EDITORIAL
Panic
By Joel F. Wade - April 16, 2012

Panic: 'of Pan,' the god of woods and fields who was the source of mysterious sounds that caused contagious, groundless fear in herds and crowds, or in people in lonely spots (World English Dictionary).

At the famous Battle of Marathon in 490 BC, the outnumbered Athenians, led by their brilliant general Miltiades, took the Persians completely by surprise, sending them into a fit of terror – a panic leading to a remarkable victory. The Athenians lost 192 men to Persia's 6,400.

I'm writing today about some very practical new research regarding genuine panic anxiety that will be useful for anybody who has suffered from it.

Panic anxiety, panic attacks, anxiety that seems to hit you out of the blue, can be extremely debilitating. It can make it difficult to function, and its unexpected nature can lead to a general background of anxiety, wondering and never knowing when you might get hit by panic.

Most of the symptoms of panic anxiety are physical: dizziness, shortness of breath, hot flashes, chest pain, racing heart, sweating, trembling, choking, nausea and numbness. Three are psychological: fear of dying, fear of losing control and feelings of unreality.

Sometimes panic can seem to have a cause – like a phobia: a fear of closed-in spaces, fear of crowds, for example, or exposure to situations where you have experienced such panic before.

Sometimes there are objective reasons for such feelings but some people experience this same kind of fear for seemingly no reason whatsoever, which means that it can seem impossible to find any clear action to take that will remove the panic – so an element of helplessness is added, as well.

But it looks like there may be something predictable and actionable after all. Dr. Alicia Meuret and her colleagues of Southern Methodist University in Dallas, Texas used 24-hour physiological monitoring of people who suffer from panic to see exactly what happened during and around the time of the panic events. (See Do Unexpected Panic Attacks Occur Spontaneously?)

They found that while these people weren't consciously aware of anything happening before the onset of the panic, there were actually subtle but significant changes in breathing and autonomic nervous system elements as early as 47 minutes before the panic set in. These people were hyperventilating, thereby lowering their CO2 levels, without any awareness that they were doing this.

It also may be that people who experience panic have a higher sensitivity to CO2 levels in general, so small changes in CO2 can have a larger impact than on other people. Part of the fear of dying that people can experience with panic may actually be the fear that accompanies trouble breathing, which can be among the most terrifying of feelings.

This means that there may be at least a predictable pattern before the panic attack happens and therefore, possibly something that you could do to prevent it.

(Unfortunately necessary disclaimer: What I am describing here is a suggestion to play with. It is not a substitute for psychotherapy, nor is it a guarantee of any kind of results. I have no way of knowing how this will affect you personally. If you try this and don't like what you're experiencing, stop and do something else.)

When people feel anxious, part of what escalates that anxiety is the label itself: anxiety, fear, panic. It feels big, unpredictable, psychological. When we have something going on that's psychological it can also seem mysterious or scary. As mysterious as the ancient Greeks might have felt it to be, to attribute it to the mischief of a god.

One of the things that I teach people that can help them deal with anxiety is to look at the experience as purely physical. What are the sensations in your body? Don't label it as anxiety. Don't think of it as some psychological problem. Look at what you're experiencing purely as a phenomenon of benign physical sensations. "Hmm, fascinating, look at those butterflies in my stomach, that tension in my chest; look at how shallow my breathing is… interesting."

This does two things: It takes you one step away from the experience, and it gives you something tangible that you can focus on: your body. Once you notice the sensations, you can do things – you can take your shallow breathing and deepen it a bit (not too much). You can take the tightness in your chest and stretch it out a bit. You can focus on the sensations, watch them and allow them to settle down.

When you think of anxiety as psychological, in addition to feeling mysterious it can feel too big – or too abstract – to do anything with. When you boil it down to physical sensations it becomes a set of concrete, manageable tasks.

Well, now we know that there are such things happening even with panic attacks. If you're not familiar with noticing the physical sensations in your body, it just takes practice. This comes easier for some people than it does for others but it is something you can learn.

Start by focusing your attention on a specific part of your body. What are you feeling in your chest? Notice your breathing – is it deep or shallow? What is the rhythm of your breathing? What does that feel like? What do you feel in the muscles of your back? Are they tense or relaxed? If they are tense, are you able to relax them a bit? What about the muscles in your arms?

If you can begin to notice what you sense in your body, then you may be able to identify the physical sensations that precede the panic. If you can do this, then you may be able to lessen or preempt the panic entirely.

In particular, notice the more subtle changes in your breathing, and take a few minutes to slow down and regularize your breathing, it may help you to pre-empt the panic itself.

What I love about this is that it has the potential to give people with panic anxiety some actual, self-generated – and non-medicated – control over their situation. This is the kind of discovery that is truly exciting – bringing effective action to people in a previously helpless and overwhelming situation.

*(It also looks like similar subtle physiological changes occur before heart attacks, strokes and even manic episodes. As these phenomena continue to be explored, we may have some very useful interventions that people could use to prevent or limit the damage from these conditions, as well.)

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