PANIC ATTACKS AND HOW TO DEAL WITH THEM

The Mad Axe Man


In this chapter I want to look at panic attacks, why we have them, what they are about, how they make us feel, and what we can do to stop them. But before going on to talk about them, I need to focus on normal body physiology, so that it makes more sense in understanding what is going on in a panic attack.

Right now ,whilst you’re reading this there are parts of your body just getting on with the normal things they do, without you consciously having anything to do with them. By this I mean, your heart is pumping blood round your body, your kidneys are sorting out waste products and your liver is doing whatever it does in life, along with all your other internal organs! You have absolutely no say in their working processes, they do it regardless of what you want. So when were healthy we never take any notice of them whatsoever, and if we’re not so healthy, we wish them to be healthier.

So as a human being, we can establish that ‘things’ are going on every minute of the day to keep us alive, and a good thing to! One of these things is the human body’s ability to react to fear. We have to have this ability or we would never be aware of any danger facing us.

The edge of the cliff - Don’t go there!
Reckless driving - Don’t got there!
The overheated chip pan - Don’t go there! Well actually do, but do it properly!
The feeling of being followed at night down the street - Oh No! Is it the mad axe man, what can I do to escape?

There are of course thousands of things that frighten us, and I can’t possibly list them all. And equally what frightens one person may not frighten another, but for the sake of this story I’m going to concentrate on the mad axe man.

So there you are, minding your own business walking somewhere, it’s dark, but you feel ok walking, as you know where you are going. The street lamps mean that it’s not that dark along the street, you are walking with confidence, head held high in the middle of the pavement, just as all the advice has told you about being safe when walking alone. So far, so good…….

But, you start to feel uncomfortable, are you being followed, you start checking over your shoulder, your pace starts increasing. At this point certain physiological changes start occurring in your body that you have no control over. These are known as the fear, fight and flight responses. These responses are there to protect you, so that if you really do need to start running hell for leather down the road, you will have more energy to do it than you would normally expect to have. You have a heightened sense of awareness, looking around you for escape routes, a neighbours front door perhaps, a shop, some other people walking up ahead, whatever. Or maybe you prepare to turn round and face the axe man and fight your way out of the situation. Don’t think I’d recommend that one myself but hey…. What do I know!

However you behave, which you won’t ever be able to decide till you are faced with that situation, as none of us know how we will react to danger, till faced with it. Best example of this, is of course, those wonderfully brave people who have been awarded the VC for valour in the face of huge personal danger. Without exception, when they have all been interviewed they didn’t know they were going to be so brave, they just ‘were’ as they seemingly had no choice within themselves when the need to help preserve life presented itself.

And other times, when we have thought that someone would cope in the face of adversity, they have fallen apart. There is no way of judging anyone’s ability to deal with fear at all. But this is a debate for someone else, as all I want to talk about is what is happening in our body when we feel in danger.

So regardless of whether the man axe man is real or imagined the changes that go on in our bodies is universal once we start to feel fear. Our bodies being the totally wonderful things that they are have a system to help us cope, and this is what happens:

First thing that helps prepare our bodies to hook into the fear, flight and fight is the realise of Adrenaline into our body. Now adrenaline is a recycled product it gets pumped out of our adrenal glands and after so long the adrenal glands demand it comes back. This means that we can only sustain terror for a limited length of time before we settle into a plateau of fear with a heightened sense of calm. Really good example of this can be seen in the film -Flight 93.

In this movie, it tells the story of the flight that on 9/11 that the hijackers were trying to fly into the White House and the bravery of the people on board, who, when faced with the certain knowledge of their deaths stopped panicking and started phoning people, to tell them they loved them and to let them know what was happening on the plane. They also managed to get the plane to crash harmlessly into a field rather than the White House so saving many, many lives. Not a film to watch without a large supply of tissues!!

However , going back to our fear of being followed, adrenaline has been realised into the body, and then several other changes follow in quick succession. We start breathing faster and more shallowly. Now, normally we breath from quite low down in our lungs. So right now, put your hands on your chest, put one at the bottom of your ribs and one just above your breasts. Now take a deep breathe in, you should feel your body move under the bottom hand. Next take a small panting type of breathe and the top hand will feel the body move under it. Well, when we are frightened we start breathing from the top part of our lungs, to take in extra oxygen into our bodies.

