Hormones and Panic Attacks

February 8th, 2010

Many of my female clients initially write to me to ask whether hormone imbalances which are present pre menstruation and during the menopause can influence anxiety and panic attacks. The simple answer is yes but it is a little more complicated than giving blame and living with it.

Yes, hormone imbalances during your period or the menopause can create the environment where you are more susceptible to anxiety disorders, but, not everyone develops anxiety or panic attacks so other factors must come into play.

You do not have to take medication or hormone supplements in order to eliminate the anxiety or panic attacks!

Although hormones may be the catalyst for your anxiety or panic attacks, they aren’t the cause and certainly doesn’t mean that you have to live with your symptoms. Anxiety and panic attacks are caused by a small organ in the brain called the Amygdala which is responsible for the anxiety reaction, even when hormone imbalances during menstruation or the menopause may have ’sparked’ the initial problem, you can quickly eliminate them again.

The Amygdala becomes ‘re-set’ at a higher than normal level creating anxiety and panic attacks.

Anxiety and panic attacks are not a symptom of the menopause or of hormone fluctuations, they are the spin off affect of those conditions. They may be the initial catalyst for the anxiety and panic attacks but they do not drive those conditions. Rather like a person who takes a drug, experiences a panic attack and then thinks that they have permanently changed their brain chemistry… it just isn’t true.

Anxiety and panic attacks need very little coaxing to get started. Once sparked, they are self perpetuating.

By correcting the imbalance in the Amygdala anxiety levels are returned to normal. This won’t, of course, affect your hormone imbalance but it will take away the anxiety and panic attacks making the situation a whole lot more comfortable and less distressing.

Anxiety and panic attacks are not a ‘normal’, or acceptable, symptoms of the menstrual cycle or menopause. I promise you that they can be reduced and eliminated quickly and simply using the correct method.

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Stopping Panic Attacks

February 1st, 2010

I’m going to share with you a few tips on how to stop your panic attacks. I’ve had them for almost 30 years so I believe I have some information that will help you out….

This is how to stop your panic attacks

Tell yourself in your mind that you have gone through a panic attack before and you lived, and this attack is no different. Laugh out loud at it and do reverse psychology on it. When you lapse, immediately get involved in something to keep your mind instantly busy to take your mind off the immediate thoughts until your manifested thoughts subside.

Force yourself to get your mind involved in a funny television show. If you can’t sit for obvious reasons stand up and watch it and pace around until your mind eases. Take a few deep breaths.

Start drinking a bunch of water telling yourself in your mind that it cools you down and makes you feel better. Drinking water Is like an IV the hospital gives you. It works!

Stand by your computer and go to YouTube and watch funny videos until your thoughts subside

Start talking to someone about anything if you can stand still and not look like your freaked out. (Depends on the level) until your mind eases.

Don’t fight it. Let it come and take its course and assure yourself that you will live because you have had them before. Also remember that as the author of these tips I’m sharing with you, that I’ve had severe panic disorder of the worst kind and if I can live this long with this disorder than so can you….

The more you beat your panic attack away from the places that make you feel comfortable the more will power you will get at beating the panic attack next time in places that normally make you feel uncomfortable and keep you from lapsing when your out and about.

Those were some of the techniques I’ve used over the last 30 years to help stop my panic attacks when I was having them.

After nearly 30 years, I do not get panic attacks anymore. But I use to have severe panic attacks where my heart would actually start skipping beats while I was having an attack along with all the other panic attack symptoms that are so typical but very terrifying. Like an intense feeling of unreality like I was going to die of a heart attack or stop breathing any second as my chest was hurting and the palms of my hands were sweating.

Well…. I don’t want to get into to much more detail as I know this can also stress you out and possibly lead into your own panic attack. Just remember this… you will not die from your panic attack.

I also want to tell you something extremely important about your panic disorder that you may or may not know….

The couple of techniques I shared with you above will only help you while your actually having a panic attack. To stop your panic attacks forever you need to get to the root of your disorder which is breaking your perpetual loop of being afraid to have your next panic attack, which leads to you obsessing when your next panic attack will come.

Its a vicious circle and it all sounds crazy, but your afraid of being afraid.

If you don’t stop worrying and obsessing about when your next panic attack will come they will just keep compounding daily, weekly, monthly and yearly and can have significant negative affects on your personality that can lead to avoidence of certain places or things. You will also develop poor relationships with people as you start withdrawling and become more introverted, which can also not only affect your relationships, but your job performance, your quality of life, and your overall health.

