For people diagnosed with panic disorder, facing down a panic attack can seem overwhelming. As those diagnosed with panic disorder know, this condition affects you in two ways. Firstly, it plagues sufferers with recurrent panic attacks. Secondly, it causes worry about the possibility of future attacks and may even lead to avoidance of usual activities in an attempt to prevent attacks. If you have been diagnosed with this condition, it’s critical that you develop a treatment team of professionals specialized in the treatment of anxiety. Your treatment team may include a doctor licensed to prescribe medication, a therapist to assist with developing insight into how to combat your symptoms, and other complementary techniques such as yoga or meditation. Although it may initially seem embarrassing, enlisting trusted friends and family could also help you get the support you need. When a panic attack strikes, drawing upon a host of tools can help you minimize attacks.
What You Should and Shouldn’t Do
Do find a therapist with expertise in anxiety. Finding a therapist with a focus in anxiety is your first line of defense against future attacks. Dedicate yourself to the practice of any homework exercises at home, so when you feel an attack coming on, you can easily engage in a set of tools that are well-rehearsed.
Don’t ignore your body. Although bodily sensations of anxiety can sometimes seem overwhelming and heighten anxiety, body mindfulness is another key component in treating panic disorder. Practicing deep breathing and relaxation techniques at home regularly can help you utilize these tools more effectively when panic strikes in public. Even five minutes a day can lead to greater expertise in this area. Developing an awareness of how your body responds to stress (stiff, tightened muscles, rapid or shallow breathing, etc.) will help you learn how to ease these patterned responses.
Do try to identify and correct any distorted thinking patterns. Recognize that your thoughts are likely to exaggerate fears when you’re feeling more anxious, and correcting these distorted thoughts can help ward off an attack even before it begins. Working with a clinician with a cognitive-behavioral focus can help you become more skilled at this.
Do develop a body mindfulness practice. You may find that a regular practice like yoga or meditation can benefit you. Remember: it’s impossible to be relaxed and anxious at the same time. Engage in any relaxation techniques you may have practiced at home. Relaxing your breathing and your body overall can go a long way in reducing the symptoms associated with an attack.
Don’t skip any doses of your antidepressant medicines. It’s essential not to skip any doses of antidepressant medicines (usually SSRIs) if it has been prescribed to you, as it must be taken daily in order to be effective. Don’t take yourself off of these medicines without discussing this with your prescribing doctor and therapist first.
Do carry a dose of short-term anxiety medicine with you. If your doctor has prescribed short-term anxiety medicine (usually benzodiazepines), carrying a dose of this medicine with you at all times may prove beneficial. Although many people may fear developing a dependency to these medicines, often when a person with panic disorder carries a dose of medicine with them “just in case,” they may find that it leads to greater confidence- even when they choose not to take the medicine. Because panic disorder often leads to avoidance of places or situations that are associated with increased anxiety, knowing that relief from a panic attack is only a dose away can help reduce these behaviors.
Do “ground” yourself in your general surroundings. During an attack, preoccupation with thoughts or somatic symptoms may worsen or prolong a sense of panic. Grounding, in essence, helps you bring gentle awareness back to your general surroundings. Examples of these techniques include bringing your attention to the ground underneath your feet, the wind on your face, or picking out a specific color in your immediate environment. These strategies can help you ground back into the here-and-now.
Don’t avoid feared places or situations. Although avoidant behaviors are very common with panic disorder, your goal with the help of a trusted therapist should be to slowly reintroduce these activities back into your life. Although it may initially seem like a good way to cope, ongoing avoidance just reinforces the misconception that you are unsafe doing ordinary things, like going to parties or taking public transit. Breaking the cycle of avoidance will take dedicated practice, but over time these activities should become easier.
Helpful Tips for Family and Friends
A word for concerned family members and friends: don’t join in the panic. Remain calm and model a relaxed approach to bringing symptoms back down to baseline. Remember that there can often be a fear that there is a medical emergency occurring, but within reason it may be helpful to focus on anxiety reduction first. If a loved one has a history of these attacks, perhaps you can remind them of their therapy tools for calming an attack, before seeking emergency services. Encourage your loved one’s need to change their surroundings- sometimes going outside for fresh air or going into the bathroom to splash cold water on their face can help. Just keep a watchful eye that the person is not so consumed with panic that they may do something to harm themselves (such as run across a busy street.) Ridiculing or even questioning the person who is having an attack can make things more acute. Even making casual observations can be misperceived by the person panicking. Often there is an underlying fear of going crazy or losing control, and being questioned during an attack can worsen related symptoms or prolong an attack. Hours or several days after an attack has subsided might be a better time to discuss concerns or patterns that you have noticed. Keep your comments limited to helping a person ground back into their body and surroundings, and feeling safe.
Panic disorder can be treated, and even cured. Don’t give up hope. Seeking help from a trained professional in your area can help give you your life back.
Vanessa Ford has been a psychotherapist since 2000, and has been in solo private practice since 2007. Her practice focuses on treating conditions such as depression and anxiety disorders, including phobias, panic disorder, PTSD, and generalized anxiety. She also helps clients heal from painful or traumatic experiences such as the death of a loved one, living with chronic health conditions such as HIV, workplace or school bullying experiences, abusive partner or family background, and sexual assault. Vanessa practices EMDR, which is a unique form of therapy that can be utilized to target negative self-concepts that arise from these traumatic losses. Her areas of expertise include working with the LGBT community and work with addictions/compulsions, ranging from alcoholism to drug addiction/abuse, as well as other compulsive behaviors such as eating disorders, trichotillomania and compulsive online behaviors. Vanessa’s approach blends traditional insight-oriented talk therapy with cognitive-behavioral approaches, including practicing body mindfulness techniques. She believes that health and wellness starts from within- mind, body and spirit.
Prior to starting her private practice, Vanessa helped serve the mental health needs of at-risk communities in non-profit environments. The populations served included Wards of the State, children and teens in foster care, HIV+ children and families, and the LGBT community. She worked as a staff psychotherapist in these settings, and managed a substance abuse program, including developing and overseeing a pilot program funded by the city of Chicago targeting crystal methamphetamine addiction.
Having an opportunity to help clients in need speaks to Vanessa’s core values as a clinical social worker. By partnering with her clients, Vanessa believes she is building on the therapeutic relationship as a foundation for both personal change, as well as addressing larger social issues. By focusing on the solution rather than the problem, you have the potential to be the change you want to see in the world.
