Don't Be Scared of Anxiety Attacks

The psychiatric world has learned much more about anxiety attacks (also called panic attacks) since I experienced them when I was in my 20s. Back in the 1970s, little was known about the reasons for anxiety attacks or what to do about them.

I had my first anxiety attack while walking on a public sidewalk. I had moved by myself from the East Coast to the West Coast after graduating from college and I was worried and fearful because I did not yet know what direction my life would take, nor did I have any friends in the area.

My breathing had become shallow and rapid because of my anxiety. This hyperventilating caused me to feel shaky, unreal, and lightheaded. My heart raced. My hands felt cold and clammy. I thought I was going to die, or at least pass out. I immediately returned to the safety of my rented room, where I recovered within a few minutes.

This scary experience set me up for future anxiety attacks. I developed agoraphobia-a fear of public places-because that's where I always seemed to have them. When I told a doctor about the strange episodes he examined me and put me on a regimen of Valium, which helped for a while. For a time I was convinced I must have a serious disease to cause the symptoms I had, and I visited a number of doctors. I also began to drink wine and beer to try to relax, something I would not recommend as a treatment. I tried an herbal remedy, valerian root, as well as a homeopathic remedy called Calms Forte, with mixed results.

Ironically, I served in the Peace Corps and traveled a lot during the years that I suffered anxiety attacks. I coped as well as I could-sometimes not very well at all-and eventually taught myself to control them by breathing slowly and evenly whenever I became panicky. It worked. I haven't had an anxiety attack in decades. To this day, whenever I feel anxious, I automatically slow down my breathing.

Most of us are anxious or fearful about something at one time or another, but when the natural "fight-or-flight" response to danger becomes overwhelming, unpredictable, and prevents you from living your life and interacting with others, you need help. Panic attacks can result from bad family situations, hereditary factors, abnormal brain chemistry, personal trauma, or damaging personality traits, and they need to be evaluated.

Not everyone who suffers from anxiety attacks has all the same symptoms, but most have at least some of them. Interestingly, women tend to have more respiratory symptoms than men. Some other symptoms listed in the American Psychiatric Associations' Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are sweating, choking feelings, chest pain, nausea, headaches, numbness and chills or hot flashes.

If you have an anxiety attack, besides slowing down your breathing, try to defuse the panic by alternately tensing and relaxing all your muscle groups. Some people carry a paper bag with them to breathe into in order to raise the carbon dioxide level when they hyperventilate, but you may not always have one available when you need it. Putting your hands on your stomach to feel your breathing movements can help to re-ground you in reality and reassure you that you're still alive.

As soon as you can arrange it, get a complete physical to make sure there isn't some other physical problem causing the symptoms such as heart disease, hypoglycemia, epilepsy, thyroid problems or other conditions. Then, visit a mental health professional to see what can be done for you.

Your psychotherapist or counselor may prescribe selective serotonin reuptake inhibitors (SSRIs) such as Zoloft or Paxil, which have been shown to cut the rate of panic attacks by up to 85% although they take up to six weeks before they have an impact. Also, benzodiazepines like Xanax and Valium have a success rate of up to 75% and work immediately, but you need to take them several times a day, there are side effects such as sedation, and you rapidly develop a tolerance for them so that they don't work anymore-this happened to me. Tricyclic antidepressants and MAO inhibitors have been used but there are too many side effects. You can become physiologically dependent on these drugs, and it's not a good idea to continue them for very long.

A more natural way to treat anxiety disorders is with cognitive-behavioral therapy (CBT), which works to change negative thinking patterns and behaviors. This includes exposure therapy, where you confront your fears in a controlled environment and in three to five months, learn to control them. If you don't confront your fears, you may end up with depression and low self-esteem besides the panic disorder.

Other ways to conquer panic attacks are relaxation techniques like muscle relaxation, controlled breathing and guided imagery; biofeedback using sensors to measure the physiological symptoms of anxiety and teaching you to control them; hypnotherapy; and acupuncture. You should also be sure to get sufficient sleep, try meditation, eat right, avoid caffeine, cultivate supportive friends, and exercise, particularly Yoga and aerobic exercise. Alcohol and street drugs are contraindicated because they can lead to alcohol or drug addiction and will actually end up making you more anxious. Whatever you do, remember that anxiety attacks are nothing to be embarrassed about, these days they're very treatable, and there is no reason not to seek immediate help for them.