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PANIC & ANXIETY The most essential thing to learn about panic is the experience of panic itself. Once it happens, a person's life changes dramatically. A panic attack brings on the fastest and most complex changes known in the human body. It is experienced as overwhelming, uncontrollable dread, as if one is terribly ill, about to die or lose one's mind. It drastically changes the functioning of major glands, heart, lungs, stomach, intestines, pancreas, kidneys, bladder, eyes, and the largest muscle groups. Even violent poisons or traumatic injuries have less effect. A cascade of stimulants and hormones - adrenaline, epinephrine, glycogen, cortical, norepinephrine, among others - flood all the cells of the body via the bloodstream. The impulse is to run, get out, or hide. Panic Disorders is the fear of having an 'uncued' spontaneous panic attack. It was first recognised and included in the American Psychiatric Association's Diagnostic & Statistical Manual (DSM) 111 in 1980. Ongoing research has increased the knowledge and understanding of this Disorder and is clearly evident in the current version of the DSM...No-4. In the DSM-111 and the DSM-111R no distinction was made in the different types of panic attacks. A panic attack was a panic attack. DSM IV recognises three different types of panic attacks.
Spontaneous panic attacks relate to panic disorder. Specific panic attacks relate to social anxiety disorder, obsessive compulsive disorder and post traumatic stress disorder. Situationally predisposed panic attacks may occur on exposure to the situational cue or trigger, but do not necessarily occur immediately after the exposure. The symptoms of a panic attack are described in the DSM-4 as a "discrete period of intense fear or discomfort in which four (or more) of the above symptoms develop abruptly and reached a peak within ten minutes. Symptoms of a panic attack are palpitations, sweating, trembling or shaking, sensations of shortness of breath or smothering, feeling of choking, chest pain or discomfort, nausea or abdominal distress, dizziness or lightheadedness, de-realisation or de-personalisation, fear of losing control or going 'crazy', fear of dying, parenthesis, and chills or hot flushes'.... 'Attacks that have fewer than 4 symptoms are referred to as 'limited - symptom attacks.' While the DSM-111R acknowledged that the avoidance behaviour (agoraphobia) relating to the panic disorder was a result of a fear of having a Panic Attack, this lack of distinction upheld the prevailing view of the time that a panic attack and the avoidance behaviour resulting from the attack was a "phobic" response to situations and/or places. Many of the earlier treatment methods for panic disorder/ agoraphobia focussed on gradual exposure to the avoided situation and/or place and did not directly deal with the panic attack itself. It is now recognised that a spontaneous panic attack is not associated with specific situations and places. The avoidance behaviour associated to Panic Disorder is recognised "as anxiety about being in situations and places from which escape may be difficult or embarrassing or in which help may not be available in the event of having an unexpected or situationally predisposed panic attack or panic like symptoms". The spontaneous panic attacks attack comes without any apparent warning, day or night irrespective of what the person is doing. Many people report that panic attacks happen when they are relatively 'calm' or 'relaxed' e.g. when they are watching TV or reading a book. In fact, a study we undertook in 1993 on the uncued/ spontaneous panic attack showed that 78% of Panic Disorder participants reported experiencing a panic attack when relatively 'calm'. 69% of Panic Disorder participants report they experience a panic attack while going to sleep and 86% report that the panic attack wakes them from sleep at night. Three internationally recognised experts in Panic Disorder describe a panic attack as follows: "An intense recurring spasm of panic that starts ... just below the breastbone and seem to spread like a white hot flame.. passing through the chest, up the spine, into the face, down the arms and even down into the groin to the tips of the toes" (C. Weekes). "The attacks start with a tingling feeling going up my spine which enters my head and causes a sensation of faintness and nausea" (J. Hafner) "A rushing sensation of a hot flash through the body.. sometimes associated with a sick feeling and a sensation of fading out from the world but this faintness is more like a 'white out' than a 'black out' and that the head may literally feel light." Sheehan C. Weekes (1962): Self Help for your Nerves. London: Angus & Robertson pp33. In our own research into the subjective experience of the spontaneous panic attack, we found that many people with Panic Disorder can experience a various sensations moving through their body - either before or during the actual panic attack. These sensations can change from one 'attack' to the next, which only adds to the confusion people feel. These sensations can include:
Link To http://www.paems.com.au/ or http://www.crufad.org/selfhelp/index.htm A self-help test is at http://www.crufad.com/K10/selfhelpindex.htm. This is a guide only and is non to be used as an official diagnosis. The worst thing you can do to yourself is self-diagnosis without seeing a professional.
