“It’s hard to fight an enemy that has outposts in your head.”
I wish I could say that I have found a magic cure for panic attacks. They are something that has plagued me since the birth of my daughter. They are honesty for me, the hardest part of PTSD, they have put me in hospital and really tested me to the limits of my endurance. I’m not going to tell you that I rid you of your panic attacks because that isn’t always true, but I can share how I manage mine and hope it helps you too.
So what are panic attacks?
Well just as with any part of mental health that we may struggle with, they are as individual as we are.
The media sometimes portrays them quite light hearted, often ones will make flip comments about them, but in reality they are very serious and can be extremely debilitating to those that suffer them.
For me they start with a strange feeling in my stomach, I often say it feels like icy fingers crawling over me. I shake uncontrollably, have awful nausea and vomiting, my teeth chatter and I get pins and needles all over me. I can’t keep still, and have an overwhelming urge to walk, or pace. Im hot then cold, and find my bladder and bowel cause me more than a little discomfort. I also get intrusive thoughts, this can be about anything, something that is worrying me, or has happened recently, they can be thoughts about myself or those I love. I do sometimes hyperventilate too, but not always. I use to also experience flashbacks, as result of my PTSD. Mine can last for hours, even days as I re-trigger over and over again. I do also occasionally have fits with them, and it takes me a few days to recover.
So what causes panic attacks?
Well they are by product of our natural ‘fight or flight response’ nature has given to protect us. For example if we were threatened by a vicious animal it would cause us to ‘stand and fight’ or ‘run’, to try and find safety. I think of it like my natural response has become over sensitive, as is often the case after suffering trauma. Things that would be normally manageable, instead trigger a melt down of panic.
So what has helped me to manage my attacks?
LEARN ALL YOU CAN
For me knowledge has been power. I have done as much research as I can about panic disorder and the fight or flight response. I learnt what the symptoms are, what the hormones involved do to my body and how this is affects me. This knowledge armed me with information about what was happening and why, which in turn lessened some of the fear and confusion. Knowing that it was my body and mind reacting to something, helped me to understand why I was responding with panic. Knowing that the symptoms were panic and not that I was desperately ill or dying, also gave relief and a starting place to try and support myself better.
KNOW YOUR TRIGGERS
For a long time I didn’t understand where the attacks had come from. I use to think they just happened for no reason and this felt like I had no control over them. However I set about working out why I had an attack. I would go over the week or days before and think about what I had been doing or thinking. I soon began to see patterns.
Tiredness was definitely a factor, as was illness in me or others. I have a phobia of vomiting, so feeling nauseous, or others vomiting would set me off. My attacks always happen at night, this was always a mystery to me. After a number of sessions with a counsellor we managed to work out that this was related to night times when I was in hospital and felt my most scared and vulnerable, as was my issue of being left alone.
I have other triggers too and sometimes I get caught out, something on the TV may surprise me and sadly set me off. Knowing most of them, why they are triggers, and how they affect me, has been a massive turning point. I can’t avoid my triggers, but I can understand them. This gives back a little of the control and also helps with the next point, challenging our thoughts.
CHALLENGE YOUR THOUGHTS
Often our own thoughts are what cause our greatest fear. I would often find myself going down the rabbit hole. One thought would become ten and they would spiral me down into the darkness. Guilt, anger, wondering why me, blaming myself for not being able to cure them, for upsetting others and spoiling things. I would beat myself up in my head and this only served to re-trigger me and make the panic worse.
Challenging these thoughts has been something I have had to really work on and it is still hard. It often feels like a battle in my own head with me as the referee! With practice it gets easier and it does work, although I find that instead of waiting until I have an attack, challenging negative thoughts is something I must do daily. CBT has helped me greatly, so has learning mindfulness.
LEARN TO BREATHE?
As I mentioned before I do hyperventilate, but not always. On many occasions well meaning individuals would say, “you just need to breath”, usually handing me a paper bag in the process. To be honest this only led to me feeling more nauseous and more triggered.
While for many regulation of breathing is enough to stem their panic, this wasn’t enough for me. For me what matters more is being able to calm myself, to gain back some control, to centre myself and give me the space to do my others approaches.
It was also importnant to find a type of breathing that did work for me. I have a breathing App I use that plays a strange sound, that rises and falls to a count of 7 to 4 to 8, with my headphones on it gives me something to focus on, controls my breathing and helps me shut out the cascading thoughts.
I also have a song, Blue Ocean Floor, by the lovely Mr Justin Timberlake. I’ve no idea why it works but it does, the words have meaning to me, describing how I feel. I think I need to write to him and let him know that he has the power to calm me!
I guess the point is that you need to build your own selfcare package that supports you as best as possible to prevent attacks but also to support you when you do have one.
So what else can help during a panic attack? For some ‘grounding‘ techniques help, that bring you back to now, to reality especially useful for flashbacks.
For others distraction can help such as naming all the blue things in the room, counting backwards from 100, or colouring books etc. Others use exercise, meditation and yes medication.
Finding what works for you can take time and perseverance. It can be easy to get discouraged and feel your not making progress, but you are.
Seek the help of others too. Everyone is different, some wish to battle alone, others wish someone by their side. For loved ones knowing what to do and how to help can be hard. So at a time when your feeling able to, sit down with those you love and tell them what you need to support you. If you support someone who suffers with panic attacks one of the greatest things you can offer is reassurance and love, reminding them that that are ok, that it doesn’t change how much you love them and you are there for them can be a source of much needed comfort.
Panic attacks are very challenging, they can blight your life and at times make life seem impossible. For me acceptance that I suffer, that I have patches where they return to test me and that sometimes I neglect my selfcare leading to struggling again has given me the reflection I need to support my wellbeing. By finding and using what works for me I have been able reduced them and on the whole manage a life, despite panic being not too far away.
I hope that you can find ways of managing your panic attacks that mean you can enjoy life too. They do not define you, just walk beside you, an unwanted companion that while not a friend, can be managed with a little, time, help and hope.