Managing Panic Disorder

Dr. Larry Cohen, Therapist and Life Coach, Voorhees, NJ (856) 352-5428 ContacT New Jersey TLC

One of the more complex mental health problems to recover from is panic disorder. Panic attacks come quickly - within minutes, you may experience shortness of breath, heart palpitations, dizziness, shakiness, and feeling like the world is coming down on you. People say that when they have a panic attack, it feels like an elephant is sitting on their chest. People often mistake a panic attack for a heart attack. In the emergency room, they later learn what happened to them was a panic attack.

Anxiety Problems

Panic attacks are part of the anxiety family of emotions. HOWEVER, having moments of high anxiety does not mean you are having a panic attack. The attacks can occur in various settings under various circumstances. Panic attacks can also occur without an emotional trigger. A hallmark problem with panic attacks is that once you’ve had one, the fear of having another one in the future can undermine you and lead to another attack. Without understanding what a panic attack is, you will not be able to quickly recover from having them.

Effects on Your Quality of Life

Because those with panic disorder find themselves fearful of having a future attack, what are called “avoidance behaviors” can occur. For example, if you had a panic attack at a particular place, such as a restaurant, you may find yourself avoiding that restaurant.

Unfortunately, when you have had a panic attack in front of other people, such as work colleagues, you can’t avoid seeing them altogether. This can affect your quality of life as each workday can become an excruciating and challenging experience. For example, if you had a panic attack during a customer presentation, you will begin avoiding having to do them. This scenario can be extreme, as you may lose your job because you can’t give these presentations.

Fight or Flight

The fight-or-flight response is a cognitive and behavioral mechanism designed to protect you from threats. It can be triggered in maladaptive ways and is at the core of panic attacks. Understanding panic attacks' physiological and cognitive parts will teach you how to manage and overcome them.

The physical sensations you experience during a panic attack can be terrifying. People report feeling like they are having a heart attack and near death. The mind and body misinterpret these sensations and create even greater feelings of anxiety.

It is essential to realize that these strong physical symptoms do not indicate life-threatening danger. They are intense and overwhelming responses to highly stressful events. Remembering this is essential - using cognitive methods, you can learn to reframe this experience and realize that what you FEEL is not based on reality.

Being better educated about panic attacks and their symptoms is the first step in overcoming them. Knowledge empowers individuals to recognize their experiences and reduces the fear of potential attacks.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy is one of the most effective treatments for panic disorder. Cognitive-behavioral therapy (CBT) focuses on identifying and changing negative thoughts lead to anxiety. In what is called exposure therapy, you will gradually be exposed to situations that trigger your panic attacks. You will learn new coping strategies to help you temper your response.

Piece by piece, you will pull apart and face the fears that are triggered. I call this attacking your thoughts. Is what you are thinking rational, or is it based on skewed, dysfunctional beliefs? In time, you will learn to challenge your thinking and understand that what you think is not in tune with “reality” but skewed thinking based on fear and high anxiety. With practice, you will gain the ability to recognize dysfunctional thinking and learn to manage your responses to anxious emotions.

Tools

Breathing exercises can also help you avoid panic attacks. Rapid breathing (hyperventilating) is a common symptom of panic that intensifies anxiety and fear. Slowly taking rhythmic deep breaths will bring relaxing feelings and help you avoid panic symptoms. Breathing in as deeply as possible through your nose and exhaling through your mouth multiple times

Being mindful and aware and practicing meditation techniques can also be helpful when you are working to alleviate anxiety and signs and symptoms you may experience related to panic attacks. Mindfulness is about being in the moment and staying present, observing your thoughts and feelings without judgment.

Mindfulness works to lower the fears you experience as you work to see reality and your emotional reactions without judgment. This removes their emotional power and helps them from becoming overwhelmed. Meditation is a practice you can use to relax.

You learn to see your experiences and feelings “from above” and learn to temper your emotional responses. Over time, utilizing mindfulness and meditation daily will have a short-term and long-term positive impact on your high anxiety and feelings of panic.

Using these new tools will reduce your fear of having another panic attack and can reduce the symptoms you experience before having an attack. Understanding that your thoughts lead to emotions and emotions lead to behaviors allows you to understand the underpinnings of high anxiety and panic. You can learn to fight off thoughts that lead to high anxiety and panic and look at your thoughts and symptoms in a new way.