I had an acquaintance, someone I used to work with. Nice girl. I tripped over her on Facebook a while ago, so we friended each other. Hadn’t heard a lot from her recently, but assumed as she’d recently got married and had a kid, that she was too busy living in domestic bliss/mopping up babysick to post. Then she posted, and it turns out she’d been in a mental hospital for the best part of a year with chronic panic attacks, among other things.
When I started this blog I called it theanxiouscook, not because I’m worried about my ability to produce meals of immense fabulousness, but because I used to suffer badly from anxiety attacks.
For those that have never had one, imagine feeling like you’re frantically trying to climb out of your own skin, whilst a horde of angry bees descend upon you. If you aren’t actually a moulting snake that keeps bees for a living, this can be a little disruptive to normal life.
I messaged her, we chatted, and I sent her details of a few of the coping mechanisms that I found helped me to manage the attacks. I include them here as well, in case they may be helpful for anyone else.
Get up. Have a shower. Eat, or attempt to eat, three times a day. Go to bed at a normal time. If you fail or succeed in these things on any given day it doesn’t matter, but keep trying because these are the basics of life and one of the keys to beating the attacks is to gradually get that normal framework of a life back.
Hyperventilation. is commonly linked to panic attacks, but I find that actually I “stop” breathing, and it takes a conscious mental effort to restart. Either way, lack of oxygen will only make the attack worse. Breathe, and breathe from your lower stomach rather than just from the top of your chest (http://www.abc-of-yoga.com/pranayama/complete.asp). I find yoga tedious beyond belief to be honest, but remembering to breathe fully and properly when an attack is imminent will help a lot with managing the attack.
One of my lifesavers was a little platform computer game called “Bounce Tales” on my mobile phone. If I started to get anxious I’d sneak off and play a few levels then come back. These are distracting, easy to use and make you concentrate on anything other than the anxiety. Because it’s difficult for your brain to justify a full-on adrenaline burst, when in reality you’re in such leisure and safety that you can sit and bounce an animated rubber-ball over various obstacles and puzzles. An interesting side effect is that, once your brain has established a link between playing this game, and calming down, even pulling out the mobile and starting to play the game automatically calmed me down. I reached the point that even mentally visualising the first few frames of the game would drop my anxiety levels. Because my brain associated it with being calm and safe.
You can substitute whatever you want to for a computer game. Knitting. A book. A piece of music on your iPod.
Other distraction techniques. Concentrating on a sign or other written material near you. Spell out each word individually, mentally….t – h – a – n – k – y – o – u -f – o – r – n – o – t – s – m – o – k -i – n – g.
Plan B / Escape Routes
Your brain is concerned about a particular activity. It starts to trigger an attack. The answer isn’t necessarily avoiding the activity, but putting a Plan B into place. You may never have to execute Plan B, but the simple fact that you have an “out” can help reassure your brain enough that it will drop the anxiety.
Example: getting a train journey home to the town where I lived, from my home town, after a family visit. I’d agree with a family member that if I couldn’t make it past the first train station on the journey, I’d get out, get a train back and they’d drive me home instead. After the first time they didn’t need to, as having the alternative option was enough to let my brain cool down.
In meetings I still try and get the chair nearest the door (the escape route).
For months after the attacks ceased to be serious issue I still carried a spare dose of diazepam in my handbag; it became battered and dirty and the protective foil peeled off, but the fact that I had something there that could “take the edge off” if I started to panic was enough to keep the attacks wound down.
My experience has been that the attacks effectively wipe your mental hard drive, and you have to reprogram lots of small sub-programs. The “take a bus journey” program. The “making a trip to the supermarket” program. The “how to hold a conversation with another person without panicking” program. You rebuild enough of these little sub-programs and normal life becomes manageable.
Pick an activity, anything you currently struggle to do. Using the other stress management techniques re: breathing etc, keep trying that activity. Start small. And if any particular occasion you really can’t manage that activity that don’t beat yourself up. It’s very much three steps forwards two steps back with this at times.
Try the activity again the next hour, or the next day. You’re rewriting your brain to accept that yes you can do that activity, without panicking.
Gradually your brain will stop freaking about that particular activity. You can then build on that, and each time go further and further outwards, onto more complex activities and interaction.
In conjunction with this, keep a diary. Doesn’t have to be anything complex, just a little notebook with a list what you managed to do that day. This is a good motivational tool as it’s human nature, particularly in this situation, to accentuate the bad, beat yourself up, and forget the good progress you have made. When you’re fighting chronic panic attacks any progress is to be celebrated, and there will be setbacks.