Since your panic attacks are triggered by fearing fear itself, then Your probably wondering how do you stop worrying about when your next panic attack will come if it completely scares the hell out of you each time that you have a panic attack?

How Do you break your perpetual loop of fear that causes you to constantly think about when your next panic attack will come, which then triggers yet more panic attacks inside you?

How do you stop your panic attacks forever? Is it even possible?

Honestly after 30 years I had no clue it was even possible to stop my panic attacks forever since my constant fear over the years had deeply damaged my thought process from all the panic attacks I had.

Maybe you’ve only had one panic attack before? Maybe you’ve had panic attacks only a few times? Maybe you have panic attacks all the time like I use to?

Whatever your case, I can tell you that based not only on my first hand experiences having panic attacks myself for years and years, but also being highly educated about panic disorder, that your panic attacks are not over. They will only continue to get worse over time and eventually haunt you for the rest of your life unless you find out how to stop your panic attacks forever.

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Calming Your Breath

January 29th, 2010

People who are anxious tend to breathe in their upper lungs (upper chest) with shallow, rapid breaths, instead of breathing into their lower lungs (lower chest).  This is one contribution to hyperventilation: shallow, upper lung breathing.

The three breathing skills that I will describe next start with inhaling into your lower lungs.  This is a deeper, slower breath.  Below the lungs is a sheetlike muscle, the diaphragm, which separates the chest form the abdomen.  When you fill your lower lungs with air, the lungs push down on the diaphragm and cause your abdominal region to protrude.  Your stomach looks as though it is expanding and contracting with each diaphragmatic breath.

The first breathing skill is called Natural Breathing, or abdominal breathing. In fact, this is a good way to breathe all day long, unless you are involved in physical activity. In other words, you should practice breathing this way all day long, since it provides for sufficient oxygen intake and controls the exhalation of carbon dioxide.

It’s very simple and it goes like this:

Gently and slowly inhale a normal amount of air through your nose, filling your lower lungs. Then exhale easily. You might first try it with one hand on your stomach and one on your chest. As you inhale gently, your lower hand should rise while your upper hand stays still. Continue this gentle breathing pattern with a relaxed attitude, concentrating on filling only the lower lungs.

As you see, this breathing pattern is opposite of that which comes automatically during anxious moments. Instead of breathing rapidly and shallowly into the upper lungs, which expands the chest, you breathe gently into the lower lungs, expanding the abdomen.

The second technique is deep diaphragmatic breathing and can be used during times when you are feeling anxious or panicky. It is a powerful way to control hyperventilation, slow a rapid heartbeat and promote physical comfort. For this reason we will call it the Calming Breath.

Calming Breath

1. Take a long, slow breath in through your nose, first filling your lower lungs, then your upper lungs.
2. Hold your breath to the count of “three.”
3. Exhale slowly through pursed lips, while you relax the muscles in your face, jaw, shoulders, and stomach.

Practice this Calming Breath at least ten times a day for several weeks. Use it during times of transition, between projects or whenever you want to let go of tension and begin to experience a sense of calmness. This will help you become familiar and comfortable with the process. And use it any time you begin to feel anxiety or panic building. When you need a tool to help you calm down during panic, you will be more familiar and comfortable with the process.

The third technique is called Calming Counts. It has two benefits over Calming Breath. First, it takes longer to complete: about 90 seconds instead of 30 seconds. You will be spending that time concentrating on a specific task instead of paying so much attention to your worried thoughts. If you can let time pass without such intense focus on your fearful thoughts, you will have a better chance at controlling those thoughts. Second, Calming Counts, like Natural Breathing and the Calming Breath, help access the Calming Response. That means you will be giving yourself 90 seconds to cool your body out and quiet your thoughts. Then, after that time has passed, you will less anxious than you were.

Here’s how this skill works:

Calming Counts

1. Sit comfortably.
2. Take a long, deep breath and exhale it slowly while saying the word “relax” silently.
3. Close your eyes.
4. Let yourself take ten natural, easy breaths. Count down with each exhale, starting with “ten.”
5. This time, while you are breathing comfortably, notice any tensions, perhaps in your jaw or forehead or stomach. Imagine those tensions loosening.
6. When you reach “one,” open your eyes again.

