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  • Panic Disorder

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    Panic Disorder

    That feeling hits you, and oftentimes it comes out of nowhere. It’s another panic attack.

    Before you know it, you’re feeling overcome by a racing heartbeat, shakiness, sweating, it seems like you can’t breathe, but you may also be thinking that you’re choking.

    The pain settles into your chest, and thought enters your mind that you may be having a heart attack, maybe THIS is the time where you actually do have a heart attack. You may begin to wonder if  your family will know how to carry out your last wishes.

    By this time you may also be feeling dizzy or lightheaded which is triggering that nausea that creeps in all the time, and you may be wondering how it’s even possible to experience so many physical sensations all at the same time.

    Many people also experience numbness or tingling along with a sense of losing a grip on reality. Soon enough, you’re convinced that you’re losing all control and you’ve officially gone crazy. Even though panic attacks peak quickly (usually within a matter of minutes), they are incredibly exhausting and can really derail your day.

    This pattern begins to impact you because now you’re noticing the amount of time spent worrying about when the next panic attack is going to hit. Before you know it, you begin avoiding people, places, and things because you’re so scared about having a panic attack in certain settings or in front of certain people. Over time, a cycle can develop where the fear of the fear of having a panic attack begins making decisions for you.

    I can imagine that you may have asked yourself, “how the hell do I get rid of this?” Or “I need to figure out how to get these to stop.”

    Stressed woman on top of dumpster for panic disorder

    That’s a lot of pressure that you’re putting on yourself, and I can imagine that you’re feeling exhausted and defeated at this point. It can also be really embarrassing for many people to experience panic attacks in the presence of others. There’s the fear that they will see you in this moment of weakness and judge you for it. It’s a really vulnerable thing for others to see or learn about your perceived weakness, so I can completely understand why it makes sense to begin avoiding things in order to try to protect yourself.

    You’re not alone.

    The reality is that every year, about 11% of Americans experience a panic attack, so they are way more common than we may think. Keep in mind that many individuals choose not to discuss their experiences with panic because they are ashamed. Because of the associated shame, my guess is that there are many unreported panic attacks out there.

    It’s also really common for those suffering from panic disorder to not even realize that they are experiencing panic. Because the symptoms are so physical in nature, many people believe that they have an underlying health issue such as asthma, allergies, or a heart defect. As a result, people seek out medical attention to try to find answers and symptom relief. Unfortunately, the medical route can sometimes be a dead end for those with true panic disorder because they are not addressing the real issue…the relationship with the symptoms.

    The good news…

    There is effective treatment for you, and you can begin to get your life back.

    According to The National Institute of Mental Health, Panic Disorder affects 6 million adults, or 2.7% of the population a year.  Use this statistic to remind yourself that you are not alone. Living with Panic Disorder can definitely feel isolating and lonely, but it doesn’t have to be that way.  You can learn how to manage symptoms of panic much more effectively and return to a better quality of life by developing a healthier understanding and relationship with the symptoms as they present. Sounds bizarre, right? Who wants to develop a relationship with their symptoms?

    Once you can develop a healthier relationship with the symptoms and actually understand them, the healing can begin.

    Right now, you’re probably thinking that panic attacks are dangerous, but the truth is, they are just uncomfortable and not dangerous at all. I know, I said it. They are not dangerous!

    When your body is entering a panic attack, you’re gearing up for flight or fight mode because your brain is telling you that there is danger ahead. 

    But here’s the thing, with panic disorder, your brain is actually playing tricks on you because chances are, there isn’t a true threat that you are experiencing. 

    Panic disorder causes us to have a bunch of false alarms time and time again. You ever get a notification from your video doorbell indicating that there is motion at your front door and you check, and there’s nothing? In fact it was merely a piece of pollen flying around. Panic disorder is kinda like that. It’s a series of false alarms or similar to tripping a sensor.

    My guess is that somewhere along the way you’ve been told to do some breathing exercises or some relaxation training. Didn’t do the trick, did it? Unfortunately there are a lot of misconceptions out there about the efficacy of these techniques when applied to panic disorder. It’s really important to keep in mind that anxiety and panic disorder are two different diagnoses that need to be treated differently. While those techniques can be very helpful in managing symptoms of anxiety, they are just one piece of the puzzle.

    If our default is to immediately jump into a relaxation technique or a breathing sequence, we’re sending a message to our brain that the symptom itself is dangerous and we need to avoid it or try really hard to get rid of it. This is the cycle that perpetuates the problem.

    Here’s what’s going to help…

    The best way to treat panic disorder is with a combination approach which involves both cognitive and behavioral work. In other words, we need to examine the degree to which we are fused to our thoughts and thus making them our reality. Additionally, we need to make sure that we are continuing to get out there and live our lives rather than avoiding things out of fear of having a panic attack.

    Part of this involves leaning into these symptoms and thoughts and learning how to allow them to be there, and also allowing them to pass. You ever notice how much more annoying hiccups are when you place all of your energy into trying to get rid of them? It’s a better use of energy to allow them to be there, and ride it out until they subside. The same rules apply to panic disorder.

    After you’ve developed an understanding of the cognitive component, it’s time to take a look at the behavioral component. The most effective way to tackle this is through exposure therapy, which can sound really daunting. Individuals need to see and experience things for themselves in order to believe that things can change, and exposure therapy is the best way to do that.

    So what exactly does that even look like?

    Let’s say there is a client who is so afraid that he is  going to have a heart attack as a result of the increased heart rate from a panic attack. While in the therapy office, this client would be instructed to do some jumping jacks in an effort to raise his heart rate. Doing so may even induce a panic attack. The client would then be instructed to allow the panic in rather than resisting it, and to wait for it to subside so that he can learn that the most feared outcome did not happen. His heart rate can increase, and it can come back down on its own, and he can be okay.

    The other part of exposure work involves facing things that you may have been avoiding out of fear of having a panic attack. Many people with panic disorder avoid large crowded spaces because they are worried that they will lose control and something bad will happen. In order to get back to your previous level of functioning, I’m going to create behavioral experiments with you. For example, if you’ve been avoiding the mall for years, we may start by having you drive to the mall and sit in the parking lot for 30 minutes. Over time, we will increase the exposure until you find yourself in the mall walking around without significant levels of distress.

    This stuff works.

    Research tells us that 70-80% of people who undergo treatment for panic disorder are symptom free upon completion of treatment with fidelity. Trust me, the work isn’t easy, but it’s really valuable. You’ll learn a lot about yourself during the process, which can increase your confidence in managing your symptoms rather than your symptoms managing you.

    We’re ready to get started when you are.