This oxygen has only one destination and that’s our heart. As our hearts job is to act as a pump for oxygen to keep us alive throughout our lives. Which is ironic, when we invest so much power in our hearts in terms of love. But no, it’s just a pump!

So our hearts start beating faster, to push the oxygen through our body, it does this by converting the oxygen to energy which then goes into the blood supply, cause the body is in crisis/ panic/ fear mode this blood is rushed to our legs, to help us run away, to our arms, in case we need to fight and to our brains.

The blood that wooshes up to our brains does two things, firstly to hit all our brain synapses so that are senses are heightened and we are capable of making split second decisions in potentially life and death situations.

Secondly it allows are pupils in our eyes to dilate. Normally are pupils dilate according to light and dark. Or when we are feeling extremes of emotion, like love, anger and in this case fear.

The last thing that happens, is our digestive system stops working, as the body knows that all resources are required for this emergency and the last thing it needs to be doing is digesting your fish and chip supper. Although what any of us are doing eating chips in these health conscious days ,who knows! Well except, they’re yummy of course!!

All of these changes happen within moments, we don’t even register they are happening, all we are aware of is how we are getting to get to a place of safety as soon as possible. And it’s only later when we’re all having a nice cup of hot sweet tea (ugh!) that we wonder at how we managed to run so fast, or notice the brand name on the mad axe man’s baseball cap!

These changes in our body are NORMAL and HERE TO PROTECT US!!!!
Without them the mad axe man would surely have got us, or whatever it is that we are frightened of. As we simply wouldn’t have an awareness of danger which would be totally abnormal in our bodies. However much we like risk taking! So that the, so called adrenaline junkies, who regularly through themselves out of planes or go bungee jumping ( why???) will experience these feelings as much as the person walking down the street feeling frightened. It’s just the adrenaline junkie loves the rush of these feelings and better still the feeling afterwards of having done whatever dastardly deed they have set themselves up for. If you’ve ever challenged yourself to do something outside your normal comfort zone you’ll know what I’m talking about here.

For me, a few years ago I went to Northern Ireland with my boys, we ended up at the Giants Causeway and went on a boat trip round a local bay, we saw a rope bridge very high up above us, instantly the boys wanted to go on it. Now I don’t mind heights at all , but I do have a lousy sense of balance. They were too young to go across by themselves, and we had no man in tow that I could hand responsibility over to, so I had to do it. It was utterly terrifying 70 feet above the sea on a rope bridge, with a base no wider than two planks. So with my eyes fixed on a spot across the other side I walked across, one foot in front of the other, one hand in holding so tight to the ropes. I got there, to the other side. It was to put no finer point on it, fucking terrifying.

Then I had to go back across, and do you know going back wasn’t as bad as the first time. In fact when we were waiting to go back I watched a young man bottle out of doing it by backing off the bridge after only a few yards. I know I shouldn’t have taken pleasure from this, but it strangely gave me confidence, as my two mountain goat sons had positively leapt across and I had this image in my head of me being a failure, cause I was so scared. So to see someone, who I’d assumed would fly over it, not be able to do it, made me feel a whole lot better.

On the way back across I even managed to look to the side rather than just the point in front of me. It was certainly worth the look, the coast around there is spectacular.
I’ve got a photograph of me coming back, and although it’s not stuck down in one of my photo albums, it is loosely lying in there as a reminder of accomplishing something huge for myself. Confronting a fear big time and pushing myself , admittedly for the sake of my sons, but still, damn well doing it. For a long time afterwards, and possibly still I can hold on to that experience as a way that I challenged my fear and won.

Just a small note here, there are very few mad axe men roaming round the streets generally and I’ve used this example because of that. So don’t go thinking- Oh no something else to put on the fear list!!! We do live in a world that increasingly feels more dangerous, and it is up to any of us to work out what we do to safeguard ourselves, from real or imagined threats. So, I do walk home at night, but I live in a small country town, whether I’d be quite so blasé if I lived in an inner city estate remains to be seen, and I rather suspect that I wouldn’t so easily!

