[NOTE] I wrote this a few years back. It appears in quite a few places online. In the interest of helping as many people as might benefit from it, I’m posting it again here.
The single most common mistake I see with regard to dealing with anxiety is the misguided idea that the goal is safety and comfort. On the contrary, you have to be afraid before you’re not afraid. You must experience fear and discomfort before you can be comfortable again. Obviously nobody wants to be afraid or uncomfortable, but this drive for safety and comfort represents the biggest impediment to truly conquering anxiety, be it in withdrawal or otherwise.
To truly overcome anxiety, panic and agoraphobia, you must first accept the fear, face it, relax into it, and expose it for what it is – baseless and harmless. From a logical/intellectual standpoint you may know full well that there’s really nothing to fear in your car, or in leaving your house yet you struggle with these things. You may understand that you’re not really having a heart attack or stroke, yet you still recoil in fear when you feel a twinge in your chest or a skipped heartbeat. The emotional side of your brain isn’t buying it. You’re still afraid, and you run from the fear. Until you actually experience the fear, face it full-on and learn that there’s nothing to be afraid of, learning does not happen and no lasting progress is made.
The recipe for success contains the following:
- Acceptance – You must accept fear, anxiety and panic. Welcome it.
- Courage – You must face the fear without running or avoiding.
- Persistence – You must do it over and over as often as possible.
- Patience – You must allow time to pass.
Simple plan, really hard to execute because being uncomfortable and afraid is not a natural thing to want to do. You must act when you feel your worst. Waiting until you have a “good day” does not help.
Here’s a short primer to help frame the whole process. Hopefully it serves as a good foundation for future discussion.
Overcoming Anxiety 101
NO REAL DANGER
A panic attack is nothing more than the natural “fight or flight” response triggered at inappropriate times. There’s nothing dangerous about a panic attack. It cannot kill you, damage you physically, or cause you to go insane, lose control, or become psychotic in any way. No matter how scary it may seem, none of these things is going to happen. It can’t be stressed enough – THERE IS NOTHING DANGEROUS ABOUT A PANIC ATTACK.
[Special note: You cannot pass out because of a panic attack. This is impossible because of the rise in blood pressure that comes along with a panic attack. You may hyperventilate in response to a panic attack (tingling sensations in your hands, feet and face are a good indicator that you are hyperventilating), which may then lead to passing out. Learning to control your breathing during high anxiety periods will allow you to avoid that. Even if you do pass out due to hyperventilation, you will regain consciousness shortly and no real harm will be done.]
FEAR FEEDS THE BEAST!
Panic and anxiety are made worse when you fear them. Adding fear to a panic attack or high anxiety situation is a sure way to make it last longer and feel more intense. Being afraid is a natural reaction to danger, but remember that in a panic attack there really is no danger. The key to beating panic and anxiety is to learn not to fear them. This is very hard and takes courage, hard work and patience, but it everyone can do it!
There are many coping techniques that can be used to navigate through a panic attack. Relaxation breathing, progressive muscle relaxation, positive self-talk and visualization/imagery can all be very helpful and effective in limiting the duration of a panic attack. Keep in mind that an actual panic attack involves the release of adrenaline into your bloodstream. Once that happens, there is no way to stop the physical symptoms of panic. It is important to remember that, but also remember that as long as you don’t feed the fear cycle your symptoms will subside naturally, usually within only several minutes. Coping techniques are designed to break the fear cycle and to limit the duration and intensity of a panic attack, not to stop a panic attack instantaneously.
There is a difference between coping and avoiding! Coping skills must be used to allow yourself to be completely immersed in a panic attack, letting it naturally run its rather short course, without adding more fear to the process (which will only prolong the attack and make it feel more severe). Many people mistake avoidance for coping. Avoidance is a problem from a behavioral and learning standpoint because it does nothing to teach you that panic is not harmful, and it creates the false belief that you must try to “get away” from a panic attack to be safe. Both stand in the way of actual recovery from panic disorder.
