If you’ve experienced panic attacks you know how distressing, even terrifying, they can be. Panic attacks occur abruptly, unexpectedly, and activate intense fear that feels catastrophic, overwhelming, and out of control.
During a panic attack, you might feel like you’re having a heart attack, stroke, or are in a life threatening medical situation. In fact, many people visit the hospital emergency room when experiencing an episode of panic because they fear they’re having a heart attack.
Because panic attacks are so intensely uncomfortable it makes sense that you’d want to protect yourself from them. This often results in a pattern of anticipatory anxiety - persistent worry about if and when the next panic attack might occur and consequences of the attack. This can lead to catastrophic and worst-case scenario thinking. Close monitoring of your body - looking for possible cues that a panic attack is coming – is also common.
Another way that you might try to protect yourself from the intense discomfort of a panic attack is through avoidance of the places or situations where you imagine a panic attack could occur. Eventually, this may expand to fear of places or situations where escape may either be difficult or embarrassing. Examples include bridges, public transportation, crowds, or lines of people. This type of avoidance is known as agoraphobia.
My approach to counseling for panic attacks encompasses a number of areas of focus, including:
The first step is to learn about panic attacks, the fight/flight response, and the lack of dangerousness of panic attacks to the mind and body. Understanding the process your body goes through when you’re experiencing a panic attack is an important step in the treatment of panic.
Reviewing your lifestyle to see if there are any behaviors that are contributing to your panic attacks is essential. Caffeine consumption, alcohol and psycho-active drug use, and the use of over-the-counter and/or herbal medications can increase anxiety.
Conversely, getting enough sleep, reducing stress, a healthy diet (especially blood-sugar balance), and engaging in social support can reduce the likelihood of panic and anxiety. Additionally, exercise can be really useful for managing panic and anxiety. Exercise decreases stress, clears the mind, reduces tightness and tension in the body, improves mood, and reduces fear and worry.
Anxiety management involves developing the tools and skills that can help you to gain a sufficient amount of control over your anxiety. Examples include:
Trauma processing approaches, such as EMDR (Eye Movement Desensitization & Reprocessing) and Brainspotting can be very useful for reprocessing disturbing memories of past panic attacks. Past experiences of panic tend to increase fear of future incidents. EMDR and Brainspotting can also be very helpful for addressing the internal (e.g., shortness of breath) and external (e.g., crowds, bridges) cues that trigger panic episodes. Trauma processing is also excellent for addressing any antecedent events that contribute to your pattern of panic, such as the death of someone important or a relationship breakup.
When applicable, attachment issues that may be underlying panic and/or agoraphobia can be addressed. For example, parent-child role reversals – situation where you had to take care of a parent (because they were ill, anxious, depressed, alcoholic, etc.) while your needs (for safety, love, nurture, connection, etc.) went unmet. The Developmental Needs Meeting Strategy (DNMS) and Imaginal Nurturing are approaches that focus on these types of attachment wounds.
A panic attack is a very physical experience. Common symptoms include sweating, shaking, shortness of breath, chest discomfort, accelerated heart rate, feeling lightheaded, tingling sensations, and abdominal distress. Increasing body awareness and the capacity to tolerate uncomfortable physical sensations is a key to learning to manage panic attacks.
Irrational thinking and negative self-beliefs are key areas of focus when addressing panic attacks. Traumatic experiences lead to a tendency to have catastrophic and worst-case scenario thinking (e.g., “I’m a failure” or “I’m not in control”). Exploring and challenging these negative thought patterns and replacing them with adaptive, rational thoughts (e.g., “I can succeed” or “I’m now in control”) is an important component for addressing panic attacks. It’s also essential to address the pattern of irrational thinking that occurs during a panic attack, such as “I’m helpless” or “I’m not safe.”
Having a panic attack is a terrifying experience and the fear of a future panic attack can be dreadful. Fortunately, there are a lot of effective ways that counseling for panic attacks can help. If panic and anxiety are having a negative impact on your life, feel free to set up a free consultation with me so that we can discuss ways to address this issue.
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