Panic Takes Your Breath Away: Remember to Breathe

Everyday life presents stress, fear, and worry for everyone, but when you experience anxiety your brain experiences stress in a different way. Although it can be overwhelming, it can be managed and does not have to control your life. In previous articles, I have addressed other mental health issues. This article, written in collaboration with my adult daughter, Kelsey, addresses anxiety.

I will always remember my paternal grandmother as a worrier and there was not much you could say or do to convince her it was okay to let some things go. In her day, resources were limited and she would not have asked her family doctor about her worrying. Now, so much more is known about symptoms and how to treat anxiousness. There is a difference, however, between ordinary worrying and clinical anxiety.

10 Crucial Differences Between Worry and Anxiety

1. We tend to experience worry in our heads and anxiety in our bodies.
2. Worry tends to be specific while anxiety is more diffuse.
3. Worry is verbally focused while anxiety includes verbal thoughts and mental imagery.
4. Worry often triggers problem-solving but anxiety does not.
5. Worry creates mild emotional distress, anxiety can create severe emotional distress.
6. Worry is caused by more realistic concerns than anxiety.
7. Worry tends to be controllable, anxiety much less so.
8. Worry tends to be a temporary state but anxiety can linger.
9. Worry doesn’t impact our professional and personal functioning; anxiety does.
10. Worry is considered a normative psychological state while anxiety is not.

ANXIETY DISORDERS

I am not alone in my experiences with an anxiety disorder. “Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18% of the population.” (Source: National Institute of Mental Health) While Generalized Anxiety Disorder (GAD) is the most common diagnosis of anxiety, many also suffer from Panic Attacks. Panic attacks fall under the umbrella of anxiety disorders. In an article written by Alex Hanna, Founder of Challenge The Storm, Panic Attack: Do’s and Don’ts, more specific details on panic attacks and how they differ from episodes of anxiety are discussed. “Panic disorder affects about 2.4 million adult Americans(~4%.) Panic disorder most often begins during late adolescence and early adulthood. It is twice as common in women as in men.” (Source: Web MD)

Kelsey and I have both dealt with the symptoms of anxiety over our lifetimes. However, just because we both experience symptoms of anxiety, doesn’t mean we experience it in the same way. We can’t diagnose or provide treatment but we can say: if you are experiencing anxiety, you are not alone, there is help, and there is hope. We provide insight into the different ways anxiety and panic manifest in our lives so that you might recognize similarities and reach out for yourselves.

What does anxiety mean to you and when did it become a part of your life?

Amy:
Anxiety entered my life as a young child. I don’t think my parents were aware of a problem or if they did, lay people were ill-informed about mental illnesses. Some of my most visual memories of childhood involve being anxious, of loud men’s voices and of being left alone. I found comfort sleeping in my bedroom closet.

I continued to experience anxiety through adolescence and in my teens, I started having panic attacks. I was unaware that’s what they were and would have benefited from professional help. As an adult, I have been fearful of feeling out of control, unable to rationalize the things in my life frightening me. I also experience anxiety stemming from a fear of rejection. When someone says something that makes me feel bad or I feel uncomfortable, I think irrationally and become either withdrawn or I strike out, classic fight or flight behavior. Dealing with a mental illness is difficult enough, trying to do so while raising a family can be overwhelming.

Kelsey:
To me, anxiety feels like having two brains that are perpetually at odds. My regular brain feels normal amounts of stress and worry, but my anxiety brain asks a thousand questions, ruminates, and does not let things go. I can rationally see a situation as being stressful or experience fear or worry, but it is my anxiety brain that keeps those thoughts moving, buzzing, and poking around. I remember having anxiety as a small child. As a kid, I wanted to enjoy activities that seemed “normal” to me, like sleepovers, staying with extended family, and staying up late for special events. However, I always struggled with bedtime. I endlessly worried about falling asleep and what would happen if I did not fall asleep. My mind would often ruminate for hours on the possible repercussions of not being able to control all of the circumstances around my sleep routine, and sometimes it prevented me from social situations or fully enjoying time with family. Sometimes I would call to get picked up from sleepovers, other times I would lie awake with insomnia hoping for some shut-eye.

I remember having my first clear episodes of anxiety during middle school. Once, I received a low grade on an assignment and when I confronted my teacher about it, I started to panic. I remember visual symptoms like objects suddenly looking neon, flashing lights, shortness of breath, and I instantly started to cry. It took the wind out of me. I had a similar instance a few years later, triggered by a stressful situation that seemed to paralyze me emotionally. In college, I experienced mostly manageable levels of stress and worry about exams, studying, and my future. However, I would sometimes get panic attacks after finals week was over. I remember talking to my dad on the phone walking down Bascom Hill, at UW-Madison, after having completed a week of finals. When I graduated, I became a teacher, which presented new stress and new triggers for anxiety. I once had a panic attack during my prep period, and I felt like I could not face my students or go pick them up without crying. The interference my anxiety had on my daily life and job led me to seek help. As a young adult and professional, now having taught for five years, I understand that I experience cognitive distortions and irrational patterned ways of thinking, at times.

How would you describe a panic attack?

