HOW TO HANDLE A PANIC ATTACK

One of Mel Brook’s funniest movies, High Anxiety, featured the Home for the Very, Very Nervous, or as the actors referred to it, the HVVN. It’s good for a chuckle, but anxiety is no laughing matter for those who are indeed very, very anxious. Extreme agitation, pounding heart, shallow breathing, stomach cramping and pain—these symptoms are frequently part of an anxiety attack and can send people to the emergency room (ER) because they think they are having a heart seizure.

Many people choose to medicate for anxiety and panic—witness the thriving sales of fast-acting benzodiazepines, such as Valium and Xanax, and the selective serotonin reuptake inhibitors (SSRIs), including Prozac and Paxil, often used to treat panic and depression. Although these medications may soothe the problem, they can’t resolve it. Lucinda Bassett, author of the best-selling book From Panic to Power (HarperCollins), has had a great deal of experience dealing with anxiety and panic—both personally and professionally. I called Bassett for advice on how to overcome these troubling conditions.

DEFINING THE PROBLEM

Anxiety attacks (feelings of incredible angst) and full-blown panic attacks (such severe fear that you must remove yourself from the situation) are emotional and physical states created by the people themselves. They result from the scenario(s) an individual creates in his/her mind about an event or situation. Anxiety-prone people overreact, over- analyze everything, including their own behavior and that of others, catastrophize possible outcomes and obsess with “what-if” thinking, fantasizing all manner of terrible things that could happen. This thinking pumps up adrenaline, sodium lactate and cortical, chemical responses that stimulate anxiety. There’s one central fear, says Bassett—that of losing control. She explains that anxious people aren’t afraid that a plane will crash—they are afraid that they’ll lose control and start running up the aisle screaming.

There may be some comfort in knowing that genes are definitely part of why a person becomes anxiety- and panic-prone. In fact, if your parents had these problems, you are seven times more likely to have them than people whose parents weren’t so afflicted, says Bassett. There are personality traits that foster anxiety, including sensitivity to such things as light and noise, and emotional sensitivity as well. Affected people also are often extremely creative and intelligent, but they have unrealistically high expectations of themselves and others, they are perfectionists and, almost needless to say, they worry a lot.

OVERCOMING THE SITUATION

Because people cause anxiety and panic attacks through their own thinking, they also have the power to overcome them by altering how they think and behave in any given situation. You can start the process today. When you feel anxiety or panic start to build, there are several things you can do that will immediately quell the feelings and keep the event from progressing…

  • Begin “diaphragmatic-paced breathing.” Most people hyperventilate or hold their breath when under extreme stress. A different kind of breathing will correct the problem, says Bassett. Exercise: Lie on the floor with a cushion on top of your waist. Breathe in through your nose and out through your mouth, making sure each breath raises and lowers the cushion. In an anxiety-producing situation, concentrate on taking 10 diaphragmatic breaths per minute. It will refocus your attention, slow your heart rate and relax you.
  • Use calming self-talk. Tell yourself, “It’s just anxiety… it will go away… I am calm… it’s no big deal.” When thoughts of “What if… ” start, say to yourself, “So what if?” instead. That shifts the sense from dread to a feeling that you are back in charge.
  • Distract yourself. Turn on music, talk to the person next to you, sing a song if you’re alone.

In general, Bassett advises people to take themselves and the world less seriously (part of “so what if?” thinking). She suggests that any time that old familiar feeling starts to emerge, use it as an opportunity to consciously focus on under-reacting. For example, slow everything down, including your speech, your movements, even your thought process. Or perhaps indulge in a leisurely bath. This is all part of taking good care of yourself, not only psychologically, but physically as well—relieving your body of the physical stress of heightened anxiety and panic.

GETTING HELP

Many people find that they need outside help to guide them through overcoming anxiety. Since body symptoms are so prevalent and frightening in panic attacks, have a complete physical to be certain that you have no cardiac, circulatory or other health issues that would send you running to the ER. Once you are confident that you are healthy, the physical symptoms of an attack won’t be so frightening and you will be able to talk yourself through the anxious moments.

After your physical, Bassett suggests that you rate your anxiety on a scale of one to 10—at one, you have little anxiety… at five, the anxiety is high but you can tolerate it… at 10, it is intolerable. If your anxiety level is regularly over five, she suggests getting professional help from a therapist who specializes in anxiety disorders. There is tremendous energy involved in these attacks, but it is all turned inward. A professional can teach you how to redirect the energy, to where it can be used constructively instead of wreaking emotional havoc. The Stress Center has a list of such experts nationwide. It also has a free cassette tape… and a self-help program with additional tapes that you can try free of charge—you pay only if you decide to go ahead with the program. Go to the Center’s Web site at Stresscenter.com.