As you know I practice craniosacral therapy. One of the reasons people seek out craniosacral therapy is for help with managing stress and anxiety. We need a little stress to thrive but if the load is too great it can have a negative effect on the way our body functions. We may not always be aware of it but when we are under stress our inner landscape changes from being balanced into a state of high alert. It is natural to feel a little anxious from time to time, but anxiety is a state of constant worrying and an excessive and persistent state of apprehension. There are many factors that contribute to anxiety, mostly centred around our unique personal history. However, stress creates the perfect environment in our bodies to generate anxious thoughts. When we are under stress the sympathetic part of our nervous system becomes activated and our bodies produce a combination of hormones and neurotransmitters, which all keep the body on the look-out for danger. It is impossible not to feel anxious if we sense an impending threat. It then follows that if we lower our stress levels we will be giving ourselves the best chance to feel less anxious.
Our stress response is in fact the incredible capacity of our body to get us out of a dangerous situation. It is programmed into us for our survival. You may have heard it called the fight or flight response. In human beings something as simple as being late for an important meeting can trigger our stress response. For the majority of us the things that trigger our fight or flight response in our daily lives are not life threatening at all. It is important to recognise how far along the fight or flight path we are, as once we have a sense of this we can seek to address it if needs be. However, this is not always a simple as it sounds. We only know what feels normal for us, so how do we know what a ‘balanced’ nervous system feels like? This is where having awareness of body sensation or interoception is invaluable. Interoception is the perception of the internal state of our bodies. For example, as you are sitting here how does your throat feel, or your chest or gut? This gives a true picture of how we are.
What is a panic attack?
A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. You may experience your first panic attack during a period of chronic stress, after an accident, surgery, illness, trauma or emotionally overwhelming event.
What does it feel like to have a panic attack?
Panic attacks last on average from 5 to 20 minutes but can last longer.
Anyone who has ever experienced a panic attack will tell you that they are extremely unpleasant. There is an overwhelming feeling something terrible is about to happen, sometimes with an urgent need to get away from wherever you happen to be.
Please note do not self-diagnose, I recommend you check with your GP if you are experiencing symptoms you are concerned about.
Physical sensations of a panic attack may include:
Heart beating very hard and fast
Feeling nausea or wanting to vomit
Chills or hot sweat
Feeling like you are going to faint
Tightness in the throat
Shortness of breath
Dizziness or light headedness
Sense of unreality or detachment
A feeling that something terrible is going to happen
This is a link to a short You Tube film from Mind with a group of people discussing their own experience of panic attacks.
What happens during a panic attack?
Knowing what is going on in your body during a panic attack might help you understand some of the sensations you experience which can be intense and frightening;
Heart beating fast – pumping blood to big muscle groups to help you run fast.
Feeling or being sick – if you have a full stomach you cannot run as fast.
Shortness of breath, – adrenaline increases breathing rate to prepare for action.
Dry mouth – the digestive system shuts down as it is non-essential in a crisis, salivating is the first part of the digestive process.
Feeling faint/dizziness/light headedness/sense of unreality – if we are in a situation where we feel seriously under threat, we ‘space out’ or dissociate.
Preventing a panic attack
In the long-term, stress reduction is vital. This should take into account all aspects of your life and there is a lot of information available about how we can do this. However, there are some targeted stress reduction techniques which are very effective. For example, breathing exercises which are able to directly access the parasympathetic nervous system and take us out of a fight or flight state. Hatha yoga, and the Mindfulness Based Stress Reduction Programme created by Jon Kabat Zinn. All of these incorporate ‘interception’ mentioned earlier.
Try to avoid highs and lows and maintain balance in the body by cutting down or eliminating caffeine and alcohol. Eat regularly and avoid excess sugar to keep blood sugar levels even. If you know your panic attacks are generated by anxiety or events in your life, Cognitive Behavioural Therapy also known as CBT or counselling may helpful.
During a panic attack
Here are a few simple suggestions that you can try during a panic attack.
We suffer less stress if we feel we have some control over our situation. Knowing you can do a few simple things that help, might take away the dread of having an attack and even lessen them.
Become aware of your needs, wear comfortable clothes which are not too tight and allow you to breath. If you start to feel hot take off your coat, if you need fresh air move nearer to a window. Commuting on packed tube trains I have learned that standing in the aisle gives you more space and air but there is a cooling draft as the train moves if you are squashed against the door!
Remember to remind yourself the panic attack will last a short time and you will feel ‘normal’ again soon.
When you feel those familiar sensations that tell you, you are starting to feel panicky, try to ‘ride the wave’ rather than control the sensations. Trying to control tends to further escalate the attack.
If you can try to be a ‘witness’ to what you are experiencing, notice the body sensations rather than reacting with negative internal monologue which will escalate the feelings of panic.
Mentally reassure yourself ‘I sense danger/a threat but when I look around me, I see nothing dangerous – I feel safe.’ It is ironic that when we are in an activated state, we are less able to discern what might be a threat but obviously don’t lie to yourself here! If you are in a dangerous situation you don’t need to calm down, you need to get ready to run.
If you are with a friend or someone you trust ask them to reassure you, look at their face and ask them to tell you everything will be okay. This is an automatic and human response for most people, but research has shown the importance of social interaction between human beings in regulating their parasympathetic nervous system.
You can try ‘shuttling’. Find a part of your body that feels okay, feet are always a good place to start. Really try to feel all the sensations in your feet – the fabric of your socks, if your shoes are tight and their contact with the floor. Do this for a minute or so, take in all the sensations as best as you can, then give yourself a break for a few minutes, if the unpleasant sensations come rushing in try to stay with them for a minute then change your focus back to your feet. Keep repeating this shuttling back and forth. This may allow you to remain in a situation you can’t get out of until the attack passes.
When we are panicking our breathing speeds up, if you are able to slow your breathing down even a little it will help you get back to feeling okay. It also gives you something to focus on. I really like this animation app for breathing during a panic attack. Looking at the image of a face rather than counting adds to the therapeutic effect.
I hope you have found this helpful.