What are some strategies for managing panic? Got Anxiety?
Mary B. Barmann, MFT
This is the final in a four-part series regarding panic attacks, including information on panic symptoms, panic-prone personalities, medical conditions that mimic panic, and strategies for controlling attacks. The series is co-written by Barry Barmann and his wife, Mary.
At our Center for Anxiety & Chronic Worry, we treat several patients each month with a diagnosis of Panic Disorder. Seen below, with the patient’s consent, is a brief transcript from our initial session:
“Whenever I start thinking about leaving my house to go for a walk, my heart races, I have difficulty breathing, my legs feel weak, and my throat feels like it’s closing. I keep trying to fight these feelings, but the more I fight it, the worse it gets.
“I guess I’m not fighting hard enough — maybe I’m not strong enough. Why can’t I beat this thing that has been going on for 15 years? Why does it keep getting worse? I’ve been avoiding leaving my house for too long, but I have no choice. I feel like I’m on house arrest.”
FIGHTING IN QUICKSAND
The patient referenced above represents someone who employs the typical strategies the majority of people use for dealing with panic attacks.
They either fight their symptoms, or avoid going to places they fear a panic attack may occur. The more they fight the symptoms, the worse it gets. The more they avoid and run from panic, the faster it chases them.
These individuals are fighting in quicksand — the more they struggle, the faster they sink. When people worry about a potential threat occurring in the near future, they put their guard up, hyper-vigilant to spot trouble.
When you’re looking for trouble, guess what happens? You’ll find it. So why keep looking? Why keep fighting? IT’S NOT WORKING!
When running the same play in a football game that results in no gain, it’s time to eliminate that play and design a new one for moving forward.
Those who suffer from panic need to think about personifying the disorder itself. That is, if panic were a person, describe its personality.
Our guess is that you would describe this person as a bully; someone who tells you what you can and cannot do each day.
Panic tells you to stay in your house where it’s safe. Panic dictates that you may not venture out to the very places you used to enjoy, such as movies, dinner out with friends, etc.
Here’s the problem — you keep following those directions. Sounds like an abusive and controlling relationship to us.
CHANGE YOUR RELATIONSHIP
The relationship you have with panic needs to change. It’s time for the pendulum to swing back to a time when you were in control and made you own rules, a time when fear did not dictate your daily activities.
In order to take control of panic, you need to first understand the relationship you have with it, followed by learning methods for changing this relationship.
However, we want to make it clear that we strongly encourage anyone who suffers from panic to seek treatment from a mental health professional who specializes in treating Panic Disorder.
The suggestions discussed below, should be performed in conjunction with a trained professional.
RESPONSES THAT FUEL PANIC
As we already mentioned, resisting symptoms of panic only makes it worse; resistance creates persistence. Seen below are response patterns that serve to maintain panic:
• Be afraid of physical sensations that you label as “panic attacks.”
• Avoid situations that might trigger a panic attack.
• Always fight and resist sensations of panic.
• Worry about when the next attack will occur.
• Fear the possibility of feeling physically and socially trapped.
• When uncertain, feel anxious and expect danger.
STRATEGIES FOR MANAGING PANIC
So here’s the paradox — to beat panic, you need to stop fighting it. Employ a new strategy. We understand that our suggestions will sound counter-intuitive regarding how you currently think about panic.
It’s OK to be afraid when panic attacks; that’s your first reaction. However, focus on your “second reaction” — a shift in attitude concerning these sensations, a response in which you DO HAVE CONTROL.
This new mindset must compete against your present “resistance stance,” the one that keeps you stuck. Your new stance must consist of the following:
• SEEK OUT opportunities that trigger panic sensations, thus disarming panic’s “unpredictable” onset.
• WANT the possible outcomes you currently fear the most.
• Label your physical sensations as UNCOMFORTABLE, not harmful.
• Move TOWARD perceived threat, lower you guard, and become vulnerable.
• Accept risk, and TOLERATE uncertainty.
• EMBRACE fearful outcomes as a possibility, and an OPPORTUNITY to practice better handling your physical sensations, emotional responses, and the judgment of others.
• Remember anti-climatic outcomes — the exaggerated ones you predicted, which NEVER occurred.
So, drop your guard, accept uncertainty, and enjoy the rewards that accompany your new attitude. Recapture a lifestyle you once cherished.
Barry C. Barmann, Ph.D., is a Licensed Clinical Psychologist in Nevada and California. His wife, Mary B. Barmann, MFT, is a licensed Marriage and Family Therapist in California. They own the Center for Anxiety & Chronic Worry in Incline Village. Barry may be reached for comment at firstname.lastname@example.org; visit anxietytreatmentinclinevillage.com to learn more.