Tag: how to stop a panic attack

How Does Exposure Work For Anxiety? Habituation vs Inhibitory Learning (Podcast Ep 226)

 Drew Linsalata This week on the anxious truth. We’re going to get a little geeky with it. We’re going to talk about how exposure works. Why sometimes? It only works part of the way and you wind up prone to setback or relapse. We’re going to talk about habituation versus inhibitory learning. I promise not to get too technical. We’re going to keep it friendly. Let’s go Hello. Everybody welcome back to the anxious truth. This is podcast episode number two to six recording in September of 2022. I am Drew Linsalata creator and host of the anxious truth. If you are new to the podcast or the YouTube channel and have just stumbled on the anxious truth is the podcast that covers all things: anxiety, anxiety disorders, and anxiety, recovery. Welcome. I’m happy you’re here, And I hope you find it helpful If you are a returning listener or YouTube viewer. Welcome back, Always happy that you’re here. Thank you for your continued support. Today we are going to talk about the mechanics of exposure, how exposure works sometimes and why sometimes it doesn’t work fully and why some people wind up in setbacks, and how we can maximize the value of our exposure. Essentially, this was requested by a lot of people when they asked about the difference between habituation and inhibitory learning, So it’s gon na get a little bit technical and a little bit geeky, but I’m such a nerd about this stuff. I dig this way back in school, at the masters level, to go through all of this stuff, But I promise I’m going to keep it a little bit friendly and that we’re not going to get too technical here. I’m going to keep it within the context of recovery, So before we get to the meat and potatoes of the episode, I just want to remind you that the anxious truth is more than just this. Podcast episode There are 200, something other free, podcast episodes. There’s a bunch of years worth of free social media content. There’s my free morning newsletter and podcast called The Anxious Morning. There are three books that I’ve written about anxiety and anxiety disorders and recovery. There is a free one-hour recovery, one on one seminar and there is a webinar that I do every month with my friend Joanna hardest. She’s an anxiety and OCD specialist from Cleveland. We do a webinar on the art of distress, and tolerance. All of those things are the anxious truth. Com Go check them all out. If you are already reading my books and you’re digging them maybe head on over to Amazon and review them for me, it helps me out And if you are enjoying my work, it is helping you and you would like to help to keep it Free of sponsors and advertisers All the ways that you can do that are at the anxious truth, com support. It is never required, but always appreciated, And thank you guys for all the different ways that you support my work. I appreciate every one of you So let’s get into this habituation versus inhibitory learning, So we know about exposure and we know about going toward the things we fear and not avoiding or trying to escape. We’re not trying to engineer our life so that we never get triggered. We know that exposure is an effective tool when it comes to anxiety disorders. We’re going to start from that premise because we know this to be true, But how does it work? I’m going to give you the TLDR. It the too long and didn’t read if you want to stop listening now ready Here. It is Old school exposure based on habituating to anxiety, which is all about learning that you’re, okay, as long as anxiety decreases or disappears Now that sort of works, But it leads to a fragile state of recovery and frequent relapses and setbacks. Current models of exposure are, in many cases a little bit harder. They’re a little harsher, but they’re based on learning that you are okay and can handle it even when or if you get anxious or panic. That leads to more durable and wider states of recovery, So habituation will get you to I’m okay. As long as I don’t get anxious, whereas inhibitory learning we’ll when we allow it to happen, we’ll get you to. I’m no longer worried about being anxious. It doesn’t matter Now, which do you think is better? I can tell you this when you encounter a fully recovered person that does not experience relapses or setbacks. You’re talking to somebody that wound up with the second result, not the first Alright, so that’s like the Reader’s Digest version of this episode. If you want to hit the eject button, go ahead and do that now, But we’re gon na get more detailed, So this can get super technical and geeky as I said, but I’m not going to get technical and geeky on you here. Now I could link a bunch of research papers in the show notes for this episode, which will be at the anxious truth com two to six, But that is probably a bad idea, And here’s, why. I know that many of you listening wind up almost obsessively researching recovery techniques and methods reading and reading and trying to make sure that either you have the best way to guarantee that you are doing it right because you need to do it right to Try to guarantee that you absolutely will recover or to get immediate relief. It can be way too easy to dig yourself into a ditch and a hole based on obsessively trying to research recovery and get it exactly right. So you can Google on your own. If you must, but I’m going to say if you are prone to that kind of habit, Please sort of think twice about doing that. Alright. So a few important points point that we want to get into here I’m working from notes today, which is a little bit unusual, but it is a little technical. So I want to make sure that I hit all the points So exposure. Let’s talk about exposure Exposure is not the thing that you are doing: right, driving, walking staying home alone, or holding a knife in your hand that’s not the exposure. The exposure is to the sensations, thoughts, and emotions that you will experience when you do those things right. So nobody listening to this podcast is using exposure to learn how to drive again or to walk to the park or nobody’s. Doing listening to the podcast to learn how to stay home alone or to hold a knife, We’re learning, and you’ve heard me say this so many times, probably sick of it. By now, we’re learning how to relate differently to the way we feel when we do those things. This is important, right? Keep this in mind as we go through this podcast episode. The exposure is the anxiety, the symptoms, the thoughts, the sensations all of those things, the emotions that are the exposure. We only use driving staying home alone, and holding a knife to trigger those things. So keep that in mind. Exposure is about coming into contact with good exposure right Where we’re going to try to leverage the mechanism mechanism of inhibitory learning. Good exposure is about coming into contact with those sensations. Those scary thoughts, then the emotions, the feelings, the symptoms, or trying to come into contact with those things, while also resisting the urge to perform safety rituals or compulsions that you are hopeful will take away the bad feelings And the fear that, because you hate that right, So what are some examples of that would be going home when you panic at work, if you’re out trying to practice driving turning the car around when you get anxious, while you’re driving and going home like exiting the exposure, only Doing certain things with a safe person Using safety devices like men,’s or snacks, or essential oils or ice packs, or always having had water with you in case you get anxious Another one would be automatically calling somebody a partner or a friend or somebody to Have them talk you through? If you get anxious And the last one is, I mean I’m involved in this one instantly. Turning on a podcast episode, when you get anxious, If you start to feel yourself panic, if you immediately run for your favorite episode of the anxious truth or your anxiety, toolkit or the panic, pod or all the hard things, whichever podcasts you like, if you immediately Run to a podcast episode that’s a safety and escape behavior right. Do you do any of those things? So let’s talk about those things that speak to the idea that when I do difficult things I’m trying to make my anxiety decrease. I need to make it a lesson that speaks to habituation Right? Habituation is a natural process, humans and animals habituate. So the idea of habituation is that you start to get used to it right When we looked at exposure based on habituation getting used to something so so that your reaction to it decreases. We kind of had that right, But we were missing some important parts of the puzzle And when we looked at some of that, when I say wave the royal way, everybody in the behavioral sciences and clinical circles, not me and you. But when we looked at this stuff over time, we started to see that hey CBT is super effective, like old-school CBT. That was just you know, exposure get used to it, get used to it, and then it goes away. When we looked at the success rates there, they were way better than other forms of therapy. True but then the relapse rate was pretty high Right, So the relapsing setback rate was pretty high with that And what is the situation we find ourselves in now? Is that a lot of people, because they tried to get a basic understanding of exposure like okay? I get it, I just have to do the things. So if you think that exposure is just doing things, then you are kind of accidentally relying on habituation. You expect that, if I do it, then anxiety will lessen over time because I’ll get used to it And yes again, that happens. Habituation is part of this for sure all the time, But that’s kind of an old-school way where exposure was done incrementally Sounds familiar right? Lots of repetition Sounds familiar, but more simplistically, simply trying to get someone acclimated or habituated to anxiety. So if you are hoping that you can just keep pushing through your exposures and engineering them so that they are as easy as you can make them and remember our list of safety behaviors, then you are purely banking on habituation to get you to a recovered state. What’s the problem with that? This often leads to partial recovery or good enough recovery. The acceptable bubble you hear me talk about this is where you can do most of what you need to do and manage life daily. You’re not completely restricted anymore, but you’re usually doing that with a big set of conditions and restrictions. So I’ll get I’ll. Give you a couple of examples. I can do the school pickup now, But if I’m having a really bad day, my partner does it. I bet this one. I can stay home alone now As long as they know that they’re or someone around that. I can call in case. I get anxious or have at this one I’m pretty good at handling my intrusive thoughts now, But I still can’t watch any movies that have babies in them or I spiral Right So that’s sort of good enough recovery. Partial recovery is acceptable, but a bubble recovery that kind of recovery has a limit. And when you cross that limit, you often experience anxiety and fear again, which you then think you can’t handle, because you’re not used to it in those contexts across your limit lines right? So a partially recovered person does some things with conditions but refuses to do other things because of how they might feel if they do them A partially recovered person just got used to it by powering through over and over and over or learned how to make It stop or lesson will tell you that they are okay in the supermarket, but still can’t go to the movies and are afraid to try So fear extinction, which is like an old term that we used to use you’re trying to make Your fear go extinct Based on habituation, tends to be very specific like habituation is okay, But it essentially teaches us that we are okay as long as we can be sure that anxiety won’t be there or it won’t last very long, And we see this when a partially recovered person may experience one or two episodes of intense anxiety and then winds up in a setback or relapse. Now, as a side