BREATHE TO RELAX When you're under stress, your muscles tense, and your breathing becomes shallow and rapid. One of the simplest (and best) ways to stop this stress response is to breathe deeply and slowly. It sounds simple, and it is. Most of us, however, do not breathe deeply under normal circumstances, so it may help to review the mechanics of deep breathing and how it helps us to relax. Breathing Under Stress When prehistoric humans were in danger of attack, their muscles tensed and their breathing became rapid and shallow, as they prepared to run or fight. Their high level of tension was a means of preparing their bodies for optimum performance. Today, the causes of our "stress" are different, but our stress response is the same. However, since we're not running or fighting, our tension has no release and our stress response builds. One way to counteract the stress response is to learn how to breathe deeply and slowly -- the opposite of how we breathe when under stress. How Deep Breathing Works Deep breathing is not always natural to adults. Watch the way a baby breathes: the area beneath the chest goes in and out. Most adults breathe from the chest. This is shallower breathing, so less oxygen is taken in with each breath. As a result, the blood is forced to move through the system quickly so that enough oxygen gets to the brain and organs. High Blood pressure results. Deep breathing can reverse these effects. Take some time to practice this kind of breathing each day, especially when you're under stress. You can be sitting, standing or Iying down, but it helps to wear loose, comfortable clothing. Begin by breathing in through the nostrils. Count to five silently saying the word "in " and let your lower abdomen fill with air. Then silently saying the word "out" as you let the all escape a pursed lips. Do this deep breathing for two minutes or more each time. With practice, you will be able to count slowly to 10 or higher; You can increase your relaxation if you imagine breathing in ocean air, the scent of flowers or forest air. Effects of Deep Breathing By helping you let go of tension, deep breathing can relieve headaches, backaches, stomach aches and sleeplessness. It releases the body's own painkillers. called endorphins, into the system. It allows blood pressure to return to normal, which is good for your heart. Deep breathing can also allow held-in emotions to come to the surface, so your emotional health benefits from deep breathing, too. Use deep breathing any time, anywhere. It's one of the best techniques for relieving stress.
MAKING ANXIETY WORK FOR YOU Why do some people strive on stress while others fear it? The determining factor may be whether or not you feel in control of your life and yourself. People who choose their path, regardless of how stressful it is, don't suffer from stress as much as those who have no choice. Take Control How can you take control of your life? The first step is to get organized. Figure out what's important, then do it. Learn not to waste time on little things that don't matter. Many of us put off organizing things because it does take time and energy at first, but the benefits of being in control of your time and energy outweigh this initial investment. Taking care of yourself also puts you in control. Be deliberate about what you eat; foods that are high in energy-producing complex carbohydrates and low in fat and sugar. Translation: Keep junk food to a minimum (Remember a bonus for achieving maybe to have a hamburger, fish n chips etc. Get energy from fresh fruits, vegetables, soups, natural snacks and sandwiches. Skip the extra cup of coffee or cocktail. Caffeine and alcohol make stress feel worse. Set aside some time every day for your own mental and physical health well being. Exercise, relaxation, enjoyable activities and fun all enhance your sense of being in control of your life. Make a Commitment People who really believe their work is important and merits their best effort can often put up with enormous amounts of stress. Whenever possible, choose work that is personally meaningful to you, work you enjoy, work that meets your needs. If you don't have that luxury of doing the job you like then at least commit to doing your best at what you do. Be Open to Change All of us are subject to the curves life throws at us. There are two ways to react to change -fight against it because it takes you outside of your comfort zone or go with it and see where it takes you. Ironically, you increase your sense of control when you are open to change. Look at each change as an opportunity to gain new skills and knowledge, a new direction to learn from. If change isn't good for you then you need to look elsewhere, whether that is work, home, hobbies, clubs etc . Control, commitment and openness to change are the keys to turning anxiety into opportunity. You can't always choose your destiny in life but you control how you cope with it. The more you're "in the driver's seat," the easier it will be to cope with stress.
