Coping with Anxiety and Panic Attacks
Over the past 4-5 months, a virus has undoubtedly played the leading role in our lives. It was a stimulus we could neither see nor hear, surrounded by a great deal of uncertainty, yet one whose impact we felt intensely and which posed a threat to our lives and our health. Some people were unhealthily relaxed, to the point of saying "oh, nothing will happen to me", while others took the precautions they needed to and carried on with their lives within a new set of rules, as they should. Some people were rightly worried about the elderly in their families or about their own health because of chronic conditions, yet some of this group still found constructive ways of coping with the coronavirus that protected their mental health. Others, whether or not they had health problems, began to worry excessively and with an unrealistic intensity about their own health or that of their loved ones; we could say they developed obsessions, began to neglect their daily routines or lost their former level of functioning as individuals. This post was written for our clients who are somewhat more prone to anxiety and to showing symptoms of panic, because we know that these are the people who struggled the most with the psychological battle against the coronavirus. In ways they could not explain, they began to worry about their health, develop unrealistic and exhausting routines, have trouble falling asleep, avoid places outside the home and wash their hands more than necessary. In the end, they may have managed to protect their health better than many others. But they lost something not to be underestimated: peace of mind!
Of course, one does not need a psychiatric diagnosis to have been affected by a global pandemic like the coronavirus. This pandemic affected all of us to the fullest extent within our own limits. However, we can say that individuals prone to certain mental health problems, such as anxiety disorders (generalized anxiety, panic attacks, agoraphobia) and OCD, have been affected more, and more negatively, during this period. In people who are anxious by nature even when there is no pandemic, and who have obsessions about cleanliness or health, it is not at all unexpected to observe changes or excesses in emotions and behaviour during the pandemic. In this post, we will talk a little about anxiety and panic disorders, discuss these concepts and offer recommendations for people who suffer from these kinds of problems.
First, it may be helpful to give a little information about anxiety disorder and panic disorder. These are two anxiety disorders that actually appear very close to each other and are not always easy to tell apart by their physical symptoms, but that differ in terms of their emotional symptoms. In anxiety, feelings such as worry, apprehension, distress, restlessness and fear are in the foreground, while in a panic attack, feelings such as fear, fear of dying, fear of losing control, and a sense of detachment from the world or from oneself are observed. In both, physical symptoms may be observed, such as a racing heart, chest pain, shortness of breath, a feeling of choking, dry mouth, sweating, trembling, hot flushes, tingling, numbness, stomach upset, headache and dizziness. However, a panic attack usually comes on unexpectedly and suddenly with more severe symptoms, while anxiety involves more widespread and gradual symptoms. Of course, it is also possible to experience both at the same time. For example, you are about to attend an important job interview and are feeling anxious about it. When the moment of the interview arrives, this anxiety may turn into a panic attack.
We can actually explain the reason symptoms appear in anxiety and panic attacks quite simply in evolutionary terms. As the human race, in order to survive and ensure the continuation of our species, we need to feel fear and anxiety when we encounter a dangerous stimulus. This fear and anxiety speed up our heartbeat and raise our blood pressure. If necessary, it provides a sudden surge of the energy we need to flee or fight. Thanks to fear and anxiety, or panic, we can give three basic responses: flight, fight or freeze. For this reason, anxiety is part of our nature, a very important emotion that ensures the continuation of our species and, when appropriate, a healthy one. Generally speaking, acute stress and anxiety are quite understandable and can be seen as part of our nature, but chronic anxiety and panic disorder make our lives harder, make us feel uneasy and disrupt our daily functioning.
The underlying causes of anxiety and panic attacks can differ for each individual. Generally speaking, however, causes such as misinterpreting external stimuli, seeing a danger as bigger than it is, perceiving certain stimuli as frightening because of past experiences, mistaken beliefs that the physical symptoms will harm one's health, and making mistaken interpretations about one's self can lead to anxiety or panic attacks. For this reason, in conditions such as anxiety and panic disorder, modern therapy approaches focus on the beliefs a person holds and aim to remove irrational thoughts and replace them with alternative, functional ones. Knowing this is important for people with anxiety disorders, because if you realize that the problem you are experiencing stems from errors in your thinking, you will be more likely to take action to change them.
Apart from going to therapy, what can you do to cope with the symptoms of anxiety and panic attacks?
1) Practise deep breathing exercises. These exercises can be done in different ways. In the simplest form, breathe in through your nose while counting to 5. Hold your breath for a few seconds, then release it through your mouth while counting to 7. You can adapt these time intervals to suit yourself.
2) During moments of panic, if you find yourself thinking that you are having a heart attack or some other health problem, this can make the situation even harder. So recognize that what you are experiencing is a panic attack, and focus only on easing the panic attack symptoms.
3) If you are somewhere crowded or in a place that is visually disturbing or stressful for you, closing your eyes and focusing on your breath can help.
4) Having learned meditation techniques such as mindfulness helps you in a moment of crisis. The important point here is that practising these activities only during a crisis may not be effective. You need to repeat and practise them plenty of times when you feel well, so that you have decided in advance how you will respond in a crisis and have prepared yourself. The aim of mindfulness techniques is to gather your attention and put some distance between you and the thoughts that pull you into anxiety or a panic attack. The moment you manage to shift your attention to different stimuli, there is no reason for the attack you are having not to subside.
5) For some people, focusing on a single object can also help. During an anxiety or panic attack, you can focus on an object you see around you and touch it, watch it or try to hear the sounds it makes. What matters is that you devote your attention intensely to this object. Mindfulness has similar techniques. Whichever you choose, if you don't work on your attention by practising plenty when you feel well, it becomes harder to benefit from these techniques when you are truly in crisis.
6) Doing muscle relaxation exercises relaxes your mind along with your muscles. You can find various muscle relaxation exercises on YouTube or other social media channels. The basic principle is to tense and then relax different muscle groups in turn. As with the other points, it needs plenty of practice.
7) You can try imagining that you are in a place where you feel good and relaxed. Try to focus as much as possible on the details of the place you imagine yourself in.
8) Light exercise at a steady pace, such as walking, swimming or jogging, reduces stress. Adding light physical activity to your daily routine will lower your chances of experiencing anxiety and panic.
9) You can carry lavender oil with you. Lavender scent is known to have a stress-reducing effect. When you feel an anxiety or panic attack coming on, or notice your anxiety level rising, putting a little on your wrist and breathing in the lavender scent can be soothing. Drinking herbal teas such as lavender, chamomile and lemon balm can also make you feel better.
10) Repeating certain words in your mind during a panic attack can help reduce the symptoms. What you repeat could be a religious phrase or a prayer, or a sentence that makes you feel good. For example, you can say "this is a panic attack and it will pass soon" and repeat it until the attack passes, or you can find a more helpful sentence to repeat in such situations.
11) If you are struggling to cope with your panic attacks, you can start medication on the advice and under the supervision of a psychiatrist.
As you may have noticed, many of the points I have listed involve techniques that focus on drawing attention in different directions. This is because panic attacks and anxiety arise from unwanted thoughts and beliefs circulating in our minds. When we shift our focus and manage to bring thoughts that do us no harm to the top layer of our mind, the symptoms of panic attacks and anxiety will decrease.
The points I have listed can help you cope with anxiety and panic attacks. However, if your symptoms continue and you want to try a different path, you can receive medication, psychotherapy or both. Consulting a specialist will help you with this.
Malik Kubilay Çadırcıoğlu, Psychotherapist