note a little bit of geekiness that I’ll throw in here, we kind of know that we never actually unlearn our fear right? That’s, not a thing. I know we talked about that And I mean other literal people who are sort of building a brand on unlearning anxiety, but you don’t unlearn that fear response, So that response is kind of coded permanently in your brain once we learn it and we Have experiences that are associated with that response And this kind of helps to explain how sometimes setback and relapse are so easy for people to fall into to some extent right. We’re, not unlearning our fear. What we are doing when we recover is that we are learning new ways to relate to it and new ways to handle it and new ways to get through it And those new pathways get encoded into your brain alongside the old pathways. So you will still kind of have that fear for the rest of your life, But that’s, okay, Because now you have stronger pathways that you can travel down in your brain is a gross oversimplification just for visualization purposes. When, when it comes up, I can pick that pathway as opposed to the old one, but the old one is still there. We never actually unlearn it if you will erase it. So if we’re aiming at fear, extinction, or making your anxiety go away, relying solely on habituation, getting used to it, just repeating it enough, so that you get used to it, makes for a bit of a fragile state, full of conditions and prerequisites for being. Okay See the problem there So now let’s go into inhibitory, learning, enter inhibitory, learning, So inhibitory, learning, isn, ‘t so much concerned with making anxiety go away as it is concerned with teaching us that we can tolerate and navigate through anxiety when it happens And at this point, you’ve got to be sick of hearing me say words like tolerating and navigate You’ve heard me say them 1000s of times, but now you’re starting to understand the reason. So let’s bring it back to some of the things you hear me talk about on this podcast And you see me write about all the time when you hear me talk about changing your reaction to anxiety and fear or giving up the fight or surrendering All those words that I use all the time, Where are we are in inhibitory learning territory there. When you hear me tell somebody to mix up their exposures and have varied experiences, because that’s most effective, We’re banking on the mechanism of inhibitory, learning right, it works better And again. This is a lot of research on this. It works better when we have a varied range of experiences to work from When I tell you to be incremental and keep adding difficulty to your exposures over time. We need them to be difficult. We’re leveraging the power of how inhibitory learning works in your brain And when this is a big one when and it’s a big one. To me, to be honest with you, When I plead with you when I’m practically begging you to take the lessons that reality hands you, and I did an entire podcast episode on this one. I’ll link it in the show notes because I don’t remember which one it is When I beg you to. Please take the lessons that the universe hands you after an exposure that nothing happened, except that you were afraid and had thoughts and sensations. I am pointing you in the direction of inhibitory learning when you refuse to take that lesson Yeah, but I had I was anxious I was afraid, but I panicked You’re, you’re saying I can only be okay. If I don’t panic – or you can only be okay if it decreases, You’re, relying on the fact that you might get used to it That’s the habituation model, I’m simplifying. But when I tell you, no, you it doesn’t matter. You just have to take the lesson that said you’re afraid, but nothing bad happened. I’m trying to get you to move closer to the way your brain works in terms of inhibitory learning, So it’s important for me. I think to say that inhibitory learning it’s not so much a technique like this isn’t a technique. It’s, not a method. Inhibitory learning is not a method. It’s more of a model that we came up with to describe how brains achieve a wider and more durable state of recovery. I’m relating it to recovering from an anxiety disorder, so be careful. Like don’t go to a therapist and say: do you do inhibitory learning here I mean a good therapist who specializes in anxiety sort of should understand what you’re saying, But they would correct you like inhibitory learning is not a therapy. It’s. This is not a therapy type, It’s, not a method. It’s not a technique. It’s a model that we use to describe what’s going on in our brains. When we learn more deeply and effectively that we’re okay – And we can get better that way, Alright, it’s a different way to get better And our brains are. We can do it. We just have to make sure that we do things that use the power of our brains to be able to do those things. So this is not so much about guaranteeing that your fear goes extinct, which would be the old way, But rather it’s about knowing that. Even if you do wind up afraid, you’re still, okay And you can move through and past that. This is why, if I have a rare panic, sell panic attacks now, but they’re very rare for me. If I have one a comes, it goes. It’s over. I’m, literally not thinking about that panic attack an hour later. I just don’t care, So you know this ties into some of the other things that we’ve talked about, And I just wrote about this in the anxious more newsletter last week. How can I not care? Well, the mechanism of inhibitory learning, if you gear your exposure to take advantage of the fact that your brain can do it, that way, will teach you that you, don’t have to care. So it’s not like you, can just snap your fingers and decide to not care about your anxiety. You can stop trying to do that because it’s not going to work, But when we leveraged the inhibitory learning model and our exposure work and our recovery work, we learned that it’s, okay, to not care anymore right? So it’s really important. That’s, why I say we’re learning this way, newer ways that, even if we do end up anxious and afraid we’re okay can move through it at that moment and then past it going forward in the long term. So then, let’s bring it back to sort of recovery And what that means, Because if we don’t have, we have no way to apply this in what we do, the things we do to try and get better then we’re good at it, So I can give you some hints here and I’m – going to wrap it up in a couple of minutes here. I don’t want to get too long on this one. I literally could go for hours on this stuff. It’s, goofy, I don’t know why I’m so into this, but I always have been So. That explains, I guess why I’m behind this microphone Anyway. What are the hallmarks of exposure and recovery work? That kind of taps into the power of that inhibitory learning process right, So your exposures should be focused on tolerating and navigating through anxiety, not making a decrease. That is huge Because if you’re approaching your recovery, so that’s okay Drew says, I have to do scary things. I’m going to do scary things, But I’m going to try to make them as less scary as possible Because I don’t I’m trying to make the anxiety not happen or happen at a low level. You’re missing the point. You want the exposure to teach you how to tolerate that anxiety and move through it. Yes, even full-blown panic. So some of this, if you’re going to try to gear your recovery work toward this model. Some of that involves an openness to say: if you insist that panic is too much and you can’t do it that way, then that’s – okay, I’m not going to try to convince you otherwise, But you can’t. Have it both ways? You can’t draw a line in the sand and say I cannot tolerate certain levels of anxiety and also want to do this. You can’t have both, So you got to have that openness to accept that this might be true and that what I’m saying might actually work for you And that you actually can do things. You think you can, And you have to focus your exposures on the act of tolerating and moving through anxiety, not trying to make it not happen. So if you’re gon na go drive on the highway today and you’re going to try and find ways to do that without being anxious, you’re missing the point. You want the anxiety you want that to happen, and you want to practice moving through it that’s important. The other thing that you need in your exposure and recovery work is an openness to experience all anxiety during exposures, rather than trying to minimize it, which is what I was just talking about. So we’re looking for exposures that have varied experiences. Now the cool thing is like you can’t just recover, you’re also living your life. So often life will hand us a lot of varied experiences. You can’t very few. People have the luxury of just sitting on the sofa and just doing exposure for a day and then going back and sitting on the sofa until it’s time to do more exposure. You’re gon na be challenged all the time except the challenges that life hands you, even if they are small, take even the small ones that’s fine, and use them to have varied experiences. I don’t care. If you drive every day Now, I did it by driving every day, but I also started doing other Things like what I did Mike And it’s funny cuz. When I wrote the anxious truth, I talked about how recovery will accelerate, But recovery accelerates. When you can take the lessons from one exposure and bring them to the other, that’s when you need those varied experiences, So mix up your exposures, Remember what I said at the beginning of this episode. The exposure is the anxiety and the panic, not the task, So drive walk, stay home alone. Go shopping, go to a pizza place and sit down, have a slice of pizza, whatever it takes, mix them up as best you can Right? So we’re still talking about using, like fear ladder and moving up you don’t go from housebound to a world cruise in two days, But within that fear ladder just mix things up that are in sort of that same difficulty level. It helps Important is super important. We’ve talked about this, the RP part of ERP exposure and response prevention, which all exposure ultimately is ERP, whether you’re dealing with OCD or not resisting the escape avoidance and safety rituals is very important. You can’t, you can’t try to hang on to your meds, your water, your phone, your partner, your safe person, your oils, your ice pack, and also do this. Now, if you are going to hang on to those things to get started, I’ve said this before go for it. I would rather, you see get started and then start to leave those things behind than never. Stop Just know that at some point you’re going to have to leave the safety, the escape rituals, the safety rituals, and those safety devices you’re gon na have to leave the crutches you’re gon na leave him behind. Keep that in mind you’re gon na, have to at some point next thing. The difficulty we need exposure to be difficult. They are supposed to be difficult. That’s the whole point of the exposure, Like one of the things that we know from the research and a lot of the stuff around the inhibitory learning model is difficulty is important, And in fact, a lot of the. If you look at some of the literature in the OCD community, they’ll, they’ll acknowledge that like yeah, we need it to be harder now, So that your life can be easier later. Keep that in mind, But we need your exposures to be challenging If they’re not challenging, then they’re, not exposures Right? So I say this all the time. If you are bored now taking a walk to the park with your kids that’s not an exposure anymore, So it’s good, to go ahead and take the walk. The park, the kids, that’s life. I hope it’s good and you’re enjoying it. It’s a good thing for you guys, But you can’t keep calling it an exposure. So exposures are a difficult thing. We need them to be challenging tiptoeing through life, trying to not be anxious and doing things here and there When you feel good That’s not exposure, So that’s just tiptoeing through life And then the last thing that I’m gon na throw In here is when I wrote the anxious truth, I talked about changing your reactions And the third reaction is the reaction.

