Panic Attacks (Anxiety Attacks)
Panic - sudden,
unreasoning, hysterical, fear often spreading quickly (Webster's New World Dictionary)
Anxiety - a state of being uneasy,
apprehensive or worried about what may happen (Webster's New World Dictionary)
A panic attack is characterized by a sudden attack of symptoms usually accompanied by an
overwhelming sense of doom or panic. A panic attack can last anywhere from seconds to hours,
depending upon how the individual handles them.
In simple terms, a panic attack is a sudden onset of panic and all the feelings associated
with panic and anxiety. Panic attacks can begin in a number of different ways, from being
triggered by a symptom and thoughts of "Oh - Oh, what's that?", to an attack of panic itself.
Because the onset is so varied, and varies from person to person, panic attacks are often
confusing and misdiagnosed.
How Do I get Better?
I believe the three steps to getting better are:
Understanding your illness
Learning the tools to get better
Regularly practicing these tools
Once you learn these steps, you will be on your way to being healthy
and in control again. Forever!!!
Understanding the Illness
Simply, Panic and Anxiety attacks are the result of a tired and overworked nervous system.
The body's nervous system is so tired and overworked, it responds incorrectly to natural
situations and exaggerates responses. Essentially, that's it and that's the easy part. The
difficult part is living with the exaggerations and 'tricks' the body's nervous system will
play on you.
In a sense, the body's nervous system makes you ill - physically and mentally. If panic and
anxiety attacks dominate your life, it is very important that you have a basic understanding
about what physically and mentally happens to your body through this illness. When you understand
the chemical changes which can occur in your body, you can then begin to recognize the
messages (symptoms) that your body is sending you, and be able to respond accordingly. Understanding
what and why your body is sending you these messages is an important part of your recovery.
Understanding the nervous system
Our nervous system is made up of three basic parts:
Central Nervous System - the brain and spinal cord
Peripheral Nervous System - nerves that run to and from the central nervous system
Autonomic Nervous System - Sympathetic, parasympathetic and enteric nervous system
* The sympathetic nervous system is aroused by stress, anger or fear.
* The parasympathetic nervous system calms and relaxes.
* The enteric nervous system is responsible for the gut or alimentary canal.
Essentially, our nervous system not only keeps us informed about the world
outside us and inside us, but it also allows us to react to it. Every muscle we move, everything
we physically feel, and every tissue
in our body is controlled or monitored by our nervous system. If we sense we are in danger, our body
naturally alters its chemistry in order to prepare us for this emergency.
It is the Sympathetic Nervous System which is responsible for causing these changes to occur.
Its function is similar to a modern country's national defense system: if danger is detected,
all stations are put on alert. These stations increase their area monitoring so that if the danger
approaches a particular location, a message can be sent to the command center which then dispatches
the appropriate response. If the danger is of only a minor concern, a yellow alert may be sent out.
If the danger is more threatening, a red alert response is sent. While in the alert stage, the various
locations continually update the command center with status reports so that the command center can
adjust its response according to the status of the danger. Information such as where the damage is
located, extent of damage, necessary troops needed to fight, amount of supplies needed and so on, is
continually sent until the danger is over.
Our nervous system acts similarly. If we perceive danger, our body's defense mechanisms are put on
alert, ready to act at a moment's notice. The degree of alertness is determined by the amount of perceived
danger. Not only does our nervous system become extremely receptive, which instantaneously feeds our command
center (the brain) information with which we can make quick decisions, but it also prepares our bodies for
action by inducing into our bloodstream a "super fuel" for us to use in the case of action.
When our bodies perceive danger, our chemistry changes according to the amount of the perceived
danger. This means that if you sense you are in a slightly dangerous situation, the chemical changes
may be small or barely noticeable. But if you perceive you are in a life- threatening situation, the
chemical changes may be extreme.
There are many theories as to the exact order of the chemical reaction, but the most agreed to is this:
When we sense danger, a part of the brain called the Hypothalamus sends out the initial alarm. This alarm
stimulates the pituitary gland which in turn signals the adrenal glands to release into the bloodstream a
drug called adrenaline (epinephrine).
This chemical action has commonly been called the "fight or flight response". This process prepares the body for action. Some of the most noticeable changes we experience are: increased rate of breathing
increased blood flow to the brain and heart
increased heart rate
increased awareness
increased metabolism
increased energy
increased blood pressure
increased muscle blood flow and constriction of blood vessels and arteries
the ability for the blood to quickly clot
Do some of these sound familiar? It has been proven that too much adrenaline
causes fear and anxiety.
It is important to know that every human being experiences this process to varying degrees when
faced with danger. I repeat that the degree of perceived danger determines the degree of response.
This process continues until the perceived danger has passed. This is very important to remember:
Once the danger is over, the body -- if allowed to -- naturally breaks down the induced chemicals,
which allows the body to return to its normal relaxed state.
