Patch my panic-addled brain.
February 4, 2011 10:09 PM
YANMD: Please help me with immediate methods of managing a panic attack.
What can I do immediately to help stave off, manage, or resolve a panic attack, when I don't necessarily have much time to myself? I do not have a job where taking ten or fifteen minutes to myself is possible.
I know I should see a professional about this -- in the past, it's not been a problem of impacting my work, but today I had a panic attack while at work that could have gone very badly if my brain hadn't automatically put itself into lockdown damage control OH SHIT SLAP A PATCH ON HERETICAL'S BRAIN mode until I was able to leave.
I do NOT want to have another incident like this. Immediate measures (including ones that could work with no expectation or chance of privacy) are welcome, as are more mid-term measures. I've not been to any kind of doctor in about ten years, so this will be very awkward for me.
Difficulty: I am horribly embarrassed at the thought of explaining this situation to my co-workers and employer, and am thus not at all comfortable telling them about it yet. (Not worried about them lurking on ask.me or I would anonymize.)
What can I do immediately to help stave off, manage, or resolve a panic attack, when I don't necessarily have much time to myself? I do not have a job where taking ten or fifteen minutes to myself is possible.
I know I should see a professional about this -- in the past, it's not been a problem of impacting my work, but today I had a panic attack while at work that could have gone very badly if my brain hadn't automatically put itself into lockdown damage control OH SHIT SLAP A PATCH ON HERETICAL'S BRAIN mode until I was able to leave.
I do NOT want to have another incident like this. Immediate measures (including ones that could work with no expectation or chance of privacy) are welcome, as are more mid-term measures. I've not been to any kind of doctor in about ten years, so this will be very awkward for me.
Difficulty: I am horribly embarrassed at the thought of explaining this situation to my co-workers and employer, and am thus not at all comfortable telling them about it yet. (Not worried about them lurking on ask.me or I would anonymize.)
Bathroom break! That's always my escape plan. (I have anxiety, too.)
Also, I would take steps in:
A) Reducing the stressors. This is the most important part. You can take 5 minute breaks. You are allowed. Do you want to know what I did? I told myself (and my SO) that my sanity was worth a slight drop in salary, and I quit my too-stessful job.
B) Go to the doctor! Unless you don't have insurance, this is the perfect excuse to see your doctor. Schedule an appointment, and tell your doc that you've been having some anxiety and panic attacks. My PCP was totally fine prescribing anti-anxiety drugs to me, so I didn't have to go to a psychiatrist. She also recommended a great therapist. And if you don't have insurance, there are many therapists that offer sliding scales for paying out of pocket. Trust me; your sanity is worth it.
posted by two lights above the sea at 10:30 PM on February 4, 2011
Also, I would take steps in:
A) Reducing the stressors. This is the most important part. You can take 5 minute breaks. You are allowed. Do you want to know what I did? I told myself (and my SO) that my sanity was worth a slight drop in salary, and I quit my too-stessful job.
B) Go to the doctor! Unless you don't have insurance, this is the perfect excuse to see your doctor. Schedule an appointment, and tell your doc that you've been having some anxiety and panic attacks. My PCP was totally fine prescribing anti-anxiety drugs to me, so I didn't have to go to a psychiatrist. She also recommended a great therapist. And if you don't have insurance, there are many therapists that offer sliding scales for paying out of pocket. Trust me; your sanity is worth it.
posted by two lights above the sea at 10:30 PM on February 4, 2011
I'm sure you'll get some good suggestions here on quick-term short circuits, but I did want to respond to your statement that you believe going to a doctor will be awkward because it's been so long since you have. Having been in your shoes, I just want to give you encouragement from the other side that scheduling and having an appointment will go much, much more smoothly than you're imagining. Health professionals want to address the problem you're bringing to them -- sure, they might suggest, helpfully, that you're making a good start on getting more regular/proactive/wellness care going forward, but all of the fear of chastisement/shaming/scolding/etc. that paralyzed me from getting care in the past (the care we all deserve!) just never, ever, ever happened. You don't need to suck this up, and you don't need to suffer, and there's nothing you need to tell (or hide from) your coworkers/employer. Please memail me if you'd like to chat offline.
