Anxiety Attack!

Anxiety Attack!

Anxiety can be intense, and may lead to ruminative thoughts, paralyzing fear, or even panic. It can trigger strong physical sensations, resembling a flight or fight response. Your heart may race or pound, you may experience numbing or tingling, and you might feel as though you cannot breathe.

What is causing this? Anxiety triggers are often unique for each individual. Some stressors may build, and cause anxiety. Perhaps there was a recent change, or major transition in your life. Or perhaps it is exacerbated by ruminative thoughts, leading to negative thinking spirals. Anxiety may come and go, or it may be persistent. Sometimes it may catch you off guard, or seemingly “out of the blue.”

A young adult client comes in for a therapy session, hair tangled, circles under her eyes, she appears to have not slept for a full night in weeks. She has recently moved out on her own, away from the security of home, and has left her small college town and has recently moved to the city. She is desperately trying to be brave in this brand new world, but is unable to focus. She recounts to her therapist,

Client: Last night at 3:00 am, I woke up sweating, heart racing, chest hurting, and my arms felt numb. My head began to spin. I couldn’t see straight, I felt like I was hallucinating. My face went numb, and I couldn’t feel my mouth. There was a tingling sensation running through my fingertips. This time, I must really be dying, I thought. I was having a heart attack! I surely felt I was going to die. My mind was racing….thinking about a million ways I could die that night. I asked my boyfriend to bring me to the Emergency Room. They hooked me up to an EKG, ran blood tests, and they all read negative. I don’t know what was happening to me.

Therapist: It sounds like you were caught by an anxiety attack, known as panic. Panic can happen when anxiety spirals out of control. Waves of anxious thoughts come in, and you “go blank.” Or panic can come on suddenly and seemingly “out of the blue.” It can take some time to identify and recognize these anxiety attacks, and even more time to learn to master them, or “ride them out.” Being afraid of panic feeds the attacks, and makes them worse. Soon you are caught in an endless fear spiral where a lion is chasing you through the jungle, but you end up feeling “trapped.”

Client: I think I have discovered a way out of panic. I have to first learn to regulate my thoughts, and confront my fears. I recognize that my panic feeds on fear and my feelings of anxiety. Addressing these fears, and anxious thoughts head-on helps me “tame the wild beast.”

Therapist: Excellent. Mastering anxiety is also about learning to regulate our feelings, and “ride the wave”…

Imagine that you are a surfer; you will quickly get sucked under a large wave, unless you manage to stay ahead of it and ride it out. Like the Beach Boys song, “Catch and Wave, and you’re sitting on top of the world…” Imagine that wave is the grip of anxiety, and mastering it means riding it out, far and long, making a smooth and graceful exit back to the shore. Noticing the fear coming in, noticing it subsiding. Externalizing it, imagining that it is outside yourself, imagine yourself riding it out, staying on top of it. Thinking, I may not be able to stop the panic, but I can master it, it will not suck me under.

The more you can successfully ride the wave, the less scary panic becomes, and eventually it does go away. But mastery takes practice, it does not happen overnight. But little by little it will get better, and you will begin to master your own anxiety.

The surfer analogy is a good way to visualize the ebb and flow of anxiety. If you can begin to recognize that it begins, often slowly, and builds, you can learn techniques to help stop the wave from crashing over you, and getting pulled into the undertow.

Here are a few strategies to help minimize anxiety in the moment:

Practice a grounding exercise. I like the “5 Senses Grounding Technique” which includes identifying sensations in your immediate surroundings. Ex, counting 5 things you can see, 4 things you hear, 3 things you can touch, etc.
Practice mindfulness. There are many ways to go about starting a mindfulness practice, and it only needs to be for a few minutes each day. There are apps you can download on your phone to manage and track your mindfulness practice.

Exercise. This one is super important. The more you exercise, get out and about, walk around the block, clear your head. It is hard to walk and think about anxious thoughts at the same time. Soon endorphins rush in, and mood lifts.

Eat healthy, don’t drink or smoke. Using drugs and alcohol may seem like a way to deaden anxious feelings in the moment, but it usually ends up exacerbating anxiety symptoms and they tend to come back at double the strength later on.

Set a good bedtime/sleep routine. Even more important than any technique is getting good rest. Your body tends to run on overdrive, and pump extra adrenaline to stay alert when your tired. Ever get so tired your body starts shaking? Needless to say this can fuel anxiety.
Talk back to your anxious thoughts. Reframe those thoughts by stating them outloud and realizing how ridiculous it sounds. Then, counter back with something from a more balanced perspective.

This is a foundation to begin your anxiety management practice. After building the foundation, you can add on the techniques.