What do you do when the panic/anxiety hits?

What do you do to cope, to ride it out?

I am not on ADs. I cannot take them. I don't think they're for anxiety anyway. I am not depressed. I am having severe panic attacks.

How do I ride them out?
Mulan

Have you ever tried Xanax? It seems to work for me. If a panic attack is particularly bad, trying to control it only puts more focus on it and makes it worse.

Without medication, the best way I have found to cope is to give it the least amount of attention possible. This only seems to work with milder attacks.

Thanks for the response, Froz. Yes, I've tried ignoring them, but that has not been successful so far! They are way too severe for that.

The worst thing is that when they hit I make the mistake of trying to contact WS for safety and reassurance. That is the worst possible thing I could do. I need some other way to cope.

I have not tried Xanax. I thought that was a long-term AD, not something one can just take when an anxiety attack is coming on. Does it work that way?

Thank you, and I hope you are feeling better.
Mulan

If you aren't receiving reassurance, it is definitely a way to make things worse. It's too fragile a time to take chances with that. Xanax is not an AD, nor is it a drug intended for long term use, as it can be addictive. If you take it only when you have an attack, you should be okay.

It is the only way I've found to cease the attack once it starts.

Anxiety attacks. Had them for weeks at a time at the beginning. Here's what helped me:

1. Know that they will come.
2. Watch what triggers them. Sometimes they do come out fo the blue.

3. When they happen, let them happen.

4. Get yourself to a safe place (if you are driving or in a meeting).

5. Notify those around you it may strike and give them assignments on how to help.

My anxiety attacks happened at home, work, in meetings, at the grocery store, in the shower, at the mall, etc. It can happen anywhere. While sometimes things can trigger it, our minds are the greatest culprits. That is why having a support team (including our children) is great.

6. BREATHE!!! Not hyperventilating, just deep cleansing breathes. <img src="/ubbt/images/graemlins/wink.gif" alt="" /> They really work.

7. I found essential oil fragrances like lavendar t/b helpful. It had a calming effect.

Hope this helps.

take care,
L.

Dr. Andrew Weil teaches breathing techniques which helped me. I used to get them in traffic, or in meetings and conference calls.

drweilselfhealing.com

He has a CD for breath work, also you might want to try his guided imagery CD's (I haven't tried those yet).

Ditto for what Orchid posted.

The deep breathing is key - also using a focal point and redirecting your thoughts to something positive - a memory of something that makes you happy, perhaps. It is similar to the techniques I used long ago for natural childbirth.

I get them from time to time. At first I made that mistake of contacting WW. This is a mistake. Don't expose your vulnerability to someone you can't trust & hasn't got your best interests at heart.

I've tried using tranquilisers but they make me feel worse.

I use two other techniques. One is to meditate, but you can't do this when you're driving.

The other was introduced to me by my hypnotherapist. She says that when you are feeling vulnerable & under attack, visualise yourself wearing a suit of armour like the knights of old. This makes me feel protected & helps me ride out the attack. It's also a useful technique to use in difficult encounters with your WS when they are being provocative & you want to avoid your weakness making you rise to the bait , using provocative & disrespectful language.

I have had panic disorder, off and on, for about 20 years.


Sublingual lorazepam (Ativan) works very well for me.

I also recomend the 'Anxiety and Panic Disorder Workbook' by Edmund Bourne.

See your doctor. There are all kinds of meds that help. Xanax is too addictive, in my opinion. But there are other meds that you can take to prevent them.

Then see if you can dig into what is causing them. They are usually caused by burying your feelings and not taking care of yourself.

I had horrible panic attacks for years. I couldn't go out to eat, to the grocery store, etc. Now that I take care of ME, they are gone.

Mulan,

I too, suffer from anxiety attacks.

I am taking medication daily that is non addictive and not only helps against depression it also helps against the frequency and intensity of my anxiety attacks.

But I still have them.

I can only reinforce what Orchid says. pay attention to what triggers them. sometimes you can avoid the triggers or train yourself, to some degree, not "to go there."

vigorous daily exercise has also helped lessen the frequency.

