The Key to Overcoming Panic Attacks

The surest path to overcoming panic attacks is to train yourself to respond to panic in accepting and calming ways.
This article will show you a specific, simple, and powerful set of tips for overcoming panic attacks. This material comes from my Panic Attacks Workbook.

As you read the steps described below, think about how they compare to what you usually do during a panic attack. The Panic Trick tells us that your gut instinct of how to respond to a panic attack will likely be to do something that makes the problem worse rather than better. The path to overcoming panic attacks requires responses that are quite different from what you usually do. If you keep doing the same thing, you'll probably keep getting the same result. If you seek anxiety relief, you need to look for different methods.
You can use these five steps to guide your responses during a panic attack. The regular use of this approach will go a long way towards your goal of overcoming panic attacks. I have adapted them, with some modifications of my own, from Anxiety Disorders and Phobias: A Cognitive Perspective, an excellent professional text by Beck, Greenberg, and Emery.

The Five Steps of AWARE

The five steps to overcoming panic attacks are:
Acknowledge & Accept
Wait & Watch (and maybe, Work)
Actions (to make myself more comfortable)
Repeat
End
Let's take a look at what each step entails.

Acknowledge & Accept

All progress starts here. This is the most important single step to overcoming panic attacks.

Acknowledge

Here I acknowledge the present reality, that I'm afraid and starting to panic. I won't try to ignore it, or pretend it's not there. I won't struggle to distract myself, tell myself to "stop thinking about it!", or snap any rubber bands on my wrist.
I'm acknowledging simply that I am afraid, not that I am in danger. The thought that I am in danger is just another symptom of panic, not an important or useful thought.

Accept

Here I accept the fact that I'm afraid at this moment. I don't fight the feeling; ask God to take it away; blame myself, or anybody else. I accept, as best I can, that I'm afraid in the same way I would accept a headache. I don't like headaches, but I don't bang my head against the wall in an effort to get rid of them, because that makes them worse. Overcoming panic attacks begins with working with, not against, my panic and anxiety symptoms.

How Can I Accept a Panic Attack?

What makes a panic attack acceptable (not desirable, but acceptable) is that, while it feels awful and fills me with dread, it isn't dangerous. It won't kill me or make me crazy. Someone pointing a gun at me, that's not acceptable. I might get hurt or killed. If someone points a gun at me, I have to do whatever I can to change that: run, hide, fight, yell, bribe, or beg, because the consequence of being shot is so terrible that I must try to avoid it.
On the other hand - a policeman giving me a ticket, even if I don't deserve it, I can live with that, and can hopefully keep my temper in check so I don't make things worse for myself.
Accepting the symptoms, not resisting, is a powerful step to overcoming panic attacks.

What Can a Panic Attack Do to Me?

It makes me feel afraid, that's what a panic attack does. And, if I'm having a panic attack, I'm already there! I'm already experiencing the worst that will happen. I just need to ride it out. That's the surest path to overcoming panic attacks.
Why should I accept a panic attack? Because the more I resist panic, the worse it gets. The more I develop the habit of acceptance, the more progress I make toward my goal of overcoming panic attacks.
That's Acknowledge & Accept. How does that compare to what you usually do during a panic attack?

Wait & Watch (and maybe, Work)

Wait

What I mean by "Wait" is this: don't just do something, stand there. It's similar to the suggestion "count to ten before you get mad".
One of the hallmarks of a panic attack is that it temporarily robs you of your ability to think, remember, and concentrate. This step will buy you a little time to regain those abilities before you take any action.
When you react before you have a chance to think straight, what do you do? If you're like most people, you probably flee, or struggle. You do things that actually make it worse. This is what people mean when they say things like "I know I'm doing it to myself" and the harder I try, the worse it gets.
Jumping into action too quickly is a big obstacle to overcoming panic attacks.
So, even though you have a powerful urge to leave, postpone that decision for a little bit. Don't tell yourself you CAN'T leave - keep that option open so you don't feel trapped - but put off the decision about whether or not to leave. Stay in the situation. You don't need to run away to get relief. Let relief come to you.

