Anxiety And Panic Attacks - Symptoms, Solutions And What They May Be Telling Us
In this post, I am getting out of my Comfort Zone and opening up about something a lot of people don't understand and are often all too quick to dismiss or pass judgment on.
Mental Health issues such as ADHD, Autism, Bipolar Disorder, PTSD, to name but a few are now rightly receiving proper recognition and treatment, but because anxiety and panic attacks can be random, infrequent occurrences in otherwise mentally healthy people, there seems to be little help available for sufferers, like myself, other than drugs which can have negative side effects and cause other, longer term mental health problems.
What Are Panic Attacks?
My own personal definition, rather than an official medical definition, is that a panic attack is a sudden change in emotional state from balance to fear, which can be brought about by either a real situation in the here and now, recall of a traumatic event in the past or an imagined situation which could be directly or indirectly related to a traumatic event in the past.
I'm not a Doctor or a Psychiatrist, so how did I come up with this definition? To help you understand, I'll relate a very scary personal experience.
This Is What Happened To Me
When I was 10 years old, we were on a family holiday at the coast. I had an inflatable dinghy and I used to like to overturn it and stand or sit underneath it in shallow water with the other kids I was playing with and of course, our imaginations would be fired up into all sorts of make believe situations and adventures.
I'd noticed over a few days that there was a couple - a man and a woman - who were often acting a bit wierd around the kids playing in the surf. Not overly menacing, but enough to make me a bit wary. The man, very large and overweight, had previously stood in front of me and had beaten his fists on his chest and made a noise like Tarzan before laughing (not in a particularly nice or friendly way) and wandering off.
A couple of days later, I was under my dinghy on my own, when this enormous weight came down on top of me and pushed me right onto the sea bed, almost knocking the wind out of me. I was sitting in only a couple of feet of water and so the dingy was right down with very little room for me even to move, let alone get myself out. I struggled for what seems like ages but would have probably been less than a minute and each time I tried to go to a different side of the dinghy a pair of female legs would be in my way, blocking me from getting out.
Needless to say, I did finally manage to just squeeze out as I felt my lungs were about to burst and there was the woman I mentioned earlier, just staring at me with a really malevolent expression on her face. What happened was no accident - the pair were deliberately trying to drown me while making it look like an accident.
I Thought I'd Got Over The Shock, But Then....
I didn't dwell on the experience as I was growing up, but I never forgot about it either. I knew I'd never meet that couple again and I only hope and pray they never succeeded in doing to any other kid what they tried to do to me.
Kids are very resilient and it was a long time before the experience came back to haunt me.
In my early 20s, I decided I would like to take up Scuba Diving. I was serving in the Forces at the time and my Unit had its own club and trained every week in the swimming pool on a neighboring base, before taking students to do their first open water dive. During the pool training, I found that I would get very anxious when doing the mask clearing, buddy breathing and 'ditch and retrieve' drills. I spent a few sessions simply sat on the bottom of the pool going through it all repeatedly and eventually my confidence grew. I knew in the back of my mind that this was down to me recalling my experience on holiday, now more than 10 years behind me.
I was very fortunate to be given a 6-month posting in Belize, a scuba divers paradise. I did some amazing dives on the barrier reef there and got some qualifications as well.
I did a bit more diving on return to the UK and was all prepped for leadership training when, as luck would have it a couple of years later, I was sent back to Belize for another 6 months!
This time however, during the descent on one of my dives I had a massive panic attack. This wasn't just feeling anxious or even scared - this was real, dread fear that suddenly took over me, completely out of the blue.
I signalled to my buddy to stop the descent and he signalled to me asking if everything was OK. I replied that I wasn't completely OK, but that I would stay holding the boat's anchor line rather than immediately abort the dive. After a minute or so, I'd collected myself and signalled to my buddy that I was OK to continue the descent.
All the time I was doing my dives, I used to like to do a bit of personal training by flooding my mask so I could stay proficient in clearing it under water, or by swapping momentarily between my main air cylinder and the small inflation cylinder on my STAB jacket which could be used in case of a malfunction of my main air supply.
This time, when doing the latter at 18 metres down, I freaked out. I had to abort the dive there and then. I signalled to my buddy and ascended as quickly as I could with safety, not giving in to my instinct to inflate my jacket, dump my weight belt and rocket to the top, which would have risked bursting my lungs or giving me the bends. We'd only been down about 10 minutes at less than 20 metres, so a decompression stop wasn't necessary thankfully.
That was the end of my diving career, although I did do other things as I was a bit of an 'adrenaline junkie'.
