Silence!! I kill you!
February 5, 2014 5:05 PM   Subscribe

Mefis, please help me quiet the terrorist in my head. I have panic disorder and I'm afraid of everything, it seems.

I have been battling this for many years, with varying degrees of success. I've read seemingly all there is to read on the subject, tried (and developed on my own) numerous techniques to mitigate the anxiety, been to therapy (and will be going back once my insurance coverage is active), take meds, etc.

Today I had a huge freak-out-panic-attack-"Boss, I have to leave right now" episode. It made me feel like I just can't handle life. I wish I could have reacted like a normal person instead of my body running on auto-pilot-freak-out mode. I just want to feel normal. I'm tired of always fearing illness and panic attacks and the physical symptoms of panic attacks and the fear of panic attacks.... I'm tired of being afraid.

(I realize my anxiety is partly due to assertiveness issues; I'm working on that. )

Would you please make a donation of your time and knowledge to help save this scaredy-cat and possibly her relationship? Any resources - scientific or anecdotal evidence, books, techniques, etc. to help me not be so afraid of the world are welcome.
posted by msbadcrumble to Health & Fitness (13 answers total) 25 users marked this as a favorite
A good friend of mine just recovered from a period of severe panic attacks with the help of the book Hope and Help for Your Nerves, by Claire Weekes. It totally cured him, as he says, and he recommends it to everyone.

He is also active on the Reddit Anxiety board. You might also post your question there.
posted by procrastination at 5:14 PM on February 5, 2014 [3 favorites]

Most likely, you'll need the help of a professional to get to the other side of this. However, my anecdotal evidence is thus: I suffered from debilitating OCD for many years, which sounds, to my ears, very much like the gymnastics your brain does w/r/t panic attacks. The voice saying, "you must do this, you must do this, if you do not do this, bad things will happen" made no sense whatsoever, but I knew I was powerless against them.

What therapy eventually brought me to realize was that feelings, while having a very physical component, will eventually dissipate. You can sit with a feeling...inflate it, examine it, or just live through it, and on the other end of it, you'll have had a feeling and...nothing. Because they're feelings. Panic attacks are a manifestation of anxiety, as is OCD, so I'd expect that lesson will be something a professional might help you deal with, as well.

I'm so sorry you're going through this, and I want to tell you that you can get through it and flourish. I don't know how much that will help, but I hope it does.
posted by xingcat at 5:16 PM on February 5, 2014 [4 favorites]

I agree with xingcat. You must not run from these emotions or kill them.

You must allow yourself to feel them and come out the other side.

Tough question is how?. I recommend you use whatever "notepad" feature your smartphone has. When you are feeling anxious, focus intently on feeling the "bad" parts of the feeling. Steer into the wind. Pay attention to how long the bad feelings last, and when it is all over, log it in on a document on your phone. At the end of the month, re-read the file. Ask yourself how bad the feeling really is and how long it lasted. Hell, rate it from 1 to 10 every time it happens.
posted by Ironmouth at 5:24 PM on February 5, 2014 [3 favorites]

Have you ever thought about why they give teddy bears to kids? It's because bears are scary - the stuff of nightmares. We give kids a cute, fuzzy representation of a bear to love and to clutch tightly while asleep, and, voila, dreams of bears cease to be scary.

The following trick is counterintuitive, like learning to steer into skids, but it's the answer to many of the mysteries and sufferings of life: love the monsters. If the monsters aren't specific enough to visualize, love them vaguely (but no less heartfully). Make everything your teddy bear.

The things that scare us or make us anxious are all quite arbitrary. A choice was made at some point, and, as a result, you're not being terrified by the things, you're being terrified by your choices - decisions to respond to certain things with fear and anxiety. So it's just a matter of hacking those choices (which is relatively easy), not your fear (which is very difficult). It's really no harder than arbitrarily deciding you prefer blue to green, or Mozart to Stravinsky. It's just a choice! But given that it's senseless to work on "un-fearing" something, the way to go is to arbitrarily swap in loving that thing. I love policemen! I love circus clowns! It's ditzy/arbitrary, but the aversion was just as ditzy and arbitrary to begin with! Our prefs really do reset with ease if we view them clinically. They're not deep.