Watch

Use the occasion to observe how the panic works, and how you respond to it. The best way to do this is to fill out a panic diary. The diary is a questionnaire which helps you notice important aspects of a panic attack, so you can respond more effectively over time. Feel free to download and reproduce it for your own personal use. You can also download a set of instructions.
My patients often report that just filling out a diary helps them to calm down. How does this work? It's not that they're distracted from the subject of panic, because the diary questions are all about panic. It helps you get a little distance from your emotions. It works because, while you complete a diary, you're in the role of an observer, rather than feeling like a victim.
The best way to use the diary is to fill it out during the attack, rather than after. If you're in a situation where writing is impractical, perhaps while driving a car, you can: use a digital recorder; have your support person read the questions to you and record your answers; or pull over for a few minutes to write.

What About "Work"?

If you're in a relatively passive situation during the panic attack - a passenger in a vehicle, getting your hair cut, or waiting in a waiting room - "Wait & Watch" is all you need. If you're in a more active role - driving a car or giving a presentation - then you also need to attend to the "Work" of conducting that activity. Do "Wait & Watch", but also remain engaged in your task.
That's "Wait & Watch (and maybe, Work)". How does that compare to what you usually do during a panic attack?

Actions (to make myself more comfortable)

At this point, you've already gone through the two most important steps to overcoming panic attacks.
These steps, and all the steps necessary to overcome panic disorder and phobia, are covered in much more detail in my Panic Attacks Workbook.

What's Your Job During an Attack?

It's not your job to bring the panic attack to an end; that will happen no matter what you do.
Your job now is to see if you can make yourself a little more comfortable, while you wait for the attack to end.
Here are a few techniques that my patients have found particularly useful in overcoming panic attacks.

Belly Breathing

Regardless of what else you do, do belly breathing. It's also known as diaphragmatic breathing, but I think "belly breathing" is more descriptive. Many people think they know how to do deep breathing, but don't do it correctly, so they don't get good results. A good belly breathing technique is a very powerful tool in the work of overcoming panic attacks!

How to Talk to Yourself

Talk to yourself (silently!) about what is happening, and what you need to do. One question my patients find very helpful is this: is it Danger or Discomfort? Some of the other responses my patients like include the following:
1. Fine, let's have an attack! It's a good chance to practice my coping techniques.
2. Answer your "what if...?" fears by saying "So what? I'll get afraid, then calm down again."
3. It's okay to be afraid.

Get Involved in the Present

People don't panic in the present. People panic when they imagine something bad happening to them in the future or in the past. This is why your panic attacks are almost always accompanied by some "what if...?" thought.  The reason you say "what if...?" is because what you fear is not actually happening!
Get back into the activity you were engaged in prior to the attack, and become involved with the people and objects around you. If you're in a store, resume shopping, reading labels, comparing prices, asking questions, etc. It will move you closer to your goal of overcoming panic attacks when you bring your focus and energy back to the present environment. By this I mean, work with what is around you.

Work with Your Body

Identify, and relax, the parts of your body that get most tense during a panic attack. This typically involves first tensing, and then relaxing, the muscles of your jaw, neck, shoulders, back and legs. Do not allow yourself to stand rigid, muscles tensed, and holding your breath. That just makes you feel worse! If you feel like you "can't move a muscle", start with just one finger!
That's "Actions (to make myself more comfortable)". How does that compare with what you usually do during a panic attack?

Repeat

This step is here because you might start feeling better, then feel another wave of panic. Your first reaction might then be to think "Oh No, it didn't work!". The Repeat step is here to remind you that it's OK if that happens. Just take it from the top again. It's not unusual or dangerous. You may go through several cycles, and you just need to repeat the AWARE steps again, as often as you need.
How does that compare with what you usually do?

End

This is here to remind you that your panic attack will end; that all panic attacks end; that they end regardless of how you respond; that it's not your job to make the attack end; and that your only job is to make yourself as comfortable as possible while waiting for the attack to end.
Have these statements been true for you? Don't take my word for it. Review your own history of panic attacks and see.
And maybe the next time you panic, when you notice yourself thinking, once again, "Will this ever end?", you'll find yourself answering, "YES!"