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After and in that book, I wrote about the story that you tell yourself and everybody else after the challenge is over. The last thing I’m going to talk about is that it’s an openness to accept the outcome of the exposure based on the fear of disaster not happening rather than how you felt like this is where you hear me say again and again, and it Sounds cruel and it sounds cold and it sounds all of those things. But when I tell you that I don’t care how it felt, I only care what happened That’s, where I am like begging you to see that. I know that it was hard And I know that you were terrified. I know that you thought you were going to die And I know that it felt like you were going to go insane, But you are now here an hour or a day, or a week later telling me that story Because none of those things happened So it’s so important to be open to the lesson that the exposure teaches us, which is that surprise. The thing that you are terrified of will happen. Doesn’t happen That’s so important. Now, if you’re listening to me, you may say, but the bad thing is the anxiety I get And for some people, it’s, not that the anxiety signals a danger because, for most of the community, it’s. Well, I’m terrified to panic, because when I panic, I think I’m going to die or think I’m gon na go insane Or I’m going to pass out or I’m going to have a psychotic break For other people. It’s just No. I don’t think that I’m just afraid of the panic itself, Because the panic itself tells me that I’m failing, I’m weak. I’m broken. I’m less than I can’t. Do this, this shouldn’t be happening, But even if that’s the way, you fear it and you don’t fear, death or passing out or a heart attack. In the end, the panic came and left, And again nothing bad happened. That does not show that you are broken or weak or less than at all. So you’re going to have to begin to accept that lesson that, like oh look, I did that again. I tolerated it again Instead of saying it was wrong for happening knowing I did a great job getting through it, So it’s so important to be open to the lesson that the experience teaches you other than just recounting the experience as a nightmare and something That you never want to happen again. That is so important And it’s why we say all the time we do. Don’t care how it felt we only care about what happened. We only care what happened So that kind of gives you. You know. 25 minutes on the difference between habituation and inhibitory learning and a rough idea of how that fits into exposure work, And I hope near the end here is how you can start to gear. Your exposure and recovery work to take advantage of the inhibitory learning model and not just try to get used to anxiety or make it go away. The key takeaway here is: am I doing these hard things to try to make it go away, Or am I doing these hard things to learn that I can do hard things and it doesn’t matter? If I get anxious that’s, really where you want to be That’s, where I want you to be, I want you there. I know that you’re trying to make it go away. We all want it to go away, But I say all the time go away is a happy secondary effect. It’s a secondary outcome. It’s a happy secondary outcome of learning that you’re. Okay, even if you do panic So please, if you take anything out of this episode, take that you should not be approaching recovery as a way to feel better and make it stop. You should be approaching recovery as a way to learn that it’s. Okay, even if you do get anxious and panic because when you get there and know that you can handle it, no matter where you are or what the situation is, then it starts to go away And it goes away more durably. It goes away across context. You don’t have to worry about like well. I can go to restaurants, but I haven’t gone to the movies yet So I got to do six months where the movie exposure to be able to go. No, you know that I’m okay if I panic in a restaurant, so I’m okay if I panic in the movies It’s, there’s magic in there. There is So that is my 2627 minutes on habituation and inhibitory learning and the mechanics of exposure. Hopefully, it has been helpful. I’ve been looking forward to doing this episode to be completely honest with you, And it was going to be super geeky at first. But I’m pretty proud of the fact that I didn’t get too deep into the technical woods here And I hope that I’ve been able to present it in a way that’s understandable and relatable. More than anything else. More than anything else, So that’s it We are done. This is episode 226 In the book. You know it’s over because of the music, that is Afterglow by Ben Drake. That is a song you hear at the beginning and end of every one of these podcast episodes. If you’d like to hear the whole song or know more about Ben and his music, you can visit his website at Ben Drake, music com. If you’re listening to this podcast on Spotify or iTunes, or some platform that lets you rate and review, the podcast leaves a five-star rating and maybe writes a quick review. If you dig it because it helps other people find the podcast. If you’re watching on YouTube subscribe to my channel, like the video leave a comment, I circle back every few days to interact on YouTube. So if you want to ask the question, I promise I’m gon na see it And I think that’s it Thanks for coming by. I appreciate your support. To find all of my other resources and goodies at the anxious truth com. I will be back again next week with another podcast episode. I don’t know what I’m going to talk about, but I will be here and remember until then. This is the way Unknown. Yeah, you’re doing fine story begins. You got a feeling that you go As found on YouTubeHUMAN SYNTHESYS STUDIO 👀🗯 Attention: Have Real Human Spokespeople In Your Videos Saying Exactly What You Want In MINUTES! 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Anxiety & Anxiety Recovery Frequently Asked Questions / Part 2

