Dear Dr Eddie, I am a 45- year-old manager who suffers from attacks of dizziness, blurred vision, and heart palpitations.
The first panic attack occurred at work. It happened in the presence of my work colleagues, and began with feelings of weakness, nausea, and dizziness. I asked a colleague to call a doctor because I was afraid that I was having a heart attack since my father had recently died of one.
In addition to this personal loss, I was dealing with a lot of stress at work. My husband is generally supportive but really hasn’t a clue what’s going on for me.
Several months before the first panic attack, there were times when I had been nervous and my writing had become shaky; but apart from that, I had never experienced anything like this before.
My doctor told me that it was stress and anxiety, and prescribed some medication. Nevertheless, the panic attacks continued, mostly at work, and in trapped situations.
Sometimes they were unexpected or “out of the blue,” particularly the ones that woke me out of deep sleep. I feel tense and anxious most of the time, because I worry about having another panic attack. Since my third panic attack, I avoid being alone whenever possible.
I also avoid places and situations, such as shops, crowds, Mass, and queues, where I fear being trapped and embarrassed if I panic. I would appreciate any advice.
Dr Eddie responds:
Getting control of your panic attacks is achievable, moving from overwhelming fear to freedom is doable.
First of all, I want to acknowledge the level of feeling terrified that you feel.
Panic attacks trigger our primitive ‘Flight, Fight and Freeze’ adrenaline response. This powerful adrenaline hormone causes our body to respond and explains the powerful physical reactions you experienced, including palpitations, dizziness and blurred vision.
Panic attacks are very common — in fact, some 10% of people reading this article will have or will get a panic attack at some stage in their lives.
The most important message I want to give to you is that of hope. Getting control of your panic attacks is achievable, moving from overwhelming fear to freedom is doable.
I have treated many hundreds of people suffering from panic attacks and they are living lives of joy.
I always believe it’s important to give hope. This hope is centred on the evidence-based practice of Cognitive Behavioural Therapy (CBT). Understanding panic attacks is part of the key to controlling them. In psychology we are very concerned about “what keeps the problems going”. If fear is the engine to panic attacks then avoidant behaviours, including being alone, and avoiding places and situations, such as shops and crowds is supercharging your panic.
Avoidance always keeps panic going. Recurring panic attacks take an emotional toll. The memory of the intense fear and terror that you felt during the attacks negatively impacts your confidence and has caused serious disruption to your everyday life. You are experiencing a fear of fear.
Now it’s time take off the straight-jacket of panic. You need to get Cognitive Behavioural Therapy, or CBT. I wish this was more publicly available, as we need rapid-access appointments so that these mental /emotional health issues don’t build up and that your quality of life is impacted so terrible.
Get a referral from your GP, or check the Psychological Society of Ireland (www.psihq.ie) or Irish Association of Counselling & Psychotherapy (www.iacp.ie) websites. Ask any prospective therapist about their CBT training and experience. Competent therapists will welcome this questioning.
Cognitive Behavioural Therapy focuses on the thinking patterns and behaviours that are sustaining or triggering the panic attacks.
I also recommend yoga as the breathing patterns taught complement the therapy and counteract hyperventilation that often accompanies panic.
Take out any caffeine in your diet. Practice thinking differently; ask is this threat a real one or is it really bound to happen? Am I exaggerating the threat? Am I misreading things? I feel bad, but that doesn’t mean things really are so bad. What would I say to a friend in this situation? What would be a more helpful way of looking at things? Where’s my focus of attention? I can cope with these feelings, I’ve got through it before. This will pass.
Imagine yourself coping in a situation that you feel anxious about. See the situation through to a successful completion. Cognitive behavioural therapy is the most effective form of treatment for panic attacks.
Dr Eddie Murphy runs a psychological and counselling service in Portarlington, Co Laois. If you are organising a speaker or training for school, community, voluntary, sporting or work groups, call Dr Eddie on 087 1302899 or go to www.facebook.com/ dr.eddie.murphy.psychologist