But once they come and are there... get yourself in a safe place and comforting place and breathe deep.

I have a ritual that calms me, usually I can do it on my own, but my best friend and D17 have instructions. They make me a pot of yogi tea, put on some Van Morrison, and start a hot bath with my favorite mixture of essential oils and some bach flower emergency remedy. No one tries to talk to me. My friend will usually putter around the house, maybe clean up the kitchen or fold some clothes. Once she sees I am alright, she quietly leaves and I call her the next day. D17 takes care of D10 in the meanwhile. On those anxious days we usually all end up sleeping in one big bed. The next morning's breakfast is much brighter.

I have struggled with sever anxiety at one stage and the breathing techniques has really helped up to a certain level. Even during times I still feel anxious, the breathing helps to reduce the physical symptoms of the “fight-and-flight” reaction like heartburns, shivering etc. Since I’ve started using Cipramil (Celexa) more than 2 years ago, my tendency to feel anxious (in certain social situations/settings), have reduced dramatically. Unlike you, the anxiety never hits me out of the blue but gets triggered by something specific and usually I can feel it coming beforehand and prepare myself mentally. The only times the anxiety hits me off-guard is when I suddenly see or bump in FOM. In the beginning when this happened the anxiety was severe, but if it happens now I only feel slightly anxious. The medication seem to help for this too.

Thank you all for your replies. At this point, the anxiety is severe whenever I am around WH and he is ignoring me (which he does most of the time at home) or when he is leaving for a trip (he's out of the state right now.)

Yeah, I know. The solution is obvious. But I will try these suggestions and continue trying to detach.
Mulan

Edited to add: Yes, I can pretty well pin it down. It's being ignored -- being abandoned -- that sets me off every time. Is anyone else affected the same way?

Here are some techniques listed by the Mayoclinic...some repeats of what was said above....some new. Hope it helps.

1. Sit or lie in a comfortable position and close your eyes. Allow your jaw to drop and your eyelids to be relaxed and heavy, but not tightly closed.

2. Mentally scan your body. Start with your toes and work slowly up through your legs, buttocks, torso, arms, hands, fingers, neck and head. Focus on each part individually. Where you feel tension, imagine it melting away.

3. Tighten the muscles in one area of your body. Hold the muscles for a count of five or more before relaxing and moving on to the next area. This is a good method for releasing tension. Tighten the muscles of your face, shoulders, arms, legs and buttocks.

4. Allow thoughts to flow through your mind, but don't focus on any of them. Many people find using autosuggestion to be a great help. Suggest to yourself that you're relaxed and calm, that your hands are heavy and warm (or cool if you're hot), that your heart is beating calmly, and that you feel perfectly at peace.

5. Breathe slowly, regularly and deeply during the procedure. Once you're relaxed, imagine you're in a favorite place or in a spot of great beauty and stillness. After five or 10 minutes, rouse yourself from the state gradually.

I understand from your former posts that you have an extended timeline before you intend to leave...this seems to be taking quite a toll on your health. Are you still sure this is your best POA?

Best wishes.

THE GOOD DAY RULE
The good day rule is simple: work hardest at developing the skills presented when you are feeling your best -- on your good days. People tend to work hardest when they are feeling their worst. Pain can provide strong motivation to take the actions required to change behavior. When you're feeling good, it's easy to discount the need to continue working.
Since you do not complete the work needed to change the thinking and behavior patterns that generate anxiety, you set yourself up for a relapse into old patterns when you again encounter the right stressors.
Remind yourself periodically of the tendency to put off work when things are going well. Then commit yourself to the task of working with this program hardest when you are feeling good. When you do, you find that ideas and skills that seemed very difficult when you were having a bad day are easy to master on your good days. Following the "good day rule" is the fastest way to progress.

