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How to Avoid or End Panic Attacks

Uploaded 21 August 2009
Re-printed with permission from the Postpartum Support International (PSI)

Author: Variety of Sources within the PSI -
www.postpartum.net





TEN RULES FOR COPING WITH PANIC

   1. The feelings are normal bodily reactions - exaggerated.
   2. They are not harmful - just unpleasant.
   3. Do not add frightening thoughts - negative, unpleasant consequences
   4. Describe what is happening - notice what IS not what you fear MIGHT.
   5. Wait for fear to pass - do not fight or run away - accept it.
   6. Notice when it fades - when you stop adding frightening thoughts, it fades by itself.
   7. It is an opportunity for progress - use it to learn coping - learn to grow!
   8. Think about progress to date despite the difficulties - think how pleased you'll be when you succeed this time.
   9. When you begin to feel better, look around you, and start to plan what to do next.
  10. When you are ready to go on, start off in an easy, relaxed way. There is no need for effort or hurry.

15 COPING TIPS

   1. Change "What If's" to "So What".
   2. Stay in the present.
   3. Don't judge your feelings.
   4. Thoughts and feeling are NOT actions.
   5. What am I telling myself that is scaring me?
   6. I am what I tell myself.
   7. The more I do, the more I can do.
   8. I've done it before, I CAN do it again!
   9. I am the same person, here or in my safe place.
  10. I can handle it, nothing terrible will happen.
  11. The feelings are distressing, NOT dangerous.
  12. In reality, there is nothing that can hurt me here.
  13. The anxiety can only go so high and then it comes down.
  14. SLOW DOWN.
  15. Take slow, deep breaths.

HOW EXERCISE REDUCES STRESS

    * Muscular relaxation and exercise reduces muscle tension. It uses up the energy released by the "fight or flight" response.
    * Prolonged aerobic exercise causes production of endorphins which produce feelings of euphoria and relaxation.
    * Exercise improves and maintains good circulation and lowers blood pressure.
    * Exercise may help to clear the mind of worrying thoughts and anxieties and can encourage more creativity and problem solving.
    * Exercise improves self image, appearance and tends to control weight. Exercise may result in increased social contact and also provide a balance with other activities, eg. work/school, home and family responsibilities.

DON'T PANIC

    * Accept the feeling, it can't hurt you.
    * Give yourself permission to feel anxious.
    * Calm yourself with positive self-talk.
    * Breathe slowly through your nose.
    * Let go, float, and flow.
    * Distract yourself, it is only anxiety.
    * Use the adrenaline in a positive pursuit.
    * Don't let a bad day scare you.
    * Give yourself credit for how far you've come.
    * Let time pass, IT WILL GO AWAY!

    - reprinted with permission from A.I.M.

TOOLS FOR COPING SKILLS
When you begin to practice, expect yourself to experience some anxiety.

You are doing something that you have been afraid of or avoiding for a long time, so anticipatory anxiety is appropriate. You may have some physical reactions such as light-headedness, palpitations, sweaty palms, etc. It is your past memories of these situations that create your anxiety response. Try to switch your thinking to more realistic thoughts like: "My body is only bluffing me. I will let go and not fight the feelings."

Whenever you feel the fear rising, WAIT.
Don't run to your safe place immediately. Research has shown that if someone leaves a situation while in a state of panic or high anxiety, they have more difficulty returning the next time. If you have to leave, just go far enough away for the anxiety to lessen. Allow yourself time to recover before going home.

Watch the fear rise and let it fall.
Notice that it comes in waves. In the past, you have run at the first sign of fear and didn't give yourself a chance to see it go down.

Rehearse going into a situation in a positive way.
Focus on rational thinking and use your THOUGHT SWITCHING CARDS (cards with a relaxing scene with you in the scene such as an ocean front, gardens, waterfalls, etc.) often until their influence is felt. Practice thought stopping.

Place emphasis on what you do, not what you feel.
Remember, you are learning that YOU CAN FUNCTION WITH DISCOMFORT. Experiencing anxiety gives you an opportunity to practice coping with it. Remember, comfort is a desire, not a need. Try to function with the fear. Accept it; don't fight it.

Try to focus on things outside of yourself,
It is this constant internal focusing that pumps you up. Listen to what other people are saying, focus on things in the shop window, count backwards from 100 by 3, engage in conversation, listen to what is being said on the radio, imagine yourself in some pleasant place, touch something soft, recite to yourself the states and their capitals, or any other thing that will get your mind off of your feeling.