Going back to these changes, that happen so fast, they happen in a great rush and they dissipate slowly, but they do dissipate, they cannot be sustained for a long time, as said previously, your adrenal glands want their stuff back!

So what has any of this to do with panic attacks, well absolutely everything!
Panic attacks are taking a normal body system and becoming frightened of it. Which if you think about it logically makes no sense. After all no-ones frightened of their liver or spleen working, it would be ludicrous. But because we feel these changes they become scary.

To recap, before we look at panic attacks more deeply, when we are frightened these are the changes that happen to our bodies to protect us in normal fear.

. Adrenaline is released.
. Breathing becomes faster and more shallow.
. The heart beats faster.
. The energised blood rushes to the legs and arms.
. The brain becomes very aware of everything around.
. Pupils dilate.
. Digestion stops temporarily.

Now to the excitement that we call panic attacks!
In panic attacks exactly the same changes take place….
That’s it, now you know. So easy to get over, right?

Well not quite, panic attacks are a dirty habit, and a bit like trying to give up smoking very to difficult to do. The first time someone has a panic attack there will be a lot of stressful things going on which lead to that very first time. Sometimes there is an event that happened which resulted in a panic attack, sometimes there are just a whole load of smaller stressful situations which result in the panic. Whatever it is, the first attack is utterly terrifying, and quite often, because the feelings being experienced feel like we think a heart attack will feel, people can end up in hospital after a 999 call. Only to be told after investigation that it’s a panic attack and there’s nothing wrong with them.
Oh well that’s alright then!
And then they have another!
Equally as frightening, and although they may accept on some level that it’s not a heart attack it still feels so scary, and they can feel so ill and out of control, that the people end up at their GPs getting help. And if they are lucky that will come in the form of counselling or CBT.

So what is going on here, well back to the normal fear, what is happening is that because there is no mad axe man or any other ‘thing’ to be frightened of, the fear becomes related to the physiological feelings that are being experienced. And the panic is because those feelings become frightening in their own right.

To explain; the feelings are released as in fear in a rush, but unlike normal fear the don’t dissipate in a straight line down they are hiccupped back up as the feelings become the thing that is frightening.



Diagram



The feelings that can be experienced are:

. Not being able to breathe properly.
. Heart pounding.
. Pain across the chest.
. Feeling very ‘spaced out’
. Feeling dizzy.
. Feeling sick.
. Feeling hot/cold/clammy.
. Having pins and needles

So going back to the normal experiences of fear:

.The breathing is fast and shallow….. Makes you fell breathless
. The heart has extra oxygen ,…. Makes your heart beat faster.
. The blood is rushing to your limbs….. Because you are not fighting or running away your muscles are full of unused energy which can cause discomfort.
. That energy has to go somewhere…… comes out in the tiny capillaries o under the skin, causing either hot/cold/ clammy feelings or possibly pins and needles.
. The digestive system has stopped ….. A feeling of nausea.
. The brain is on alert for anything …… the brain is not being used, so spaced out is the feeling associated with this one.
. The pupils dilate….. So helps with the spaced out feelings.

Depending on how severe the panic attack is, some or all of these feelings can happen.

The good news is that; no-one has ever- fainted. died, collapsed, had a heart attack, as a result of a panic attack!

Just read that sentence again several times if you have ever had a panic attack in your life. Panic attacks cannot hurt you, they are they there to protect you from the mad axe man and any other genuine frightening experiences that life throws at us.

So understanding the normality of the fear flight and fight response is the first step in learning to stop using panic attacks as a way to cope with whatever stress is going on in your life.

The other two steps involve you proving how much power our bodies have when we treat them in a particular way.

The first of these two steps is learning the emergency aid for when feelings of panic threaten to overwhelm us. This step needs to be practised at times when are feeling reasonably relaxed, watching television, doing the washing up, doing the ironing, anytime really when we are doing fairly mindless activity. The reason it needs to be done at these times is so that when we do start to feel stressed it’s not so difficult to utilise the technique. A bit like when a woman is pregnant and she goes to anti-natal glasses and gets taught relaxation strategies for the day she goes into labour.