STRESS SYMPTOM INVENTORY
Indications Your Body Is Sick, Hungry, Tired or Overstressed
Irrational thinking, self-defeating behaviors, and unpleasant symptoms increase whenever you are sick, hungry, tired, or overstressed. This is normal. Everyone experiences this to some degree. As pointed out, the best way to minimize these reactions is to become skilled at identifying the early stages of stress and fatigue. Here are several common symptoms:
• Irritability
• Tension or pain (common places are the head, neck, shoulders, stomach, arms, or legs).
• A change in the way you use language (often the increased use of profanity, put-downs, sarcasm, or other negative language you normally do not use).
• Inability to concentrate or think straight.
• Memory deficiency (you cannot remember things as well as you usually do and may forget important things).
• Unusual behavior or thoughts (in some cases, "weird" or morbid thoughts).
• Irregular sleeping patterns.
Your specific signs may be one or more of the above or they may be something not on the list. Review the symptoms listed on the above Stress Symptom Inventory. Identify three to five specific symptoms you can use this week which indicate your body has used its limited supply of energy and needs time to rest and rebuild itself. Whenever you notice one of these symptoms, reduce your activities and take care of your body's physical needs.

TWO OR THREE STEPS FORWARD, ONE STEP BACKWARD
Progress is rarely continuous. Often, you go two or three steps forward then one step backward. There will be times when you slip into old patterns or need to stop briefly to practice what you have learned. Unfortunately, people with anxiety-related problems often attach great significance to lapses into old behaviors or resting periods. The result is usually self-talk similar to the following:
"This experience proves that nothing works (all-or-nothing-thinking)."
"I will never get over this (fortune telling)."
"This experience is awful (magnification) and has undone all of the work I have done (overgeneralization/fortune telling)."
"If I return to past behavior this one time it means I will always return to it (overgeneralization). I will never change or overcome this condition (fortune telling)."
"This is a major setback (magnification/labeling). I guess I haven't really changed anything (minimization)."
Whenever you have a lapse into old behaviors or are in a resting period, challenge this type of negative self-talk with rational self-talk. Remind yourself that it is normal to slip into old behavior patterns periodically. It is not a failure. Eliminate the term "setback" from your vocabulary and start referring to these experiences as "lapses," "learning experiences," or "resting periods." Then examine the experience objectively by answering the following questions on the TROUBLE-SHOOTING CHECKLIST.

TROUBLE-SHOOTING CHECKLIST
Was I tired, sick, or hungry? (this will be the primary cause of most lapses) *
Did I use the skills I have been learning? *
If so, how did I use them? *
Did I forget to use one or more important skills? (see the Summary of Recommended Activities, which will be posted later in this series) *
How can I handle this type of situation more effectively in the future? (answer this question in detail) *
Using the above checklist turns lapses into old behaviors into valuable lessons and creates a firm foundation for future growth. As you begin to accept these negative experiences as a natural part of the relearning process, you no longer view them with alarm. With time your lapses into old patterns become fewer and farther apart.

SUMMARY OF SKILLS FOR REDUCING ANXIETY
The following is a summary of the skills for managing stress and reducing anxiety that follow.
Methods for Reducing the Symptoms of Anxiety:
1) Understand what causes and maintains severe anxiety.
You experienced frightening physical symptoms and told yourself lies about what the symptoms meant.
Because the symptoms frightened you, you worried about them and became aware of any body sensation that resembled the frightening symptoms in any way, you repeated the lies you had been telling yourself about the symptoms. This caused the symptoms to increase and you fell into the anxiety/panic cycle.
2) Use cue-controlled relaxation or, if practical, a relaxation response exercise.
3) Check your breathing and use relaxed diaphragmatic breathing to correct any tendency to hyperventilate that is present. (Do not spend too much time focusing on your breathing.)
4) Use coping self-statements to tell yourself the truth about your physical symptoms and remind yourself of your various coping skills.
5) Distract yourself with one or more of the following:
• Simple externalization: observing carefully, listening attentively, feeling textures, tasting or smelling, doing repetitive activities
• Simple tasks which require concentration
• Conversation
• Work
• Play
6) Other things to do when experiencing severe anxiety:
• Eliminate caffeine intake
• Be patient
• Reduce contact with negative friends/relatives
• Wait to help others until after you have overcome your condition
• Work hardest at developing the skills presented when you are feeling your best
• Reward yourself when you have successes, even small ones.
• Turn negative experiences into valuable learning experiences by reviewing them in an objective, trouble-shooting fashion to determine what you could do differently next time