Remember to go slowly.
Try not to rush because this tends to pump the body up and make the anxiety worse. If you have to leave, leave as slowly as possible. Imagine yourself in slow motion.

If you begin to feel light-headed, try one or all of the following:
(a) Breathe slowly through your nose to the count of 4 and then exhale through your mouth to the count of 4. (b) Always practice breathing through your nose, slowly.

Try to remain in the present.
It is the constant fear of what you are GOING to feel that keeps you anxious. Say to yourself, "If this is the worst it gets, can I stand it?" Identify what you are feeling at the moment; don't add to it by jumping into the future. Deal with it from moment to moment.

TWENTY WAYS TO MANAGE STRESS

   1. Work off stress.
   2. Talk to someone you trust.
   3. Learn to accept what you cannot change.
   4. Avoid self medication.
   5. Get enough sleep to recharge your batteries.
   6. Take time out to play.
   7. Do something for others.
   8. Take one thing at a time.
   9. Agree with somebody.
  10. Manage your time better.
  11. Plan ahead.
  12. If you are ill, don't try and carry on as if you're not.
  13. Develop a hobby.
  14. The answer lies with you.
  15. Eat sensibly and exercise.
  16. Don't put off relaxing.
  17. Don't be afraid to say no.
  18. Know when you are tired and do something about it.
  19. Delegate responsibility.
  20. Be realistic about perfection.

10 GOLDEN RULES FOR COPING WITH PANIC

   1. Remember that although your feelings and symptoms are frightening, they are neither dangerous nor harmful.
   2. Understand that what you are experiencing is merely an exaggeration of your normal reactions to stress.
   3. Do not fight your feelings or try to wish them away. The more willing you are to face them, the less intense they will become.
   4. Don't add to your panic by thinking about what "might happen." If you find yourself asking, "What if?" tell yourself "So what!"
   5. Stay in the present. Be aware of what is happening to you rather than concern yourself with how much worse it might get.
   6. Label your fear level from zero to 10 and watch it go up and down. Notice that it doesn't stay at a very high level for more than a few seconds.
   7. When you find yourself thinking about fear, change your "what if" thinking. Focus on and perform some simple, manageable task.
   8. Notice that when you stop thinking frightening thoughts your anxiety fades.
   9. When fear comes, accept it, don't fight it. Wait and give it time to pass. Don't try to escape from it.
  10. Be proud of the progress you've made. Think about how good you will feel when the anxiety has passed and you are in total control and at peace.

EXERCISES TO REDUCE PANIC SYMPTOMS

    * Use abdominal breathing.
    * See, touch, and feel the objects around you.
    * Tell yourself the feelings are not harmful.
    * Tell yourself the feelings will pass.
    * Visualize a peaceful scene.
    * Let your mind go blank.
    * Passively accept your symptoms.
    * Meditate.
    * Sing or hum a tune.
    * Read a book.
    * Talk to a friend.
    * Pat your dog or cat.
    * Take a walk.
    * Take a warm bath.
    * Splash cold water on your face.
    * Clean the house or wash the car.

WHAT HELPS?
44 tips from members of anxiety-l

EXERCISE OF SPECIFIC TYPES.
Yoga, because it incorporates breathing, and it is deeply meditative as well as being centering. Aerobic exercise because it lifts my mood, and alleviates my "sluggishness", and strengthening exercises, such as situps, pushups, squats, because a strong body, a capable body, can translate to a strong mind. I am a very physical person, when I am well, and I use this as health maintenance and insurance against getting sick again. When I am sick, my body often gets lost, becomes just a lump of dead meat I drag around with me. Exercise attacks that feeling.

GARDENING.
It is meditative and absorbing. It means I have managed to go outside, but still feel safe. It extends my safe boundaries beyond the inside of my house. It gives me exercise, and a connection to the earth. I have a sense ofachievement, which is absent when I am ill. It is a small step which can translate to much bigger steps.

SELF HELP, of many varieties.
Especially researching, reading lists, understanding my disorder, breaking it down to its root parts, not concentrating on its symptoms, which is dangerously self fulfilling for me.

TRANSENDENTAL MEDITATION

REGULAR AEROBIC EXERCISE

PRACTICING BELLY BREATHING

POSITIVE SELF-TALK

A LOT OF SUPPORT
from my spouse (safe person and confidant) and keeping busy with my two boys.

