Don’t Panic! *

David A. Gershaw, Ph.D.

If you have ever been in a serious car accident or suffered through strong turbulence in an airplane, you have a brief idea of what it is to panic. You tense up. Your heart pounds like a jackhammer. You tremble, feel nauseated, and are short of breath. You are drenched in sweat.

What if you felt that way several times a day? What if these feelings occurred when there was really no danger at all? If so, you may have a panic disorder. A panic disorder involves multiple episodes of intense, unprovoked terror with at least four of the following symptoms:

Researchers are still confused about what starts feelings of panic when no danger exists. For no apparent reason, the nervous system starts a "flight-or-fight" response. It can happen anywhere – on a bus, in an elevator, or in a store.

We do know that the fear or worry of a panic disorder is so severe, it keeps a person from functioning normally. It affects about 13-18% of all Americans, and almost two-thirds of them are women, typically ages 18-34. Unfortunately, these women are least likely to seek treatment. From a recent poll conducted by the Anxiety Disorders Association of America (ADAA), they either attribute the feelings to stress or dismiss them as trivial.

Although there can be a genetic predisposition to panic disorders, nurture is also influential. Overprotective parents can give their children the idea that the world is a basically dangerous place. If a parent is lost in the child’s early life – by death or separation – this increases the probability of panic disorders. Panic is more likely to strike when people are going through a period of change.

Jerilyn Ross, president of the ADAA, says it may be difficult to get proper treatment. The average sufferer sees 10 health professionals, before the condition is correctly diagnosed. Only one-third get proper care.

Without treatment, panic disorders can become fatal. The panic feelings can lead to agoraphobia – victims are so afraid, they cannot even leave their homes. Some try to self-medicate to reduce their fears – 30% abuse alcohol and 17% use illegal drugs. About half of all victims become depressed, and some of these attempt suicide.

The best short-term treatment
is to teach anxious people how to relax.

However, with the right treatment, panic attacks can be reduced or eliminated in about 70-90% of the cases. In the short term, cognitive-behavioral therapy helps clients relax and cope with the "false alarm" their bodies are sending. This can be helped by antidepressants or anti-anxiety drugs. Support groups help too. Sharing anxieties helps people feel less alone and less fearful of future attacks.

From time to time, all of us experience anxiety. It can be felt as uneasiness or apprehension. Worries may keep us from sleeping. We may shudder at the thought of speaking in front of a large group. It may have some of the physical symptoms discussed earlier – like a racing heart or a cold sweat. At the extreme, it could be a sense of impending disaster.

Anxiety can also be positive, stirring us to action or helping us to achieve our goals. It can help us to deal with future challenges. However, excessive anxiety can cloud your thinking and interfere with making effective decisions.

If anxiety is mounting, there are effective strategies you can use. Here are some recommendations.

• Show yourself that your fears are unfounded. Keep a journal of all your fears for several days and put it away for a week. When you look at it again, you will see that almost all of your fears were baseless.

• Focus on the present. Anxiety is future-oriented. Rarely is anything threatening in the present. Sit back and attend to your current surroundings. You can’t do this and worry at the same time. As the saying goes, "Stop and smell the roses."

• Schedule a "worry break." Schedule 30-minutes each day just to worry. If anxieties occur, postpone them until your "worry session." Chronic worriers have reduced their suffering by 40% within a month by scheduling "worry breaks." These sessions can also be used to "brainstorm" possible solutions to your worries.

• Concentrate on taking deep breaths and relaxing. When anxiety strikes, put you hand on your stomach to feel it rise as you breathe deeply. Repeatedly inhale to a count of four, then exhale to the same count.

• Practice healthy habits. To reduce tension, do aerobic exercise at least 20 minutes a day, three times a week. Adequate rest is helpful, since lack of sleep can worsen anxiety. Since stimulants increase tension, cut back on your caffeine.

The New Year is viewed as a time of new beginnings. You may find yourself worrying about this prospect rather than looking forward to it. If so, use the methods mentioned above. If these suggestions are not effective, don’t hesitate to seek the help of a health professional. Make your next year a better one.

* Adapted from "Fighting Panic Attacks," Easeline Pamphlet, Fall, 1997, pages 1, 4-5.

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