 Drew Linsalata: on episode 217 of the anxious truth, we’re gonna do 10 More of the most frequently asked questions about anxiety and anxiety recovery. So let’s get to it Hello, everybody, and welcome back to the anxious truth. This is podcast episode number 217 to one seven were recorded at the end of July 2022. Welcome, I am Drew Linsalata, creator and host of the anxious truth. This is the podcast that focuses on all things anxiety, anxiety disorders, and recovery. So welcome. If you’re new here, welcome aboard. If you’re a returning listener, welcome back. Today we’re going to do part two of our frequently asked questions. These are 20 of the most frequently asked questions about anxiety and anxiety recovery that I encounter in my many years in this community and doing this work that I do. Last week in Episode 216, we did the first 10. So go back and listen to that if you have not. And today in 217, we’re going to do the second 10. The show notes for these two episodes are quite detailed. So you can find the show notes for this episode at anxious truth.com/ 217. And I have included in there all the links to all the other resources and podcast episodes that I’ll talk about here. So go to the anxious truth.com/ 217. And check that out. And while you’re on my website, I would like to remind you that the anxious truth is more than just this podcast episode. There are 200, and somewhat other podcast episodes as a ton of free social media content. There’s my free morning newsletter called The anxious mourning. And there is three excellent books and anxiety and anxiety recovery that I have written that are helping 10s of 1000s of people around the world. So while you’re on the anxious truth.com, check out all of those resources, they’re good, and most of them are free, so go ahead and avail yourself of them. And if you are enjoying my work, and it’s helping you in some way, and you would like to help me keep it free of sponsorships and advertising. All the ways to do that can be found at the anxious truth.com/support. So check that out. Never required, always appreciated. So let’s get into part two of our frequently asked questions. And we’ll get right into it. We’re going to do 10 today. So question one this week is whether recovery is possible, even if you’ve suffered for many years. And the answer to that is sure is this is a short answer. Many, many members of our community can turn things around even after years of dealing with disordered anxiety. For me, it was over 2025 years of my life on and off and three or four major episodes. So yeah, the amount of time that you have suffered with this. I’m not gonna say it doesn’t matter completely, but it is certainly not a reason why you could not get better you can do that. Yes, you may build some habits, but at some point, the hole can only get so deep. And I think that’s what people worry about, like, oh, I keep digging a deeper and deeper hole. I’ve been digging for 20 years. So how am I ever going to crawl out of this hole? That’s not the right way to visualize it. I like to say the hole can only get so deep once you are to the point where you’re avoiding everything your housebound or stuck in one room or you’ve got yourself down to eating only three foods because you’re afraid or you know, you’re super restricted there’s, there’s only so much restriction you can impose on yourself. So assume that the hole has gotten as deep as it is ever going to get. You just start decorating and get comfortable in that hole. you personalize it, hang artwork like you put in a stereo system, and listen to your favorite music while you’re there. So if the hole doesn’t get deeper, you just get more comfortable in it. That doesn’t matter. You can turn this around, it doesn’t matter how long you have suffered, I promise you can get better. I was 20-plus years, 25 plus years. I know people even longer than that, that have dealt with this, and one woman over 40 years. And she has turned things around. She’s well on the way to recovery. So yes. In terms of resources, Episode 124 of the anxious truth talks about that. So you can go check that out. So question number two today? What if I don’t have panic attacks, and I just feel anxious all day? So there are two things that I want to address in this question. First of all, there’s a misconception that people that have panic attacks are somehow calm or not anxious between attacks. And that is 100% not true. Like people with panic disorder, I had panic disorder, I was anxious all day long, too. So if you’re in that boat, and you don’t have panic attacks, the first thing I want you to be aware of is that that’s not necessarily a special condition. And it’s not like people that do have panic attacks, have attacks, and then are calm the rest of the day. It doesn’t work that way. So don’t feel bad about that. Now, being anxious all day can be the result of the same mechanism that drives things like panic disorder, you can start to learn to be anxious just because you’re anxious. And the longer this goes on that becomes part of the puzzle for a lot of people. Like I’m anxious all day long. I can’t figure out why. So now I start to become anxious about being anxious. That’s one of those things or another reason why you might be anxious all day long. And this starts to get into the realm of generalized anxiety or generalized anxiety. disorder. A lot of people that have gad are anxious all day long, but not everybody that’s continually anxious has gad. So really God is defined by excessive worry and focus on external things to the health of your family, your health, doing good at work, not letting people down taking care of everything being perfect being a people pleaser, like those are things where we are trying to control the world to an excessive degree. And that’s sort of the hallmark of generalized anxiety disorder, it’s based on that sort of stuff. And then it gets off the rails and gets carried away. So people with gad can have a general background anxiety that lasts all day long too. So there could be that and then you could also begin to just be anxious about being anxious because you can’t solve the anxiety problem. So it’s not that this is a special thing or it can’t be fixed. Sometimes if you’re the in that gad camp, get a look at some of the underlying things that go with that. Things like excessive worry, overthinking over planning, perfectionism, and people-pleasing, are things that can drive anxiety state, but that you think could be good things about your personality. Gotta look at that. So I talked about this in Episode 119. I had Dave Carbonell on and we talked about generalized anxiety disorder, and episode 148 of the podcast covers this. But if you’re anxious all day long, you don’t have panic attacks. It’s okay, you can still get better I promised. So Question three, how can I drive during a panic attack or anxiety spike, it’s not safe. So this one, I did two podcast episodes that specifically talked about this Podcast, episode number 55. podcast episode number 105. We’re specifically about driving and driving anxiety. So there’s an assertion here that people will make that when you are in a high anxiety state or a state of panic, that you lose control and have no agency anymore. Like some external force rolls in and possesses you and makes you do things or prevents you from doing things. This is a thing that you have to start to challenge has that ever been True? Now, you are most certainly afraid you’re very uncomfortable. But the choices that we make in those moments in an attempt to alleviate that fear and escape from the discomfort are not involuntary. So, when talking about whether is it safe to drive during a panic attack, you have to realize that, yes, a rapid heartbeat during panic is involuntary, you can’t control that, and yes, maybe feeling a little short of breath is involuntary. Yes, feeling nauseous is involuntary. Feeling a little depersonalized is involuntary. That’s all true. But the things that we do to add fuel to that fear, fire, omg omg, calling for help trying desperately to get to a safe place trying to run away from it. Those are voluntary. Those are choices that we make. So you can’t control how you’re going to feel. But we do have some agency in what we do about that. And you have to realize that the uncontrollable feeling or the idea that you will completely lose control of your mind and your body or that you do lose control of your mind and body is you know what you’re doing, and you know what that activity looks like, and you’re calling that uncontrollable. But really, we do have choices, we are making choices to do those things. So it’s important to consider that because that sort of challenges the narrative that says it’s not safe to drive because I lose control. Well, no, you choose to help to fuel a frantic state in your frantic effort to try and get away from the fear. But there is a choice there. And there’s an agency that’s important when you’re talking about driving. And I would urge you to consider another thing. And that is all the times that you have been anxious behind the wheel or experienced full-blown panic behind the wheel, and you have run home with that car or pulled over immediately or got off the highway or the motorway. In all of those situations, you are surprisingly adept at maneuvering your vehicle, even though you’re insisting that you can’t and you must stop maneuvering the vehicle. So sometimes we have to insert a little bit of objectivity here, take two steps backward from that emotional reaction of oh my god, I’m out of control. It’s horrible. And look at the facts like, Am I out of control? Or am I just worried that I will be and have I ever even shown any sign of being unable to control my vehicle? Now, I’m not saying that driving with a panic attack is comfortable or easy in any way, shape, or form and it’s okay to pull over and let it pass. It’s okay. But you got to start to challenge that narrative. But in the end, you’re the only ones that get you’re the only one that gets to decide whether you should drive or not. I can’t tell you Yes, go ahead and drive. I can tell you to start to really try and think objectively about the way you’re evaluating that. And let reality be a bit of a guide. But I cannot tell you now, go ahead and drive you only you can determine that. Again, take a listen to podcast episodes, 55 and 105. And maybe those will help. So let’s go on to our next question. Question five. What if you have a real medical condition? Okay. This is unfortunately, common human beings have medical conditions all the time. More than one thing can be true at a time. So when this happens, you have to remember that you have an actual medical or health issue and can also be caught in the grips caught in the grips of disorder and anxiety, those two things will get glued together, and you will stick them together and think that they are one big giant ball of fear. But really, they are not. So there are two things in the face of a health challenge or a medical condition, that medical the condition can cause actual restrictions, lifestyle restrictions, but it can also cause fear, uncertainty, vulnerability, anxiety, worry, and normal things like human beings that are having health problems will normally experience those