LIMITING MY PROFESSIONAL LIFE
Realizing the fact that I was happier and less PA prone by limiting my professional life and by not trying to reach for the pinnacle of my profession. This was a conscious decision since I think I had the tools to do it.

MY TWO DOGS,
I believe therapy through contact with animals is a possibility for some of us, with positive end results. Some cats and dogs have really found a new line of work. Every week, they have to visit humans in hospitals, nursing homes, retirement homes, etc.

STOPPING, SLOWING DOWN,
and examining my feelings because I find most times when I have a lot of anxiety it has to do with anger, hurt, or feelings of both which are conflicting.

ALLOWING MYSELF TO EXPRESS MY FEELINGS,
whether verbally or through tears.

POSITIVE SELF-TALK ,
believing in the stronger parts of my survivor self.

ANYTHING THAT KEEPS MY MIND OFF MYSELF
and the physical symptoms that go along with anxiety ie. light headedness, palpitations, shortness of breath etc. Examples: puzzles, video games, basically anything that requires you to concentrate on something besides yourself.

ANXIETY-L

INFORMATION
It helps to know that I'm not the only person experiencing these terrible symptoms. I'm convinced that if I had been diagnosed properly from day 1, I wouldn't have the phobias that I have now. I went for 6 months not knowing what was wrong with me and it was terrifying.

ALCOHOL [This stirred a big debate in the group and is not necessarily recommended.]

SEGA MEGA DRIVE

GIVING UP CAFFEINE

PAYING ATTENTION TO MY BODY and resting accordingly.

REMEMBERING THE WORDS
of a therapist who taught me to say "To hell with it!" (Strategy for putting things in perspective!)

THE REALIZATION
that "Dust is a protective covering for my furniture!"

SIMPLIFYING AND PRIORITIZING
my life. Things I have to get done get done, everything else gets its turn when I am feeling up to it.

TAKING A NUMBER OF DEEP BREATHS about every half hour.

SITTING IN SILENCE for a short while.

CHANGING MY THINKING .
I am allowed to make mistakes. What I think of myself counts, not what other people think. I don't have to please everybody. It is okay if someone gets mad at me as long as I know I am doing the right thing.

GETTING INFORMED
about the problem through research, this list, and good counsel.

GETTING ENOUGH SLEEP

FAITH -
I believe in God, but probably any spiritual awareness would be good.

MEDICATION -
To finally get relief enough to try and challenge myself.

SUPPORT -
therapy and sharing with other sufferers, such as the wonderful people here, and my friends on IRC #anx/pan.

WATCH THE CYCLICAL NATURE OF THE FEELINGS.
Note how a high state of anxiety will be followed by a low, followed by a high, followed by an eventual low. Watch the sine curve of your emotions.

WRITE IN MY JOURNAL
Lie on the bed on my stomach and write in my journal--noting the sinusoidal movement of the stress, describing my feelings. One or two or three pages and then walk around a bit, and go back and write a little more.

REPEATING GENERAL AXIOMS OF ANXIETY ACCEPTANCE
to myself: "bear the unbearable", "you are responsible for your feelings", "this is nothing new-you survived the last ones", "suffering is a privilege" etc, etc,

MAJOR ATTITUDE CHANGE.
Being happy, feeling good about myself etc.

GETTING ANGRY and fed up with PA's and Anxiety

FACING FEARS
directly and not caring about the consequences.

TO REMEMBER A PARAGRAPH
I read in an anxiety self-help book (wish I could remember the name and the exact words), but, in effect, it said to consider an anxiety attack as caused by a simple nerve impulse. That to consider it as that simple of a phenomenon, you can realize that you are bigger and stronger than that one part of your body, and can therefore handle it.

TRY TO THINK OF ONE THING YOU LOOK FORWARD TO
doing, even as simple as going shopping for something you really want, or baking a cake you really like, or renting a movie you've been wanting to see.

REMEMBER THAT PANIC ATTACKS ALWAYS END
and you'll feel ok again when it ends.

COOL, WET CLOTHS stop my attacks.

TRYING TO READ or concentrate on something else.

LAYING DOWN.

MAKE SURE YOU'RE INVOLVED
in something that interests you intensely (preferably something done with and/or for others). I feel this helps to distract from anxiety.


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