(on preview, pretty much what monkeydraws and two lights said!)
posted by argonauta at 10:36 PM on February 4, 2011
(on preview, pretty much what monkeydraws and two lights said!)
posted by argonauta at 10:36 PM on February 4, 2011
Advice which seems contradictory: don't resist the panic attack. Resistance is what builds the adrenaline that fuels the panic. If you feel it coming on, then go limp. Say to your anxiety, "Do your worst." You should find that not feeding your fear will defuse it. It's just a physical feeling, don't let it bluff you.
I can't take credit for this--Claire Weekes' books taught me so much about panic and demystifying it. Hope and Help for Your Nerves is her best book, but she wrote several more.
Hope this helps!
posted by sister nunchaku of love and mercy at 10:49 PM on February 4, 2011
I can't take credit for this--Claire Weekes' books taught me so much about panic and demystifying it. Hope and Help for Your Nerves is her best book, but she wrote several more.
Hope this helps!
posted by sister nunchaku of love and mercy at 10:49 PM on February 4, 2011
When you need an immediate way to stop the thought-loop that reinforces the panic attack, try pinching the web of skin between your thumb and forefinger, repeatedly and forcefully if necessarily.
Listen to your breathing and force yourself to slow it down. Pick a small spot of light within your line of sight (examples: LED light on computer monitor, sun glinting off a car in the parking lot, etc.) and pretend like the light is a candle flame that you're slowing going to blow out with steady breaths.
Those are measures you can do to force yourself to stay in the moment and concentrate on anything other than panicking. Hopefully they'll get you out of emergency-mode until you can get away to collect your thoughts.
But, don't forego seeing your doctor. Anti-anxiety meds really do work.
posted by amyms at 11:03 PM on February 4, 2011
Listen to your breathing and force yourself to slow it down. Pick a small spot of light within your line of sight (examples: LED light on computer monitor, sun glinting off a car in the parking lot, etc.) and pretend like the light is a candle flame that you're slowing going to blow out with steady breaths.
Those are measures you can do to force yourself to stay in the moment and concentrate on anything other than panicking. Hopefully they'll get you out of emergency-mode until you can get away to collect your thoughts.
But, don't forego seeing your doctor. Anti-anxiety meds really do work.
posted by amyms at 11:03 PM on February 4, 2011
Breathing for sure. I started having panic attacks as a teenager and have had them on and off for over 25 years. Dr. Andrew Weil has some exercises that help.
Also, a little GABA under the tongue can help. Open the capsule and just use maybe half of what's in it at one time. Tastes like crap, but it's more effective than swallowing the whole pill if you need to calm down quickly. A therapist taught me that.
Finally, yeah, if you can get away long enough to run up and down a flight of stairs without attracting unwelcome attention, that's good too.
posted by treblemaker at 11:10 PM on February 4, 2011
Also, a little GABA under the tongue can help. Open the capsule and just use maybe half of what's in it at one time. Tastes like crap, but it's more effective than swallowing the whole pill if you need to calm down quickly. A therapist taught me that.
Finally, yeah, if you can get away long enough to run up and down a flight of stairs without attracting unwelcome attention, that's good too.
posted by treblemaker at 11:10 PM on February 4, 2011
Breathing. 3 second deep breath through the nose, expanding your tummy. Hold for 3 seconds. Exhale slowly through the mouth over 3 seconds. Repeat.
Take a look at your diet. A lot of simple sugars can result in a blood sugar crash, and the body just doesn't respond well. Complex carbs help balance things out.
posted by hungrysquirrels at 11:23 PM on February 4, 2011
Take a look at your diet. A lot of simple sugars can result in a blood sugar crash, and the body just doesn't respond well. Complex carbs help balance things out.
posted by hungrysquirrels at 11:23 PM on February 4, 2011
Panic or anxiety? Two different animals, and many times people who do understand/suffer from anxiety think that solutions extrapolate to panic. They don't, not in my experience, which is considerable, not as a doc but as the guy on the other side of that desk.
