Last month my son spent his school break in the Bahamas with his father. I suppose a benefit he gets as a child of divorce is twice as many vacations, much like double the Christmas presents. What this means for me, however, is half the time spent with him and twice the amount of time worrying about him.
I’ve gotten used to the weekends away and splitting up holidays, but something about vacations sends me into a downward spiral of anxiety and panic. I think my own fear of flying comes into play whenever he gets on a plane. I also think the extended period of time away from him forces me to give up that much more control, something I’m not good at.
This last trip was no different. My anxiety levels were high in the days before he left and intensified during his time away. Trouble sleeping, intrusive thoughts and irritability were all among my symptoms. The day he was flying back, as he was in the air, we were experiencing an intense thunderstorm on the ground. I took one look outside and my heart began thumping in my chest; I felt nauseated, detached. I was having a conversation with my boss at the time it started and was able to maintain a fairly normal demeanor even though inside I was completely freaking out. It intensified before it got better, but just as quickly as it came on, about 15 minutes later it was gone—just like the storm itself.
I’ve spent a lot of time learning how to navigate anxiety and panic attacks over the last year and have found a few things that have helped me. It doesn’t stop them, it just gets me through them a little more quickly and often helps to make them feel less severe. Before I share some of the techniques I’ve learned, let’s first make the distinction between “normal worrying,” anxiety, and panic. To do this, I sat down with CHD’s Director of Psychiatry, Dr. Jalil Johnson.
Worrying, or “normal worrying,” can be helpful and may even make us productive and keep us safe. For example, a person may worry about disappointing their boss at work, inability to keep their child on a bedtime routine, or whether or not they filed their taxes correctly. Psychological symptoms may include, but are not limited to, difficulty concentrating or remembering, nervousness, restlessness, or feeling tense. These symptoms can be upsetting, but they are relatively benign. Most people experience normal worrying to some degree or another. However, if a person is unable to stop worrying, or if these worries start to affect a person’s ability to function or their relationships, they may want to consult with a healthcare professional.
“Humans have large complex brains, and with a large brain comes the ability to imagine things, events, or circumstances that haven’t happened. This ability allows us to be creative and solve problems. It also allows us to experience emotions like anxiety,” explains Johnson.
According to the National Alliance on Mental Illness (NAMI), 19% of U.S. adults have an anxiety disorder.
Anxiety attacks are typically related to fear of a particular thing, situation, or problem. The symptoms of anxiety arise when a person thinks about these things and may include worry, restlessness, and irritable mood. Physical symptoms may include, but are not limited to, palpitations, elevated heart rate, headaches, sweating, and stomach aches. Some minimal or mild anxiety symptoms, related to stressful or fearful things, would be considered a normal psychological reaction. Depending on the frequency and intensity of the symptoms a person may be able to remain functional in their tasks and relationships despite their anxiety symptoms. If a person experiences anxiety symptoms that are persistent or start to affect a person’s ability to function or manage their relationships, they should consult with a healthcare or mental health professional.
Panic attacks are intense episodes of high anxiety, associated with fear or dread. They can also develop spontaneously, or they can be triggered by a real or imagined event. Despite the feeling of imminent danger, panic attacks are typically not associated with any danger or threat of danger. The symptoms a person experiences during a panic attack are akin to the body and mind reacting in a fight-or-flight response, without the need to fight or run. During a panic attack a person may feel detached from reality, terrified as if they have lost control, as well as a sense of impending doom or fear of death. Physical symptoms may include, but are not limited to, trembling, shortness of breath, nausea, chest pain, headaches, and rapid, pounding heartbeat. Generally, panic attacks affect a person’s ability to function, and may affect their relationships with others. These kinds of episodes are not useful, as the physiological and psychological effects do not serve any real function. Therefore, a person who experiences panic attacks should consult with a healthcare professional.
Treatment for all types of anxiety include non-pharmacological therapies like diet, exercise, meditation, and mindfulness exercises. For some people, especially those with intense anxiety symptoms or those with underlying or co-occurring mental health conditions, they may benefit from psychotherapy. Additionally, people may require medication to help manage their symptoms. Regardless of which type of treatment modalities a person decides to use, anxiety symptom management should be balanced and tailored to the individual.
Personally, I have benefited from a combination of psychotherapy, medication, and non-pharmacological mindfulness therapies like the ones below. These are a great place to start for anyone who is experiencing any type of anxiety symptoms. The following have helped me through some difficult situations. I hope that they can be useful tools for you too.
