I'll kindly try to add a word on word choice. Panic is not whatever someone says it is,
so it may be helpful to avoid that word if others suffice,- anxiety, waves of anxiety, dread, anxious spells, etc. Doesn't minimize the problem at all, but may help.
And another word... I don't know Salzberg at all, but since CAS says they're getting older, it's possible that a different set of writers and meditation guides may be helpful. There are lots of other resources which are not so similar in voice, stylized speech, and* kindly here.*..verbosity. ( TNH being one.)
CAS, if finding a competent therapist, vs the masses of "trained" ones, has been a problem, that is no obstacle at all. Your course will never rely on them.
Dear Sara, My son gets engulfed in anxiety without warning. I've wanted to find something he can turn to on the spot at those moments. John Crace the Great who writes funny columns in the Guardian and is so accomplished, described once that he's got a massive anxiety problem but he'd found a breath training that was like a miracle. I tried to find such a thing and my son's psychiatrist just said there are plenty of yoga teachers around. This was just last week. Then tonight VOILA here you are with this breath message. Tucked into all your other good advice. Thank you. Can I get him interested in this though? Maybe! A thousand thanks from random wonketeer, Gingerwentworth.
I’ll just stress the point to see your regular MD first and foremost. You don’t really describe your symptoms, so what you are experiencing may not be panic attacks at all.
When I was 25 yo, I was working full-time and going to law school at night from 6-9 PM. I started having these episodes - usually at night, but sometimes during the day - where it felt like an elephant was sitting on my chest, I had trouble breathing, and I would start sweating. I went to the doctor many times, and even the hospital ER. Because of my symptoms, the doctors always checked for heart issues, which I didn’t have. Because of my age and lifestyle (working FT plus law school PT), the diagnosis of “panic attacks” was the next logical choice.
After 5 years, one of my docs ordered an abdominal ultrasound. Turned out I was having gallstone attacks, which didn’t present in a typical fashion. Got my gallbladder removed at 30 yo, and no more problems. My surgeon told me the delay in diagnosis was likely because I didn’t fit the typical parameters (I was young and thin) and my symptoms were atypical. So, don’t assume your issues are necessarily because of a mental health issue, because they may very well have a physical cause.
Seconding this, especially if you are a uterus haver whose eggs are somewhere between “shriveledy” and “last few crushed chips in the potato chip bag” as mine own are. Every time I have thought “Oh I am a dying basket case” and then I look in the big Dr. Jen vagina or menopause books, it turns out it’s those last few damn crumbs in the bag that is my ovaries, and they are trying to murderize me in the most sobby way they can think of.
I’m going through perimenopause myself (thought I had my last period in January, but had another in June, so I guess I have to restart the clock). I’m not saying I don’t have issues with depression and anxiety, because I absolutely do, but sometimes there is an underlying physical condition.
Tell your ovaries to fuck off and stop trying to kill you!
Ta, Marcie. I've recommended Bach flower remedies (especially Rescue Remedy) for those who can tolerate alcohol (it's tinctured), but for those who cannot, there are people producing alcohol-free versions preserved with vinegar.
Best thing any therapists did for me regarding panic attacks is for me to say or shout 'this will not kill me, I am not dying'. Cuz you really thing you are sometimes. Then he taught me to talk myself down. If you need to get up and walk around do it. If you need to sit down and talk it through do it. If you need to scream, yell or release the anger anxiety do it.
Talk to yourself out loud and say your name out loud while doing it. Talk to yourself like you'd talk to your best friend out loud. Out loud makes it more real and not just head talk. Whether you need to be kind and caring or take a snap out of it approach you do what it takes to get yourself out of your own head. That is where the panic is coming from.
Talking out loud to yourself activates different neural networks to help rewire the brain. It feels weird at first, but when it starts working, you don't need to do it as often. It also changes the internal monologue that can exacerbate anxiety and depression. I suggest it to my clients frequently.
It was one of my breakthrough moments that resonated with me that I will walk through life with in my mental health arsenal. A good therapist is their weight in gold. They gave me my life back.