CUE-CONTROLLED RELAXATION
Summary of Recommended Activities
Begin Developing Cue-Controlled Relaxation *
Continue practicing a relaxation response exercise at least once a day. have more than one practice session a day if it is practical. If you have not yet tried all of the approaches, decide now and then when and where you will try each one.
As you practice your relaxation response, begin using a cue that will become associated with the response. Three common types of cues are listed below. Decide which type you like best or develop your own and begin using it. However, be sure to use the SAME cue each time you practice.
• Word Cues: Any word repeated over and over as you relax will work. Common word cues include "relax," "peace," "calm and controlled," and "one."
• Imaginary Cues: Imagine any scene or image you find relaxing such as a mountain meadow, the beach, or a forest.
• Physical Cues: Physical cues work best if they involve an action that is out of the ordinary. At the same time, it needs to be inconspicuous so you can use it in public. Three common physical cues include touching the thumb and first two fingers of either hand, touching an elbow, or touching the back of a wrist.
It may take several weeks for you to develop the ability to produce a state of deep relaxation through a set method. It may take a little longer for the association between your cue and the relaxation to become firmly established. However, once you are able to trigger a relaxation response, you will find it a valuable skill.

RELAXED DIAPHRAGMATIC BREATHING
Develop Relaxed Diaphragmatic Breathing *
Exercise:
Do this twice a day, once at night before you go to bed and once in the morning right after you awaken. At these times you are wearing loose fitting clothes and can easily lie down. This is especially important if diaphragmatic breathing is difficult for you.
Lie down and place one hand on your abdomen over your navel and breathe in such a way that it moves up and down in a relaxed manner. Your chest may move a little while you do this, however, most of the movement needs to be in the abdominal region. If you are unable to tell what your chest is doing, place your other hand on it so you can feel how much it is moving in relation to your abdomen.
Each practice session only needs to last about a minute, just long enough to take four or five relaxed and comfortable diaphragmatic breaths. DO NOT make this hard work. It is important to avoid over-breathing.
Your goals are 1) to be able to tell when you are breathing with your diaphragm without the need to place a hand on your abdomen, 2) know what a comfortable, RELAXED diaphragmatic breath feels like, and 3) breathe in a gentle, relaxed manner with your diaphragm whenever you want to without effort.

COPING SELF-STATEMENTS
Reduce a major internal source of anxiety by keeping a journal using the Block Method of writing to identify and challenge distorted thinking. Write the though, change the thought; write the reality, as below. The following example shows every Vignette, which you will find as the last post of this series (overgeneralization, magnification, minimization, fortune telling, emotional reasoning, accepting questionable sources as authoritative).
Ex.: "This is terrible." "I'm dying." "I can't handle this."
Change to: "Anxiety is not dangerous -- just uncomfortable. I've survived feelings like this and worse before." "I can be anxious and still function effectively; stay focused on the task at hand."
List Coping Self-Statements on a Card and Memorize them *
Example:
(cont …..
- KATHIE'S CARD -
___________________________________________________________

1. Anxiety is not dangerous, shameful, or humiliating -- just
uncomfortable; it is none of your business what other people think.
2. Your anxiety is just a conditioned response reaction -- a learned
habit pattern -- it will become less as you desensitize yourself by using
the tools.
3. Stay focused on the TRUTH, do not believe any of the lies that your
disease (Satan) tries to tell you; use diaphragmatic breathing and
relaxation response anchor, then distract yourself.
____________________________________________________________
____________________________________________________________

