by Michele Carelse
 
Many people who suffer from panic attacks would be surprised to hear that this is a relatively common condition.

Some people experience panic, or anxiety attacks once or twice during times of stress, while others have a full blown Panic Disorder, experiencing panic attacks a few times a week, or even on a daily basis.

A Panic Disorder will be diagnosed if there are at least three panic attacks within a three-week period in reaction to situations that are not life threatening and which are not associated with physical exertion.

Panic attacks can occur at any time of the day or night and are so disturbing that many people have been rushed to emergency medical centers with suspected heart attacks or seizures, only to be told "It's only a panic attack".

ONLY a panic attack! Most people who have suffered a full-blown attack would have difficulty accepting this phrase. There is nothing 'only' about a panic attack, which can be so terrifying that the person is convinced that she is about to die on the spot!

To be told that you are 'only' having a panic attack does not make it less real or less frightening - but often leaves the person feeling foolish and misunderstood, convinced that there is some undiagnosed medical problem which the doctors have missed.

Unfortunately, it has been my experience that many medical doctors have not been sufficiently trained in how to help people suffering from panic attacks.

The usual medical treatment involves reassuring the patient that she is 'fine' and prescribing medication, which is often addictive and which may come with side effects that are sometimes more debilitating than the panic attacks themselves.

If more doctors recognized that panic attacks are relatively easy to treat without prescription medication, patients would be referred for treatment at the early stages of the problem.

This would mean that there would be fewer people with chronic and severe forms of panic disorder and fewer dependent on strong drug therapy.

This eBooklet will examine the nature of panic attacks so that you can understand exactly what is happening to your body during an attack.

With this knowledge, you can learn to identify the early stages of an attack and use certain techniques to minimize the attack or even completely prevent it from occurring.

What are Panic Attacks?

A panic attack is a physiological response to fear or sudden anxiety. Sometimes the object of fear is physical (like a spider) or an event (fear of flying, fear of heart attack or dying). Other times the panic attack occurs without an apparent trigger and may just 'happen'.

The symptoms of a panic attack include the following: shortness of breath or feelings of suffocation; vertigo or faintness; heart palpitations; chest pains; trembling; sweating; chills or flushes; nausea; tingling sensations in hands, feet and face; feelings of de-personalization or de-realization; fear of dying, collapse or 'going crazy'; an uncontrollable desire to run away or escape.

If you look closely at these symptoms, you will agree that they very closely resemble the body's reaction to a frightening or life-threatening event.

The experience of a panic attack is no different in symptoms or intensity to the experience of being threatened with a knife in a dark and lonely alley, or coming face to face with a dangerous wild animal!

There is the same feeling of intense fear, the same rush of adrenaline and the same overwhelming need to escape. The only difference is that there is no actual danger present, or the perceived danger is one that would not unduly worry the majority of people.

In essence, then, a panic attack occurs when the brain 'misinterprets' a situation or event as life threatening and sets into motion a series of physiological and chemical events which result in what we call a 'flight or fight' response.

Your body is made ready to either run away or to fight to the death! There is a surge of adrenaline, which provides the energy (and the desire!) to fight or to run away.

Then there is an increase in the heart rate and the person begins to breathe faster and with shallower breaths, trying to get more oxygen to flow into the lungs. If there was really physical danger present, the individual would use up all the adrenaline in fighting off her foe and that would be that!

During a panic attack, however, there is no actual need to fight or run away, so the rapid breathing often becomes hyperventilation. Hyperventilation upsets the levels of carbon dioxide and oxygen in the body, causing dizziness, tingling sensations, shortness of breath, chest pains, feelings of suffocation and fear of collapse or dying.

All of these sensations, in turn, further frighten the person who is experiencing the attack - leading to more severe symptoms, thereby significantly prolonging the attack and increasing the severity of symptoms.

How to control a Panic Attack

Now that you understand that a panic attack is a series of physiological and chemical responses caused when the brain 'misinterprets' a situation as life threatening, you can use this knowledge to achieve control over your panic attack so that you can either minimize it significantly, or even completely prevent it, without the use of strong drugs.

The first thing to tell yourself is that a panic attack cannot kill you. Nobody has ever died of a panic attack and you are not going to be the first one in history!

While panic attacks FEEL life threatening, they are not at all dangerous. Other people may not even notice that you are having a panic attack, unless you tell them. Panic attacks feel MUCH worse than they look!

Secondly, your body cannot sustain a panic attack for long. Even if you do nothing at all, your body will adjust itself to balance oxygen and carbon dioxide levels and remove excess adrenaline from the blood stream within at most 10 - 15 minutes, but usually only a few minutes.

So what you are facing is not a life threatening illness, but only a brief 'episode' of panic. Many of my clients have been significantly helped by this knowledge and find that it really makes a difference to tell themselves that "This will only last a few minutes and then it will be gone".

Thirdly (and here's where YOU can be in control!) there are two main things to work on when preventing or minimizing a panic attack.

The first is preventing hyperventilation syndrome (see above). The second is preventing a build up of adrenaline. Of the two, preventing hyperventilation syndrome is by far the most important - and so easy to do that it almost seems too simple!

