Thursday, 05 September 2013 00:00Written by Guy SInes
Anyone who has suffered chronic panic attacks knows how futile, helpless and permanent your situation can feel. This is of course exacerbated by the failure of others to understand your predicament.
Accusations, feelings and diagnosis of hypochondria, as well as a myriad of other blanket terms which often assign blame and/or ridicule to the sufferer, only add insult to injury. As negative self-talk and poor self-worth are common denominators in this condition, friends, family members and members of the medical establishment who contribute to this thought process even inadvertently can add to your suffering indefinitely.
The symptoms of a panic attack or prolonged stress are all too familiar to those of us who have experienced this condition: Tightening of the chest, numbness in the extremities, shortness of breath, tunnel or blurred vision, dizziness and disorientation as well as an almost "out-of-body" experience are all hallmarks of a panic attack. They are also symptoms of a number of medical conditions, which causes the sufferer to think they are experiencing a medical emergency. This of course will only elevate your level of anxiety. Many of us have made multiple runs to the emergency room during these attacks, only to be told, often condescendingly, that there's nothing wrong with us. This is often reassuring information at the time, but it quickly becomes expensive and is only a temporary fix. Unless you deal with your condition at its root, your panic attacks will be chronic, and you will continue in this cycle.
But there's good news! You're not dying and you're not going crazy, even though this condition can make you feel as though you are. And, going against established mainstream medical opinion, I even refuse to think of this condition as a disorder, and certainly not as mental illness. Unfortunately, this is how it is most often treated. The patient is given a mental health diagnosis and prescribed various psychotropic drugs, such as antidepressants, sedatives and tranquilizers.
It is important to understand that the symptoms that one experiences during a panic attack are a natural and normal physiological response to stressors. They are most certainly NOT a disorder of the brain. I submit instead that they are symptoms of a disorder in our modern society and its stressful and sedentary lifestyle.
The title of Robert M. Sapolsky's wonderful book Why Zebras Don't Get Ulcers (1994 W.H. Freeman and Company) says it all. Wild animals do not suffer from stress related conditions. Hunter/gatherer and agrarian humans do not either. In non industrialized nations, you may find a variety of other types of illness, but you probably won't see people suffering from panic attacks, ulcers, coronary disease, obesity or other manifestations of stress related illness, even though they experience many of the same stressful events as those of us in the "civilized" world. To understand why, you need to have a basic understanding of the physiological chain reaction caused by stress, which I shall attempt to explain in the most simple and concise terms for this article (the chemistry and function of neurotransmitters and hormones such as epinephrine, norepinephrine, serotonin, dopamine, substance P, cortisol, etc. have already been covered in great detail in many other publications, so for the sake of brevity, and to keep you from getting bored, I will simply use the blanket term "chemicals" for the remainder of this article). Furthermore, I will also address how one can alleviate and eliminate the long-term effects of this chain reaction by simple changes in lifestyle and nutrition.
Stress, just like pain and fear, is a gift when it occurs at the appropriate time. Fear tells us not to do dumb things that will hurt us. Pain tells us that we're doing something dumb that is hurting us. If we had no pain receptors, we wouldn't know if we were being cut, bitten or on fire, and as a result our bodies would sustain significant and potentially irreversible or terminal injury. Likewise, stress also has a very important physiological function. It's not simply an annoyance. Even though abstracts such as fear, pain and stress are thought of negatively because of how they manifest themselves, it is important to think of them as necessary tools for survival. They are not something that one should strive to eliminate, but our modern society has made it necessary to think of them in a different context than our predecessors had to.
The body is governed by the nervous system, which is divided into two parts: The sympathetic nervous system, and the parasympathetic nervous system. The sympathetic nervous system is responsible for the "fight-or-flight" reflex, while the parasympathetic nervous system controls rest and relaxation. Stress, as one might guess, is dictated by the sympathetic nervous system. When stress occurs, your "fight-or-flight" reflex becomes dominant. In nature, if you are attacked or threatened, your body releases a number of chemical components which cause dilation of the pupils, tunnel vision, constriction of blood vessels, hyperventilation and rapid heartbeat. They also have stimulating and anesthetizing effects. Additionally, your digestive system goes nuts in order to rid your body of extra weight. These are all normal and necessary events which enable an organism to either fight off an attacker or run from it.