Amy:
My problem is with breathing. I forget to do it sometimes. Depending on the severity of the panic attacks, they come on differently and have intensity levels. When they are at the worst, I feel so out of control. I am not sure that I feel like I am going to die but I know that sometimes, I will have feelings of suicidal ideation, being better off dead. Or that the pain was going to kill me. When I was not properly treating my anxiety, the episodes were quite severe, but now under treatment, much less.

Kelsey:
I experience both physical and mental symptoms during a panic attack. As I mentioned before, sometimes I experience neon, blurry, or spotty vision, increased heartbeat, shortness of breath, crying, dizziness, and a need to sit down. Mentally, my thoughts spiral pretty quickly. Before seeking help, they would be fixated on what if the episode did not end and it feeling like it would last forever. It felt like paralysis….like an inability to process. After seeking help, and experiencing racing and irrational thoughts, I try to use positive self-talk. I remind myself to breathe, find a private space, and to wait it out or ride the wave until the panic and symptoms subside.

How would you describe an episode of anxiety?

Amy:
I treat my mental health issues as being just important as my physical health issues. I do not need to suffer in silence. I want to lessen the stigma.The constant I experience with anxiety is difficulty breathing. Ever since I was a little girl, I would unconsciously hold my breath when I was afraid, sad or nervous. When I go to the dentist, I am reminded to breathe many times during procedures. When I am having anxious thoughts, I have to tell myself to breathe to control myself and calm myself down. I think of my generalized anxiety as being related to triggers, claustrophobia, large crowds and having to go outside of my comfort zone.

Kelsey:
When strategies to lessen anxiety fail, at times, I experience similar symptoms of a panic attack but it is triggered by something specifically (confrontations, important events, large crowds.) As these episodes are triggered by a specific situation, I can try to withdraw from what is triggering me, such as walking out of a crowded grocery store or taking a break during an event with a large crowd.

How do you manage your anxiety?

Amy:
I have had therapy and learned about irrational thinking v rational thinking, I have come to avoid some situations which I know trigger me. I also realize that there are different levels of anxiety and I try to determine at which level I am experiencing. It was not until adulthood, I received therapy and medications to combat these symptoms. One thin, in particular, that was beneficial was a book given to me by my therapist called The Worry Trap by Dr. Chad LeJeune. “ LeJeune says that it’s important to learn how worry works. Imagine you’re hiking along a cliff, he says. Your brain tells you “I might fall,” and you picture yourself falling. This thought helps you realize that you need to be extra careful about where you’re walking. This is “a helpful thought to have,” he says. However, “when your anxiety is high, you’ll experience that image not as ‘I might fall,’ [but as] ‘I will fall.’” With heightened anxiety, “we are less able to discriminate [between] the thought that might happen” and the reality. This is called “cognitive fusion,” when “a thought becomes fused with what it refers to.” We experience a thought “as a reality, an almost inevitability.”

Kelsey:
I pulled my hamstring in high school, and anxiety also reminds me of caring for that injury. At its worst, I sought medical help and treatment (both with my hamstring and my anxiety). After learning to manage it on a daily basis, it sometimes flares up, but I know that I need to take extra care in certain situations. To compare, for my hamstring that looks like stretching before a dance class or after a strength training session. For my anxiety, it means I practice self-care before and after a particularly stressful event. My management of anxiety (and also my pulled muscle) has created an awareness that currently is mostly preventative. I know that if my anxiety worsens or interferes more with my daily life, I can and will seek more help. I currently practice deep breathing and relaxation, as well as engage in activities that I enjoy, such as working out, playing guitar, or spending quality time with friends and family. I also reflect on my own thinking. A therapist taught me about cognitive distortions and how at times, my brain is reinforcing my negative thinking and anxiety by distorting what I am experiencing. ( https://psychcentral.com/lib/15-common-cognitive-distortions/ )

I self-evaluated which cognitive distortions my brain was often doing, reflected deeply on what aspects of my life trigger my anxiety. To combat the cognitive distortions I experience, I use positive self-talk to help evaluate how I’m doing in terms of experiencing stress and life as it is, without letting my “anxiety brain” take over. For example, a colleague at work once made a comment about my age, and assumed that I had less experience than I did. My anxiety brain and distorted thought pattern experiences this comment as: This person thinks I am young. They do not value my experience. If this one person thinks this, many people at work probably think this. Perhaps everyone thinks that I am young and inexperienced, and I am not valued. I’m working on flipping comments from disempowering to empowering. It can be difficult, but in this situation I could think it was possible that I do look young, objectively, and that perhaps I seem eager to learn and try new strategies, a quality that some might attribute to being young. It’s a work in progress.

ON A FINAL NOTE

Amy and Kelsey have both worked with qualified professionals to help determine and reflect on the root of their anxiety. We would encourage others to seek help from a therapist or psychologist to provide insight into your particular situation. It is helpful when those around you have an understanding of what I experience as an anxiety sufferer.

7 things an anxiety sufferer wants friends and family to know:

1. Just because you don’t understand it doesn’t mean it doesn’t exist.
2. I am embarrassed and ashamed that I cannot do the things you can do.
3. I don’t like feeling this way.
4. I don’t use anxiety as an excuse.
5. Stress can make my anxiety much worse.
6. I know many of my fears are irrational.
7. It’s okay if you don’t know what to do.

Originally published at challengethestorm.org.