See a doc, for sure. I'm not a doc so I don't know what it might be but there could be something underlying it all that they would want to address. Might be he/she would/will write you for xanax, no telling; they don't write for it like they used to, as it has such a huge potential for abuse, huge potential for addiction. But for many who suffer panic disorder, xanax cures what ails. Rounds off those sharp corners, allows the truth of the matter to be seen, which is that there really aren't all that many big deals.
As said upthread, really sorry you're experiencing this. Yet I'm glad it's got your attention to the point where you're willing to get help to get it resolved -- cool. No need to suffer.
And no need to tell co-workers or bosses or most anyone else, either -- while I understand it, and it doesn't reflect badly upon you in any way in my eyes, many people just cannot or will not let go their judgments around this stuff and no need to open up to that if you don't need to.
Good luck.
posted by dancestoblue at 11:27 PM on February 4, 2011
See a doc, for sure. I'm not a doc so I don't know what it might be but there could be something underlying it all that they would want to address. Might be he/she would/will write you for xanax, no telling; they don't write for it like they used to, as it has such a huge potential for abuse, huge potential for addiction. But for many who suffer panic disorder, xanax cures what ails. Rounds off those sharp corners, allows the truth of the matter to be seen, which is that there really aren't all that many big deals.
As said upthread, really sorry you're experiencing this. Yet I'm glad it's got your attention to the point where you're willing to get help to get it resolved -- cool. No need to suffer.
And no need to tell co-workers or bosses or most anyone else, either -- while I understand it, and it doesn't reflect badly upon you in any way in my eyes, many people just cannot or will not let go their judgments around this stuff and no need to open up to that if you don't need to.
Good luck.
posted by dancestoblue at 11:27 PM on February 4, 2011
Deep, slow, steady breathing. Inhale slowly through your nose, pause at the top of the breath, then let it out slowly through your mouth. As you inhale and exhale, do so with a slow count; start out counting to 4, then work up to 6, then 8.
Also, you know the cliche about having a "happy place" in your mind's eye? Well, it can really work. Decide ahead of time when you're feeling good what your own place is (mine, for example, is the pond in the mountains where my grandparents took my sister and me picnicking when we were kids). Wherever your place is, close your eyes and start drawing the picture in your mind. Think of the sights, the scents, the sound.
Now, practice envisioning this space. Once a day, perhaps, just close your eyes and go there for a few minutes. Practice breathing slowly and steadily. Get used to going there, noticing the details, associating them with feeling calm, secure, and in control.
Then, the next time you panic: all you have to do is close your eyes, go to your place, and breathe. Just hang out in your calm place and breathe. Breathe.
posted by scody at 12:33 AM on February 5, 2011
Also, you know the cliche about having a "happy place" in your mind's eye? Well, it can really work. Decide ahead of time when you're feeling good what your own place is (mine, for example, is the pond in the mountains where my grandparents took my sister and me picnicking when we were kids). Wherever your place is, close your eyes and start drawing the picture in your mind. Think of the sights, the scents, the sound.
Now, practice envisioning this space. Once a day, perhaps, just close your eyes and go there for a few minutes. Practice breathing slowly and steadily. Get used to going there, noticing the details, associating them with feeling calm, secure, and in control.
Then, the next time you panic: all you have to do is close your eyes, go to your place, and breathe. Just hang out in your calm place and breathe. Breathe.
posted by scody at 12:33 AM on February 5, 2011
As far as I can tell, it's not a generalized anxiety issue. I'll be fine for days, weeks, and then out of nowhere, SUDDEN OH SHIT BLINDING PANIC over something really inconsequential.
The suggestions regarding breathing are very welcome. I have other non-psychological breathing issues that are turning out to be exacerbated by these attacks, so I'm discovering that it's hard to figure out when the breathing issues are a result of the impending panic attack or just asthma/whatever.
