensations, which in turn feeds the anxiety and fear and tells your mind that there is indeed a reason to be scared, there is danger, and so the adrenal glands pump out yet more adrenaline and cortisol, both toxic chemicals that cause a massive imbalance in the body.
Once a first panic attack has been experienced, a template is laid down in the brain, and if we find ourselves in a similar environment to the initial panic episode, such as out in the open, in a small space, somewhere with lots of people around, if we are feeling anxious anyway, we then start to overthink our thoughts of “what if I have a panic attack here, what will people think of me, what will happen to me, what if I pass out etcetera”. Your brain pays attention to your thoughts and will match them to what has occurred before, and if you are constantly thinking the “what ifs”, the fight or flight response could be triggered, the physical symptoms appear, and before you know it, you are looking for some way to escape the situation. It could be an everyday situation, like queuing at the supermarket (people around you), stopping at traffic lights or roadworks (people around you), out in the park (open space, no cover), in a small space (no way out). Many clients tell me the first thing they do when going into any building is to make sure they have a clear route of escape to the exit, so for instance if they are in a cinema, they will choose a seat at the end of an aisle, close to the exit door. This can apply to any situation, such as shopping, going out for meals, flying, driving and a myriad of everyday activities that we all do. Of course, the perceived danger is not real; the response is created by your own thoughts, not the surroundings.
Here are a couple of tips to help you reduce the panic attacks:
Once the feelings have passed, and you are feeling calm, write down all of the sensations and thoughts you had, and then go over the list and see if you can put them in order of how they occurred. Do this in a left column, and give it a score from 1-10, with 1 being minimal, and 10 being overwhelming. In the right column, next to each one, write down a number between 1-10 as to how real the danger actually was in relation to your feelings, with your rationale. It might look like this:
Felt panicky when queuing at the supermarket. Lots of people around me, nothing moving, feel hot. Want to get out. Definitely 10
Real immediate danger 0. There were lots of people because it was a Friday, and the woman at the front had dropped her purse. People were just waiting to pay for their shopping.
Car broke down, felt really frightened and panicky – wanted to be home and safe. 10
I had pulled over safely to the side of the road, it was daylight, and I had a mobile phone. There were a lot of mums driving past to pick up their children at the local school. I had called the breakdown people and they were on their way. I had phoned my husband and he knew where I was. I wasn’t far from home, and even if the car couldn’t be fixed, I would be taken home. Real immediate danger 0
If you feel the familiar feelings starting up, say out loud “OK, I know I’m feeling a bit anxious right now, but is there actually anything to be scared of? My naughty amygdala (the part of your brain that creates the feelings) is in overdrive again! I’m going to count from 1-20, then breathe in for the count of 4, then out for the count of 6, until it passes.
By acknowledging your feelings, and letting them pass (they absolutely can’t harm you!), you are taking back control, instead of letting the feelings control you. The breathing technique helps to bring your body back to normal (via the parasympathetic nervous system).
One thing to remember: when you experience a panic episode, your adrenal glands pump out the chemicals adrenaline and cortisol in readiness for you to run away or fight (neither of which is appropriate these days, unless there is actual real and immediate danger – see lorry above!). Once the adrenal glands have run out of adrenaline, the panic episode slows down and stops, because the adrenals are depleted of their supply of the chemicals.
Panic attacks don’t need to be a part of your life! Take back control, book yourself in for an appointment, and in the meantime use the tips above to take charge of that naughty amygdala!
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