It’s simply no good waiting till the day of delivery, to say, now what do I do to relax, it’s too bloody late, relaxation has to be practised throughout labour so that on the day of delivery the technique can be fully used as a way to control the pain every time a contraction takes place .

I have been in the very privileged position once of being asked to be a birth partner for someone I knew very well. And cause I was kept reminding her to relax, with every contraction she delivered her wonderful son with no other analgesia at all. So I know it works for other people as well as me with my second son.

So what do you need to do?

Take a deep breathe in through the nose as normal, and then very slowly breath out through your mouth as if very gently making a candle flicker. Do this for the count of three inside your head and do it between three to five times. As you do this you should feel yourself relaxing especially around the shoulders. If it helps as you breath in hunch your shoulders and then release as you breath out.

This is your first aid breathing, there are lots of other ways suggested that you control your oxygen input, but, do you really want to be in the supermarket starting to feel panicky and breathing in and out of a sodding paper bag? Would make me instantly want to panic more looking such a prat! If you do complicated yoga breathing, of which there is nothing wrong at all if you have mastered it, but if you don’t know how to do it, then working out whether your stomach is supposed to be in or out when you breath in or out again is enough to drive me also to panicking!

I have never had a fully fledged panic attack, but have come close on numerous occasions, and each time I have immediately started doing the breathing till I felt calm again, and I could carry on with whatever it was I was doing.

The second and last piece of evidence needs you to be tough on yourself, so I’d advice you get a friend or family member to help you do this. First off ,it won’t hurt you, but it might well make you feel a bit yucky for a few moments.

Sit comfortably, straight up in a chair you can easily stand up from. Get a clock with a second hand, as this experiment takes one minute to do. And then breath from the top of your chest for a whole minute, as if panting, this minute by the way, will seem extremely long, but try and stay with it. As you do this, you may become aware of sensations akin to those that you have when in a panic attack, but not as severe. At the end of the minute close your eyes stand up, then sit down and open your eyes. And describe or think about what feelings you are having. What you will be having is, the start of panic attack feelings, and everyone who does this will feel this, as this is what happens when anyone breaths badly for one minute, not just people who suffer from panic symptoms. When you stand up you may feel dizzy, but you will have not fallen over, you will not have died, had a heart attack, or fainted.

To have a fully fledged panic attack you’d need to do this for three minutes, just so you know!!

And what you have just proved is that by hyperventilating the name given to this shallow fast breathing, that you can cause physiological changes in your body….. WOW how powerful is that?
This is what you do when you are having a panic attack, nothing more or less. By putting too much oxygen in your body, that it doesn’t need you get to feel like this!!!

OK , the two things you can’t control are the release of adrenaline, but even if the adrenaline is rushing round your body telling it to panic, panic, panic, if you don’t put the oxygen in, you can’t get the other things to happen, cause they are dependant on oxygen to occur. You also can’t stop feeling potentially feeling nauseated, cause as said before, it’s a different body system, and initially when learning to control panic that system will kick in.

The problem with panic attacks is that I said at the beginning they are a dirty habit, and even though you can learn to control them, you will always be susceptible to them, just as the reformed smoker will always occasionally yearn for the after dinner cigarette!

This means that as you get better at managing your psychological health then you will need this particularly nasty way of coping less and less. Unless you stop being mindful and the stress builds up again and then ‘whoppee do’ a panic attack ensues.

It is totally possible to stop using panic as a way to deal with stuff, but only if you are prepared to look at your whole self as already discussed, if you hold on to the knowledge that the feelings are there to protect you and never to harm you.
That becoming aware of your breathing, both good and bad allows you to control your body in a way that when you are just hooked into panic attacks never seemed possible.


As an ex client said to me recently who is now undergoing psychotherapist training and is heading for an MA right now, learning about panic attacks saved her life. As without that knowledge she would never have known that she could live her life differently and move on from the deep unhappiness that she was suffering emotionally that was resulting in endless panic attacks.

Seems as good an argument as any other for beating them to me!