Panic attacks are generally very responsive to Cognitive Behavioral therapy if the MD rules out physical causes. Even though every instinct is to withdraw from anything that feels threatening, when it comes to anxiety, avoidance is NOT your friend. Also, even though they feel absolutely huge and terrible, they are not damaging your body in any way.
I've had lifelong anxiety issues comorbid with (for the first 4 decades) undiagnosed ADHD, which sometimes resulted in panic attacks. Because of the (untreated) ADHD, many of the medications I was prescribed to help with the anxiety and panic barely touched the problem, or actually exacerbated it, so I can fully understand the resistance to adding medications.
Your results may vary, but both pre- and post-ADHD diagnosis and treatment, the only thing that consistently helped/helps me reduce my overall anxiety and prevent panic attacks has been exercise. It doesn't have to be intense, but the deeper into "runner's high" zone that I get, the longer the benefits of any given exercise period last. I'm a large human, so I don't actually run; I lift weights and use an elliptical or walk because my joints don't like high impact.
TL;DR: Exercise good, anxiety bad. Hopefully you find something that works for you!
Same! With the exception of a sublingual benzo I would take directly before I knew I was going to experience a very specific trigger (going to Target during back-to-school season, or to the mall ever), they didn’t help much. Getting diagnosed with ADHD and going on my stimulant med? My overall anxiety is down by about 75%, more if I don’t have anything stressful going on in my life. I didn’t realize how anxious having everything in my environment screaming at me all of the time made me until the meds turned down the volume. It’s way easier to deal with everyday stressors.
I did the same. I became someone I didn't recognize but embraced the shit out of her and still do. I quit caring what others thought about me and looking for validation. What they think about me is none of my business and I don't give a shit.
Great article Sara. Panic attacks are terrifying. Mine started after my mother's death when I was 16. For YEARS I didn't know what was going on...this was in the early 80's, there was little to no discussion about this type of mental illness back then. My world got smaller and smaller and when I had a panic attack sitting around a dining room table with my family I knew I needed serious help. Therapy helped tremendously, I hated the meds too but I used them as a tool to get through talk therapy and the thing that helped the most....behavioral therapy. My attacks were really triggered by going to restaurants, theatres, etc. I had the most wonderful therapist who would, literally, go out to lunch with me in restaurants during my sessions and talk me through it all. Use the meds, do the work, it will get better and then you won't need to lean on the meds so much.
I have experienced mild panic attacks which I think held me back professionally. Now retired and I still have anticipatory attacks prior to leading meetings with a volunteer org. I'm having one right now and distracting myself by posting here. I could not have read Sara's post at a more opportune time... real time.
Deep breaths (10 seconds technique) and into the fray...
I will add to some of the comments here, regarding medication. I began experiencing panic attacks as a result of what I now know was workplace bullying. Getting out of that situation definitely helped, but so did a prescription for a low-dose SSRI.
It's not really that the medication I was given completely suppressed the symptoms, or did something like totally flatten out my personality or anything. What it did do was just turn down the anxiety enough for me to take stock of things, and work to identify what was triggering me, and ways that I could address that, as well as the more immediate symptoms. It also helped with things like sleep disruption, which was one of the things I was experiencing. You can also work with your doctor to find the right drug and the right dosage. If the first thing they give you doesn't provide the help you need in the way you want it, continue the conversation with your doc.
Of course, now I'm starting the process of quitting my prescription. It served its purpose, and definitely helped, but at this point, I feel like I no longer need it.
Dear Ms Sara and CAS,
I'll kindly try to add a word on word choice. Panic is not whatever someone says it is,
so it may be helpful to avoid that word if others suffice,- anxiety, waves of anxiety, dread, anxious spells, etc. Doesn't minimize the problem at all, but may help.
And another word... I don't know Salzberg at all, but since CAS says they're getting older, it's possible that a different set of writers and meditation guides may be helpful. There are lots of other resources which are not so similar in voice, stylized speech, and* kindly here.*..verbosity. ( TNH being one.)
CAS, if finding a competent therapist, vs the masses of "trained" ones, has been a problem, that is no obstacle at all. Your course will never rely on them.
Damn! This was done perfectly!