Overcoming Panic Attacks

Want a copy of my Panic Attacks Workbook? It'll take you through the steps, from A to Z, of how to handle panic attacks in ways that lead them to fade away, as well as how to overcome the phobias and avoidance that usually accompany panic.

Source: http://www.anxietycoach.com/overcoming-panic-attacks.html

Anxiety/Depression/Citalopram- CBT Done - what next ??

OK so ive posted a few times, I suffer with depression and anxiety/ panic attacks , which come out the blue generally but some days i feel like i kinda just know im gonna have one ! as feel edgy all day then bam ! No particular triggers , often if works busy , it happens and yesterday shopping. As for the depression , ive always suffered years ago was on Venlafaxine then came off when ttc. Manged for 9-10 yrs without meds. Before xmas went to gp who originally gave breathing excercises , then went back as no luck and got given Sertraline 50mg. That didnt really work , and lacked sleep so much so they added Mirtazipine but gained alot of weigh in a short space of time , so they then stopped the Mirtazipine and doubled the Sertraline - as you can imagine the side effects i was suffering waqsnt good and got signed off work for 6 weeks , the 100mg of Sertaline still no good so he put me on Venlafaxine , started 75mg then 150 then 225 , 4 weeks into 225mg i started bruising very badly so had to stop them as its int he very rare side effects . So 3 approx weeks ago he put me on 20mgCitalorpram then 40mg 4 days later. which im still on , Im between all this i have had CBT Panic workshop which to be honest hasnt overly helped but then again i was doing it over the period i was changing meds,
I get down at things that have happed in the past , things not even my family know about , domestic violence and being forced to 'do things ' i disdnt want to do with my 1st proper partner ( if u can call hin that ) then my childs dad was also a bit ' handy' which we finally split because of it 8yrs ago - my family only knew about the final time not any of the others he did it , or my partner before . I was then in a happy relationship for 7 yrs and that ended in feb this yr , ive tried to be strong about it but i still cant belive its happened.
Last yr i had an op , which was meant to be day surgery , 3 days in hospital as was more complicated than thought ,  , 4 weeks off work - made myself ill by going bk too soon so had another 3 weeks off ( and the op has not improved anythign )  , i then had to move house whilst poorly and couldnt help much  ( which i love my new pad  just un needed at the time )
On top of all that , my child has behavioral issues and i just feel do drained from life . I work p/t as on my own so cant do much more , work are good as had alot of time off but  i knwo ppl talk about me , i can just imagine it ' oh shes off again ' ;what for now '  ( not many know the real reason )
Just realised im babbling but i have no one to talk to , just wanted to know the next step after cbt - i have a telephone apt with a phyc pratitioner this week just dont knwo what to expect ( and one of my triggers is talking in the phone :? )
Source:  http://patient.info/forums/discuss/anxiety-depression-citalopram-cbt-done-what-next--425564

10 Ways to Overcome Your Anxiety and Panic Attacks

Those who never experienced anxiety and panic attacks – Just don’t get it. The constant fear of another panic attack, the fear of dying, the loss of breath, the chest pains, the weird tingling and numbness, the feeling that it will never go away, the daily frustration – It’s literally destroying your life.

You can’t work, you can’t talk to anyone (who will understand?) and you can’t function.

As a former sufferer of this awful condition, it’s important to me to convince you that hope is out there. There are many ways to overcome anxiety and panic attacks and don’t let anyone tell you otherwise.

I’ve compiled a list of the top 10 natural and effective ways to overcome anxiety and panic attacks – Without medication. All you pill-fans out there – Don’t get mad at me – But I hate medication. Especially medication that only hides the symptoms (if it even works) and does nothing to actually cure your condition.

Instead, anxiety meds do two things: The first is cause awful side effects, sometimes worse than the anxiety itself, while potentially causing liver and kidney damage (not to mention how addictive they can become). The second thing they do is get pharmaceutical companies richer every day, at your expense.