How It Affected Me In The Short To Medium Term
Over the years, I gradually gave up my various white knuckle type pass times in favour of more serene, but no less enjoyable, things. Getting married and having a couple of kids was the driver behind that. I no longer just had myself to think about. I want to see my kids grow up and I don't want them growing up without a Dad.
When I was younger, I was never reckless. I was a thrill seeker without a doubt, but I would never act irresponsibly or take silly risks, especially when it involved the safety other others too.
But I had absolutely no fear of anything that I was doing, however dangerous it may have looked to a bystander. I know it used to give my Mum grey hairs, and my joking responses to her concerns like 'Stop worrying. I'll only get hurt if my chute doesn't open.' probably didn't help calm her nerves even though that was my own way of trying to reassure her that the chances of anything going wrong were extremely slim and that in reality there was almost nothing for her to worry about.
What I noticed as time went by was that I was becoming claustrophobic.
After the diving, I decided that I wouldn't go pot holing anymore either. Gradually, over time, things I'd loved doing became less and less appealing, especially if they involved water or confined spaces.
Even when I went offshore sailing and qualified as a yacht skipper, I would have a feeling of unease getting into my bunk below decks to sleep after a period on watch. These feelings were compounded by the knowledge that the company I was sailing with had suffered a tragic accident just a couple of months earlier when the keel dropped off one of their yachts a couple of miles offshore and the boat had capsized, drowning two students. This was not the fault of the company, who were of excellent repute, but of the third party maintainers and inspectors who had certified the yacht seaworthy.
The Compounding Effects Later On
I love nature and the great outdoors and if not actually in amongst it, I like to watch natural history and wildlife programmes on TV. I found that I would become very uneasy while watching programmes where the cameras took you under water or into caves. I would find myself inhaling heavily, and convincing myself that I was having difficulty breathing when all that was happening is that my lungs were at full capacity and I couldn't actually take anymore air in. I would have to look away from the TV screen or get up and walk out of the room so as to bring myself back down again.
This mainly used to happen if I was watching in bed and was starting to drift off to sleep, but it gradually became a more frequent occurrence at any time I was watching.
Then, in April 2017 I had a bad cold that developed into quite a severe chest infection. My Wife was away on a training course in the States with her work at the time. I awoke one night at about 1AM feeling like I couldn't breathe. I just about managed to stay in control and not succumb to panic but I telephoned my neighbours and asked them to come around to collect the boys, who were 8 and 6 at the time, and then I dialed 999 and called for an ambulance still struggling for breath.
Being a true Englishman, my immediate priority was to get the kettle on so I could offer the Paramedics a cup of tea when they arrived, which they accepted but didn't actually drink. As well as being utterly unthinkable and unforgivable for me not to do this, I wanted to give myself something to do and they said yes for that same reason.
They hooked me up to some monitors that confirmed that my body was taking in sufficient air and that I was in no danger. They advized me to sleep on the sofa sitting up if I could, since by lying down in bed the mucus in my lungs would spread over their surface area and give me the impression of suffocating. They left after about 30 minutes after very kindly assuring me that I had not wasted their time as they'd seen this sort of thing plenty of times before, and that fear plays nasty tricks on the mind, especially after a rude awakening from sleep when you're not fully with it.
From that day onward, I would frequently experience the onset of a panic attack when on the cusp of sleep at night, or if I woke up during the night, but in the main I've managed to stay in control when it happens. I sometimes have to get out of bed and stick my head out of the bedroom window to get some fresh air, or I go downstairs and stand in the front doorway. The site of me in a pair of boxer shorts stood on my doorstep in the early hours would probably give the neighbours a panic attack too!
Then they would start happening earlier on in the evening, ironically when I was starting to relax after a busy day. I'm an occasional hay fever sufferer and this 'Summer', not that we've had much of one in England so far this year, the pollen has caused my nasal passages to get inflamed and the resulting slight capillary bleeding would encrust in my nostrils and make it difficult to breath through my nose. The predictable result has been an increase in the onset of panic attacks.
It was only the night before last when I actually 'lost the plot' so to speak. It was a warm, stuffy night and although we had the bedroom window open there was very little air flow through the house. I woke up and literally leaped out of bed, charged downstairs and almost pulled the front door off its hinges when opening it to get some fresh air.
This time I had my Wife with me who always does an extremely good job of calming me down, from gentle words of reassurance graduating up to threatening to knock me out with a frying pan if I don't pull myself together!
Yesterday, I went online to do some proper research into panic attacks and how to deal with them, as it was starting to get a bit worrying.
