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In her fourth blog, Dr Rosie explores panic attacks, why we get them, how the affect us, and how we can overcome them.

We have talked about panic a couple of times already in this blog series. In this post I want us to think about how and when panic might show up in military family life so you can plan to deal with it effectively. 

Every human knows what it is like to panic. A panic “attack” happens when this natural reaction snowballs and becomes overwhelming. It can feel as though you are having a heart attack or an asthma attack and many people think they are going to die. The brain is a VERY powerful thing.

A panic attack is usually the result of a loop between the older and newer parts of the brain. Specifically, the problem is caused when the “old brain” that sets off the body’s fight or flight response believes that thoughts we are having are reality. The old brain floods the body with stress hormones to try and respond to the “threat” but the “new brain” then thinks that the symptoms caused by the fight or flight response (like shallow breath, sweating, pounding heart) are a sign of impending doom. 

 

 

I can provide a textbook example from my own life. I am claustrophobic so often when I wear my face mask I get the thought “I can’t breathe.” If I am not being mindful my body will react to this thought by giving me lots of fight or flight hormones. One of the effects of this is that my breathing rate will increase and become more shallow. My mind is then likely to interpret this as meaning that I need MORE oxygen and I will get the thought “oh no I really don’t have enough oxygen” I will therefore breathe more rapidly. Before I know it I will have breathed IN so much that my lungs are actually full and I can’t fit any more air into them BUT because my head is now screaming at me “we don’t have enough air, get more air” I will most likely believe this is because I am suffocating and continue to try to breathe IN when I really need to breathe OUT. 

This is an example of how our minds can give us a panic attack if we don’t watch what they are doing carefully. It is also the story of the first five shopping trips I made after masks became mandatory. 

Common reasons for panic attacks

Panic attacks often feel as though they “come out of the blue.” This is because the fight or flight system is ruled by the oldest part of your brain. Because it is not very sophisticated it is very FAST so it can be activated by something your much slower, thinking mind, is not yet aware of. Think about when you accidentally touch the hob when it is still hot. You have pulled your hand away a long time before you actually think “that was hot!”

Thankfully nothing actually happens for no reason at all. Here are some of the common reasons for panic attacks. I call these “threat triggers” because they trigger the “threat” response we talked about in the first blog of this series.

 

 

I am sure your head is probably already buzzing with many situations you have dealt with recently that could easily justify a panic attack. Military life during a global pandemic ticks a lot of these boxes. But let’s look at a couple of examples in more depth.

Adrian’s Story

Situation: Adrian has just been told that his wife is deploying at short notice. She will be gone in four days time. Adrian works full time in an office job that he can do remotely. He has no family support locally but has been Ok with this up until now as he takes great satisfaction and personal pride in his work. Their daughter, Stephanie, has a health condition that means she is frequently unable to attend school. There are also rumours of local lockdown in their area which could mean Adrian has no help with childcare at all. Today Adrian’s boss told him that he has missed his targets over lockdown and he will need to improve his performance if he is to survive the next raft of redundancies. 

Thoughts: “I’m going to lose everything,” “no one will respect me”

Symptoms: When Adrian finishes the call with his boss he notices that his hands are shaking, he is breathing fast and his chest starts to hurt. Suddenly his heart starts racing and he feels as though he is fighting for every breath. The tips of his fingers start to tingle and he does not even feel able to talk enough call for help. 

Thoughts: “I’m going to die”

Michelle’s Story

Situation: Michelle has just worked through lockdown on her own as her partner was deployed throughout. She had two young children at home, nursery was closed and no one lives anywhere near them. Her family are keen to leaves forces accommodation and move into their own home and Michelle’s income is essential in order to get a mortgage. She has just been told she is being made redundant as she has not been “as productive” and the team is reducing in size.

Thoughts: “I’ve let everyone down” “I’ve always been so good at my job” “I can’t see a way out of this”

Symptoms: Tight chest, fast breathing, sweating, dizziness

Thoughts: “I can’t cope” 

Solutions for dealing with panic attacks

There are two techniques that are effective for dealing with a panic attack and they work best in combination. Practice these for yourself and you will also find that you are quickly able to help others (including children) when they experience panic.

Solution 1 Drop an anchor

This helps you to become mindfully aware of the role your thoughts are playing and to engage in the rest of the world (stops steps 1-3 of a panic attack in its tracks)

This technique is about noticing what is going on in your mind and body and engaging with something OTHER than the panic thoughts. It is not about distracting yourself, just shifting your attention to something else. You can do long and short versions of this exercise but the basic principle is this:

1. Scan your body are there any feelings in there? Where are they right now?
2. What is your mind saying to you right now? Tune in and listen for a second or two.
3. Can you feel your feet on the floor? Notice what the floor feels like?
4. Can you feel the sides of the chair (or any nearby object)? Notice the texture and temperature.
5. How is your breathing? What muscles are you using right now? Take a couple of breaths and notice the effect your breath is
having on your body…”
6. Now stretch out and touch the sky, reach down low and touch the ground. Notice that you did that even though you are
feeling bad right now.

Here is a recording of these steps if you want to use something to help you practice:


Solution 2 Breathing

To restore balance & get your body back to normal

We’ve covered why breathing works to help us with anxiety in this blog series already. Panic is a little different. When we panic we are actually very prone to breathing too much. Often we actually really don’t need to take “deep breaths” as this can cause us to “unbalance” our system as we have too much oxygen and not enough CO2.

Belly breathing/soothing breathing/diagrammatic breathing as we have practiced will help restore balance to the system as it has a focus on a long out breath. This is key to getting your body back to its normal state and getting rid of the painful symptoms of hyperventilation.

Look back at the second blog in this series for a demo of soothing breathing.

IMPORTANT NOTE: BREATHE OUT FIRST

If you try some soothing breathing but still have tingling or a tight chest you may need to breathe into a paper bag or similar. This isn’t usually needed but can help if you are struggling to force yourself to do a long out breath.


I hope this gives you a helpful overview of panic attacks, why they might strike and how to work through it. I’ve given two redundancy examples here because I know that is a reality many of my clients are facing at the moment but this can equally apply to any situation that falls into the “threat” categories above. 

Any questions? I’ve got two blogs left in this series so let me know if you have any burning questions you want me to answer on any mental wellbeing related topic.

Dr Rosie

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