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Thanks for coming back for Part 2! Today I'm going to talk about some of the ways I learned to prevent and manage my panic attacks and anxiety. Click for Parts 1, 3 and 4.
Please note: I am not a therapist and I cannot guarantee that what worked for me will work for you. I hope you can learn a thing or two from my experiences, and that some of my tips will help you keep anxiety and panic at bay. If your experiences are debilitating, I recommend you talk to both a medical doctor and a therapist to get to the root of the problem.
Tools and techniques
During my first round of panic attacks after my car accident in 1990, the therapist at that time focused on helping me reduce anxiety while in the midst of an attack. These tools mostly consisted of breathing, relaxation and visualization techniques, and they were very helpful.
In several situations, such as a transatlantic plane ride, or the time on the Tube in London where the train stopped for a few minutes in the middle of a dark tunnel, I was able to use these techniques to keep myself from completely freaking out in the small, cramped space. Visualization has been especially helpful inside an MRI machine! You can find many resources on the Web for these kinds of exercises. I have a free relaxation and vocal preparation handout here and and an article with additional tips here. At that time, they were very helpful.
This time around, however, those techniques seemed almost worthless. My mind was completely in control of my body, so using techniques that started in the body were not working. I was so sensitive to heat, noise, crowds, small spaces, and pain (mine or anyone else's -- even on a TV show), that triggers were everywhere. Here are some additional tools I learned from my current therapist that went a step further.
In my case, I needed to go directly to the cause of the panic -- my thoughts. As I mentioned in this post on emotional reasoning, thoughts and feelings can take control, whether or not they are based on reality. Thought stopping is simple, but not easy: Stop thinking that thought!
When I caught myself starting to worry about my sick cat, or feeling hot and oppressed in a restaurant, or wondering if I might get panicky because I felt claustrophobic in the car, or any of a million other worrisome thoughts, I literally told myself to change the subject. If I was with my husband, I would ask him to tell me what was going on at work that day. If I was alone, I would distract myself by consciously noticing the color of the sky or the trees or feeling the breeze on my face.
If I could stop my thought and stay in the present, I could keep it from escalating into the physical sensations of a panic attack. Once the "danger" was past, I could move on.
Planning to plan... or... avoiding avoidance
Sometimes I would become anxious just thinking about future anxiety. An upcoming crowded party, a trip away from home, an extra-busy week... just the thought of the possibility that I might have a panic attack (aka "anticipatory anxiety") made me want to avoid any possible trigger.
However, "The role of avoidance -- a type of security move -- is complex. It is responsible for perpetuating your fear of certain places because the longer you avoid a place, the more likely it is that you will begin to believe that avoidance is what's keeping your fears under control. So the longer you avoid a place, the harder it becomes to go there again.
By avoiding specific places you are attempting to avoid the frightening sensations and thoughts you predict you will experience. By trying to eliminate the sensations of anxiety or panic at all costs, your fear of having these feelings ultimately intensifies." From the book, "Overcoming Panic, Anxiety and Phobias"
Instead of avoiding scary situations, I made plans for how to deal with panic, should it arise. Drinking water calms me, so I made sure I had a bottle of water on hand. Going away for the weekend with friends made me nervous, so I took my own car in case I needed to leave. If I had a lot of commitments in a week, I made sure to plan some quiet downtime. I always told myself there was a plan B. I faced my fears, but in an organized way.
Keeping my anxiety a secret just made it worse. Of course, I talked to my therapist once a week, but in between those sessions, I still needed an outlet.
I had a small group of my closest friends who knew what was going on. That way, if I started to panic on a car ride or something, I didn't have to explain. Even a tiny moment of panic that passed quickly was worth it to me to share with my husband, so I could acknowledge it and also acknowledge getting past it. And thank goodness he was understanding and listened when I needed it.
Going a step further, I needed to change the way I was living my life that led me to a state of heightened stress and aggravation in the first place. Why wait until I'm having a panic attack to deal with it, when I might be able to make my life panic-free?
Four simple changes have made all the difference: Eat better. Get more sleep. Exercise. Don't overdo it.
I'm not kidding you. It sounds ridiculously and deceptively simple, but how many of you are paying attention to these things every day?
It's easy to eat an unhealthy diet; it's easy to stay up and keep working; it's easy not to exercise! And, especially in our American business culture, it's really easy to overwork, overschedule, and overcommit. It's even considered a badge of honor to be extremely busy. It makes us feel important and needed.
However, ignoring physical and mental self-care is what destroys our health, not to mention our relationships and our happiness.
For example, when you're tired, it's easy to overload your circuits. When you're tired, it's harder for your mind and body to handle difficult situations.
For example, our bodies need nutritious fuel and water. How can we expect to feel healthy, strong and energetic if we are fueling ourselves with nothing but sugar, fat and caffeine all day? Caffeine and alcohol can exacerbate anxiety all on their own in fact, so cutting back can have a huge benefit in reducing your anxiety.
Now, I get up in the morning when I'm rested, not when the clock tells me to. I make an effort to be conscious of what I'm eating and why. I try to stay hydrated. I work out regularly. And I take downtime and "funtime" whenever I need some. And I don't feel one bit guilty about it! I'm not perfect and I am human, so I fail at some of these some of the time. But my physical and mental health are more important to me than my job or what anyone else thinks of me.
Cultivate a positive outlook on life
When I was going through this rough time, I started seeing people differently. I started realizing that I was interacting with people every day who might be going through their own rough times. Maybe they were sick, maybe they were in pain, maybe they were living in fear, maybe their cat (or mom, or child) had cancer. I realized that, if I could walk around looking "normal," so could other people. I realized that people who seemed like jerks might be feeling the same way I was feeling inside. I wanted to be more open to people, more friendly, more accepting. I wanted to see the good in people and in life.
I admit it, I'm an optimist. I was born that way. But even optimists can sometimes let our experiences jade us and turn our minds dark with worries, anger, fear and negativity, instead of focusing on the good in the world and the abundance of good things in our lives.
Sometimes it's not easy, but I believe it's worth it to let go of the negative, feel the weight lift from my shoulders, and truly enjoy the life I've been given.
If you're a chronically negative person, imagine how your life could be better by letting go of the dark thoughts. What more could you accomplish if you always believed you could? How much more could you enjoy life if you allowed yourself to enjoy life? How much time do you waste on fear, anger, melancholy, worry and drama?
I started a blog halfway through the year last year just for the purpose of focusing on the positive, and on the things that make me happy in life. Maybe it's a little (or a lot) corny, but as part of my healing process and lifestyle rearrangement, it has been like additional therapy.
Recognize warning signs
I had six months or more of warnings in 2008 that I failed to heed. Sure, I knew I was having panic attacks, but I waited way too long to do anything about them.
Now I know that ignoring them will not make them go away, and will likely cause them to build up again to massive proportion. I will never make that mistake again.
In Part 3, I'll talk about getting off the meds, and the rest of the story. Please feel free share your resources and tips in the comments.
End of Part 2.