states. But then there’s the extra state on top of that. So that’s the medical condition itself and the normal human reaction to that. And then there’s the disordered part that comes on top of that, which is now I am going to excessively worry beyond what is helpful about my health condition. I’m going to try to make predictions, I’m going to write giant horror stories and screenplays in my head about what might happen even though it’s not happening. Now. I’m going to ruminate and worry and ruminate, and worry and research and Google, and I’m going to try to solve this problem in my head. But you can’t, that’s the part that you don’t have to do that part is not required, that part is not helping you in any way. It’s kind of hurting you in terms of mental health. Right? So you have to recognize there are two things, oh, I’m worried right now, I’m concerned, I’m afraid I feel uncertain and vulnerable because of this medical condition. Okay, that’s okay. And that sucks. And my heart goes out to you. But that’s part of being human. But the part where you latch on to it and spend 24 hours a day, every waking moment trying to solve this problem and writing stories about it in your head that’s not needed, then in many cases, your anxiety level goes up, because you’re doing that, and then you’re anxious because you’re anxious. So it’s important to step back again, try to insert a little objectivity, and say, Oh, I see what’s going on here. I don’t have to say, Well, I have a health condition, and it sends my anxiety through the roof. No, I have a health condition. And that makes me feel certain things. And then I am adding on top of that with some of the habits that I think are safety or protection for me. And I can recognize that and begin to tease that apart and start to work on those other habits. So that’s my answer to what if I have a real medical condition, people will often say like, well, I have a real medical condition. So all bets are off to bed like I’m going to have to be an anxious mess. No, that’s not true. Now I did an episode of the podcast with my friend Jessica Seidner. Jessica doesn’t have anxiety disorders, like, as we are aware. But we did a great episode together, where she talked about having to deal with the increased anxiety of breast cancer diagnosis, which came right on the heels of losing her husband. So she had a lot going on with her medical condition and a huge life loss. And her anxiety went up because it normally did. And we talked about how she had to work through that which might be helpful. I also did an Instagram live on this topic, probably a year and a half or two years ago. So again, if you go to the show notes for this episode, the anxious truth.com/ 217. Under this question, you’ll see that link to Instagram. So next question, we are on to question number 6789 10. Okay, so the question, I think five or six, how do you accept anxiety or surrender to it? So this is a question I get every day. And this question is really like other statements in code? This question is really, it’s super scary to surrender. So please tell me how to do it without being afraid or uncomfortable. Right? So there is no way to do this without being afraid or uncomfortable. And I know that’s a glib answer, a brutal answer. It’s it sounds like a cold answer. But we need to confront these things. It doesn’t help us to try desperately to make it easier or fluffy, or it doesn’t work that way. So you also have to recognize that when you ask the question, but how am I supposed to accept this or surrender to it? What you’re doing is insisting that you must continue to resist it. But why? Why do you think you have to continue to resist it? So if you are in this camp right now, where you want to keep asking, but I don’t understand how I’m supposed to surrender, or how I’m supposed to accept it. What you’re telling me is number one, I don’t want to be afraid, which I understand I’m not picking on you for that nobody wants to be afraid. And number two, no, no, no, I How am I supposed to I can’t if I drop all this resistance, then it’s going to come and get me? And my answer is yes. Correct. So how can I accept or surrender is an insistence that you’re not supposed to accept or surrender because you have to continue to fight it and resist it? Because if you don’t, you won’t be safe. And if you want one big step that you can take toward acceptance and surrender, is to face the harsh, brutal, cold reality that all the things that you are doing to resist it, stop it, make it go away. All your rituals and safety behaviors and escape behaviors are doing nothing. Don’t leave a big pregnant pause. They’re lit doing nothing, no amount of tapping your cheeks sniffing oils, drinking cold water popping men’s calling for help snapping rubber bands, chanting, counting backward from 100. None of those things is doing anything because that danger has never actually existed. So in terms of how can I accept and surrender, I will say if I walked up to you and said, I am so tired from having to hold up the moon all the time, but I can’t stop holding up the moon or it will fall to the ground, you would look at me and say, no, no, you can stop holding up the moon, because you’ve never been holding up the moon, it doesn’t fall to the ground, it’s okay, you can let go. The same thing applies here. So the thought that you can’t possibly accept anxiety or surrender it and by the way, acceptance doesn’t mean liking it, do not get confused, you can still hate it, and you can still want it to not happen. That’s all normal and you can’t control that’s human, you’re allowed to be human. Accepting doesn’t mean liking it. But accepting and surrendering means you will drop all of those safety behaviors, all of those resisting behaviors, because you must face the realization that they are doing nothing, they have no impact on your safety at all.  They’re just designed to make you feel different. But feeling different isn’t safer at all, because you’re never in actual danger from feeling anxious. Right? So you’re gonna have to confront the reality behind that question. But how am Did I suppose to surrender or accept? Well, look what those questions mean. So next question is, what exposures can I do get ready for dot dot dot, pick an event, a wedding, a concert, a family vacation, something. And so in the end, this is a simpler answer. You have to remember what exposures are therefore, people think, or they get confused. And they think, Well, I’m learning to drive on the highway. Again, I’m learning to go shopping, I’m learning to stay home alone. Again, you’re not learning to do anything. The only thing that you’re learning to do, which is portable across situations and challenges, and context is learning how to get better at experiencing anxiety and fear. So we only do exposures, do specific things like drive go for a walk or stay home alone or eat food that you’re afraid of. So that it will trigger that anxiety, we were intentionally triggering anxiety, fear, uncomfort, discomfort, uncertainty, all of those things were intentionally triggering them so that you can practice feeling them and moving through them in a new way, a the more productive way that ultimately teaches you that you don’t have to save yourself from them. So if the exposure is not to the event, the task, or the place where the food or whatever the exposure is to the feelings, then every exposure is an exposure that works for other things. Right? So if you’re getting ready to go to, for instance, you’re going to a concert all you got tickets to a concert, how can I expose myself to that? I mean, yes, can you do things that sort of mimic a concert? Yeah, that doesn’t hurt in any way. But remember, you’re only you’re not afraid of the concert, you’re afraid of how you will feel at the concert. So if you want to take a cruise around the world get better at staying home alone for two hours. That’s what I tell people all the time. If you want to go back to work, then get better at walking around your block. Because you’re really in the end, you’re learning a new way to relate to anxiety across all contexts. And if you can adopt this, then you don’t have to worry about specific exposures for every single thing you might have to do in your life, life gets a lot simpler that way. And your recovery starts to become a little wider and more durable. So it’s really important, like think about that. I’m only doing these things because they trigger my anxiety, the anxiety, fear, that’s the exposure, not the task or the place. So let’s move on to the question. You know, in 10. I know which one I want to take, we’re on seven right now. This question is what does this method work if I have trauma too. So first of all, I always have to say this is not a method like I’m not teaching them. This isn’t the drew method. It’s not my method. I didn’t invent any of this. These are just the principles of a cognitive behavioral approach to anxiety disorders. So there are parallels between anxiety disorder, recovery, and trauma resolution, that’s 100% True, a lot of things will look the same. If you’re working with a trauma resolution specialist, some of the things that you would hear would sound a lot like the things that I talked about, but they’re not the same. And the issue here is, let’s assume that you do have a traumatic background and you’ve experienced some traumatic events in your life. And maybe that that trauma did spawn your anxiety disorder that can happen. But then what I always say is that one problem, the trauma has now become two problems. You have trauma and an anxiety disorder. Right? So you have to realize that it doesn’t mean that the anxiety disorder doesn’t count because it’s only the trauma if you had one problem now you have to That’s okay though, don’t freak out. You can successfully deal with both of those issues. A lot of people do, right? A lot of people do that work on both fronts. But traumatic experiences do not mean that the anxiety disorder doesn’t count, so some people are under the assumption that like, well, this all sounds good, but I have trauma. So what you’re saying doesn’t apply to me. Okay, you may have trauma, and I’m very sorry for the things that you’ve lived through. That’s possible. But in the end, if you will have learned to be afraid of your heartbeat, or your breath or you have learned to be afraid of, you know, depersonalization or jelly legs, and you refuse to go out of the house, or you are convinced that you have some sort of health problem, and you will only eat foods as a result. Maybe some trauma spawned that, but But knowing about that trauma doesn’t help you become less afraid of your heartbeat. Now you’re afraid of multiple things. So maybe you are having, you know, you’re afraid of the experience. But now you’re also afraid of yourself. So you have to do both things. But of them, if two problems, you can solve them both. So traumatic experience can be a roadblock 100% to executing the recovery plan that we’re always talking about here. It’s 100% true if you have lived experiences that teach you that you are always unsafe, the world is dangerous, you are weak, you’re not capable, you’re stupid, and you’re not worthy of being better. trauma can do that to you. And if you have those beliefs about yourself, because