I used to fear panic attacks. More accurately, I used to fear the fear of panic attacks. When you live in a state of fear that something might happen, it is like providing a place setting at the table of your life, filling the empty plate with delicious morsel after delicious morsel and then just waiting. Sitting across the table, staring at the feast you’ve prepared for your enemy and . . . waiting. Wondering if there is a way to poison his food before he comes in but knowing that he moves through walls like a ghost and getting caught poisoning his food would lead to a fate worse than that which you originally feared. So you tolerate his impending visit. Fear is like a ghost.
I no longer have panic attacks. I have learned that the feeling I used to get moments prior to an attack is actually an invitation to panic, not an entrance into an attack itself. It is the difference between standing outside the door of a party and deciding to step over the threshold. Life is a series of choices and I was able to regain my sense of freedom when I learned that even as I could feel by pulse quickening, my breath becoming irregular and my hands getting cold, I could still choose to walk away from the door, instead of going through it. My last panic attack was the day after Christmas in 2012.
For me, anxiety looks like a furrowed brow, constantly grasping and squeezing my hands, breath that gets stuck in the tension I’ve allowed in any given part of my body that causes my chest to fill and empty with breath that is too shallow, or too quick. Sometimes, I stop my breath for seconds at a time without realizing I’ve stopped its flow. Anxiety for me feels like foreboding, impending doom and sometimes even a precursor close to death itself. All within the comfort of my own home. Or a movie theatre. Or a restaurant. Or my car.
Between depression and anxiety, anxiety is the end of the spectrum that I have learned to manage the best. I promised I would not get too teachy in these blogs for fear of hiding my true experience behind a veil of pedagogy. However, I would like to teach you how to avoid panic attacks altogether. I will do so by sharing two things:
- How to get control of your breath.
- The most helpful resource I have ever found on the topic of anxiety and panic attacks.
During the worse season I have ever endured under the influence of anxiety, I was having panic attacks in front of my classes, while teaching, and no one ever knew it. It was the fall of 2012. I had over 120 students that semester and I was teaching at two different universities. Ironically, I was teaching Public Speaking. To most, speaking in public is a fate worse than death but I do not have any fear of speaking in public. What I was experiencing during this season were internal fears that had nothing to do with the topics on which I was teaching each day, or even the environment in which I was working. Here is a slice-of-life example of how anxiety began ruining my life, one day at a time:
I would walk into class and I was genuinely happy to see my students. I loved teaching (I still do) and I loved my students. I would begin class by taking role and as I did, I would feel the tightening of my breath and begin to breath from my chest, instead of from the center of myself. Then, I would begin to feel the need to breath more quickly (not more deeply, more quickly). The presence of too much oxygen would begin to make me feel dizzy. Dizziness, for me, was a trigger to panic: the physical sensation of light-headedness and the thought that I could pass out at any moment (which I never actually did though by the amount of fear I had assigned to passing out you might think it was a daily occurrence in my life). This dizziness caused me to brace myself, physically, mentally and emotionally. Perhaps “steel” myself is a more accurate word. My thoughts were as follows, “I don’t feel normal, I wonder if I needed to eat something before I came to class. Can they tell I don’t feel normal? Just keep talking. Focus on the words, focus on the topic. Why can’t I breathe? I would be horrified if I passed out in class. They would lose respect for me. I am losing respect for myself. Keep talking. Oh man, I feel dizzy. I wish I had some water.” Thoughts like that. Thoughts that pulled me in two different directions.
As a side note, I will add that the very first time I ever felt this feeling of dizziness was the first time I had a panic attack in 1997. During that time I was trying to decide what I should do concerning the high school teacher who made seduction an art and made grooming young women for future sexual favors part of his daily curriculum. This first panic attack caused me to call 911 because I thought I was dying. Alas, since the doctors could not find any medical condition that might have lead to the symptoms I described, they diagnosed me as Hypoglycemic. I lived with this diagnosis until 2013 when I realized that the symptoms I attributed to a need for protein—chief among them was dizziness— were actually the symptoms of anxiety. This would become extremely helpful information as I learned to understand the sensations that triggered my panic attacks.
In truth, that semester I was having heart palpitations every hour, I began drinking at night to help ease the stress of the day, I began eating more to combat the “dizziness,” I stopped spending time with anyone outside my home because I was afraid I would have a panic attack in front of them, and I made a decision that I could never teach again. That decision did not end up holding because I later learned that if I gave into the anxiety by making such a choice I would have been letting it win. Instead, I ended up winning.