An intermediary step, if that proves difficult, is this: when you fearful, reassure someone else. If no one else is there, make it a vague imaginary someone. It's another form of love. Don't feel like you've got to be specific or make a story of it. It doesn't need to be any more intellectual or rational than loving one's teddy bear. Just do.
posted by Quisp Lover at 5:26 PM on February 5, 2014 [13 favorites]

I'm going through a relapse of panic attacks, anxiety and health anxieties. It's been rough, so I can understand how you feel. I did the same thing to my boss yesterday and today.

I'm going to be honest - the only thing in the past that has helped me is xanax (even my low dose) and an SSRI (Celexa for me). Once the Celexa kicks in, I don't need the xanax anymore. I switched my meds about 4 months ago and thats when all hell broke loose. I've been back on my Celexa for only a week now.

Other things that help me personally:
-Sometimes breathing exercises can help my panic stay away - but I'll still have the anxiety.
-Talking to someone funny can help. I often call my Mom or my sister when I start to get nervous.
-Going for brisk walks during the day at work and keeping busy helps a lot.
-I see two therapists and talking to them helps me understand the science behind my panic.
-Trying to explain to my boyfriend is very hard because he has never had these issues but he is usually supportive but sometimes I can tell that he's not in the mood to deal with my anxiety and panic all the time since it was (sometimes still is) multiple times a day.
-Assertiveness issues I had when I was younger were helped a lot by CBT.
-I've had two therapists recommend Tai Chi because it keeps you concentrating on movements and breathing. I tried some at home techniques since there doesn't seem to be any classes locally.

I have a few books and they tell me what I already know but sometimes they can reassure me. A good one is The Anxiety and Phobia Workbook.
I just recieved this book today and it looks awesome so far.

Hang in there, I know it can be difficult and scary. You're not alone!
posted by KogeLiz at 5:31 PM on February 5, 2014 [2 favorites]

From a Zen perspective, I recommend Cheri Huber's The Fear Book:
Rather than explaining typical strategies for overcoming fear, this book focuses on examining how fear is experienced, how to recognize that experience as nothing more than conditioned reaction to circumstance, and how to mentor oneself into letting go of beliefs about "appropriate" responses to fear. The notion is debunked that fear is anything other than a label we have learned to put on a set of physical and emotional responses, which is a Buddhist view of emotion in general.
Best of luck.
posted by Pirate-Bartender-Zombie-Monkey at 5:46 PM on February 5, 2014 [1 favorite]

How long have you been experiencing the panic attacks? In my experience anxiety can ebb and surges with circumstances, stress, and seasons. It might be worthwhile consider whether you're getting enough sunlight, regular contact with people who love and support you, exercise, activities you find enjoyable and interesting. Also go to your doc and get a workup if you haven't done that recently.

I have trouble making myself do it, but intense exercise definitely helps.

Also, think back. Chances are you have not always been THIS panicked. The thing about anxiety and depression is that they tell you that they are all that you have ever been. That's almost certainly not true. It might help to make a mental timeline and think of times when you felt happy and relaxed or just normal and manageably anxious. And if you had happy and relaxed times in the past, chances are you will have them again in the future.
posted by bunderful at 6:10 PM on February 5, 2014

Per Pirate-Bartender-Zombie-Monkey's posting, I think Huber properly understands the cause, but not the cure.

A fear response is, indeed, nothing more than a learned response to a label (that's another way of expressing what I posted, above). But if you understand that, why not just swap in a new label, rather than seek to understand and unravel and revamp one's entire label-making process?

The new labeling I suggested is "love the monsters". Make Teddys of all imagined Bears.

I mean, if you want, sure, you can "mentor oneself into letting go of beliefs about appropriate responses to fear". But, Jesus, that's an awfully tough road to hoe to recommend for readers who've come to your book looking for a little relief, no?
posted by Quisp Lover at 6:38 PM on February 5, 2014

Your body "running on auto-pilot-freak-out mode" is a medical problem requiring a medical solution. Just like a diabetic can't think him/herself out of a need for insulin, you can't think yourself out of this level of severe anxiety.