of your past experiences, that can 100% present a roadblock to doing the work that I was talking about, have to acknowledge that and I always will always well never going to invalidate that. So in that situation, you’re going to have to work on that too, right? You’ll have to work on that. It’s kind of hard. And this is different for everybody, right? There’s no set answer to this on the other side. So in that situation, you may find you have to do a little bit of work on yourself before you can effectively do this recovery work that I’m talking about. Some other people find that their anxiety disorder is so bad, that they’re so wracked with panic and irrational fear that they can’t do the trauma work until they put out this fire. So some people have to do this first and then go back to the past and do that work. Some people can do it at the same time. It’s individual, it depends. So there’s no set answer to this. But I can tell you that you can recover from both trauma and anxiety. And the things that I’m writing about which are geared toward anxiety recovery can be effective while you do that. It’s just a very individual situation. But please don’t feel that since you have lived the traumatic background, you can’t get better. That’s not true. That’s not fair. And I understand why you might think that but it’s not true. You can get better. It’s not easy. But there’s hope for you too, I promise. So last few questions. This is a really common one I’m accepting, why am I still anxious? So I might argue that if you are asking why you’re still anxious, then you’re not accepting. We can’t qualify for our acceptance. I’m accepting. I’m accepting this, but I also want it gone. Well, you can’t have both of those things. Think about that for a second. I know it sounds a little bit glib and a little silly. But think about it. There’s truth in there. I’m accepting this, but I also don’t want to accept it, and I’m not accepting it. I know you want your anxiety to go away, but accepting and doing all the things we talked about. It’s not a recipe for banishing it, right? If that’s why you’re doing this like you are hoping that if you do the Claire weeks acceptance or the Dru surrender, or the Josh Fletcher willful tolerance, if I do this, then it will stop. You’re trying to skip the part where you have to experience the anxiety and use it as a classroom. It’s super important. So if you’re trying to skip that, and you’re just hoping that okay, I except, wait a minute, how come it hasn’t gone away? You’re missing the whole process. And you’re going to wind up disappointed, frustrated, and do and ask this question I don’t understand. I’m accepting why isn’t gone away. So expectations are important. Understanding the concepts of recovery. Why are you accepting that is that the whole thing? Or is it just part of it? That’s important, aiming at the right target is important. So in this situation, I did episode 192 of the podcast, which is linked in the show notes here, go listen to that, that will probably help you. And this is related to question number nine, which is, I’m doing my exposures. But it’s not working. This is what you think you’re doing. I’m doing all the things I’m doing exposures but not working. Why? And there are a couple of common explanations for this. Number one would be we’ll ask you a couple of questions. And this is right at the show notes. Are you trying to do exposures without being too afraid? Are you trying to do your exposures without triggering high anxiety or panic? Are you only doing exposures now and then when you’re forced to or when you’re having a good day? Are you doing exposures while also using all of your soothing and coping tools to calm you down if it gets uncomfortable? These are all red flags as to why exposure might not be working. So remember what I said a couple of questions before the point of exposure are not doing the task. The point of the exposure is experiencing the fear the anxiety, the discomfort you want that you need that if you’re trying to find ways to do your exposure tasks without feeling that or minimizing it or soothing or calming it or making it’s easier Don’t do the exposure, there’s no point in it. Because you’re not, you’re not learning to drive again, you’re learning how to get better at experiencing anxiety. So this is one of the main reasons why people will say my exposures aren’t working well, okay, but you’re not doing exposure, in some cases, for a common mistake. The other thing would be that you know, that you’re supposed to experience that experience, panic, but you are still hanging on to those who escape behaviors and those rituals. So some people get close to like real exposure, I would say real exposure, but most effective exposure, but they still hang on to like, well, there’s a line that I just can’t cross with anxiety and panic. And when I get close to that line, I will break out all of my copings skills. And I will break out my, safety skills and my make it go away skills. And that’s the response prevention part. So we’ve talked about exposure and response prevention, ERP, which is very commonly used in the OCD community, you hear ERP in that community all the time, but even for all of the anxiety disorders. Exposure is always ERP. So doing the things, you’re doing the things, you’re intentionally triggering this comfort, and you’re doing that without using your old responses, your safety responses, and soothing responses, you’re preventing those responses. So one of the reasons why another key reason why exposure might not be working air quotes for you is first of all, what does working mean? It doesn’t mean to make it go away. Remember, it means teaching you how to get better at being anxious. But why do you think it’s not working? Well, one of the reasons is doing the exposure without doing the response prevention. I’m out there driving on the highway, but I’ve got my mints and my cold water and I got my radio on, I’m calling and I’m talking to my friend or I bring my husband or my girlfriend with me that that’s one good reason why it might not be working. Right. So if you go to anxious truth.com and just search for the word exposure, you’ll see quite a few podcast episodes where we talked about this in more detail. And then question 10 Final question for the day. This is a big one. How do I deal with a setback? So this is a such question I hear every single day and I the word setback, I almost want to be stricken from the vocabulary. Many times when people are in the recovery process, they feel like they’re doing great because they’re not experiencing anxiety or panic. Like they’re feeling good. That’s, that’s awesome. We want everybody to feel good. I want you to feel good to write, I want you to have good days. We all want to have good days. Everybody deserves a good day. So when you start to string good days together, and you’re feeling pretty good. And it’s been a while since you had a panic attack, or it’s been a while since you had those scary thoughts or it’s been a while since you’ve had an anxious day and then you have an anxious day or the thoughts come back or you have a big panic attack one night. A lot of people will say up, it’s a setback. That’s not a setback. That’s not a setback, right? If the core principle of recovery, is to learn that anxiety and panic are not emergencies, then how is feeling that a setback, it’s no longer an emergency, you are trying to learn that it’s not an emergency, we do not declare it a special event. We don’t retreat from it. So setback is usually a red flag word and it indicates that you’re still insisting that the only successful recovery is one year where you will never feel anxious or panicky ever again. And if you’re trying to recover to that degree, where you never you can guarantee that you never panic or ever have another scary thought in your life. You’re going to be disappointed and frustrated. So setback is not feeling things. If you haven’t felt anxious for two weeks, and then today you feel anxious. Well, your job today is to move through those feelings and practice being better at being anxious. That’s not a setback. That’s just life happening. And that’s an opportunity to get even better. Like we want it we get to the end of the road to recovery when we don’t care if we’re anxious or not. And I know that if you’re in the thick of it right now you are thinking that is an insane statement. But that is truly where you are headed with this. That is when the war is over. So if every time you experience anxiety, you yell setback and want to know what to do I do with a setback? You’re kind of missing the point and you’re not being fair to yourself. Okay, so the only true thing that I might call setback is setback is also really what happens when we say up all bets are off and I’m going to return to my old rituals. I’m gonna go back to my figuring it out trying to fight it trying to resist it hiding from it. Going back to my compulsive. My compulsions, like that, might be setbacks. Yes, if you start to revert to those old habits, I’ll call that a setback with you. But how you feel and what you think is not the setback. But even if you do start to revert to those old habits as soon as you waive the setback flag and one piece of advice just remember, oh wait, I have to start doing what I was doing before. No problem that happens to everybody move forward again. So if anxiety returns after some time, right at the show notes here your job is not to wring your hands and try to figure out why and how to stop it and declare a disaster. Your job is to surf through it, move through it like you presumably did as part of the progress that you said you had made. So I did do an episode on this early on in 2015 of the podcast, episode 14 talks about the nonlinear nature of recovery and goes over setbacks. But I know setback is a thing that we talk about all the time in this community. Hopefully, this helps. And that is it. Those are our second 10 frequently asked questions about anxiety and anxiety recovery. We are done with episode 217. If you have not heard to 16 go ahead and listen, because those are the first 10 questions you know, we’re done because he told me that music. Anyway, I will pay you out as usual. Afterglow by Ben Drake, you can find Ben and his music ed Ben Drake music.com Go check them out and tell him I said hi, I will ask you a favor. If you’re listening to the podcast on iTunes on Apple podcasts or Spotify or some platform that lets you rate and review. Please leave a five-star rating and maybe take a second to write a review because it helps other people find the podcast. If you’re listening on YouTube. Sorry, there’s no video this week. But if you’re listening on YouTube, Like the video, subscribe to the channel, and leave a comment. You know the deal. I appreciate you guys coming by all the time spending time with me giving me your attention. Hopefully, I’m able to help you. I’m doing the best I can. I’m hoping it’s working out for you. I’ll be back next week. We’re gonna do it again. I don’t know what I’m gonna be talking about. But I will be here. And as always remember, this is the way Unknown: this is where your story begins. 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Wellness 101 Show – How to Stop a Panic Attack