So…without more nagging, here are 10 Natural Ways to Overcome Anxiety and Panic Attacks:

 #1 – Herbal Remedies

A number of studies have already confirmed that Chamomile, St. Johns Wort and Valerian root can significantly reduce anxiety symptoms. In my experience, these are more effective for mild cases of anxiety and they will not be very helpful for an acute panic attack.

Chamomile tea is especially recommended if anxiety is ruining sleep due to its sedative effect. If you want to know about preparation and dosage of St. Johns Wort and Valerian root – Read more here.

If you are taking any medication, check for counter interactions before you start.

 #2 – Supplements

Researchers have found that Magnesium is necessary to dissipate the effects of traumatic stress that can occur from intense episodes of fear or anxiety. Magnesium also helps undo the bad programming from prior anxiety attacks by helping to create new brain response patterns not influenced by fear or anxiety. If you can, get a blood test and check to see if you have a magnesium deficiency. If you do, consider a Natural magnesium supplement. You might be surprised by the results.

Magnesium supplement

Omega 3 fatty acids were found to reduce the effects of stress and anxiety by 20 percent. Make sure you get proper omega-3 status by having more fatty fish in your diet, or by taking an organic fish oil supplement. It can reduce anxiety and also systemic inflammation all over your body.

GABA – GABA is short for gamma-aminobutyric acid, and its role in the body is to calm the firing nerves in our central nervous systems. Long term stress can interfere with production of this neurotransmitter, and you don’t have enough of it, you can experience manic behavior, alcoholism, anxiety and recklessness.  Other symptoms of GABA deficiency include headaches, palpitations and low libido. You may consider trying 500-1000 mg a day of a GABA supplement, or have more food that increases its production: Nuts, bananas, broccoli and spinach, green tea, citrus fruit and rice bran.

#3 – Anti-Anxiety Diet (Not Actually a diet at all!)

 Anxiety and panic have always been considered to be mental conditions, right?

Wrong. New research has found Anxiety and depression may actually originate from the gut. That’s why so many people suffer from both Irritable Bowel Syndrome and Anxiety at the same time. A healthy diet will definitely, and I repeat definitely, dramatically help you overcome anxiety and panic attacks.

We all know what a healthy diet is, so no excuses please. Reduce sugar, fat, meat and dairy as much as you can, and eat much more vegetables and fruits.

#4 – Eliminate Food Triggers

Many people report that caffeine is a major panic trigger for them. Others say the glutamine is. You may have a ssensitivity or allergy to certain foods, which can cause your panic attacks, or make them worse. A good way to find out is to write a food diary.

Write a diary and list all the food that you eat everyday and look for a potential link between your diet and anxiety or panic attacks. If you find a link, eliminate the source and see what happens. Sometimes there’s a simple solution to a big problem.

#5 – Relaxation Therapies

Massage, Yoga, Reiki, Meditation – Are not only a lot of fun – They are very relaxing as well. If you can get a relaxing massage once a week or two – Good for you and very good for chronic anxiety. Yoga and Reiki are helpful as well and meditation, if you have time for it, is especially effective.

All of these therapies elevate the levels of your “feel good” hormones – Like Serotonin. They have other amazing benefits to your overall health, which help your body deal with stressful events thus preventing panic attacks.

#6 – Exercise, Exercise and more Exercise

You have to get your heart pumping every day. Remind your heart that you’re still alive and it will love you back instantly. Many studies have proven that regular exercise (and I don’t mean your daily walk from the bathroom to the kitchen) is an excellent anxiety treatment.

It reduces the stress hormones and elevates those “feel good” hormones mentioned above. At least try to walk (as fast as you can) for a half an hour every day. You won’t believe how amazing you will feel (not to mention how much healthier you will become).

#7 – Acknowledge Work Related Anxiety

40 million Americans suffer from anxiety just because they resent their job, hate their job or just work too much (more than 48 hours a week). If you have no idea where your anxiety and panic attacks came from, it’s time to ask yourself if you work too much or just simply hate your job.

I know that some of you will say I’m crazy and these are hard times and work is sometimes hard to replace, but if it gives you anxiety which ruins your life, isn’t it time to look for something else?