Incidentally, I was later diagnosed as being “high functioning with Generalized Anxiety Disorder.” I agree with the high functioning part, as evidenced by the fact that I got the highest teaching evaluations in my department that semester. (As I have said before, I am stubborn and I refuse to let others in public see this struggle). I still take issue, however, with the “disorder” label because, psychologically speaking, a disorder usually indicates an inability to function in your daily life. While this particular season I am currently telling you about was certainly marked with extreme difficulty in functioning, I could still function. Even more so now. But, perhaps that is simply a semantical issue. Also, I do not like the label. I digress . . .
So, as I promised above, #1: I will share a resource with you that explains how to control your own breath as I learned it from Dr. David Carbonell whose wisdom saved my life and career. To anyone who does not struggle with anxiety this might seem like an odd tutorial. It might even sound amusing. However, to anyone who has actually uttered the words, “I can’t catch my breath,” this will be helpful.
When you feel like you can’t catch your breath, it’s because you forgot to do something: you forgot to exhale.
- Place one hand just above your belt line, and the other on your chest, right over the breastbone. You can use your hands as a simple biofeedback device. Your hands will tell you what part of your body, and what muscles, you are using to breathe.
- Open your mouth and gently sigh, as if someone had just told you something really annoying. As you do, let your shoulders and the muscles of your upper body relax, down, with the exhale. The point of the sigh is not to completely empty your lungs. It’s just to relax the muscles of your upper body.
- Close your mouth and pause for a few seconds.
- Keep your mouth closed and inhale slowly through your nose by pushing your stomach out. The movement of your stomach precedes the inhalation by just the tiniest fraction of a second, because it’s this motion which is pulling the air in. When you’ve inhaled as much air as you can comfortably (without throwing your upper body into it), just stop. You’re finished with that inhale.
- Pause. How long? You decide. I’m not going to give you a specific count, because everybody counts at a different rate, and everybody has different size lungs. Pause briefly for whatever time feels comfortable. However, be aware that when you breathe this way, you are taking larger breaths than you’re used to. For this reason, it’s necessary to breathe more slowly than you’re used to. If you breathe at the same rate you use with your small, shallow breaths, you will probably feel a little lightheaded from over breathing, and it might make you yawn. Neither is harmful. They’re just signals to slow down. Follow them!
- Open your mouth. Exhale through your mouth by pulling your belly in.
- Continue with Steps 4-7.
If you would like to read further, please visit Dr. Carbonell’s website. I have logged hours on this site and I cannot tell you how often it has made me think the words, “Oh! I am not crazy, after all!”
Moving on, #2: the most helpful resource I have ever found concerning how to stop panic attacks is also from Dr. Carbonell. He wrote a book called, Panic Attacks Workbook: A Guided Program for Beating the Panic Trick. Incidentally, this man has no idea who I am. I have never met him in person and I in no way get any reimbursement for this recommendation.
There is a chapter from this book printed in a PDF format online: http://www.anxietycoach.com/support-files/panicattacksworkbookchapter7.pdf
The name of the chapter is “The Panic Cycle.” This chapter was a lifeline to me the first time I read it. In fact, the first time I read it was the day of my last panic attack. I went for a drive in my car that day and I was crying out to God, “Lord, I have no idea what is wrong with me but you do. I NEED your help. I NEED you to send me a person or a resource that can HELP me. I NEED your HELP. If I don’t get your help I do not think I can survive this torture for even one more week.” I guess I would not say I was suicidal because I did not want to die. I was, however, desperate for the pain to end. This prayer–this fervent request for help–was answered that same night when I read this chapter. After I read it, there was a long journey of medications, doctors, psychologists and learning that had to take place BUT this chapter was like a crack of light in an otherwise dark room.
I would like to make a specific invitation to anyone who would either like to share their story of anxiety and depression with me or has questions about their struggle. According to the Anxiety and Depression Association of America, it is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder. Over 40 million Americans, or 18% of our population, in involved with this struggle. So, the odds are that at least a few of you who are reading my blog can relate to this topic. There is hope for you.
Tomorrow I will share with you the reason anxiety took hold of me at this particular time in my life. The deeper why behind the what.