And now it’s time for another Wellness 101 – How to Stop a Panic Attack…presented by St. Luke’s University Health Network!Panic attacks are truly terrifying experiences that affect nearly 2.5 million Americans every year. Attacks can happen without rhyme or reason causing fear or extreme anxiety for 10 minutes or more. The physical symptoms of a panic attack can sometime make people think they are having a heart attack and can include: extreme perspiration, rapid pulse rate, increased heart rate and dizziness.No one knows what truly causes panic attacks but researchers suspect they may have to do with a combination of biological and environmental factors. The good news is that panic attacks are one of the most treatable anxiety disorders…and we’ve got the steps to help keep you calm!Step One: Talk Yourself Off the Ledge When you feel an attack coming on…one of the best things you can do is kindly remind yourself that you are simply experiencing anxiety and that you are in no real danger. The use of positive affirmations works wonders here such as: I am in control, all is safe in my world right now, I’m not dying and the deeper I breathe…the more relaxed I feel.Step Two: Breathe As an attack hits, it’s crucial to get your breathing under control. Short, shallow breaths can make you feel worse, so consider closing your eyes, inhale slowly through your nose and exhale through your mouth. Try placing your hand on your belly while breath so you can see your hand rise and fall. After a few minutes of this…you should start to feel more like yourself again.Step Three: Stay in the Present When you are in a state of panic, consider giving your mind something to focus on other than fear. Try using all of your senses, what can you see, hear, taste, touch and smell. Continue noticing new things until you start to feel better.Step Four: Progressive Relaxation Progressive relaxation can be very effective in the midst of a panic attack. Tense up one muscle group at a time for 4 to 10 seconds and then relax it. Repeat this process everywhere until your entire body is completely relaxed and you start to feel like a million bucks!Thanks for watching. Panic Attacks can strike without warning and while it’s understandable that you want to avoid them at all cost, it’s important not to let them control your life. Instead of avoiding places where you had panic attacks in the past, kindly remind yourself that you are safe and that nothing horrible actually happened. And that if and when a panic attack strikes again, with the help of the previous steps just mentioned, you can regain control. Don’t forget to smash that like button, subscribe to our YouTube channel, and share to all who suffer from panic attacks. Until next time this is Mr. Wellness saying be well and follow the steps…to a calmer you!