Interesting sidenote, a lot of the breathing suggestions are similar to what I used when I was getting my tattoo. Hadn't thought of adapting the same for this situation. Somewhat amused by this.
posted by Heretical at 1:08 AM on February 5, 2011
The suggestions regarding breathing are very welcome. I have other non-psychological breathing issues that are turning out to be exacerbated by these attacks, so I'm discovering that it's hard to figure out when the breathing issues are a result of the impending panic attack or just asthma/whatever.
Interesting sidenote, a lot of the breathing suggestions are similar to what I used when I was getting my tattoo. Hadn't thought of adapting the same for this situation. Somewhat amused by this.
posted by Heretical at 1:08 AM on February 5, 2011
Here's something I learned from a previous therapist. He called it 5-4-3-2-1.
The basic idea is to pick an object in the room. You then list 5 physical characteristics of it (typically adjectives). Pick another object and list 4 descriptions. Ditto for 3, 2 and 1. When I was having a really bad time (I used it for panic attacks as well as dissociative episodes) I would do it multiple times or start at 10 and go to 1.
Bonus points for not repeating any of the descriptive words.
As an example, I might pick a picture hanging on the wall. My five words might be wooden frame, landscape, Monet, large, and peaceful.
posted by kathrynm at 3:50 AM on February 5, 2011
The basic idea is to pick an object in the room. You then list 5 physical characteristics of it (typically adjectives). Pick another object and list 4 descriptions. Ditto for 3, 2 and 1. When I was having a really bad time (I used it for panic attacks as well as dissociative episodes) I would do it multiple times or start at 10 and go to 1.
Bonus points for not repeating any of the descriptive words.
As an example, I might pick a picture hanging on the wall. My five words might be wooden frame, landscape, Monet, large, and peaceful.
posted by kathrynm at 3:50 AM on February 5, 2011
Some people who get panic attacks wear a rubber band around their wrist. When they start to have a panic attach they snap it against their skin. It focuses you on the real sensation of (mild) pain in constrast to the illusory sensations of imminent doom that characterize a panic attack. In the absence of a rubber band, pinch yourself, or even slap yourself across the face...hard if you have to. It's worked for me before anyway.
posted by banishedimmortal at 4:05 AM on February 5, 2011
posted by banishedimmortal at 4:05 AM on February 5, 2011
A therapist friend of mine (older and quite experienced) told me that studies show that it is virtually impossible to have a panic attack and be angry at the same time. She heartily recommends, as a short-term, spur-of-the-moment patch, getting angry about something.
According to what I have read, many people who suffer from panic attacks also display passive characteristics (i.e. Not standing up for themselves; a general sense that they lack the ability or right to insist that they not be stepped on by others, or even by life and circumstance). If there is validity to that observation, the "get mad" quick-patch makes sense. Anger is the emotional response to a sense of unfairness or violation. It is taking a stand.
I have used this personally, and it does seem to work for me. Note that I am not saying that an injustice done to you *causes* the attack. So, you may not feel that you have anything to be angry about at the time. Find something. Does not need to be related to anything in the area you are in. Fantasize, if necessary, about being able to exercise a righteous indignation over something and being able to do something about it. Get mad.
Remember that this is a spur-of-the-moment patch. Get help. Get meds. Get whatever you need. Don't go through life pissed off just to waylay panic attacks.
posted by skypieces at 5:48 AM on February 5, 2011
According to what I have read, many people who suffer from panic attacks also display passive characteristics (i.e. Not standing up for themselves; a general sense that they lack the ability or right to insist that they not be stepped on by others, or even by life and circumstance). If there is validity to that observation, the "get mad" quick-patch makes sense. Anger is the emotional response to a sense of unfairness or violation. It is taking a stand.
I have used this personally, and it does seem to work for me. Note that I am not saying that an injustice done to you *causes* the attack. So, you may not feel that you have anything to be angry about at the time. Find something. Does not need to be related to anything in the area you are in. Fantasize, if necessary, about being able to exercise a righteous indignation over something and being able to do something about it. Get mad.