This early warning defense system helps us to survive in times of danger, but unfortunately, if
we continue to remain in the "red alert" stage or continue to push the panic button without the
necessary time for our bodies to rejuvenate or rebuild, we can overwork our nervous system. Not
only does our nervous system sense danger from outside our bodies, it also senses danger or damage
from inside.
For example, if we are over-using a particular muscle, this muscle, with the help of our nervous
system, will tell our brain there is a problem which needs attention. The message that is sent by
our nervous system may be pain or fatigue. If we listen to the message, as we should, we would stop
working until the pain or fatigue goes away, which is how the nervous system lets us know when we
can resume working. If we do not listen to the message, further damage may result and the messages
become stronger. These messages will continue to intensify until we are forced to stop the damage.
In the case of a muscle, the message may be intense pain or muscle spasms.
Our nervous system is no different. If we are continually over-working the nervous system, it will
send us early warning messages that tell us something is wrong. These messages may be in the form of
a headache, stiff neck, fatigue, trembling, depression,
tight muscles, insomnia, and so on. There are
a vast number of messages that could be sent. If we listen, relax, and give the nervous system some
time off, it will rebuild itself and be ready for more later. If we don't listen to the messages, they
will continue to intensify until we can no longer ignore them.
Understanding how you got ill
Everyday life experiences such as anger, frustration, sorrow, worry, excitement, tension, strenuous
exercise, anxiousness, nervousness, always being in a hurry, always having to please people, always
doing the absolute best you can, caffeine, alcohol, sugar, and many other drugs or emotions, cause
our emergency system to be activated.
Everything we do stimulates our nervous system to some degree or other. Our nervous system is
"hard-wired" into our bodies and there is nothing we can do to change that. What we can do is
understand how it works and be aware of what messages it is sending us so that we can respond to
those messages with positive rejuvenating actions.
I want you to think back in your life to shortly before your illness began. Ask yourself:
Were you under a lot of stress recently, or for a sustained period of time?
Did you experience a frightening event?
Were you working too hard or too many hours without proper rest?
Was there an illness in the family?
Were you facing an operation?
Were you experiencing financial problems?
Did you feel you would never get caught up?
Did you always have too much to do?
Were you experiencing family problems?
Were you fired from a job you enjoyed?
Did you change jobs recently?
Were you extremely frustrated in a job that you couldn't quit?
Are you afraid of flying and your job requires that you fly a lot?
Are you afraid of being alone?
Were you in an accident recently?
Were you afraid of being sick?
These are only examples of the many things that may have happened before
you became ill.
As I mentioned earlier, if we don't allow the nervous system time off, it has no chance of
rejuvenating itself. Life is a matter of balance. If we are bothered by something eight hours
a day, we should have at least an equal eight hours a day of mental time off just to break even.
The more the balance shifts away from the rejuvenation period towards the stress period, the
more over-worked your nervous system becomes.
Unfortunately, continuous stress can happen over an extended period of time, and consequently
we don't notice the effects of a tired nervous system immediately. When we do notice the messages,
most of us will either ignore the symptoms or get a quick fix "band-aid" medical treatment.
For example, if we get a headache, we'll take a pain reliever. If we get acid indigestion, we'll
take an antacid. If we get shaky, we'll have a couple of drinks or perhaps a cigarette. If our
shakiness becomes worse, we'll get a tranquilizer. The list goes on and on. We've been trained
to think that if we mask the symptom, the problem also disappears. As you now know, that doesn't
work. What we really should do is eliminate the underlying problem, or at least give ourselves
sufficient rest until our nervous system says that it's okay to return.
In most cases, our responsibilities, social commitments and time schedules dictate how our
priorities are set. Our technological society today is bombarding us with a deluge of information,
responsibilities and demands. It seems to be human nature that the more we can do, the more we want
to do. Our boom in technology is nourished only by our desire to make things that are better and
faster. This race to perfection has us doing more so we can do more, as quickly as humanly
possible.
Our nervous system doesn't work that way. It needs a balance. It needs time to rest. Because the
nervous system senses danger from the outside and inside, it's difficult to give it a rejuvenating
rest. If we are living and breathing, the nervous system is active. Even though we are away from
the physical problems of day-to-day life, the internal system is still working. If we have a
particular problem on our mind, our thoughts stimulate the nervous system accordingly. If we are
only mildly bothered, the body responds slightly. If we feel we have a major problem, the body
naturally responds with a major reaction.
If we are continually working the nervous system without sufficient time to recover, and we
continually ignore the early warning messages, our symptoms will intensify until they get our
undivided attention by making us ill.
How did you get ill? By not allowing your nervous system time to rejuvenate.
Understanding what's keeping you ill
Once our symptoms are strong enough to make us ill, another situation occurs. If we don't receive
the proper help and advice, these strong symptoms may now become the cause of the nervous system
"always being on alert". Now our symptoms become the problem. We become afraid of our symptoms because
they feel so bad and are so unsettling.