In nature, an organism's response to this attack will burn up all of the chemicals released when it either fights or runs away at top speed from the threat. After the organism has expended all of these chemicals, the parasympathetic nervous system takes over, and R&R occurs. However, if these chemicals are prevented from being used up appropriately, they quickly become toxic to the body. This is not dissimilar to the analogy of continuously eating food and never eliminating the waste, and therein lies the problem.
In our modern society, we don't typically have to worry about attacks from wild animals, and most of us can go a very long time without ending up in a hostile situation. However, smaller stressors (rent due, relationship problems, school or work deadlines etc.) will over time build up to the point that they release the same chemicals as a full-on attack. Then, seemingly out of the blue, you find yourself in "fight-or-flight" mode with no visible threat or cause in sight. Feelings of dread, panic and despair come out of nowhere, making the sufferer feel as though they're "losing it". As odd as it sounds, you'd have been better off immediately reacting to a direct attack on your person.
So the key, as you may have guessed by now, is keeping a check on these smaller stressors and not letting your body's defensive chemicals build up to major threat levels. You need to burn them up regularly, as quickly and as often as they occur.
Movement is life. Plain and simple. We are not designed to sit on our butts day in and day out without substantial amounts of movement. Animals don't have the modern conveniences that we do, so they have no choice but to do two things, and only two things, during the course of their day. They walk around looking for food, and they try not to become food. Walking around looking for food is movement. Occasionally sprinting either after their food, or to avoid becoming food is intense physical movement. At night they sleep. This pattern is mirrored in the behavior of our hunter/gatherer ancestors, as well as in contemporary stone-age societies. Our bodies are composed mainly of water, and, just like water, if we sit still for too long we will become toxic. Primitive societies alleviate this problem naturally. They maximize their sympathetic nervous system by hunting and gathering during the day, and then once they are tired, they relax together in the evening, by eating their bounty, singing, telling stories, lovemaking, etc.
You already know that when you eat or drink something, it's going to be converted into energy and then waste. You know that the waste part will have to leave your body or you'll have problems. This is absolutely the same for the chemicals released during stress. They need to be used up as energy, and then the waste products need to be removed.
You already know about solid and liquid waste, but the primary means of waste elimination are respiration and perspiration. I.e., you need to breathe deep and hard and you need to sweat. Regularly. Your lymphatic system is also responsible for the removal of toxins, and unlike the circulatory system, your lymphatic system has no pump of its own. It relies on physical activity to move toxins through its ducts and into the bloodstream, which will carry it to the lungs and sweat glands for elimination. This is also true of the integumentary system, which is composed of the skin and sweat glands. Your skin is your largest organ, which is responsible for waste removal via perspiration, as well as protection and synthesis of Vitamin D from sunlight. You'll notice that people who are in poor health and who do not exercise will often have skin conditions, chronic bad breath and body odor. This is because they're not regularly flushing toxins from their respiratory and integumentary systems.
Before I get into the self-care portion of this article, a word needs to be said about this controversial topic. I first need to state that I am not a doctor. However, I have found in my own experience that a typical medical doctor has a poor general understanding of this condition, and they are after all trained to treat symptoms of a condition versus treating the person as a whole. The medical establishment is under the control of pharmaceutical companies, which are simply businesses who rely on your continued suffering. If you are cured, they make no more money from you. In my work in the mental health field, I have never seen anyone who was on an antidepressant for a prolonged period of time who did not end up requiring larger and larger doses, before eventually having to move on to a more powerful drug. I've also observed these subjects developing worse conditions over time as their brain chemistry gets scrambled from constant artificial manipulation of their neurotransmitters. Nevertheless, this is a controversial and intensely personal topic, and you must arrive at your own conclusion as to how you will address it.
My own experience with psychotropic drugs was fortunately a brief one, one which provided temporary respite while I went through the process of making the lifestyle changes which I required. It began at a time when I was working a very high-stress job. Even though I'd been able to partially get my panic "disorder" in check a few years before, with the stress I was under it began to return. With it came a myriad of health symptoms such as severe, chronic fatigue, acne and digestive problems. After my doctor had treated me for a variety of conditions with no success, he started me on Zoloft, which was new at the time. The relief I felt was instant. Unfortunately, the way in which most of this variety of drugs works is to make you simply not care about things, and this became evident in my work life. I was fired from my high-stress job as a result, which was actually a blessing in disguise.