Remember that this is a spur-of-the-moment patch. Get help. Get meds. Get whatever you need. Don't go through life pissed off just to waylay panic attacks.
posted by skypieces at 5:48 AM on February 5, 2011
I agree with those above that breathing and distraction work for me. But rather than hurting myself (and I don't think that the rubber band snapping would be inconspicuous enough for me in a meeting), a therapist once suggested I keep strongly flavored lozenges or gum around all the time. The strong flavor and chewing/sucking help distract me and it just gives me a talisman that I can carry around all the time just in case. It's also completely normal looking to others.
In a similar vein, rubbing cold water on my neck really helps, too, and is inconspicuous. My therapist correctly predicted that developing a routine of getting a piece of gum, walking to the bathroom, washing my hands, rubbing my neck, then drinking some water gave me a sense of control over the attacks.
BTW, I never wanted to explain anything to coworkers either and a doctor would just want to medicate me, so seeing a (campus) psychologist for 2-3 months was a good compromise for me--I got to confide in someone and develop coping mechanisms. You might see if there's an option for you to see someone.
posted by parkerjackson at 5:53 AM on February 5, 2011
In a similar vein, rubbing cold water on my neck really helps, too, and is inconspicuous. My therapist correctly predicted that developing a routine of getting a piece of gum, walking to the bathroom, washing my hands, rubbing my neck, then drinking some water gave me a sense of control over the attacks.
BTW, I never wanted to explain anything to coworkers either and a doctor would just want to medicate me, so seeing a (campus) psychologist for 2-3 months was a good compromise for me--I got to confide in someone and develop coping mechanisms. You might see if there's an option for you to see someone.
posted by parkerjackson at 5:53 AM on February 5, 2011
Say to yourself, "This is a panic attack. I am freaking out for no reason. It's okay that I'm freaking out, and more cosmically the world is okay, there is no reason for this. Deep breaths."
Labeling it what it is gives it less power; knowing it's "just" a panic attack rather than actual legitimate panic may help you get control over the reaction, but in any case knowing that it is what it is seems to lessen the panic.
Also, I'm SURE you've had the experience in your life where you wake up from a terrible nightmare with a HUGE adrenaline rush, upset and unable to get back to sleep; or where you're almost in a car accident/snag a toddler racing into traffic/similarly adrenaline-inducing incident and then have to actually engage with the world in some fashion. (Once I had a car near-miss that was extremely terrifying and had to walk into an important job interview 5 minutes later when I was still near-tears and trying to regain control of myself.) How did you get a grip then? Some of the same strategies will help with a panic attack. With the nightmares in particular, many of us are able to say, "Man, that sucked, I just have to ride out the adrenaline now and distract myself from the scary thing." If you can just "ride out" the adrenaline of your panic attack (and maybe even wrench your mind away from the panic by thinking about something else -- breathing, 54321, whatever you have to DO now), you can survive it.
(And you can probably say to your coworkers, at least once, "Man, I just got this crazy rush of adrenaline," which has happened to everyone now and then, I think.)
posted by Eyebrows McGee at 5:56 AM on February 5, 2011
Labeling it what it is gives it less power; knowing it's "just" a panic attack rather than actual legitimate panic may help you get control over the reaction, but in any case knowing that it is what it is seems to lessen the panic.
Also, I'm SURE you've had the experience in your life where you wake up from a terrible nightmare with a HUGE adrenaline rush, upset and unable to get back to sleep; or where you're almost in a car accident/snag a toddler racing into traffic/similarly adrenaline-inducing incident and then have to actually engage with the world in some fashion. (Once I had a car near-miss that was extremely terrifying and had to walk into an important job interview 5 minutes later when I was still near-tears and trying to regain control of myself.) How did you get a grip then? Some of the same strategies will help with a panic attack. With the nightmares in particular, many of us are able to say, "Man, that sucked, I just have to ride out the adrenaline now and distract myself from the scary thing." If you can just "ride out" the adrenaline of your panic attack (and maybe even wrench your mind away from the panic by thinking about something else -- breathing, 54321, whatever you have to DO now), you can survive it.