Examples of avoidance behavior include:
- Running to be in the presence of a friend or “safe person”
- Fleeing to a “safe place” (i.e. your home, your car, or a specific room in your home)
REACTING TO SYMPTOMS
It is important not to react physically to the sensations of a panic attack. For example:
- If you’re feeling short of breath, just let that happen. Don’t run to an open window in a frantic effort to get air into your lungs. Your lungs are working just fine. Remind yourself that shortness of breath is a common panic attack symptom and that if you don’t react to it, you will feel better very shortly.
- If you’re feeling a tightness in your chest, do not spend all your time poking, probing, stretching or otherwise trying to find a position that alleviates that tightness. Instead, allow your chest to be tight and remind yourself that this is nothing more than a panic attack symptom that will go away within minutes if you don’t fear it.
- If you suddenly get very hot or very cold, do not start removing clothing or running for the nearest heating duct. Just allow yourself to feel hot or cold and remind yourself that there is nothing dangerous about feeling that way and that the sensation is just part of panic and will subside shortly.
Use your coping techniques to calm your mind and to allow yourself to sit quietly, letting your symptoms come and go. This is a key aspect of recovering from panic disorder. Reacting in fear only leads to the belief that something you did somehow made you “safer”.
THERE’S NO COMFORTABLE WAY
This is a big one. There is no “comfortable” way to recover from panic disorder. Don’t waste your time or money on books, CDs, DVDs or websites that claim to have a “cure” for panic attacks unless you’re willing to face your fear head on as part of the process. Nobody can get you around that. Nobody. Sorry, but that’s just the way it is. The very heart of recovery lies in learning not to be afraid of panic The only way to do that is to fully experience panic without fleeing, avoiding, or adding more fear to the situation. This means that you will experience times of extreme fear and discomfort. That’s just the way it has to be. The good news is that if you’re willing to do that a few times, it will begin to get easier very quickly. It doesn’t take long for your courage to pay off as you suddenly find that you are no longer deathly afraid of having a panic attack. Reach that point and you’re most of the way home!
You have to be afraid, before you can not be afraid.
FINDING THE ROOT OF THE PROBLEM
Finding the causes of your panic attacks is a good thing, but not by itself. Stress, negative thinking, reactions to past traumas and emotional issues are just some of many possible panic and anxiety triggers. We’re all different, our life circumstances are all different, and that means that there is no one “cause” for panic attacks. Learning to identify your triggers and deal with them is an important part of recovery, but only if you’re also facing the panic and learning not to be afraid of it. Again, there’s no way around that. Learn not to fear panic and in the long run it won’t matter what happens in your life – you’ll never spend your time worrying about having panic attacks again.
THERAPY AND PROFESSIONAL HELP
Cognitive behavior therapy (CBT) is hands down the most effective current long-term treatment for panic disorder and related anxiety disorders. If you’re seeking professional help, look for a therapist that specifically specialized in CBT and anxiety disorders. Therapy focused on simply talking about your life might be helpful to a degree, but that is a very long term process and really does very little to address the immediate needs of a panic sufferer. Use CBT and related techniques to get past your panic attacks first. Once that’s done then feel free to talk for years about how your mother might not have hugged you enough as a child.
THE IMPACT OF LIFESTYLE
Lifestyle choices can influence your panic disorder positively or negatively. Eating a healthy diet can go a long way toward making you feel better overall. Avoid alcohol and mind-altering substances like recreational drugs. Anything that changes your mental state can be an anxiety trigger when you’re in a hyper-sensitive state (as many in the grips of panic disorder are). Get regular exercise and expose yourself to sunlight for at least 15 minutes every day if you can (use sunscreen when needed of course). Get plenty of sleep. Learn effective time and stress management techniques. Don’t ignore your emotional and spiritual needs. Living a healthy lifestyle make you feel better physically and mentally, and can really contribute to boosting your confidence and the feeling that you are in control of your life!
THE GOOD NEWS
Panic disorder and other anxiety disorders are among the most treatable conditions on the face of the planet today. Regardless of how long you have dealt with panic and anxiety, full recovery is within your reach at all times, even on what might seem to be your worst day!
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