As you apply these skills, keep two things in mind. First, our breathing is dictated in part by our current thoughts, so make sure you also work on changing your negative thoughts, as well as your breathing, during panic. And second, these skills work to the degree you are willing to concentrate on them. Put most of your effort into not thinking about anything else — not your worried thoughts, not what you will do after you finish the breathing skill, not how well you seem to be at this skill — while you are following the steps of these skills.

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Panic Attack Breathing

January 27th, 2010

During an emergency, our breathing rate and pattern change. Instead of breathing slowly from our lower lungs, we begin to breathe rapidly and shallowly from our upper lungs. If during this time we are not physically exerting ourselves, then it can produce a phenomenon called “hyperventilation.”  This in turn can explain many of the uncomfortable symptoms during panic:

* dizziness
* shortness of breath
* a lump in the throat
* tingling or numbness in the hands or feet
* nausea
* confusion.

The good news is that by changing your breathing you can reverse these symptoms.

By shifting your breathing rate and pattern, you can stimulate the body’s parasympathetic response. This is the body’s equally powerful and opposite system to the Emergency Response and is often called the relaxation response. For our purposes I will call it the Calming Response.

The table below lists the physical changes that take place in the Calming Response. As you can see, all of the primary changes of the Emergency Response are reversed in this process. One of the differences in these two physical responses is that of time. The Emergency Response takes place instantly in what is called a mass action: all the changes occur together. Once we flip on that emergency switch, it takes awhile for the body to respond to our calming skills. For this reason it is important for you to know what specific skills will reverse this emergency response and will help calm your body and clear your mind.

You will now be introduced to three breathing skills. In later steps you will learn how to change your fearful thinking and your negative imagery, because each time you frighten yourself with catastrophic thoughts or images, you re-stimulate your body’s emergency response. To begin with, however, you need a solid foundation in proper breathing.

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Overcoming Anxiety

January 25th, 2010

Overcoming anxiety after it’s developed into a major difficulty in your life can often be confusing and upsetting. However, anxiety disorders are very treatable problems.

This article is a consumer guide for people who seek anxiety relief, but don’t know how to get there. However, I suggest that everyone who seeks relief from chronic anxiety should review these steps, and complete any which you haven’t yet done.

Step One: Learn a little about anxiety disorders

Understanding how anxiety “works” is one of the keys to overcoming anxiety. Read my description of the different anxiety disorders and compare your experience with those descriptions. Take a look at these sites, hosted by nonprofit organizations, which offer a wealth of consumer information about anxiety disorders, anxiety treatment, and overcoming anxiety.

The purpose here is not to self diagnose yourself – please consult a licensed clinician for a diagnosis – but to inform yourself as much as possible before you consult a clinician so that you can evaluate what a clinician tells you, be an informed consumer, and find effective methods for overcoming anxiety.

It’s common to experience some depression along with an anxiety disorder, and this is often a source of confusion to people. If this sounds relevant to you, read a little bit about depression.

Step Two: Consult with your primary physician

A consultation with your physician is a must if you suspect you have panic attacks or generalized anxiety.

These symptoms can be caused by a variety of physiological disorders, and you should rule them out as part of the diagnostic process. You should certainly have one complete physical after the onset of these symptoms.

The other anxiety disorders don’t generally require a physical, because there isn’t any reason to think that they are caused by another physical ailment. However, you might still want to consult your physician, especially if you have a long history with that person. You might want his/her opinion about your situation; you might want a referral; or you might want to find out about possible medications you could use.

Be aware, however, that most physicians, because they specialize in various aspects of physical health, have very little training in the area of anxiety disorders. What training they do have, with respect to overcoming anxiety, is usually limited to medications. They may often be surprisingly unaware of cognitive behavioral treatment for anxiety disorders, even though it is generally regarded as the treatment of choice. When it comes time to seek professional help for overcoming anxiety disorders, you will probably need to go elsewhere.

If you don’t have panic attacks or generalized anxiety, and have no other reason to consult your physician about overcoming anxiety, then skip ahead to Step Three.

Before you call for an appointment, make some written notes of what you want to discuss with your physician. The doctor’s staff will probably ask you why you want an appointment; tell them that you’ve been having some problems and summarize them, briefly.

Many people have a fear of doctors, and have trouble making an appointment. This is a phobia, and will generally respond to the same CBT approach, once you decide that a visit to the doctor, however anxiety provoking, is in your best interest.

What to Expect from Your Physician?

