Breaking the Vicious Cycle
of Panic
 

People may be predisposed to experience panic because of a sensitive
temperament, high levels of stress that sensitize nerves, emotional
disorders (social phobia, obsessions, and depression), a hyperactive
imagination, or a perfectionist personality. The actual first episode or
trigger incident will be caused by a surge of adrenaline due to one of three
things:

• A tense situation: conflicts with people, giving a speech, dealing with
  painful memories, being in a place where a person feels trapped, or
  a recent death—“What if I die like my aunt Mary did three weeks
  ago?”

• A conditioned reaction to certain triggers that bypasses thinking
  processes—A young girl had a near-drowning experience. A year
  later, in a submarine ride, she had her first panic attack.

• A nonthreatening physical condition that causes unexplained
  symptoms (dizziness, nausea, blurred vision, sweating, shaking,
  faintness, rapid breathing, palpitations, or hot flashes) that are not
  fear, but feel like fear.

Once the first panic attack happens, it can quickly develop a life of its own.
People begin to think, “What was that? Is it going to happen again? Do I
have some terrible illness? Am I having a nervous breakdown? What if
people notice me?” Negative thoughts that flash through the mind almost
below the level of awareness can trigger subsequent incidents until they
start happening with increasing regularity.

A woman with high standards was physically stressed from a miscarriage.
She first became panic-stricken while grocery shopping in the aisle of baby
products. Later, she began having anxiety attacks anywhere in the store,
and then, even when driving past the store—just because these cues were
associated with her first attack.

TWO ADDITIONAL PROBLEMS

When panic is not understood as a part of anxiety, episodes can increase
in intensity due to two additional problems. Once these are recognized,
they can be eliminated by learning coping strategies.

Coping Stategies

                 Symptom                                           To Cope































THE VICIOUS CYCLE OF PANIC

Even when stresses, depression, tense situations, or a temporary physical
condition have passed, people can continue to have panic just because
they fear it will happen. This is the fear of fear. People become afraid of
their own bodily reactions—“I’ve been doing pretty well lately, I wonder if
panic will come back.” “What if I really do have a nervous breakdown this
time?” “What if people can tell that I am perspiring?” This aggravates
predisposing factors of temperament, emotional disorders, and personality
traits and creates on-going stress that produces the vicious cycle of panic.

BREAKING THE CYCLE

The steps of recovery from panic can restore peace with calming swiftness
and make each link in the “vicious” cycle an opportunity for change:

• Reattribute predisposing factors to minor physical conditions (ear or
  thyroid problems, PMS, allergies, low blood sugar, anemia, high
  blood pressure) and unrecognized emotional problems
  (temperament, stress, overactive imagination, perfectionism,
  depression, social phobia, obsessions) that are little cause for
  concern once they have been treated and/or identified.

• Relabel troubling “symptoms” as a surge of adrenaline. This
  eliminates fears of dying, going insane or making a fool of yourself.
  People who have anxiety are overly concerned with reality while
  people who become psychotic are out of touch with reality. They may
  think they are Jesus, hear voices or speak in a way that makes no
  sense. Although people with anxiety can have vivid imaginations,
  they know who, what and where they are.

• Retrain yourself not to react to anxiety triggers and negative
  thoughts by refocusing on pleasant activities or facing, flooding and
  floating past the worst sensations of panic.

• Revalue panic episodes as opportunities to practice coping with and
  minimizing symptoms.

• Expose yourself to difficult situations to increase your comfort zone
  as panic attacks reduce in frequency. Friends and family can help
  until you can face triggers alone.

• Get additional help if needed to reduce stress from conflicts or
  painful memories..

• Reread information on panic disorder at the first sign of reoccurrence
  of symptoms or after intense episodes of anxiety.