Symptoms Of A Panic Attack
Believe me, you'll know if you're having one! But typical symptoms are tightness of chest and breathlessness and a sense of being trapped with your surroundings closing in on you. Even if your lungs are full of air, once you've inhaled as much as you can you will still feel the urge to breathe in some more. When you're unable to do this, you'll convince yourself that you're having difficulty breathing even though your not and you'll try to breathe in some more. When you still can't, you'll lose sense of reality and create a vicious circle.
After going round the circle a few times, your chest will start to ache and you'll start to think you're having a heart attack, which you're not. You're absolutely fine and its all in the mind. You just have to try to grab hold of this thought amid all the other crazy thoughts that will be racing through your mind, and then keep a tight hold of it.
How To Get Through A Panic Attack
One of the most effective relaxation techniques is to take deep breaths. HOWEVER.....this only applies when you're already grounded and are about to embark on some meditation exercises.
During a panic attack, you are already breathing far too deeply and you need to slow it down a bit.
Sit up straight in a comfortable position when you feel able to do so. It may help to remain standing at first because in this position you have a bit of a feeling of being in control - the ability to 'fight or flight'. You're on the defensive and a physical defensive posture can help get your mind right. You're facing your enemy - the panic - and telling it 'Look, I don't want a fight, but I'm ready for you.' Don't let somebody try to make you sit down, which they'll be naturally inclined to get you to do.
Get a hold of something that you're standing near to, like a door handle or the back of a chair. Get a firm grip on it, but not like you're trying to strangle it. Just a firm grip to give yourself the feeling of being in control.
Take a few SHALLOW breaths - in through your nose and out through your mouth. You're already at risk of hyper-ventilating, so don't be tempted to breathe deeply as conventional wisdom says you should when you're doing relaxation exercises in a normal state of mind.
Breathe from deep down rather than taking sharp intakes of breath from your chest as though you've just run a race. Just to clarify here, when I say 'Don't breathe deeply', I mean don't try to take huge lung fulls of air. Deep down means from the belly, not from the chest. You need to take shallow breaths, but from deep down, if that makes sense.
In a short while you should start feeling a little calmer and this is the time to sit down.
Sit up as straight as you can whilst keeping a relaxed posture. Don't lounge or slouch, as this will restrict your breathing.
Focus on 5 things that you can see. I sit on the sofa in front of the fire place and everything is nice and symmetrical as per my Wife's arrangements, so its easy for me to focus on the mantelpiece, the 2 candle sticks one at each end, the clock in between them and the large wedding photo above.
Keep breathing as before for a minute or so and then focus on 5 things you can't see.
I imagine my family stood in front of me and I do it in a specific order - cat, youngest Son, Wife, eldest Son, cat. We only have one cat now (see one of my previous blog posts) but I still imagine our dear departed Rosie as being there.
Keep breathing as before. Now you have focused your mind, you should start to feel the panic subside. It takes time and there is no set time, but keep doing this until its gone completely. If you stop before then, chances are you'll just have another panic attack.
Indirect Triggers Of Panic Attacks
This is a very important point. I can't emphasize enough how important it is.
I've related a specific traumatic event in my earlier life that sowed the seed for panic attacks later on, which began subtly in my twenties and gradually crept up on me without me really noticing until it came to a head just a couple of years ago.
That is a direct cause. Then there is that sort of 'domino effect' where the very fear of a panic attack can lead to a panic attack. It's a bit like these being the kids and the grand kids of the original panic attack, so these could be called 'indirect' causes.
So, what is the difference between a 'cause' and a 'trigger'? Again, this is something I've come up with myself, not something I've read in a medical journal.
A trigger, to me, is something that creates the emotional conditions in which a panic attack can occur. It doesn't have to be anything to do with the original event that sowed the seeds.
It can be an argument, stress over a deadline at work, an historical emotional condition such as depression or anger issues caused by such things as family or origin issues or an abusive spouse or a bereavement, for example. None of these are related to the cause of the panic attack, but they may create the emotional conditions in which the cause can suddenly rear its ugly head. Hence my definition of 'cause' and 'trigger' and the difference between the two.
The cause is the direct symptom of specific traumatic event. The trigger is something deeper within oneself but unrelated to the event. They are telling us that we may have a wider emotional issue we need to deal with.
I'm not going to go into my triggers because they are private and personal to me, and I think I've laid quite enough bare for one blog post, thank you very much!
If you've experienced panic attacks yourself, I hope what I've written here has been useful for you and will help you deal with them from now on if and when they occur.
I put the breathing exercises into practice last night and successfully fended off 3 attacks - one when I was first going to sleep and one at 2AM and then at 5AM when I woke up and I didn't have to get out of bed once.
It's now 25 past Midnight on Wednesday morning here in a drizzly, un-Summerlike England and I'm off to bed now and looking forward to another peaceful night's sleep!
Cheers for now