Your physician should listen to your symptoms, review your history, ask questions, and offer feedback and recommendations for overcoming anxiety. Since most physicians are trained principally in physical health and medicine, there is no reason to expect him/her to be an expert in anxiety disorders. However, your physician should take your complaints seriously, evaluate them, and offer suggestions for finding additional help.

If you are having panic attacks and have never been tested for thyroid malfunction, for instance, you should receive such a test, because thyroid problems can sometimes cause a person to have panic-like symptoms. If your symptoms resemble those associated with mitral valve prolapse, you should probably have an echocardiogram to evaluate that possibility. There are numerous physical conditions which can produce panic symptoms, and your physician should evaluate you for those possibilities if that has never been done before.

However, if you have had those tests before, and your doctor assured you that you were in good health, do not push for continual retesting! Many people do this because they hate the idea that they may have an anxiety disorder, and instead hope to find a physical problem. You can waste lots of time and money this way.

One set of tests is generally enough. If you need a second opinion for a particular reason, then get one. If you get more than two sets of tests, seriously consider the possibility that you are getting diverted from your task of overcoming anxiety!

Let’s suppose that you’ve had a good consultation with your physician, the appropriate tests have ruled out any physical ailments which could be causing your symptoms, and you want to get professional help with overcoming anxiety. Now you’re ready for step three.

Step Three: Learn about the available treatments

There are basically two kinds of treatment which clinical research has shown to be effective in overcoming anxiety disorders: cognitive behavioral treatment (CBT) and certain forms of medication. Other forms of psychotherapy are often helpful in resolving some of the issues associated with anxiety disorders, but are generally not regarded as capable of resolving the primary problem. Which form of treatment should you choose?

My view is that most people with anxiety disorders are best served by trying a cognitive behavioral treatment first, and seeing what kind of results you get from that. You can always try medication later, if the CBT doesn’t provide all the results you seek.

There are three principal reasons to try CBT first. First, unlike medication, CBT has no side effects. Second, the use of medications tends to lead a person to believe that he or she is now “protected” from anxiety disorders, and the sense of being protected often leads an anxiety sufferer to feel more vulnerable in the long run. Third, the results you get from CBT treatment will generally be much more long lasting than those you get from medications. Results from medication treatments tend to fade after the medications are withdrawn.

Some patients will need medication in addition to CBT, and some will not, depending on the severity of their condition and their particular diagnosis. Medication is nothing to be avoided if it seems necessary. However, I do believe it’s true that in our culture, medications are overprescribed for these problems. This can be avoided if you start with CBT first.

The Anxiety Disorders Association of America website includes an overview of medications used to treat anxiety disorders

There are new forms of CBT in development, often labeled as “Third Wave” therapies. One in particular, Acceptance and Commitment Therapy (ACT) is quite useful in the treatment of Panic Disorder and other anxiety disorders. In my work, I blend methods from both traditional CBT and ACT, and find them both very useful in overcoming anxiety disorders.

Do I Need “Treatment” at All?

You may be wondering if you really need to see a professional, or if you can’t just solve this problem on your own. In general, the more difficulty you are having, the more you may need professional help, but only you can decide how urgent your need is. Certainly there are many good sources of self help information you can use in overcoming anxiety disorders. If you choose to try anxiety self help, I suggest you follow a few guidelines.

* Get a “buddy”, a coach, or a support person, with whom you can discuss your efforts on a regular basis. They don’t have to be an expert. A major benefit is that, by telling someone of your efforts, you will find it easier to monitor your progress and hold yourself accountable. It’s easy to forget about all your good intentions when you keep them to yourself.

* Follow an organized plan. Find a good self help book which pertains to your problem, and make that the basis of your work. If you have panic attacks and like the approach you find on this website, then try my Panic Attacks Workbook.

* Evaluate your progress at regular intervals, at least monthly. After six months, re-evaluate your progress. If you’re satisfied you’re making reasonable progress toward overcoming anxiety, continue on course. If you’re not, consider seeking professional help at that time.

* Sign up for my free e-mail newsletter for more thoughts and suggestions for overcoming anxiety.

What about Group Treatment?

Among the advantages of group treatment for overcoming anxiety are lower cost and the opportunity to share experiences with others who can relate to your situation. This can be particularly important for people who feel especially ashamed and imagine that they are one of a very few who suffer in this way.

I don’t really think there are any disadvantages to a well run group treatment, although many people shy away from it because they believe they would pick up more fears from hearing other people’s problems. In my experience in running groups, this has not been a problem and, while people are usually quite nervous before the first meeting, their anxiety is usually much lower by the end of the meeting.