Dear Sara, My son gets engulfed in anxiety without warning. I've wanted to find something he can turn to on the spot at those moments. John Crace the Great who writes funny columns in the Guardian and is so accomplished, described once that he's got a massive anxiety problem but he'd found a breath training that was like a miracle. I tried to find such a thing and my son's psychiatrist just said there are plenty of yoga teachers around. This was just last week. Then tonight VOILA here you are with this breath message. Tucked into all your other good advice. Thank you. Can I get him interested in this though? Maybe! A thousand thanks from random wonketeer, Gingerwentworth.
I’ll just stress the point to see your regular MD first and foremost. You don’t really describe your symptoms, so what you are experiencing may not be panic attacks at all.
When I was 25 yo, I was working full-time and going to law school at night from 6-9 PM. I started having these episodes - usually at night, but sometimes during the day - where it felt like an elephant was sitting on my chest, I had trouble breathing, and I would start sweating. I went to the doctor many times, and even the hospital ER. Because of my symptoms, the doctors always checked for heart issues, which I didn’t have. Because of my age and lifestyle (working FT plus law school PT), the diagnosis of “panic attacks” was the next logical choice.
After 5 years, one of my docs ordered an abdominal ultrasound. Turned out I was having gallstone attacks, which didn’t present in a typical fashion. Got my gallbladder removed at 30 yo, and no more problems. My surgeon told me the delay in diagnosis was likely because I didn’t fit the typical parameters (I was young and thin) and my symptoms were atypical. So, don’t assume your issues are necessarily because of a mental health issue, because they may very well have a physical cause.
Seconding this, especially if you are a uterus haver whose eggs are somewhere between “shriveledy” and “last few crushed chips in the potato chip bag” as mine own are. Every time I have thought “Oh I am a dying basket case” and then I look in the big Dr. Jen vagina or menopause books, it turns out it’s those last few damn crumbs in the bag that is my ovaries, and they are trying to murderize me in the most sobby way they can think of.
I’m going through perimenopause myself (thought I had my last period in January, but had another in June, so I guess I have to restart the clock). I’m not saying I don’t have issues with depression and anxiety, because I absolutely do, but sometimes there is an underlying physical condition.
Tell your ovaries to fuck off and stop trying to kill you!
I have never been so bummed as when my June period disturbed my February shutdown.
Ta, Marcie. I've recommended Bach flower remedies (especially Rescue Remedy) for those who can tolerate alcohol (it's tinctured), but for those who cannot, there are people producing alcohol-free versions preserved with vinegar.
Andrew Weil may be a fine meditation teacher, but should be ignored for anything actually medical.
My first thought as well; he is kind of a snake oil salesman.
Yeah, he is not a practitioner of evidence-based medicine.
Thank you, Sara. You always make the kindest, most well thought out sense :).
Just ran across this. Relieving Anxiety - The election is stressful, but avoidance won’t help. The key, says Harry Um, is taking action.
https://www.lionsroar.com/electing-freedom/?utm_source=Lion%27s+Roar+Newsletter&utm_campaign=3f0f64e5a1-EMAIL_CAMPAIGN_2023_05_15_03_13_COPY_01&utm_medium=email&utm_term=0_-070340879e-%5BLIST_EMAIL_ID%5D&goal=0_1988ee44b2-3f0f64e5a1-22617385&mc_cid=3f0f64e5a1&mc_eid=3cd8c438fa
Not directly related, but this matches what I know of trauma: It is not the experience itself that is traumatic, it is the feeling of powerlessness.
And the triggers that can follow for life.
Best thing any therapists did for me regarding panic attacks is for me to say or shout 'this will not kill me, I am not dying'. Cuz you really thing you are sometimes. Then he taught me to talk myself down. If you need to get up and walk around do it. If you need to sit down and talk it through do it. If you need to scream, yell or release the anger anxiety do it.
Talk to yourself out loud and say your name out loud while doing it. Talk to yourself like you'd talk to your best friend out loud. Out loud makes it more real and not just head talk. Whether you need to be kind and caring or take a snap out of it approach you do what it takes to get yourself out of your own head. That is where the panic is coming from.
Talking out loud to yourself activates different neural networks to help rewire the brain. It feels weird at first, but when it starts working, you don't need to do it as often. It also changes the internal monologue that can exacerbate anxiety and depression. I suggest it to my clients frequently.
