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  On Panic  

Right ho, my fellow sufferers, let us get down to the proverbial brass tacks about this disease . For those of you that have been suffering from Panic for a while and are aware of your condition , skip this sections. Rookies, however may read on.
You had your first attack and now you are convinced that death is around the corner. Not so !!! As terrifying and lonely an experience as a Panic attack is, know body has ever died from it. Since it is unlikely that you will believe me at this point (nobody ever does) you must educate yourselves .
Remember that knowledge about the disease is one of your prime weapons against it. It is also important that you act fast after your first couple of attacks, for there is a good chance of becoming agoraphobic if one fails to confront the condition right away. It happened to me, and apart from being terrifying it is also a rather boring condition . Right, the next step is to go see a good shrink. If you can't afford one, a doctor will do. Whether you choose to treat this disease medically or not, a visit to the medics will at least serve to reassure you that you are indeed physically fit to live. 


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Uncoventional advice
Over the years , I have developed quite a repertoire of techniques that have me helped cope with PD. In the hopes that some of these might work for you, I have listed them underneath., I am pretty certain that most of these have not shown up in print before. Should anyone have other unconventional tips that they would like to share please, feel free to get in touch with me.
- when a panic attack hits, divert your mind. Easier said then done, I know, but one trick is to cause yourself some pain, e.g. fingernail dug into arm. Please keep it within limits: no need to mutilate yourself.

-holding your breath prevents hyperventilation.

-keep painting a mental picture of a time before you had panic attacks. Make it a pleasant one and use it to realize that your present state will not last forever.
summon up courage. Panic attacks are instinctive fears of death that have run amok. Reverse the situation by trying to become defiant in the face of death. By this, I do not mean running into traffic or anything as silly as bungeeing with too loose a cord. Instead, a 'heroic' mantra can do the trick; the kitschier, the better. "It's a good day to die", is my favorite one.

- whenever you encounter a panic situation, one that you have become afraid off, return to it as soon as you can. Even if it means another panic attack ( you will find, that the more of these you get, the easier they become) Example: I was doing a lecture in front of 40 undergrads when a PA came suddenly. I left the room, went into the washroom and dowsed my head in cold water (similar to the pain hint above). It took every ounce of strength that I had to return a few moments later. Had I not, I would never have taught again.

-make good excuses: panic attacks often hit when you feel that there is no way out of the situation without loosing face. If you have already prepared an excuse in your mind beforehand, the fear abides somewhat. Example: before you begin a discussion, mention that you will have to leave on the spur of a moment since you are waiting for an important call. If your anxiety gets too a point where you have to head out, pretend that your pager is going off, look at it and make a quick exit. Hopefully it won't come to that, for knowing that you can leave without fear of embarrassment usually lessens the chance of a panic attack.

-tell people of that you are having a panic attack. They might feel awkward, but who cares? Most of the time the people around me, even strangers , understood. After all, most everyone has experienced something similar at one time in their life.

- when in a cycle of panic attacks, laughter is a great medicine. When you laugh, it is impossible to feel anxious. With this in mind keep a well stocked library of material that has proven to put a grin on your face. ( Here I put in a plug for Tom Sharpe, Stephen Fry and PG Woodhouse, three very funny English writers).

-Have sex: no Panic during orgasm

- get a calm dog. It might sound a bit silly, but a dog offers a lot of distraction when you need it. Dogs also force you to get out of the house, thus reducing the chance that your panic attacks turn to agoraphobia. Finally, the execise they need also benefits you: tiring yourself out without overexerting yourself reduces the chance of a Panic attack.

Panic advice offered by visitors
Some other, less conventional tips, offered by visitors to this site. If you would like to join the fray, please e-mail your advice.
- close off one nostril and breath in slowly and exhale to a count of 4
jump in place
- Take a warm relaxing bubble bath, it helps me so much
- Read something, anything whether it be a book, newspaper, leaflet
- If you feel you can, go for a walk, somewhere quiet (I walk down to the duck pond nearby)
- you're tired during the panic attack, put on some music that makes you happy, climb into bed under the duvet and close your eyes
-"I have found that repetitious activities like needlework (crochet, needlepoint, knitting, etc.) or a videogame is a good fix. The necessity of using both hands and keeping count leaves less gray matter to STRESS OUT.

from a Psychologist (name withheld ...just in case):
"I've got an unconventional (to say the least) approach, which I have seen
stop a panic attack dead in its tracks in my office. Go to
to take a look at it. It is hokey, it is kitschy, calling it "experimental"
overstates the evidence supporting it--but the damn thing often works.
Quickest, easiest thing I've come across for managing panic, and it works
with most people. The manual for the technique can be downloaded for free."