The "fear cycle" begins. An over-worked nervous system begins to send us messages by itself
whenever it decides to. We could be trying to relax in a quiet room when all of a sudden we
feel one or more of those dreaded feelings. This usually makes the unsuspecting person think
"oh-oh, what's happening", which in turn activates the emergency warning system which then
causes the chemistry in the body to "get ready for action". Now the chemistry in the body that
over-worked the nervous system in the first place is being induced into the bloodstream again.
This sets up a repetitive cycle: symptom-fear-adrenaline symptom-fear-adrenaline... Once you
understand that the more adrenaline there is in the bloodstream, the more sensitive you become,
and the more sensitive you become, the more symptoms you'll experience... it's easy to see how
someone who has an over-worked nervous system can be trapped for a long time.
Let's recall the emergency response chain of events:
Hypothalamus senses danger and sends a message to the Pituitary gland.
The Pituitary gland sends a message to the Adrenal glands.
The Adrenal glands release adrenaline into the blood-stream.
Adrenaline sets up other chemical reactions and prepares the body for action. All systems go.
To further clarify the "fear cycle":
Our over-worked, adrenaline-fatigued nervous system causes a symptom.
We become concerned and fearful about the symptom.
Our mind senses danger and sends an automatic message to the Pituitary gland.
The Pituitary gland sends a message to the adrenal glands.
The Adrenal glands release more adrenaline into the bloodstream.
Adrenaline sets up other chemical reactions and prepares the body for action. All systems go.
Another symptom, more fear, another chemical reaction, another symptom, more
fear, another chemical reaction, and so on. As this "fear cycle" or ill spell becomes established
in the individual, the emergency chemical levels increase in the blood. This produces more symptoms
and the occurrences of the fear cycle becomes more regular and more intense. The body is telling
you to give it some rest to recover. The problem is that since the danger is now being sensed inside
you, you have no means to get away, hence you can't relax and the "fear cycle" intensifies. This not
only makes the individual sensitive and stressful, the illness also forces that person to change his
or her lifestyle because of poor health, which adds more fuel to the "fear cycle".
Since the sick spells are coming more often and are more intense, normal everyday experiences become
difficult to live with. Because of the nature of the symptoms and the fact that they can come at any
time, the individual now only finds comfort at home. Therefore, any venture away from these comfortable
surroundings produces a nervous response, which will make the individual ill. Even places where the
individual used to go may be uncomfortable because of an earlier "bad experience".
For example: Joe X is becoming nervously exhausted. He doesn't know what is about to happen to him
because he hasn't paid attention to his earlier symptoms. Joe is always on the go in search of his
financial freedom. One day while having lunch at his favorite restaurant, he experiences his first
panic attack. He becomes overwhelmed by these feelings and has to immediately leave. He rushes home
and stays in bed for two or three days. Because of the nature of this illness, he feels okay again
and returns to his hectic lifestyle only to suffer another attack. These attacks continue to happen
out of the blue and because he doesn't get the proper information, he now becomes afraid of the
attacks. Since he doesn't want those feelings, he begins to stop going to the places where he had
his attacks in order to prevent them from returning. One day he is asked to go for lunch at the
restaurant where he experienced his first attack and because this brings back the memory of his
bad experience, he declines in fear. He goes to another restaurant but because he is now afraid
of having an embarrassing attack there, he is nervous. While sitting and talking, he has another
attack, becomes afraid and has to leave once again. This experience tells him not to go to restaurants
because he can't handle it. He knows that he can't quit work so he has to go there no matter what.
The thought of "no matter what" scares him and now he is nervous about what will happen if he gets
sick at an important meeting. The next morning an important meeting is scheduled for two o'clock that
afternoon. He thinks to himself that he had better not get "that feeling" during the meeting. He
becomes nervous about it and while in the meeting, as he thinks to himself, "what happens if I get
sick, I'll make a fool out of myself and I can't leave". This thought stimulates the emergency
response and his chemistry changes to prepare for danger. This chemical change, as you now know,
is enough to make Joe X have another attack. He has to immediately leave the meeting and ends up
home ill again. As Joe X continues in his illness, his world begins to shrink. More and more things
that were normal to him are now riddled with bad experiences. His world continually shrinks until he
is house-bound, afraid to go anywhere because of the panic attacks.
My dictionary defines "agoraphobia" as "the morbid fear of open places". This term is often used to
describe an individual who becomes house-bound because of the illness I am describing. Unfortunately,
in this case it is a misconception to think that the individual is afraid of people or open places.
The reality of the situation is that they are afraid of the panic attack, or the fear itself. Since
the over-worked nervous system is extremely sensitive and the emergency chemical levels are on average
abnormally higher, even the slightest increase in adrenaline can tip the scales from just being nervous
to an all-out panic attack.
Therefore, if you add together the average everyday stresses with an already very over-worked and
sensitive nervous system, plus the stress of being ill and trying to find the proper answers, plus
the embarrassment of not being able to function normally, plus the sheer fear of the panic attacks
themselves, it's easy to understand why this illness can consume the sufferer for a long time if
the proper help is not found.
What keeps you ill? Not understanding your nervous system and being trapped by the "fear cycle".
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