DISTRACTION (REDIRECTION)
Distraction is the process of shifting or diverting your attention from one activity to another and is sometimes called redirection. Distraction uses an important principle: shifting your attention TOWARD something neutral or positive is always easier than shifting it AWAY from something negative. The process of telling yourself not to be anxious focuses your attention and energy on your anxiety and usually causes it to increase. One form of practice is simple externalization:
• Observing carefully: Read signs; examine the design of a nearby wall, clothing, or carpet; observe the intricate activities of people around you; or observe surrounding scenery.
•Listening attentively: Listen to random conversation or background noises such as a ticking clock or a passing plane.
•Feeling textures: Feel the texture of clothing, paper, a gum wrapper, or the steering wheel of the car you are driving.
•Tasting or smelling: Taste and smell gum or candy you carry with you, note the various smells surrounding you.
•Doing repetitive activities: Count floor tiles, lights, or cracks; tap a finger rhythmically; fold a piece of paper in a systematic manner.
•Changing our surroundings or activities: If you're inside, go outside; if you're sitting, go for a walk; if you're in the livingroom, go into the kitchen.
Simple tasks that require concentration *
Simple mental activities that require concentration such as recalling the words to a song, determining how much a total purchase will cost, balancing a checkbook, timing an event such as a trip to a friend's house, or recalling an even that arouses positive emotions such as happiness, satisfaction, or joy. These are often very difficult to do when you are very anxious. However, with practice, they become effective distractors.
Conversation *
Conversation is an effective form of distraction that can be used almost anywhere. Talking over the telephone can be just as effective as talking with someone in person. Even a stranger such as a person standing in line next to you can offer distraction. Conversation works best as a distractor when you are an active speaker rather than a passive listener. It is also best if the topic or conversation is unrelated to your anxiety symptoms or to the situation generating the anxiety.
Work *
Many people use work as a form of distraction without even knowing it. Work can be mental or physical and can involve household chores or work related to a job outside the home. Work is most distracting when it is interesting, pleasurable, or involves competition. Activities that have become automatic because you have done them often do not work as well as ones which demand more attention. One way to increase the distracting quality of routine work is to do it in a somewhat different manner. For example, you can change the order in which you do the various steps of a given chore.
Play *
Play includes anything that is both interesting and pleasurable. Working crossword puzzles, playing video games, dancing, and working at hobbies are examples of play that can be used to distract yourself. Activities requiring physical activity are usually more distracting than games where you are passive. Also, the more pleasure you derive from an activity the more distracting it is. The key element is that the activity holds your interest.
Play can often be combined with other forms of distraction. For example, you can make a game out of simple externalization by trying to connect the dots on acoustical tile to form faces or make up stories about people around you. You can create simple games which require concentration such as guessing the number of telephone poles on a stretch of road. At first, it may be difficult to be playful and find humor in anxiety-producing situations. However, with practice it becomes easier.

MEDICATION
Take medication exactly as prescribed.

FOR THOSE WHO ARE HAVING DIFFICULTY SLEEPING
Sleep is essential for good mental and physical health. If you are having sleep problems, developing skills that help you sleep well helps reduce anxiety. It also makes it much easier to understand the ideas in the lessons and helps you to apply them to your life.
Always go to bed and get up at the same general time(s) every day. Get enough hours of sleep in. Use the bedroom for SLEEP AND/OR SEX ONLY -- do not read, watch TV, eat, socialize on the phone, discuss business, etc., in the bedroom.

GENERAL AND OVERALL CARE TIPS
Set priorities and reduce your overall activity during times of stress. *
Plan ahead and take action during times when stress is low. *
Spend extra time with decisions. *
Build stress tolerance with a balanced diet and exercise. *
Have a close circle of friends and loved ones for emotional support. *
Helping others is a wonderful distraction, do this when you can. *

RELAXATION
* Passive Forms of Relaxation:
Biofeedback
Diaphragmatic Breathing
Hot tubs, showers and baths
Massage and bodywork
Meditation and Prayer
Movies and Theater
Music (both as background and just sitting and listening)
Reading
Relaxation response exercises
Self-hypnosis
Sleep
Television
Yoga
Video Games
* Active Forms of Relaxation:
Avocational classes (ex.: photography, cooking)
Dancing
Hobbies and crafts (ex.: art, fishing, gardening, woodworking)
Individual sports (ex.: tennis, golf)
Informal afternoons or evenings with friends
Jogging, swimming, and other forms of exercise
Road trips and vacations
Shopping
Team sports (ex.: baseball, basketball)
Walks