I've looked at your website with great interest. I'm a clinical psychologist in London Ontario, and I specialize in working with people with anxiety and panic disorders, as well as stress in general, and depression.
By far the most valuable tool for managing panic is retraining your body to breathe diaphragmatically/abdominally all the time (not just when you start to feel panic rising).
Chest breathing (also called "stress pattern breathing") is what 70% of adults do, but all infants and animals are diaphragmatic breathers.
When a chest breather is under stress, respiration can become so rapid and shallow that too much Carbon Dioxide is expelled, upsetting the O2/CO2 balance in the brain. THIS is what causes many if not most of the unpleasant symptoms of a panic attack, such as:
- dizziness and light headedness
- trembling and shaking
- feeling detached from your body or "spaced out"
- blurred vision
- poor concentration
- confused thinking
- feeling breathless, or "smothered"
- rapid heart rate (your heart is working extremely hard because chest breathing is 3 times less efficient than diaphragmatic breathing, in terms of amount of blood oxygenated per minute).
- chest pain (because chest wall muscles are overworked)

All these symptoms, and others, are extremely scary if you don't know why they are happening.
I have found, without being able to do actual research - very difficult to have time to do when you're in private practice - that at least 70% of the panic symptoms disappear once the patient has learned to become very mindful of the location of the breath, to recondition their respiratory muscles into a natural and automatic diaphragmatic pattern of breathing, and to make frequent "breathing checks" during the day - just applying mindful awareness of where the "centre of gravity" of the breath is and lowering it into the belly whenever chest breathing is observed.
In my experience, most health professionals are totally ignorant of the significance of chest and belly breathing patterns in the creation of different emotional states. This includes respirologists and cardiologists, not to mention family doctors. Everyone thinks they understand breathing because they have done it all their lives without thinking about it.
Taking a "deep breath" is counterproductive, if you are taking that breath into the upper chest. It is "low breathing" that makes the difference. Diaphragmatic or abdominal breathing is known to generate the parasympathetic nervous system's Relaxation Response.
Most people will automatically shift into belly breathing when they are lying on their backs. Try this for yourself - lie on your back for about 10 minutes. Don't try to breathe in any particular way but just passively observe your breath as it happens. Put your hand on your belly just above the navel and notice how it moves up and down with the in and out breaths - and see how much more relaxed you feel. This is not just because you are lying down. Belly breathing creates the physiological conditions for calmness, and subjective feelings of being grounded and relaxed.
Learning to breathe abdominally when you are sitting or standing is more difficult and feels unnatural to begin with. However learning to produce the belly breath is just the first step. More difficult is to remember to breathe abdominally over time. However, it is the mindfulness of the breath that becomes your key ally in maintaining a balanced and calm emotional state.

Here is a very conventional tip which works every time: Just let the panic come! Embrace it. Welcome it in. Do not fight it. Do not cringe from it. Allow it to come. Keep a calm and composed attitude through the attack. Do not fuel your symptoms with "what if" thinking (e.g. what if I have a heart attack, what if it never stops". If you do not fight it, it will pass very quickly. Once you successfully stop a panic attack, they lose their importance and will stop altogether eventually.

very hot baths by candle light,
relaxation tapes both instructional / hypnotic,
relaxation music (sheherazade is great),
take deep breaths, exhaling count down from 10,
smile when you are in a bad situation -- enjoy knowing that you do have control over the attack,
xanax and alcohol (sambuca works well) can stop an attack in its tracks. On bad flights I would take 1/2 a dramamine, 10mg xanax, a swallow of sambuca -- you sleep through the whole thing.
I no longer need to take any of these...

Ylang Ylang Aromatherapy works a treat... Having suffered a terrible PA, my fiancee lit an oil burner with Ylang Ylang in it, and I was almost instantly brought back to reality.


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