(And you can probably say to your coworkers, at least once, "Man, I just got this crazy rush of adrenaline," which has happened to everyone now and then, I think.)
posted by Eyebrows McGee at 5:56 AM on February 5, 2011
I had to deal with these for a little while after a bit of a highway accident. Here's what I learned.
While some are saying that it's good to tell yourself that its "just" a panic attack, that it might quell things, that didn't work at all for me. For me, the most important thing was to accept that I could not think my way out of a panic attack. I could not rationalize it away. In fact, attempts to do so made things much much much much worse.
This was hard for me; if you're like me you want to respond to a panic attack by saying "this isn't rational, these pains are not real." You'd want to gain control over the situation by knowing it for what it is. Right?
I tried this. But then I'd start thinking about multiple sufficient causality, and I'd say to myself "Look, just because I *know* this is a panic attack, that doesn't mean that I'm not also having a heart attack at the same time." That would turn into some awful mental feedback loop, and the next thing I'd know, I'd be in the emergency room.
And that's the fucked up thing about the panic attack. It's not just that it's irrational. It's that rationality can even work against you.
So things that did work for me? First and foremost, accept that it's happening and don't try to talk yourself out of it. Second, scody's visualization thing, which always struck me as a corny cliche when I heard others speak about it, worked. It actually worked. Third, for me, when things got full-blown awful, I'd start pacing. So, somehow sitting still and focusing on good posture somehow helps me. It gave my something physical to focus on other than phantom pains, and something that I could focus some mental/analytical energies on.
Good luck!
posted by .kobayashi. at 6:05 AM on February 5, 2011
While some are saying that it's good to tell yourself that its "just" a panic attack, that it might quell things, that didn't work at all for me. For me, the most important thing was to accept that I could not think my way out of a panic attack. I could not rationalize it away. In fact, attempts to do so made things much much much much worse.
This was hard for me; if you're like me you want to respond to a panic attack by saying "this isn't rational, these pains are not real." You'd want to gain control over the situation by knowing it for what it is. Right?
I tried this. But then I'd start thinking about multiple sufficient causality, and I'd say to myself "Look, just because I *know* this is a panic attack, that doesn't mean that I'm not also having a heart attack at the same time." That would turn into some awful mental feedback loop, and the next thing I'd know, I'd be in the emergency room.
And that's the fucked up thing about the panic attack. It's not just that it's irrational. It's that rationality can even work against you.
So things that did work for me? First and foremost, accept that it's happening and don't try to talk yourself out of it. Second, scody's visualization thing, which always struck me as a corny cliche when I heard others speak about it, worked. It actually worked. Third, for me, when things got full-blown awful, I'd start pacing. So, somehow sitting still and focusing on good posture somehow helps me. It gave my something physical to focus on other than phantom pains, and something that I could focus some mental/analytical energies on.
Good luck!
posted by .kobayashi. at 6:05 AM on February 5, 2011
Running up a set of stairs has worked for me as well. I feel like exerting myself to a physical task helps to get past that panicky awful feeling and takes your mind off the feedback loop. Also, singing a song out loud has worked for me. I dont know if you can do that at your job inconspicuously, but maybe you can! I've also found that after everything passes and you're feeling "good" and the world makes sense again, LAUGH at how silly it all seems now. Really, actually laugh out loud. The more you can trivialize each attack, the better off you are going into one the next time around. Now, if I feel one coming on, I draw on that silliness to downplay the impending event. It's sort of like the happy place idea, but with your happy place being the knowledge that these things will pass. Good luck, these things suck indeed.
posted by ps_im_awesome at 6:23 AM on February 5, 2011
posted by ps_im_awesome at 6:23 AM on February 5, 2011
Always take 3 long deep breaths before ANY possibly stressful situation. Breath in long an slow and hold it and then slowly release. Best advice I ever got about public speaking. Most of that quivery voice comes from the shallow breathing that accompanies panic attacks.
posted by any major dude at 6:35 AM on February 5, 2011
posted by any major dude at 6:35 AM on February 5, 2011
I had what I called anxiety attacks, though when I described them to my doctor, he called them panic attacks: rapid heartbeat, shaking hands, unable to concentrate on anything at all, horrible feeling of helplessness and certain doom. I'd have an attack that lasted up to four days. My heart would pound so hard it felt like somebody jumping on my bed and kept me from falling asleep at night.