- One of the most powerful things I’ve been able to do to control my anxiety/panic is name it—literally give it a name. Mine is named Fred. Fred is a bastard—no offense to any Freds out there. I don’t know why I picked that name in particular, it could have been any name, but to be able to call it something allowed me to speak to it. I can recognize when Fred walks into the room and tell him he’s not welcome. “Uh oh, what’s happening?… Oh, it’s just Fred again. Go home, Fred.” Naming my anxiety and speaking to my panic provides a lightness and humor to a very serious feeling which helps make it all a little less scary.
- Breathing exercises are one of the simplest, yet easiest ways to alleviate symptoms. Although there are many that work, I like to focus on one that can be done anywhere. We’ve all heard “take a deep breath” and while inhaling deeply controls the fight-or-flight response, it may not always calm you down. When we feel anxious, sometimes breathing too much can result in hyperventilating and actually make symptoms worse. It’s all in how you inhale and in lengthening your exhale. Exhaling is linked to the parasympathetic nervous system, which influences our body’s natural ability to calm itself down. Try exhaling for longer than you inhale. I like inhaling for four seconds, exhaling for seven. And remember to breathe from your diaphragm. This is sometimes called “belly breathing.” It reduces the amount of work your body needs to do, avoiding the risk of hyperventilating.
- Journaling may not be something you are able to sit down to do while in the midst of a panic attack but it’s something that helps when those anxious feelings begin to creep in. Writing can help the anxiety from building up to an attack. I know that the thought of keeping a journal can actually induce anxiety in some people, but remember you are the only one who is going to read it, and even you don’t have to. I’ve known people who write and write through their feelings only to rip the pages out and throw them away! Treat yourself to a lovely journal and the next time your thoughts start to go somewhere unwanted, purge them onto the paper. Allow it not to make sense, to be grammatically incorrect, to be messy, to have doodles all over it—it doesn’t matter! Just purge the thoughts from your mind and agree that once they’re down on paper, you don’t have to think about them again for a while.
- Practicing meditation and mindfulness can be very helpful. There are so many techniques out there, so it’s about finding the one that’s right for you. It’s easy to be hard on ourselves for having feelings of anxiety and panic. Our minds are quick to judge and think “What’s wrong with me?” Practicing self-compassion is essential. I was introduced to mindfulness and compassion by my therapist through a meditation called RAIN. The acronym was first coined twenty years ago by Michele McDonald, a teacher of Vipassana, one of India’s most ancient meditation techniques. Today, RAIN is an easy tool recommended by meditation teachers and therapists alike as a helpful approach for practicing mindfulness and steering us through challenging emotions.
There are four steps:
- Recognize what is going on.
Consciously acknowledge the thoughts, feelings, and behaviors that are affecting you.
- Allow the experience to be there, just as it is.
Usually during a difficult experience, we judge ourselves, try to numb our feelings, or distract ourselves by focusing our attention elsewhere. By pausing and relaxing our resistance, we acknowledge and accept the reality of our experience in the moment.
- Investigate with kindness.
Investigating directs a more focused attention to our present experience. Pause to ask what is happening but with a deeper curiosity. What am I believing right now? What does this feeling want from me? Once you have investigated, remember the kindness part. Respond by offering yourself love and compassion. I often whisper to myself “Everything is going to be okay” or “This will pass.”
- Natural awareness, which comes from not identifying with the experience.
There’s nothing specific to do in this last step. Each time you practice the steps above, when you slow down and recognize your feeling – this is fear – this is hurt – this is judgement, you begin to break the old habits, these old limiting thoughts and feelings. You’ll gain a natural awareness of yourself separate from your thoughts and develop a compassion and love for your true self.
These are just a small sample of the many non-pharmacological therapies like diet, exercise meditation, and mindfulness exercises that can aid in the treatment of anxiety and panic symptoms. The key is to introduce these ideas into your routine and practice them regularly before panic or anxiety strikes so that you are as prepared as possible to use the tools you have when you need them the most. As helpless and powerless as you may feel during times of struggle, remember you have the tools and the strength that it took to make it through your last attack. You are brave, you are strong, you’ll make it through. You always do.
If you are looking for ways to help control your anxiety, please reach out today to speak with a caring and compassionate CHD counselor. 1-844-CHD-HELP.