To prevent hyperventilation syndrome, all you have to do, at the first sign of anxiety, is to slow your breathing down to about 10 deep breaths per minute.

Breathe slowly and deeply in through your nose (try to breathe from your diaphragm rather than from your chest), hold your breath in for a few seconds and then release your breath slowly from your mouth.

While you are breathing out slowly, it helps a lot to silently say (think) something calming like 'relax'. Your diaphragm is a big sheet of muscle just under your lungs at the bottom of your rib cage.

To achieve breathing with your diaphragm, you must push your diaphragm down towards your navel, so that your stomach 'balloons' out, while at the same time allowing air to enter your lungs naturally.

When you relax your diaphragm, it will return to its usual position and thereby expel the air slowly from your lungs.

It is worthwhile practicing this technique while you are alone and relaxed, but if you find you struggle too much - don't worry! Slow, even and deep breathing will do the trick just as well. It is more important that you relax, than worrying about technique!

Once you have controlled your breathing and are more relaxed, you may find it useful to walk around a little, thereby using up some of the adrenaline in your body.

Sometimes a panic attack can creep up unexpectedly and before you know it you have all the full-blown symptoms, without even having a chance to practice your breathing.

You may even wake up at night in the middle of an attack. Don't worry! Even right in the middle of a panic attack, you can begin to control your breathing - slow breath in through your nose, hold your breath for a few seconds - and then slowly release the air through your mouth, thinking 'relax' and even consciously allowing your muscles to release tension and loosen up.

The first few breaths may be a little difficult, but you will soon get the hang of the slow rhythmic breathing. Remind yourself that the panic attack will only last a few minutes and that it cannot harm you. Continue the slow breathing and before long you will be feeling much better!

Learning to control the symptoms of a panic attack improves with practice. Most people find that the breathing technique alone helps almost immediately, but some people need to keep trying until it works properly.

It is advisable to find about 10 - 15 minutes once or twice a day to sit comfortably in a quiet spot and practice deep, slow breathing, not forgetting to think the word 'relax' every time you breathe out and making sure that you relax all your muscles as you breathe in and out.

If you do this regularly, you will not only decrease the incidence of panic attacks, but you will also increase your ability to control the panic attacks if they do occur.

Many of my clients find that once they have learned to control their panic attacks, the attacks disappear altogether!

Is there anything else I can do?

There are many other things one can do to decrease the incidence of panic attacks.

The first thing to remember is that the healthier your lifestyle, the less you will suffer from panic attacks. Regular exercise is a big help - as is a balanced healthy diet and regular meals.

Make sure that you get sufficient sleep - studies have shown that sleep deprivation increases the incidence of panic attacks.

Avoid stimulants like alcohol, drugs, caffeine and foods high in sugar. If you suffer from anxiety and stress, try and find out the causes and take steps to address them. If you are not sure why you are experiencing anxiety, consult a professional.

Many therapists use techniques like progressive relaxation or meditation to help the client learn how to access his own calming response (everybody has one!) and to lower anxiety levels to more comfortable states.

This is often combined with psychotherapy to help improve self-esteem and understand the causes of the anxiety and cognitive therapy to 'reprogram' the negative thoughts underlying the anxiety or panic.

There are also many natural products which help and may be used alone or in combination with therapy.

Regular use of MindSoothe (a combination St John's Wort/Passiflora capsule) can minimize anxiety and stress and improve overall mood, thereby reducing the incidence and severity of panic attacks.

For more information go to Native Remedies

Read as much as you can about panic and anxiety and how to help yourself. Visit the Feelgood Counseling Reference Library to see a list of reviewed and recommended books. Go to www.feelgoodcounseling.com/reference_library.htm

Try and involve yourself in something enjoyable and fulfilling. If you are a very active person socially and career-wise, take up something relaxing like yoga or pottery. If you are withdrawn and inactive, join a club, offer your services as a volunteer, or take up a hobby or sport which would bring you into contact with people.

Taking your mind off your problems is often a big help! If you tend to take on too much, learn to ask for help!

Finally, it is important to note that most anxiety and panic disorders respond well to treatment and I would encourage anyone who suffers from these disorders to go for help. It can make all the difference to your life!

Conclusion

As we have discussed, panic attacks are the body's physiological and chemical response to perceived danger, where no danger actually exists. There are many things which one can do oneself to control or significantly reduce the symptoms of panic attacks.

Practice and persevere and you will feel empowered to control your panic attacks without the use of prescription drugs. If you have a friend or family member who suffers from panic attacks, encourage them to learn about what is happening to their bodies and teach them the techniques described in this E-booklet.

For more individual help with anxiety, panic attacks, phobias, depression or any other problem, visit a Licensed Counselor or consult me online at:
Native Remedies

Good luck and be well!

Michele Carelse is a Registered Clinical Psychologist and Licensed Counselor with more than 15 years experience. She runs her own private practice, as well as an online counseling and information service at Native Remedies

Michele has also developed Native Remedies - a range of natural herbal and homeopathic remedies for adults and children, specifically aimed at promoting emotional, psychological, cognitive and physiological health.

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