The advice of others here so far is great: deep breathing, bathroom breaks. You might be able to find short meditation exercises in podcast format and listen to them on an MP3 player while you're in the bathroom, too. I'm afraid I can't recommend any in the three-to-five-minute bathroom break length, but surely they are out there.
One thing I did while I was working my way up to talking to a doctor about it was taking l-theanine capsules. This really helped me. It's possible that it was placebo effect -- the science on theanine is a little iffy -- but it doesn't matter if it was placebo or not; the important thing is that it helped me.
I also completely eliminated caffeine. There was a direct link between how much caffeine I'd had and how bad my anxiety was that day.
And finally... my triggers were almost all work-related. The one thing that could resolve an attack was simply facing the task or email that was triggering the anxiety and tackling it head-on. Once I got into a state of flow for my work, the anxiety bit just went away.
Incidentally, my issues have completely resolved with treatment for (as it turned out) some serious vitamin deficiencies caused by food intolerances. Absolutely see your doctor. And if your doctor doesn't seem concerned, find another doctor. (The first doctor I mentioned it to told me I should "have your boyfriend take you out to dinner." DO NOT accept being dismissed like this; it set my recovery back six months, easy, before I could bring it up to another, better doctor.)
And... it's going to be OK. You're not alone, and you aren't broken, either. Practice being kind to yourself when you're not at work, OK? You're going through a lot right now, and you deserve to cut yourself a lot of slack.
posted by Andrhia at 6:57 AM on February 5, 2011
The advice of others here so far is great: deep breathing, bathroom breaks. You might be able to find short meditation exercises in podcast format and listen to them on an MP3 player while you're in the bathroom, too. I'm afraid I can't recommend any in the three-to-five-minute bathroom break length, but surely they are out there.
One thing I did while I was working my way up to talking to a doctor about it was taking l-theanine capsules. This really helped me. It's possible that it was placebo effect -- the science on theanine is a little iffy -- but it doesn't matter if it was placebo or not; the important thing is that it helped me.
I also completely eliminated caffeine. There was a direct link between how much caffeine I'd had and how bad my anxiety was that day.
And finally... my triggers were almost all work-related. The one thing that could resolve an attack was simply facing the task or email that was triggering the anxiety and tackling it head-on. Once I got into a state of flow for my work, the anxiety bit just went away.
Incidentally, my issues have completely resolved with treatment for (as it turned out) some serious vitamin deficiencies caused by food intolerances. Absolutely see your doctor. And if your doctor doesn't seem concerned, find another doctor. (The first doctor I mentioned it to told me I should "have your boyfriend take you out to dinner." DO NOT accept being dismissed like this; it set my recovery back six months, easy, before I could bring it up to another, better doctor.)
And... it's going to be OK. You're not alone, and you aren't broken, either. Practice being kind to yourself when you're not at work, OK? You're going through a lot right now, and you deserve to cut yourself a lot of slack.
posted by Andrhia at 6:57 AM on February 5, 2011
Oh! One more thing, per the stair-runners above: Exercise helped a lot lot lot, too. I called it "going to the gym to sweat the crazy out."
posted by Andrhia at 6:58 AM on February 5, 2011
posted by Andrhia at 6:58 AM on February 5, 2011
My doctor told me to (a) get up and go to the men's room, maybe splash some water on my face and (b) keep reminding myself that I am not going to die from the panic attack. That last suggestion was most helpful...