Group treatments are often not available, so consider yourself fortunate if they are offered in your area. Your own personal preference is probably the most important deciding factor in the choice between group and individual treatment.

…and Support Groups?

You may also find it helpful to attend a support group. There are general purpose support groups designed to help people with a variety of psychological problems, and there are anxiety support groups which have a more specific focus – anxiety problems in general, or specific anxiety disorders such as Panic Disorder, Obsessive Compulsive Disorder, etc.

I think most people with a clearly defined anxiety disorder are better served by a support group which focuses specifically on their kind of problem, if such a group is available. However, there are also some good “general purpose” groups, such as Recovery International.

Step Four: Identify and Interview Some Therapists

If you decide to get professional help, be prepared to do some work to find a good therapist. You can start by getting the names of therapists in your area who offer the kind of treatment you seek. The websites of the Anxiety Disorders Association of America and the Association for Behavioral and Cognitive Therapies offer a “therapist finder” section to help you find a specialist in your area. The sites for the Obsessive Compulsive Foundation and the Trichotillomania Learning Center (compulsive hair pulling) offer similar lists of professionals who specialize in those areas.

You will probably be better off if you can find a therapist who has specialized training and experience with the anxiety disorder for which you seek help. However, be aware that these lists will generally include any therapist who wishes to be included; they are not a licensing or accreditation process, simply a place to start. You still need to be an informed consumer.

If you live in the Chicago area, and want to work with me, or one of my associates, we would be happy to schedule an appointment with you.

Step Five: Select a Therapist and Begin Treatment

An initial evaluation with a therapist may take anywhere from one to two sessions. It should enable the therapist to learn enough about you to give you some feedback about your situation and how that therapist proposes to help you, and should also give you a chance to ask more questions. One area you should certainly discuss with the therapist is what to expect in treatment, i.e., how will you know it is working? What would be a sign that it is not working?

You will probably also want to know how long treatment will take. What I tell new patients is that, while I can’t immediately predict how long their particular situation will require, I do expect that they will have a gut feeling that we are moving in the right direction within the first month of weekly sessions, and that they should see some progress within the first two months. If this doesn’t happen, it’s a sign that something isn’t working right, and we should figure out what’s wrong.

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Other Anxiety Symptoms

January 20th, 2010

Being like a hypochondriac, muscle twinges, worry all the time, tingles, gagging, tightness in the chest, tongue twitches, shaky, breath lump, heart beat problems, head tingles, itchy tingling in arms and legs, and so many more.

In addition to these anxiety symptoms, you may also find yourself worrying compulsively about:
• Having a heart attack
• Having a serious undetected illness
• Dying prematurely
• Going insane or losing your mind
• Suddenly snapping
• Losing it
• Uncontrollably harming yourself or someone you love
• Losing control of your thoughts and actions
• Being embarrassed or making a fool out of yourself
• Losing control
• Fainting in public
• Not breathing properly
• Losing control of reality
• Choking or suffocating
• Being alone

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Touch Anxiety Symptoms

January 13th, 2010

Aanxiety symptoms commonly associated with touch:

* Burning skin sensations, skin sensitivity
* Feeling cold or chilled
* Numbness
* Numbness tingling, numbness and tingling
* Pain
* Tingling, pins and needles feelings

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Sight Anxiety Symptoms

January 11th, 2010

Anxiety symptoms commonly associated with sight:

* Distorted, foggy, or blurred vision
* Dry, watery or itchy eyes
* Eye tricks, seeing things our of the corner of your eye that isn’t there, stars, flashes
* Eyes sensitive to light
* Spots in the vision
* Flashing lights when eyes are closed
* Your depth perception feels wrong

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Sleep Anxiety Symptoms

January 6th, 2010

Anxiety symptoms commonly associated with sleep:

* Difficulty falling or staying asleep
* Frequent bad, bizarre, or crazy dreams
* Hearing sounds in your head that jolt you awake
* Insomnia, or waking up ill in the middle of the night
* Jolting awake
* Waking up in a panic attack
* You feel worse in the mornings

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Skin Anxiety Symptoms

January 4th, 2010

Anxiety symptoms commonly associated with the skin:

* Burning skin sensations, skin sensitivity
* Numbness
* Numbness tingling, numbness and tingling
* Skin problems, infections, rashes

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