The relief that Zoloft provided was immediately evident to me and those who were close enough to me to see the difference. Unfortunately, it had side effects that I didn't care for. It gave me cottonmouth, caused me to sweat profusely, softened my stools to the point that I always had to be near a rest room, and all but eliminated my libido. However, it also rendered me nearly completely apathetic to these symptoms. Fortunately, I never lost the wherewithal to see that apathy was probably not a good thing in the long-term, so under the supervision of a naturopathic physician, I began the process of weaning myself from the drug.
I had also begun to exercise once again during this period, something which I'd neglected for a number of years. I began to make the connection that during the times in my life when I was the most physically active, I also experienced the least amount of unnecessary stress. A few years later, I was given a prescription for the sedative Xanax to control my flying anxiety. Eventually, I found that simply having the Xanax in my possession gave me the security to not even need to take it. Today when I fly, I need nothing more sedating than a glass of wine, my Ipod and a big, fat magazine or a good book.
So this is the part you really wanted to get to, isn't it. I apologize for putting it at the end, but I feel that it's more effective if you have an understanding of the physiology of the condition. The adage "Know thy enemy" may come to mind, but I would suggest altering your perception to "Know thy enemy, and embrace it." Never forget that stress is a gift! It is a life-saving tool which you must simply learn to control and channel appropriately. Like everything else, when out of balance it is a monster. Here's how you can tame your monster.
Your person is composed of matter and the energy that moves it. Physics tells us this; that matter and energy are both finite and exclusive. Matter does not create its own energy, and energy does not create matter. One however, can manipulate the other. Form follows function in nature, in other words, your body follows your mind, and your mind lives in your body. Therefore, you must use the approach of balancing your mind with your body. This isn't mysticism, it's physics. Simple physics.
A word of caution; if your symptoms are more severe, if you are in poor health or if you are already on medication, I strongly suggest that you seek the advice of a naturopathic physician to assist you in this process. Some may require counseling as well. While there are many good allopathic physicians who are sympathetic, I recommend naturopathic physicians simply because they are trained to heal the whole person, versus simply treat symptoms. They are also trained to interview and listen to their patients. I have also had the best results with them when dealing with chronic conditions, as they tend to have more of a "camel's back" approach, i.e. they strengthen the system as a whole, while eliminating troubling symptoms. For panic/anxiety conditions, this is the most appropriate action one can take.
In dealing with the mind, or energy part of the problem, you need to examine yourself and the conditions that lead to your attacks. If you have difficulty finding this, or if there is past trauma that's too painful for you to deal with on your own, you will need to find a counselor who you can trust. Ask your naturopath to recommend someone who they have worked with before. For me, it was a matter of simply examining the worst that could happen. That always ended up being death, and so I had to come to terms with death. I had to begin accepting it as a natural and cyclical process in the order of the universe. Once I was able to do this, everything else went away. In a recent stress survey in a men's health publication, I scored "The epitome of at ease", which I can tell you came as a tremendous shock to the formerly very-highly-strung me. It was no surprise to my co-workers however, who simply brushed it off with a casual "Yeah, you're a really laid-back guy. That's why we like working with you." Amazing isn't it, how we sometimes only see the changes in ourselves through the eyes of others.
On the physical or matter side, as I previously stated, movement is life. And if you didn't skip the boring physiology part of this article, you understand why. If you frame houses or stack bricks for a living, I seriously doubt that you're reading this article at all. You probably work at a desk, or don't work at all and have a sedentary lifestyle. We animal organisms are designed to MOVE! Being sedentary is an affront to nature and will lead to stagnation. For this reason, getting an appropriate amount of exercise is absolutely crucial. You need to be breathing deeply and circulating your blood and lymphatic system on a daily basis.
Exercise in and of itself is a very broad subject. Choose a mode that works best for YOU! For me personally, high intensity exercise works best, as well as activities that either have or mimic an element of danger, such as skiing, climbing and martial arts. These activities in particular are highly neuromuscular, and require a balanced mind/body connection. They will also initiate an adrenaline response while allowing you to use up your adrenaline appropriately. Recent studies have indicated that this type of activity is highly beneficial for cardiac health. For others, simply going for a daily walk will be all that they need. The important thing is to find an activity that you enjoy and that stimulates you physically, and then do it consistently. If I find myself in a situation where stress is quickly building, I'll find a quiet corner, and do a set of pushups or squats til exhaustion. That is, until my muscles won't perform the action any more and I'm gasping for breath. If it's convenient, I'll go outside and run a few hill sprints.
