First Step to Remission

Okay so the first thing you need to do, although I'm sure most of you have already, is go to the doctor and just make sure that everything checks out.  Let the doctor listen to your heart and lungs and really listen to them when they tell you that everything sounds good.  And I think it is really important to find a doctor who understands your condition and doesn't make you feel bad, or disregard what you are saying.  You will need to be honest with them and tell him that you have been struggling with anxiety.  Depending on how the doctor reacts, you should be able to tell if you have found the right person for you or not.  It needs to be someone that feels comforting.  Someone who understands what panic attacks actually are and does not blame you for your condition.  So let this person give you a full physical and try as hard as you can to believe them when they tell you that you are okay. 

Now you need to do something that will probably seem really scary.  But hopefully from what you have read in my previous posts and from what you hear from your doctor, there is absolutely no risk to doing this.  You need to ride out the panic attack.  You need to let the adrenaline wash over you and teach your amygdala that the fight-or-flight response is not dangerous.  Up until this point, your brain thinks that panic attack is a dangerous and potentially deadly experience.  In reality, it is not.  But you will need to teach your amygdala that.  In order to prepare for this you need to practice a few techniques.  One of these is the ability to separate yourself from your thoughts (it sounds really weird, okay, but just trust me on this one).  So just take 10 minutes per day and sit down in a quiet area and just notice what you are thinking.  Without any judgement about the thought.  Just be aware of what you are thinking.  So just say to yourself: "Okay I am now having the thought that I should be doing dishes.  Now I am having the thought that this is really boring.  Now I am having the thought that this exercise is incredibly stupid....etc" (and yes, until I realized the power of this exercise, a lot of my thoughts tended to be about how I thought this whole listening-to-your-thoughts thing was stupid - and that is perfectly fine but remember there is no judgement.  Just notice the thought, period).  One of the other benefits of this exercise is that, at least for me, I ended up feeling noticeably calmer after this 10 minute break.  Just sit or lie down, set a timer and close your eyes...  

Anyway this ability to separate yourself from your thoughts is really important because during a panic attack your mind will be flooded with thoughts of "I'm going to die" "I'm having a heart attack" "I can't breathe" "I hate this" "I need to go to the ER" etc etc.  and you need to be able to recognize that these thoughts are actually symptoms of the panic attack just like heart palpitations and dizziness are symptoms.  These thoughts are linked to your fight-or-flight response and will keep coming up with each panic attack but that doesn't mean they are correct and that you need to listen to them or believe them.  So if you can separate yourself from these thoughts, and just notice "okay, I'm having the thought that I can't breathe" it is actually super powerful.  Instead of thinking "I can't breathe!!!!!!!!" it is "I am having the thought that I can't breathe".  This reminds you that you are only having a thought that you can't breathe, not that you actually can't breathe.  And this shift in thinking is really critical for you to retrain your amygdala.

Now in the moment of a panic attack this takes a LOT of practice.  The fight-or-flight response is such a powerful response that it is very difficult to do the above exercise in the heat of the moment (especially if you are not at home) but if you keep practicing it becomes so natural that you can do this shift in thinking in any context.  But since it is so difficult, I want you to just have one goal in mind for the first few panic attacks that you ride out: just breathe.  Sit down and just focus on breathing in and out very slowly.  If you can start to recognize your thoughts as thoughts, that is awesome.  If not, just breathe.  Breathe and know that it will be over in about 10 minutes (and if you really are just breathing through it, it will be much shorter).  And importantly, NEVER feel bad about yourself if you fail, if you forget everything you are supposed to practice in the heat of the moment.  This stuff is SO HARD.  Even just to sit still is so difficult, I know it is.  You might be panicking for 20 minutes before you remember to focus on your breathing.  That is fine.  Do not get mad at yourself, do not judge yourself.  Recognize how hard it is to do this and celebrate every single baby step you make during this process.  I cannot emphasize this enough.  If you are constantly berating yourself every time you forget these exercises during a panic attack it will slow your progress.  Celebrate any possible positive change from the last time you had an attack.  And also recognize that there are good and bad days.  This is completely normal, and in no way does this mean that you are taking steps backwards (even though it might feel like it, try to be positive!!). The process of retraining your amygdala does not happen overnight.  It is a tough road but one that is so well worth it.  I know that you can do it.  Just start simple: Breathe.

 So the first steps towards getting over your panic attacks are the following:

1) Get checked out by a doctor and try as hard as you can to believe them when they tell you that you are fine.

2) Try to sit in a quiet place for 10 minutes per day and notice what you are thinking without judging your thoughts

3) Sit through a panic attack (don't run away, don't pace, just sit) and focus on breathing in and out.  Let the adrenaline surge through your body and just breathe.  The panic attack won't hurt you at all.  It SUCKS but it won't hurt you. 

4) Try to notice your thoughts during the panic attack, and recognize that they are symptoms of the panic attack itself.  They are only thoughts, they are probably not true.

Good luck.  I am proud of you for taking this step forward.  I know how hard it is.  If you have questions or need help or support do not hesitate to contact me: panicremission@gmail.com