SELF ESTEEM Everyone has wonderful special qualities that are unique to them. It is important to recognize them and nurture them. There are many ways to develop a sense of self worth and self esteem. You can read books on self development, you can do courses on self esteem or talk to a therapist, you can treat yourself kindly and acknowledge your accomplishments and special qualities as well as being aware of what is important to you. Below are some helpful ways to start developing self esteem. Ways to enhance your Self Esteem
There is a little poem that I like to read to myself every now and then, and I would like to share this with you now. It is called THE PLUM, and is about accepting you just as the way you are.
THE PLUM You can learn that you cannot be loved by all people
RELAXATION To overcome high levels of anxiety, phobias, or panic attacks it is of paramount importance to learn how to relax. It is impossible to feel relaxed and tense at the same time. People who live with high levels of anxiety often do not know how to relax or to release the tension stored in their muscles that is contributing to the experience of anxiety. The best relaxation that makes a difference in dealing with anxiety is the regular, daily practice of some form of deep relaxation. Deep relaxation involves a number of physiological changes including:
Other benefits of deep relaxation include:
How do you achieve a state of deep relaxation?
PROGRESSIVE MUSCLE RELAXATION TECHNIQUE Progressive Muscle Relaxation is a technique for achieving a deep state of relaxation. Tensing a muscle and holding it for a few seconds, then releasing that tension will produce a deep sense of relaxation, and will rid the body of the built up tension from living with high levels of anxiety on a daily basis. Guidelines
Technique Progressive muscle relaxation involves tensing and relaxing, in succession, sixteen different muscle groups of the body. The idea is to tense each muscle group hard for about 10 seconds, and then to let go of it suddenly. You then give yourself 15 – 20 seconds to relax, noticing how the muscle group feels when relaxed in contrast to how it felt when tensed, before going on to the next muscle group. Often it is helpful to have some quiet, gentle music in the background. LINK: http://www.socialanxiety.com.au
BELIEFS & COGNITIVE THERAPY Cognitive Therapy is a very effective way of understanding how you think, and therefore feel. Cognitive Therapy helps us to explore our underlying belief patterns that result in negative, irrational and unhealthy thoughts. It then allows us to explore our thoughts and replace them with more useful ones in order to manage our emotions more effectively. Basically, we can think of our mind as being a suitcase which over time has collected many beliefs, thoughts, memories and past experiences. Some of these thoughts and beliefs are helpful, and some of these thoughts and beliefs are not so helpful and are causing us much discomfort. Cognitive Therapy assists us to examine what we are carrying around in our suitcase, and then helps us to remove the baggage that it unhelpful and causing us difficulties, and replace it with more useful thoughts and beliefs that help us to gain control over our emotions and behaviour. Cognitive Therapy is based on the following process: Beliefs LEADS TO Thoughts LEADS TO Emotions LEADS TO Behaviour Albert Ellis identified 10 major beliefs, which tend to emerge commonly in people who live with anxiety.
Every one of the above beliefs is unhealthy and are commonly found in people who live with Social Anxiety Disorder. If we can change our unhealthy beliefs and thoughts and replace then with more healthy and realistic beliefs and thoughts, we can therefore change our emotions (Anxiety) and hence our behaviour (Avoidance/Drug and Alcohol Dependence etc). The techniques used to assist us in this process are very simple, yet practical and are the foundation of helping us overcome our anxiety. Used in conjunction with some of the other therapies and treatments they become even more powerful. Cognitive Therapy helps us to take control of what we think and believe, and helps us to look at situations for what they really are - more realistically and rationally. When we can, we often realise that there is not really anything to fear as we previously thought, and as a result our anxiety diminishes. When we gain control of our thoughts and emotions we are then in a position to make choice about how we respond to situations. |
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