You say you "take meds" but clearly they aren't working. You need to go back to your psychiatrist and tell her/him what you told us and either get your dosage upped or switched to a different medication.

I was initially prescribed Xanax to "take as needed" for my anxiety but the problem with that is it required me to already be having a panic attack to then use it to cut the attack short. When my doctor switched me to 1mg/night of Klonopin as a proactive anti-anxiety medication instead, everything started getting much better literally three days later. Things that seemed impossibly hard before (like leaving the house or answering the phone or opening the mail) became trivially easy again.
posted by Jacqueline at 7:51 PM on February 5, 2014 [3 favorites]

Sorry you're going through this. When I've had panic attacks it's been helpful to focus on something else as intently as possible--for example, looking at every detail of my shoes. Though I don't meditate, I have a feeling it would be really helpful, as it helps you take control of what you think about. Once you feel like you can direct your own thoughts, you might stop fearing more panic. In the long run, I think regular physical exercise is also really important.
posted by three_red_balloons at 8:07 PM on February 5, 2014 [1 favorite]

This online therapy course was intended for people trying to get into CBT on the NHS with the huge waiting time that entails. It may not have much to offer you if you've already dine lots of reading and been to therapy. However, they don't charge for it until after a month. So you can sign up, review the material, and back out if it doesn't look helpful before being charged.
posted by K.P. at 2:10 AM on February 6, 2014 [2 favorites]

Sorry, that might be a bad link. Try this one.
posted by K.P. at 8:26 AM on February 7, 2014

I think Huber properly understands the cause, but not the cure.

There is no cure for fear. The messages that get sent to the amygdala that set, in this case, a panic attack in motion are much faster than the thinking mind can process yet alone try to stop. And, the apprehension that follows? No matter how much work a person might do to mitigate the subsequent anxiety something about the attack may have left a indelible mark leaving a person permanently anxious about some aspect of the attack.

But, Jesus, that's an awfully tough road to hoe to recommend for readers who've come to your book looking for a little relief, no?

This, in part, is where I think you misunderstand Buddhism. I'm far from being an expert on this topic and haven't read her book so can't speak to it directly, but from my limited understanding the aim in Buddhism isn't to find a (new) way to deceive yourself from feeling the pain you feel, but to be with it without labelling it good or bad/wanted or unwanted. To learn to observe its nature without judgement(s). To understand that we create a lot of additional suffering for ourselves when/in trying to distract ourselves from how we're thinking and feeling as a result of those thoughts. Pema Chodra calls some of this "the itch" in Getting Unstuck.

And after my panic attack (please god let it be my one and only!), I have to largely agree with the idea that much of my discomfort came from trying to find a way to never feel that feeling again, as I scrambled to find the means to distract myself. I went through a phase where I didn't want to feel anything at all. Still haven't figured out how to do that trick yet.

Over the years I'm finding anything that helps put my focus on my body helps heaps; yoga, stopping just for a second to take a few deep breaths, exercise, meditation. The meditation is helping realize how distracted I can get since I can get so lost in my thoughts I forget to breath which causes dizziness and feelings of vertigo and ... oh shhhh... here comes the anxiety again! If I can catch myself in those moments and do something physical, even if its just focusing on my breath, the anxiety lessens.

Meditation over the long haul has been the greatest balm of all. Jon Kabat-Zinn gets a lot of praise for MBSR which is how I was introduced to meditation. Full Catastrophe Living is his book on the MBSR program and definitely worth reading. There is also another therapy called MBCT based on Kabat-Zinn's work, and though it's aim is to help with depression, it also might be something to look at. They created a 8 week course as a book with guided meditations called (IIRC), Mindfulness - Finding Peace in a Frantic World and they have a website for the book. Though I wasn't fond of the guided meditations because the narrator talked too fast for my liking and used others.

ps: xanax helps too
posted by redindiaink at 9:11 AM on February 17, 2014 [1 favorite]

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