How to Help in a Panic Attack | Mental Health First Aid


Panic attacks are incredibly common, and it can cause people to hyperventilate and to breathe out a lot, which breathes off the carbon dioxide, can make you feel very light-headed and means that you can just not be able to control your breathing at all. It is very, very frightening. It can give you palpitations, it can give you tremor. There's a lot of people get so frightened, that they think they're having a heart attack. If you suspect somebody is having a panic attack, please don't be tempted to use paper bags or anything that you may have heard about in the past.


The best way is to stay as calm as you can and breathe nice and calmly, too, and the calmer you are, the calmer they will be. Try and encourage them to breathe in and out very slowly. So, try and remove them from anything obvious that is causing them the distress, if you can, and try and get them to focus on breathing slowly in and out. Sometimes it can help to use your hands to do that. But breathing techniques have been shown to be the most effective to calm somebody when they're having a panic attack..



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5 PANIC ATTACK MYTHS | Kati Morton


Hey everybody! Today we're gonna be talking about the five myths of panic attacks. So let's get into them. *intro music* Now the first myth is that they're caused by stress and anxiety. If you yourself have ever suffered with a panic attack you know that they come out of nowhere we don't even know what necessarily triggers us, something may not even trigger us. It's not necessarily something that environmental or something that's occurring right now. Panic attacks honestly happen because our system gets overwhelmed and overloaded and sends us into a fight or flight response, AKA, a panic! I also don't like this myth because it implies that we have control over it like we can stop our panic attacks if we just change our environment and the truth is the panic attacks will happen in a wide variety of places for a wide variety of reasons those of which we aren't even privy too.


We don't even know why they happen. And the second myth is that they're going to make us go crazy. Panic attacks, if they happen for too long we're just gonna go insane. I've heard a lot of my clients say this, that it feels like they're losing their mind and they wonder if it can cause other mental illnesses to occur and the truth is the panic attacks usually happen because we have some underlying mental illness, whether it be another anxiety disorder or depressive disorder, any kind of mood disorder can be a lot of different components that can lead us to having panic attacks and being more predisposed for panic.


The truth is that panic attacks in no way affect the functioning of our brain as a whole in the hormones, like dopamine, norepinephrine or any kind of neurotransmitter that could cause another mental illness or psychosis or quote, unquote, make us go crazy. The third myth about panic attacks is that having a severe one is going to cause us to go into cardiac arrest. I've heard from a lot of my clients that because a racing heart is one of the symptoms that they experience most with panic attacks, or even the build-up to a panic attack, they'll start feeling their heart race and they worry that if they're in a really extreme or intense panic attack for a sustained period of time, let's say for an hour, that they're going to go into cardiac arrest and this is going to be how they're going to die and it sends them into panic even more quickly and keeps them there longer.


But the truth is and this is something important to kind of note and to tell yourself, maybe when you're, you feel those symptoms happening is that our heart is extremely strong it can beat at over 200 beats per minute for days, if not weeks especially if we're young, it can be four weeks at that rate without sustaining any damage. I just want to take a second to let that sink in. We can essentially be in panic for a really really long period of time without our heart ever being hurt or even potentially considering it going into cardiac arrest or having any kind of malfunction.


Therefore on average, panic attacks last from three to ten minutes so a three to ten minute panic attack is not in any way going to harm your heart or cause a heart attack. The fourth myth is that they're used as a way to get out of something we just don't want to do. Uh, if we hear that one more time. Am I right? For those of you who don't understand what a panic attack is or what can cause a panic attack, like I stated earlier, they come out of nowhere. They are not triggered by our environment, it's not due to an over reaction by up if usually a result of another underlying mental illness and these feel like they come out of nowhere, happen quickly and can stay and they're extremely uncomfortable, so if you found yourself having these attacks anytime you went into the grocery store, then you would start to not want to go to the grocery store or whenever you're in a crowded place, like I've had a lot of clients are like, "If I'm ever in a busy thing like a club or a concert or even like a really busy day at the mall," they've had panic attacks, we don't really know why but they're then attaching busyness and a lot of people with panic attacks therefore if someone's going to call you, if a friends going to ask you to go out to a party, and you think it's going to be a small group you're like sure, then later you find out there's going to be like 50 people there, you're like I'm gonna have to say no.



But we need to understand that panic attacks and panic disorder is a real diagnosable mental illness and because we don't know what triggers them and they come out of nowhere we fear the next one may be just around the corner. So of course we're going to limit the amount of things that we do until we can get them more under control. And the fifth and final myth about panic attacks is that there is nothing that we can do to treat them. Meeh. That's wrong, there are a lot of things we can do to treat them. Yay! Number one, and something that I've been reading because if any of you follow me or have been on the live streams or follow me on snapchat or Instagram, I have been working very hard at your anxiety workbook and I'm super excited for it to come out, but the thing that I learned through all the research I've been doing, is that progressive relaxation, you know like clench your feet, relax your feet, clench your calves, relax your calves, that type of exercise, doing that 20 to 30 minutes a day can calm our system down to such an amount that those who struggle with panic disorder may rarely, if never again, if they continue to do the progressive relaxation each day, they may never have the symptoms again.


They're still doing more studies on it but progressive relaxation is, surprising to me, but it's so amazing and been so helpful and beneficial. And the other is that CBT, so cognitive behavioral therapy, is also helpful with panic disorder and those of us who struggle with panic attacks because a lot of times we build up the panic and our system's fight-or-flight response by worrying about all of those things like it's going to cause a heart attack, I'm going to be super embarrassed, I'm going to go crazy, I may fall over or faint, all those worries and kind of falsely held beliefs that we have, CBT can really help us challenge those.


Also medications have been shown to be extremely beneficial SSRIs, SNRIs, and benzodiazepine have been shown to be extremely helpful for those of us who struggle with panic disorder and I know that not all of you are interested in taking medication this is another option that's available and if you're out there and you're struggling with panic attacks and you feel like they're happening with more frequency, it's controlling the way you live your life please reach out, please talk to someone. There are different professionals and a ton of help available, we just have to ask for it and we just have to reach out and I know it's scary to do the first reach out, but know that we're used to managing it we can handle it. We are kind, calm, wonderful people and maybe bring an extra supportive person with you to that first appointment or maybe they make the call and set up the appointment for you.


Find ways, use your resources to get the support and help that you need. Please share this video, I think a lot of people talk poorly about panic attacks or don't understand and I also put some in here, if you didn't notice for those of us who struggle and the myths that we tell ourselves about panic attack because I think both are really important to note, and leave in the comments what are some myths that you've heard. What is the way that you talk back to that, so that we have as a community are raising the stigma associated with mental health. I love you all and I will see you next time. Bye!.



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