posted by brownrd at 6:58 AM on February 5, 2011
posted by brownrd at 6:58 AM on February 5, 2011
Someone in another recent thread mentioned offhand they visualize something concrete and non-threatening and somewhat mentally engaging, IIRC the pathways and all the visual details one by one in a relative's house. That is excellent advice in my opinion; I occasionally have freak outs a la David on Six Feet Under of the post-trauma intense-visualization kind, and one of the only things that seems to be reliable in helping me get through it until it passes without seriously being, cough, too outwardly noticeable or whatever is that kind of intense, very step by step detailed walk through of something else unthreatening and unrelated. There is also the "warm golden ball" trick--imagine a warm golden ball of comfort and light rolling from the bottom of your feet up sl-o-wly to your calves, winding around your knees, up to your stomach, rolling up and down your arms, your heart, your nose, your forehead, etc., that sort of slow specific detail and gradual moving from A to B, where wherever it is at the moment is warmed and soothed. Take your time going through the steps and really "feeling" the warmth. Helps me anyway. Something about that whole "just get from A to B, very small concrete steps" with visualization helps.
posted by ifjuly at 7:12 AM on February 5, 2011
posted by ifjuly at 7:12 AM on February 5, 2011
After reading more of the comments--Obviously, you'll need to figure out what kind of responses work for you. Exercising when I'm NOT having an attack does really help me manage my anxiety levels, but the idea of doing anything strenuous DURING a panic attack would be ridiculous for me since my attacks originate from physical symptoms like heart rate and worrying about my breathing (sometimes I even have exercise-induced panic attacks). So YMMV.
+1 on eliminating caffeine. Also, I notice that drinking alcohol leads to panic attacks for me in the week following (I'm talking just one drink sometimes).
posted by parkerjackson at 10:06 AM on February 5, 2011
+1 on eliminating caffeine. Also, I notice that drinking alcohol leads to panic attacks for me in the week following (I'm talking just one drink sometimes).
posted by parkerjackson at 10:06 AM on February 5, 2011
Make sure you research any meds you're taking. Psychoactive meds are a delicate balance. Also, if you are using an inhaler or other medication, it could be causing panic attacks.
A very cold, wet washcloth on the face helps a lot. Cold water on the face triggers the mammalian dive reflex, which fights panic attacks. Xanax is very helpful, on an as-needed basis only. Xanax can be put under the tongue for fastest action. IANAHCP(Health Care Professional)
Tell your employer you are having a medical problem getting your asthma meds sorted out, and that sometimes you have to take a mini-break to get your asthma under control. Then take a 5 minute bathroom break.
posted by theora55 at 10:09 AM on February 5, 2011
A very cold, wet washcloth on the face helps a lot. Cold water on the face triggers the mammalian dive reflex, which fights panic attacks. Xanax is very helpful, on an as-needed basis only. Xanax can be put under the tongue for fastest action. IANAHCP(Health Care Professional)
Tell your employer you are having a medical problem getting your asthma meds sorted out, and that sometimes you have to take a mini-break to get your asthma under control. Then take a 5 minute bathroom break.
posted by theora55 at 10:09 AM on February 5, 2011
All the advice above is excellent - I just wanted to throw one thing in there. For me, the long, deep breathing makes panic worse, not better. I've had to train myself to take small, shallow, slow breaths. For some people, perhaps a minority, the longer deep breaths lead to a bit of hyperventilation which prolongs the anxiety.
posted by VioletU at 11:17 AM on February 5, 2011
posted by VioletU at 11:17 AM on February 5, 2011
A tablet of beta blocker (I use 20 mg. propranolol) under the tongue helps me get my heart rate under control quickly if too much adrenaline has already gotten loose. (Xanax actually *causes* panic attacks in me.) I also have one of those little heart monitors I can pop on my finger so I can reassure myself that my heart rate is coming down. I find watching it come down very comforting.
posted by jocelmeow at 3:55 PM on February 5, 2011
posted by jocelmeow at 3:55 PM on February 5, 2011
This thread is closed to new comments.
Finally - in my situation, I was seriously on the verge and I called my GP. She saw me immediately. Just go and get help. As she said to me, take it easy on your self. You do not have to feel this way. Memail me if you want. Good luck.
posted by mokeydraws at 10:29 PM on February 4, 2011