When approaching the subject of the physical, it is also necessary to take nutrition into account. Are you eating right? Are you eating enough? Are you getting enough of the proper nutrients in your diet? Processed foods should be avoided as much as possible, as they tend to be loaded with substances that can trigger panic attacks or contribute to poor health in general. Vitamin B-12 is an adaptogenic nutrient which helps your body cope with stress. It is contained in meats, organic dairy, eggs, fish and dark, leafy green vegetables. You may also want to consider taking a supplement which contains high doses of Vitamin B. Simple sugars and caffeine are stimulants, which means they will trigger your sympathetic nervous system, which may lead to a "fight-or-flight" response, or panic attack. They're also acidic, and your levels of stomach acid are already elevated during stress. Prolonged use of these acidic substances combined with stress can lead to ulcers or other digestive ailments.
While there are a variety of supplements and formulas available that promote relaxation, there is no magic shot in the arm that will cure your condition. YOU have to do it, and you do it by finding the root of the problem and reversing it. You are your best physician in dealing with this condition, as your symptoms are largely subjective, and therefore immeasurable to others. For this reason, I avoid supplements that promise to relax me, promote a good sense of well-being, etc. Although I do eat foods and drink teas made from substances that are historically known to do this.
As a general rule, a person should not eat when they are under stress. Your digestive system is already effectively shut down, and combining food with the cortisol your body has released can lead to weight gain. Wait until you are relaxed and in a good mood to begin eating again. You should also avoid trying to calm yourself down with alcohol during a stressful period, as this will only further constrict your circulatory system and raise blood pressure.
What to Do During a Panic Attack
When you find yourself at the outset of a panic attack, you're going to notice a lot of negative self-talk in your head. Turn this around immediately! Instead of saying things like "Oh no!" or "I'm going crazy!" or "I'm dying!" (I know you've been there, that's why you're giggling), tell yourself "I'm okay, this is a normal reaction, it will pass soon". Try to think of something that makes you happy. Engage your mind. Try counting by multiples of two: 1, 2, 4, 8, 16, 32, etc. By the time you get to 131,072 you'll have forgotten you were having a panic attack. Panic attacks usually only last a few minutes, and seldom go on longer than 20-30 minutes. Remind yourself that the one you're having will also be short-lived.
Be aware of what's going on with your body. Is your chest tight, breathing rapid and shallow? Are you short of breath? You're only hyperventilating. Start taking slow, deep breaths. And by deep, I mean not just into your lungs. Breathe DEEEEEEEP down into the bottom of your belly. Imagine you're breathing all the way down into your heels, as if your body were a huge balloon that you're filling with air. When you've taken as deep of a breath as you can, pause just briefly, then fully exhale. Repeat. This alone will "re-boot" your parasympathetic nervous system so to speak, and you should be feeling much more relaxed by your third breath. Is your heart racing? That's tachycardia, which will also return to normal along with your breathing when you perform the above exercise. Your shoulders are probably scrunched up to your ears as well. Let them relax, and drop them down and back to where they belong. This will further free up the constriction you're feeling in your thorax.
If you need to, and it's convenient, exercise vigorously at this time. You can probably run faster than you ever have with all the chemicals that are flooding your system. Use em up! Sprint, swim, do pushups, lift weights or whatever it is that you do. Just do it until you're tired and your attack will be gone.
Sounds easy, doesn't it. Well it is when you begin to put it into practice. Just start small, wherever you are, doing what you can without overextending yourself. Be consistent, and always watch for the signs that your stressors are building up to a level that needs to be dealt with. Better yet, be consistent in your health regimen and prevent them from building up at all. Replace negative self-talk with positive self-talk. Talk to yourself about accomplishments and goals, about things you or others have done that make you happy. Focus on the positive. Know that you are not crazy or experiencing mental illness.
When I suffered my first panic attack over twenty years ago, not much was known about the condition. It was, and still is, erroneously considered to be a psychiatric disorder, which is how it has been treated. Again, I state that this is NOT a psychiatric disorder, but a result of our living conditions in modern society, and our failure to evolve fast enough to keep up with the gains of the industrial/technological revolution. Just knowing this and being able to put it into perspective has helped me tremendously.
I had to find a solution for myself, and the process has led to a lifetime of studying natural health practices, and for that I am thankful for the condition. I have condensed what I have discovered and what has helped me into this article, and I hope that it has been a blessing to you as well. Know that you can beat panic attacks naturally, on your own, and for good!
Wishing you the best in health and well-being