Q&A: Anxiety and panic attacks

Patient: I was just diagnosed with anxiety and panic attacks. What do I do?

Therapist: I am sorry to hear you are suffering with anxiety and panic attacks and hoping that you are under the care of a collaborative team made up of a medical doctor, psychiatrist and mental health professional.  The combination of such care should hopefully alleviate your symptoms and help you understand the causes and the triggers of your diagnosis. I would strongly recommend being under the care of a mental health professional as it should not be overlooked and important in learning about yourself as well as practicing the tools to manage your symptoms.

 

Why can anxiety make you feel sick?

Anxiety can often have physical symptoms that do leave one unwell and sick. It is one of the many ways that it manifests in our bodies. Symptoms of anxiety include:

• Feeling nervous, restless or tense
• Having a sense of impending danger, panic or doom
• Having an increased heart rate
• Breathing rapidly (hyperventilation)
• Sweating
• Trembling
• Feeling weak or tired
• Trouble concentrating or thinking about anything other than the present worry
• Having trouble sleeping
• Experiencing gastrointestinal (GI) problems
• Having difficulty controlling worry
• Having the urge to avoid things that trigger anxiety

If you are experiencing any of these symptoms I would recommend getting in touch with a mental health professional who can help you further.

Managing Anxiety and Stress

Last week I wrote an article about understanding anxiety which you can find here on my website. Today we will talk about ways to manage it.

When you care about someone who has pervasive challenges with anxiety, it can sometimes feel helpless.  It can be difficult to assess what provokes anxiety at times, especially if there is no clear trigger for it. Sometimes there is a discernible theme, but not always.

Anxiety Signs and Symptoms

Anxiety shows up differently for different people. Often there are common traits however, and these might indicate that you or a loved one are experiencing anxiety.

Increased heart rate:

While this is more of an internal indicator, it is a very common symptom of an amped up, physiological stress response. Increased heart rate has a purpose; it puts us on alert, prepares us to act quickly to protect ourselves from the stressor at hand.

Hypervigilance:

In most day to day situations, we don’t require our high-alert systems to be activated. Anxiety tells us to ‘get ready’ even when there is no real danger. When we become hypervigilant, it heightens our awareness of every little thing. This can be overwhelming, especially when combined with other symptoms.

Obsessing on subjects:

Anxiety can feed into worry thoughts. Often with anxiety, there are particular topics that our minds can get stuck on. If there are areas of our lives in which we feel particularly out of control, the anxious mind may perseverate on these topics in an effort to problem solve.

Sleep issues:

Anxiety often interferes with sleep. For some, sleep initiation is the only problem, while others fall asleep fairly well, but wake frequently during the night. Insomnia due to anxiety is mostly connected to the overtaxed inner alert system and being unable to shut off the worried mind.

How to Help Anxiety

Click here to read the remainder of this artince on my website.

Q&A: Anxiety and Habits

Client: Can thinking anxiously turn into a habit and personality?

Therapist: This is an interesting question and can be answered in many different way. Consistent worrying and anxious thoughts can lead one to be predisposed to anxiety disorders that do affect the personality.  It’s normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that are difficult to control and interfere with day-to-day activities may be a sign of generalized anxiety disorder.

It’s possible to develop generalized anxiety disorder as a child or an adult. Generalized anxiety disorder has symptoms that are similar to panic disorder, obsessive-compulsive disorder and other types of anxiety, but they’re all different conditions.

Living with generalized anxiety disorder can be a long-term challenge. In many cases, it occurs along with other anxiety or mood disorders. In most cases, generalized anxiety disorder improves with psychotherapy or medications. Making lifestyle changes, learning coping skills and using relaxation techniques also can help.

Generalized anxiety disorder symptoms can vary. They may include:

• Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events
• Overthinking plans and solutions to all possible worst-case outcomes
• Perceiving situations and events as threatening, even when they aren’t
• Difficulty handling uncertainty
• Indecisiveness and fear of making the wrong decision
• Inability to set aside or let go of a worry
• Inability to relax, feeling restless, and feeling keyed up or on edge
• Difficulty concentrating, or the feeling that your mind “goes blank”

Physical signs and symptoms may include:

• Fatigue
• Trouble sleeping
• Muscle tension or muscle aches
• Trembling, feeling twitchy
• Nervousness or being easily startled
• Sweating
• Nausea, diarrhea or irritable bowel syndrome
• Irritability

Your anxiety, worry or physical symptoms cause you significant distress in social, work or other areas of your life. Worries can shift from one concern to another and may change with time and age.

I would recommend being under the care of a mental health professional so that you may understand your symptoms better and learn how to manage them.

Understanding Anxiety

Do you remember the last time you felt anxious?

It was probably in response to something going on at the time; maybe a stressful event at work or a situation in your personal life. Anxiety is a normal emotion. Each of us experience it in our lives at varying points, to varying degrees.

Not only is it a normal part of the human experience, it is responsible for our survival at times. We flee from dangerous situations because we experience fear or a pervasive sense of anxiety that something is about to go wrong. A little bit of fear is healthy.

When fear take center stage in one’s life, it can cause an array of problems.

For people with Generalized Anxiety Disorder, the distress of it is a regular occurrence and can have devastating consequences such as relationship tolls, career issues and interpersonal problems.

Symptoms of Anxiety

Symptoms of Generalized Anxiety Disorder can vary. Often there are clusters of symptoms. You may experience some, and not others.