Think about it before you dismiss it. It’s closing a door, which could be frightening, but opening a door to a new adventure, to a chance of a happier and a fulfilling life – A life without anxiety.

#8 – Limit Facebook Time

It’s o.k to use Facebook to keep in touch with friends occasionally. But, when Facebook becomes “an addiction” (those of you who are addicted know who they are), it’s difficult to notice how it promotes feelings of loneliness, low self-image, jealousy, insecurity and feelings of inadequacy – All og them leading to anxiety.

Limiting your time on Facebook is one of the best things you can do for your mental health in general.

#9 – Breathe

There are specific breathing exercises and techniques that can be very helpful when you feel anxious and practicing them every day can really lower your symptoms. I’ve written about the top 2 breathing exercises for anxiety – Right Here . Why not give them a try?

#10 – Cognitive Behavioral Techniques

I’m not talking about cognitive behavioral therapy sessions, though I highly recommend it if you can get it. There are CBT techniques that you can practice at home whenever you need to, and they can be very effective (In my case so effective that I got rid of my health anxiety completely).

The first thing you have to understand is that emotions are like waves. They come and go, but they can’t get a long-term grip on you. Every emotion you have, even the awful and crippling fear of dying – Is only temporary. This is something you forget when you are having a panic attack.

Keeping this in mind when a panic attack starts rising its ugly head will help you relax and reduce the intensity of the panic attack.

Source: http://healthworkscollective.com/frmeital/33853/10-ways-overcome-your-anxiety-and-panic-attacks-drug-companies-won-t-tell-you-about

Dealing with panic attacks

A panic attack is an experience of sudden and intense anxiety. Panic attacks can have physical symptoms, including shaking, feeling confused or disorientated, rapid heartbeats, dry mouth, sweating, dizziness and chest pain.
The symptoms of a panic attack normally peak within 10 minutes. Most episodes (attacks) will last for between five minutes and half an hour.
Phobia sufferers will try to avoid whatever is causing their fear, but in some cases, such as agoraphobia, this can seriously restrict their movements.
Professor Paul Salkovskis, a psychologist at King's College London, says it's important not to let your fear of panic attacks control you.
"Panic attacks always pass and the symptoms are not a sign of anything harmful happening," he says. "It's important not to restrict your movements and daily activities."

Confront your fear

During an attack you experience a whole range of frightening symptoms, and worrying thoughts may go through your mind.
"Many people have a sense of impending disaster, and think they're going to faint, lose control or even die," says Salkovskis.
"You need to tell yourself that this is not going to happen and the symptoms you're experiencing are caused by anxiety."
He says don't look for distractions. "Ride out the attack. Try to keep doing things. If possible, don't leave the situation until the anxiety has subsided."
"Confront your fear. If you don't run away from it you're giving yourself a chance to discover that nothing's going to happen."
As the anxiety begins to pass, start to focus on your surroundings and continue to do what you were doing before.
"If you’re having a short, sudden panic attack it can be helpful to have someone with you, reassuring you that it will pass and the symptoms are nothing to worry about," says Salkovskis.
"Then you need to try to work out what particular stress you might be under that could make your symptoms worse.
"There's no quick fix but if your attacks are happening time after time, seek medical help."

Relaxation techniques

If you have panic disorder, you may feel constantly stressed and anxious, particularly about when your next panic attack may be.
Learning to relax, which isn't as easy as it sounds, can help to relieve some of this stress and tension, and may also help you to deal more effectively with your panic attacks when they occur.
Regular exercise, especially aerobic exercise, will help you to manage stress levels, release tension, improve your mood and boost confidence.
Phobia support groups provide useful advice about how you can effectively manage your attacks. Knowing that other people are experiencing the same feelings can be reassuring.
Antidepressants and cognitive behavioural therapy (CBT) are the two recommended treatments for panic disorder.
Cognitive behavioural therapy aims to identify and change the negative thought patterns and misinterpretations that are feeding your panic attacks.
"CBT is particularly effective. Most people will be completely free of panic disorder at the end of therapy and will remain that way," says Salkovskis.
Source: http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/coping-with-panic-attacks.aspx