Panic Attacks
I read recently of a couple who had been sightseeing in London when the underground bombs exploded, on a tropical island in Indonesia when the tsunami struck and on the plane that landed in the Hudson River. It would be little wonder if these people were to begin to experience a fear of all forms of travel and to be reluctant to leave the safety of their own homes. Even though you may not have been as unlucky as these people you may well suffer from various fears and anxieties. Often we can trace the cause of our nervousness to some experienced event such as these, and we are not surprised when a news item or press report brings the fears to the surface, and we feel a similar level of anxiety as we felt at the time.
Perhaps as a result of the news coverage of disasters we all have an underlying anxiety about possible impending doom in events outside our control, but we are usually able to quickly rationalise them and get on with our lives. We know we are not going out of our minds, but we are just experiencing the automatic 'fear of flight' reaction built into every human being.
But sometimes any of us can experience a sudden feeling of extreme anxiety that comes like a bolt from the blue and for which we can admit of logical explanation. In the grip of the anxiety our usual cognitive powers seem frozen, our primary emotions are fear and panic, and our bodies' react with cramps, loss of temperature control, our hearts race, we have trouble breathing and we may experience many other symptoms. We can feel out of control and as if we are going crazy, or even that we are dying. And if we are able to look at the other people around us we see that no one else is panicking - it is just us! This can be a very frightening situation to be in until we learn that what is happening is that we are having a panic attack or anxiety attack and that it is really nothing to be concerned about.
If you recognise the symptoms described and you have experienced them recently then you are likely to be between 15 and 24 years of age, or between 40 and 45. If you ask ten of your friends, at least one will have suffered some form of anxiety disorder during the last twelve months. And three or more of the ten will suffer a panic attack, anxiety incident or phobia during their lifetime. You are not alone in your suffering, and while to some degree the figures suggest it is almost normal, it can be, none the less, very frightening, particularly as the symptoms can be similar to those for a heart attack.
Often the attack will begin with a tightening sensation in the chest and throat accompanied by a rapid increase in heart rate, sometimes with nausea and dizziness. Disturbed or tunnel vision, hot flushes, or chills and shaking with hot or cold sweats may also be experienced. These are the physical bodily symptoms of a panic attack.
The first response should be to make yourself safe. If you are with someone tell them as calmly as possible how you are feeling and find a seat. Tell children with you that you are unwell but not to worry. Move outside if you easily can. If you are driving, immediately safely pull to the side and stop. Wind down the window a little way.
It seems that deep breathing is one of the best things you can do, and while it can be helpful to move outside to get some fresh air, often the sufferer is actually not short of air but is hyperventilating and thereby giving the body too much oxygen. Splashing the face with cold water helps, the colder the better, and try breathing into a paper bag (not plastic) until the symptoms abate. A sheet of newspaper folded twice and pushed out into a cone will provide a make-shift paper breathing bag. Some people find it helpful to control the breathing by counting. Three seconds breathing in must be followed by six seconds breathing out. Then increase to seven seconds breathing out. By using these strategies you are reducing the hyperventilation, and equally importantly you are taking control. Don't let yourself feel embarrassed, you don't need to explain yourself to anyone, you are just feeling unwell and need some space. The physical, bodily symptoms of the attack usually pass within a few minutes and you will feel in control once more. However if you feel a sharp pain in the chest, upper arm, neck or shoulder, or if your heart continues to race you do need to seek medical advice and reassurance by going to A. and E. or contacting a doctor just in case.
You may know what has brought on the panic attack because of something that is going on in your life, but often the cause of one or a series of attacks is unclear. Anxiety disorders, panic attacks and phobias often run in families which may suggest that some families are in some way more sensitive emotionally or in their actual sympathetic nervous system, or even that in some families this is the way in which emotional distress is usually shown.
It will come as little surprise, therefore, that phobias (seemingly irrational fears) have often been experienced by those who also have panic attacks. For example, fear of crowds and public places (agoraphobia), a cognitive or emotional process, can sometimes be seen as a trigger to the bodily event of the panic attack. Likewise with claustrophobia (fear of enclosed places), fear of flying, etc.
This idea that the body is acting out what the mind is concerned about, as in the above, seems very plausible. Often the trigger for the onset of panic attacks is some major life change, (the likely age groups noted above are at known difficult life stages: post-puberty teenage autonomy struggles, mid-life crisis issues) or with the experience of loss. This may be an actual loss of someone or something you love or the feeling that you are losing control of yourself and the people and the world around you. Subconscious worries and emotional stresses that are difficult to put into words, or cannot be heard by a supportive and sympathetic listener may play themselves out in the symptoms of the panic attack.
Knowing that you have suffered a panic attack can may be you afraid to go out and mix with other people but by understanding what is going on and having a strategy for dealing with the symptoms at the time of an attack (see above) should provide some reassurance. You have survived the attack and you are better prepared should you have another one. Just carrying a paper bag, rehearsing the breathing control, and knowing that you can tell people simply that you are unwell and just need some space and air can be very empowering. It may be helpful to document any attack with how you felt, what happened, what you thought triggered it, and with what was most helpful at the time and afterwards. Be honest with yourself. You are dealing with mind (cognition) body (physical experience) and spirit (emotions). Write down what was/is happening in all three parts of your being and you will see connections. Seeing connections can help stop them from becoming triggers. There is no reason to continue to suffer. Your doctor can provide medical help. There are drugs available (e.g. Xanax and Ativan), and you can seek counselling help from professionals such as Absolute Discretion Counselling Therapy. Cognitive Behavioural Therapy (CBT) and Rational Emotive Behaviour Therapy (REBT) can be most helpful in dealing with the fears that cause panic attacks and calming the fear the attacks themselves can cause.