It was one of my breakthrough moments that resonated with me that I will walk through life with in my mental health arsenal. A good therapist is their weight in gold. They gave me my life back.
Panic attacks are generally very responsive to Cognitive Behavioral therapy if the MD rules out physical causes. Even though every instinct is to withdraw from anything that feels threatening, when it comes to anxiety, avoidance is NOT your friend. Also, even though they feel absolutely huge and terrible, they are not damaging your body in any way.
I've had lifelong anxiety issues comorbid with (for the first 4 decades) undiagnosed ADHD, which sometimes resulted in panic attacks. Because of the (untreated) ADHD, many of the medications I was prescribed to help with the anxiety and panic barely touched the problem, or actually exacerbated it, so I can fully understand the resistance to adding medications.
Your results may vary, but both pre- and post-ADHD diagnosis and treatment, the only thing that consistently helped/helps me reduce my overall anxiety and prevent panic attacks has been exercise. It doesn't have to be intense, but the deeper into "runner's high" zone that I get, the longer the benefits of any given exercise period last. I'm a large human, so I don't actually run; I lift weights and use an elliptical or walk because my joints don't like high impact.
TL;DR: Exercise good, anxiety bad. Hopefully you find something that works for you!
Same! With the exception of a sublingual benzo I would take directly before I knew I was going to experience a very specific trigger (going to Target during back-to-school season, or to the mall ever), they didn’t help much. Getting diagnosed with ADHD and going on my stimulant med? My overall anxiety is down by about 75%, more if I don’t have anything stressful going on in my life. I didn’t realize how anxious having everything in my environment screaming at me all of the time made me until the meds turned down the volume. It’s way easier to deal with everyday stressors.
You can quite literally feel yourself calm down as the stimulant takes hold. It's like magic.
Wow - my story too...untreated ADHD can make you very panicked indeed: "how will I mess up next?"
When I was in my 30s I started getting hot flashes. I figured it was too much coffee. Then the panic attacks started. It turns out I was menopausal.
I did the same. I became someone I didn't recognize but embraced the shit out of her and still do. I quit caring what others thought about me and looking for validation. What they think about me is none of my business and I don't give a shit.
Mindfulness helps for me, it helps me get some perspective and to regard what is happening impersonal, I ask myself, where is this co.ing from?
Great article Sara. Panic attacks are terrifying. Mine started after my mother's death when I was 16. For YEARS I didn't know what was going on...this was in the early 80's, there was little to no discussion about this type of mental illness back then. My world got smaller and smaller and when I had a panic attack sitting around a dining room table with my family I knew I needed serious help. Therapy helped tremendously, I hated the meds too but I used them as a tool to get through talk therapy and the thing that helped the most....behavioral therapy. My attacks were really triggered by going to restaurants, theatres, etc. I had the most wonderful therapist who would, literally, go out to lunch with me in restaurants during my sessions and talk me through it all. Use the meds, do the work, it will get better and then you won't need to lean on the meds so much.
I have experienced mild panic attacks which I think held me back professionally. Now retired and I still have anticipatory attacks prior to leading meetings with a volunteer org. I'm having one right now and distracting myself by posting here. I could not have read Sara's post at a more opportune time... real time.
Deep breaths (10 seconds technique) and into the fray...
I will add to some of the comments here, regarding medication. I began experiencing panic attacks as a result of what I now know was workplace bullying. Getting out of that situation definitely helped, but so did a prescription for a low-dose SSRI.
It's not really that the medication I was given completely suppressed the symptoms, or did something like totally flatten out my personality or anything. What it did do was just turn down the anxiety enough for me to take stock of things, and work to identify what was triggering me, and ways that I could address that, as well as the more immediate symptoms. It also helped with things like sleep disruption, which was one of the things I was experiencing. You can also work with your doctor to find the right drug and the right dosage. If the first thing they give you doesn't provide the help you need in the way you want it, continue the conversation with your doc.
Of course, now I'm starting the process of quitting my prescription. It served its purpose, and definitely helped, but at this point, I feel like I no longer need it.