EFFECTIVE STRESS MANAGEMENT, A PART OF DAILY LIFE
~ Make effective stress management a part of your daily life ~
1. Basic stress management principles:
• Treat your body with respect by understanding and using the concepts of your body as a machine with a limited supply of energy.
• Learn to recognize the early signs of stress and what they can mean.
• Build stress tolerance with a balanced diet and exercise.
2. Guidelines for periods of high stress:
• Set priorities and reduce your overall activities.
• Spend extra time with decisions. For major decisions, consult with people you trust who are objective.
• Plan ahead for high stress periods and take action during times when stress is low.
3. Develop a lifestyle based on stress management principles:
• Eat a balanced diet.
• Exercise regularly.
• Make relaxation a regular part of your life.
• Develop a good sense of humor.
• Build a strong source of spiritual support.
• Create traditions and routines that support the above.

VIGNETTES
a. Overgeneralization
b. Magnification/Minimization/Labeling
c. Accepting questionable sources as authoritative
d. Emotional reasoning
e. Fortune telling
f. All-or-nothing thinking

CLOSING ~ SPIRITUAL FITNESS
God,
Grant me the Serenity to accept the things I cannot change, the Courage to change the things I can, and the Wisdom to know the difference.
- Amen.

(This is a summary I put together after doing a workbook, I had to keep a copy in every room!!! Hope it helps.)

Mulan - I am so sorry you are feeling so anxious and 'under attack'. I had a full blown panic attack a few years ago when we discovered my WH had kidney failure and this summer I was ill and suffered terrible palpitations and anxiety. It is rotten and I felt so out of control.

If you believe your anxiety relates to the way WH treats you, then you need to act in your own best interest to rectify that situation. Does he understand that he has that effect on you or do you keep it to yourself? tt

This might not be a good remedy for severe panic attacks, but I'd thought I'd throw it out there. I have been using something called "Bach's Rescue Remedy", it is some kind of holistic, "hippy" thing, but it helps me and the girls. I also have "Bach's Mustard" drops for the weepiness I feel.

Little drops you put under your tongue, about $10 at the health food store, might be worth a try.

Someone also suggested this to me, sitting with your palms on the soles of your feet for a few minutes. I do believe in the effectiveness of this, but it might just be the conscience effort in taking time out.

Sorry you are having a tough time. Walking outside barefoot helps me too, some magnetic connection to the earth thingy. I like alternative medicine, but I don't pretend to understand it all.

I'm not sure how this post got bumped up - I didn't do it - but I do appreciate all the new responses.

It is usually the worst when he is here and ignoring me. I have found that what seems to help most is to simply cut off all contact with him - "taking the phone off the hook," either literally or figuratively.

If I am at home (I work at home) and he is gone, I take the phone off the hook or turn off the ringers. I don't have to wonder whether or not it's going to ring because it's NOT going to. My kids will call my cell if they need something or even send me an email. If he is home I will close the door to my office/room and pretend he's not here.

I think these things help because they give me a slight sense of control over the situation - yeah, about as much control as "you can't fire me, I quit."

I have also found Kava to be very helpful, but you have to check the contraindications before trying it -- especially if you are female.

Again, I don't usually post much about my own situation because it is so pathetic. I am only responding because somehow this post got bumped up, I appreciate the responses, and maybe it will help somebody else.
Mulan

Early on before and after dd I was shaking like crazy, the nearest thing I could compare it with was having a nervous breakdown.

Time and things getting better, along with a/ds have helped my shaking.

Could it be that you are panicing from the fear of having to face life on your own Mulan??

There is nothing worse than a panic attack. I am so sorry you are going through this.

Are you getting enough sleep, food, water????

All those can lead to having an attack.

My suggestion is to change your frame of mind. Easier said then done, right?

Maybe you can explore ideas and dreams of what you have always wanted to do but couldn't because of your husband.

Start daydreaming of what good things you could do without your husband. I think once you are open to life being good without your husband, the fears, causing your panic should subside or disappear, IMHO.

Once I realized I could have a totally different life without my husband and it could be good, I was able to let go my need to cling to my w/h and develop a healthier outlook. Human nature is set up where people want what they either don't have, or they have to work hard for.


Get well Mulan,


Sincerely,
K.D.'s Heartbreak