Anxiety Disorders and related conditions
Missing tect here as it is an image it seems
Health Anxiety
'Suffering The Fear That You Are Suffering From a Physical Illness.'
Health anxiety, also known as illness phobia or hypochondria is the name given to the Obsessive Compulsive Disorder (OCD) where those affected have an obsessional preoccupation with ideas or thoughts that they are or will be experiencing a physical illness. While commonly these health anxieties tend to involve conditions such as cancer, HIV, AIDs etc, however, the person experiencing health anxiety may fixate on any illness, usually of a physical sort with the sufferer discounting any mental anxiety as such. Both men and women in about equal numbers may be sufferers and onset can be at any age.
Those who are affected have become convinced that harmless physical symptoms indicator some serious disease or dangerous medical conditions. For example if their chest feels tight, they may believe that they are having a heart attack or a headache is assumed to be a brain tumour, and their anxiety may be such that they may misinterpret any physical symptoms as a sign of an impending medical problem. Often the individual will scan their body for signs that they are developing a physical illness. Or, they may link non physical problems to having a serious illness. A sufferer forgeting a name, an address or where they left their car keys immediately believes that it is not a lapse of memory but that this means the onset of Alzheimer's.
The anxiety may be such that they become so convinced that they have a certain physical illness that they become obsessed with getting a diagnosis, going to as many doctors as they can looking for confirmation of a diagnosis, sometimes seeking opinions from several doctors. They may be willing to undergo many different tests and even exploratory surgery but even these tests are often not enough to convince them they are not physically ill. Often, a lack of the diagnosis that is acceptable to them is blamed on the medical care or the doctor, and may remain as a medically unexplained symptom.
These repeated visits and consultations not attention seeking but are due to the fact the sufferer honestly believes that they are experiencing a physical illness.
A great deal of time may be spent by the sufferer with carrying out excessive checking behaviours seeking sores, marks, lumps or rashes that indicate the onset of a physical illness, and in their anxiety they may have family and friends to check to but will remain unconvinced. The anxiety arising from the possibility of finding something that indicates a particular illness can lead to high levels of anxiety. As we know, anxiety feeds itself and can increase the physical symptoms of anxiety including increased heart rate, chest pain or tightness in the chest, dizziness, blurred vision, confusion, dry mouth or sweating, and thoughts they are experiencing a physical illness is reinforced.
Even the periodic Government campaigns and press publicity of a particular illnesse can lead to sufferes experiencing health and illness anxiety and the experience or memory of having had symptoms of that specific illness. Symptoms of health anxiety may be longlasting or sufferers may be symptom free for long periods.
Not all sufferers pester their doctors with some refusing to go to the doctor for fear that they will get the news they fear and that their suspicion of having a physical medical disorder will be confirmed. Instead of becoming overly focused on the feared illness, they will avoid any reminders relating to symptoms and will avoid people who may be ill, staying away from hospitals and surgeries where they are likely to see people who are ill. They may fear that any contact with people experiencing physical illness will cause them to catch that illness, even if it is not contagious.
Others, may not share their concerns at all and not tell anyone about their fears as they are convinced that they will not be taken seriously.
The causes are not clear or easily identified in may cases but among the factors which may be a trigger are:
- Having a close family member or friend with a serious illness.
- Having an illness as a child
- The death of a close relative/friend.
- Having a peoccupation or morbid fascination with death and disease
- Being affected by some other anxiety disorder.
- Holding the belief that being 'physically healthy' means experiencing no bodily discomfort or imperfection, physical symptoms or sensations.
- Having close family members who themselves have health anxiety.
If you are reading this article either you or someone close to you has experienced some anxiety symptoms such as:
Belief that your bodily symptoms suggest you have a serious illness.
Preoccupied with the need to constantly self examine, check with others and to self diagnose.
Feeling distressed due to being preoccupied with your symptoms and fears.
Believe that others will not tell you the truth.
Find that this preoccupation impacts negatively on family life, social life and work.
Or:
- Not accepted a doctor's or hospital's diagnosis.
- Not believed your doctor's reassurances that you are fine.
- Constantly and repeatedly need reassurance and in the receipt of
- this still don't believe you are fine.
- This anxiety has been ongoing for many months.
What to do now.
Acceptance that your anxiety may be unfounded and that there is probably no cause for concern is a step forward. It may be a matter of making a first visit to your doctor or yet another visit, whichever, don't put it off. But do explain not just your symptoms but also that the anxiety is getting you down and that you recognise that you may he suffering from health anxiety and not some physical ailment.
There is no need to continue to suffer the fear that you are suffering from a physical illness.
Following you getting the GP's all clear, a good counsellor will then be able to help you to live with the your health anxiety and to get back to leading a normal healthy life.
Why not go to out Useful contacts section for websites and helpline numbers, and to our Helpful Books section for details of some available books?
Body Dysmorphic Disorder
See separate entry on this Website for this and associated conditions
See also our Useful Contacts section which includes First Steps to Freedom organisation 08451202916 www.first-steps.org And Anxiety UK www.anxietyuk.org.uk
OCD must read online book. www.com/tightrope/OCPD2.pdf