Physical symptoms:

While physical symptoms can vary, people frequently experience heart racing, shaking or trembling hands, sweating, lightheadedness or feeling overheated. Sometimes people get shortness of breath and tingly feelings in different parts of the body. Often people get physically tense and stomach can feel tight or nauseated.

Feelings:

Sometimes people experience an intense sense of dread or a feeling as if something bad is about to happen. Some people describe a fear of “going crazy” or feel detached from reality for a brief period of time. This sense of detachment further exacerbates the feeling of being out of control, which increases the sense of urgency and confusion.

Thoughts:

Anxious thoughts are generally centered around ‘what if’ thinking. These thoughts can take many forms, including excessive worry and thought patterns that reiterate a particular set of fears. Such thoughts can be very challenging to shut down. If often takes deliberate steps to push through anxious thoughts and reduce distress.

Do’s and Don’ts:

Click here to read the remainder of this article on my website.

Q&A: How do you know when you need a therapist for anxiety?

Therapist: This is a great question and thank you for your honesty.  It is a personal choice whether or not to seek counseling for mental health issues as sadly there is still a great stigma attached to it.  Self awareness and personal growth are an investment in self and never a waste of time and I would encourage anyone who experiences any level of anxiety to seek professional help.  A good therapist will provide a safe environment to explore the issues that are triggering your anxiety and will work with you to give you tools to help manage it better.

Q&A: Can headaches and backaches be anxiety related?

Therapist: Thank you for your question.  Backaches and headaches can absolutely be a symptom of anxiety and triggered by stressful situations.  Our mind and bodies communicate with each other and send internal messages to prepare us for fight/flight syndrome which has been a part of our evolution.  Even though we have evolved in our societies, our core responses remain the same. Many symptoms of anxiety left untreated manifest in psychosomatic symptoms such as backaches and headaches and although medical treatment may help the physical symptoms it does not tackle the problem and the origins of it in the first place.  My initial recommendation is to seek medical treatment followed by professional counseling if symptoms are not resolved.

Q&A: How do I know if I am having a panic attack?

Therapist: A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you’re losing control, having a heart attack or even dying.

Panic attacks typically begin suddenly, without warning. They can strike at any time — when you’re driving a car, at the mall, sound asleep or in the middle of a business meeting. You may have occasional panic attacks, or they may occur frequently.

Panic attacks have many variations, but symptoms usually peak within minutes. You may feel fatigued and worn out after a panic attack subsides.

Panic attacks typically include some of these signs or symptoms:

• Sense of impending doom or danger
• Fear of loss of control or death
• Rapid, pounding heart rate
• Sweating
• Trembling or shaking
• Shortness of breath or tightness in your throat
• Chills
• Hot flashes
• Nausea
• Abdominal cramping
• Chest pain
• Headache
• Dizziness, lightheadedness or faintness
• Numbness or tingling sensation
• Feeling of unreality or detachment

One of the worst things about panic attacks is the intense fear that you’ll have another one. You may fear having panic attacks so much that you avoid certain situations where they may occur.

Panic attacks are terrifying and can create havoc on our mental and physical health.  If these symptoms are familiar, I would recommend getting help from a mental health professional as soon as possible.

Q&A: Stress and Weed

Client: I am stressed easily between work and personal life. I find using drugs helpful because it calms me down. I smoke a joint on regular basis and occasionally use harder drugs as needed.  I feel like I am becoming more and more reliant on them than anything else. 

Therapist: Thank you for your question.  Normal use transforms into dependence and addiction when it becomes pathology. Something is considered ‘pathology’ when it deviates from a healthy norm and negatively impacts one’s’ life.

Our typically benign behaviors (having a drink with dinner, catching up with friends on social media or having sex with our partner) is perfectly fine until it becomes a drive to indulge beyond the norm and causes problems in life.

When a substance or behavior becomes a primary focus and other important parts of life are disregarded, it has transformed into addiction. Pay attention to the frequency, duration and intensity of your behavior.

Dependency and addiction include an element of obsessiveness and urgency. Being “able to quit” for a short time doesn’t mean you are in the clear.   Do Involve a therapist or professional addiction counselor to help you process the thoughts and feelings that emerge.

 

Q&A: Business Travel

Client: Hello. I travel often for work and find myself at a bar of some sort on most evenings.  I usually just have 1-2 drinks but recently finding that its double the amount. My work life is stressful and I have anxiety so I find the alcohol relaxes me and takes the edge of but I don’t know what else to do?

Therapist: Thank you for being honest and sharing your concern with me.  One of the most important things to do is to challenge oneself and ask the unmet needs that the behavior is trying to cover up.  If the addiction meets a need for escape from depression or anxiety, alternative treatments may be helpful. There are endless coping strategies  that can be used to manage anxiety and stress levels.

By explored the purpose our behavior serves, we begin to wonder why the the behavior is so appealing.  Once these underlying needs are identified, alternative behaviors can be found.  

Q&A: Recreational Drug Use

Client: Hi.  I am a recreational user of cocaine on weekends and don’t feel like it it is causing me any problems but I am wondering if regular use will lead to addiction? Should I be concerned?

Therapist:

Thank you for your question.  The general answer will differ based on each individual’s impulse control and addictive behavior patterns.  By nature, drugs can be highly addictive due to the increased stimulation and dopamine levels which leave you feeling elated.  Dopamine reinforces the behaviors since it is a pleasure hormone of the brain.

Addiction can comes in many forms.  Most addictions begin as casual use and offer a soothing distraction from a difficult circumstance.  The behaviors starts as a well deserved break but somewhere along the the way it shifts from being a choice into a need.

Individual or group therapy options can be a helpful way to work on recovery from addiction.