By Diana Holbourn
Becky Gives Lectures at her Old University About Overcoming Anxiety Problems
Book eight of the online Becky Bexley series. Continued.
This series accompanies the books about what Becky does at university and afterwards, which you can find out more about on my author website. (The online series is in draft form.)
A couple of hours before her second lecture, Becky met up with some of her old student friends for a chat.
After they'd caught up on each other's news, they had a bit of a laugh.
Becky told the others she'd read some funny quotes about worry from famous people she'd never heard of. One said: "The good Lord gave me a brain that works so fast that in one moment I can worry as much as it would take others a whole year to achieve."
She told them about another one that said, "You probably wouldn't worry about what people think of you if you could know how seldom they do."
She said one of the most interesting ones she'd read came from a French philosopher who said, "My life has been full of terrible misfortunes ... most of which have never happened". She thought he must have meant they'd happened just in his imagination because he'd been worrying they'd happen a lot.
One of the group said, "That just shows how worry can ruin people's lives." Then she said she'd heard some funny quotes herself about worry, like, "I've developed a new philosophy... I only dread one day at a time," and, "I try to take one day at a time, but sometimes several days attack me at once."
She said another funny quote went, "Troubles are a lot like people - they grow bigger if you nurse them." She said it reminded her of the one about so many misfortunes happening in the mind; she said she'd known from experience that people can end up far more upset about things once they've spent time worrying about them than they were when they first happened or it first looked as if they might happen.
Becky said another quote from a famous person said, "Education is wonderful - it helps you worry about things all over the world."
The others chuckled.
Soon after that, Becky went to get ready to give her lecture.
Becky started her new lecture by saying, "I'm going to say a lot about panic attacks today.
"When it comes to things like that, one of the books I've read recommends that as scary as they are, and although it might take a fair bit of practice before people can get used to the idea and then manage to do it well, instead of trying to control them and force them to go away, or being terrified of them, people face them, perhaps as if they're more like horrible curiosities than overwhelming things, and that they analyse each of their panic symptoms in turn, describing each one to themselves, to decide whether they really think they need to be as scared of it as they thought they did.
"So, for instance, one of the symptoms tends to be the heart beating faster. If people think something like, 'OK, so my heart's beating faster, more powerfully than usual. I don't like the feeling; but hearts don't get damaged by this, since after all, it would be beating faster if I was exercising hard too, so I know it's just natural in some circumstances for the heart to beat faster. So I'm sure I can put up with this really', - if they think things like that, then they can stop feeling so scared of that symptom.
"Likewise with butterflies in the stomach or stomach cramps. If people think, 'OK, this isn't nice; but it's something I can put up with', the symptom can start to seem less scary.
"It's the same with each one of the other fear symptoms, such as the feeling of giddiness some people have when they're really anxious. If they can think something like, 'This is a dizzy sensation. I don't like it; but I've felt dizzy before in other situations and managed to live with it; so I can live with this really; it's just my nervous system being over-sensitive, and sending some fear symptoms into overdrive for a while; but I can put up with it till it stops', then it can start to seem less frightening.
"It can be hard to do that kind of thing, because the symptoms can be so intense. But they can start dying down pretty quickly if you recognise them as just the nervous system over-reacting temporarily, and nothing harmful, so you stop feeling so scared of them.
"The thing is that panic attacks tend to come on more and more easily and get worse the more people are scared of them; it's the fear that makes them as bad as they get, and the way the fear makes the brain think there really must be some danger. So facing each of the panic symptoms and deciding it's possible to live with each one after all, instead of being frightened of them, and also being willing to wait for the nervous system to stop triggering them off, instead of increasing the anxiety with worry about them, can calm the fear, so the nervous system calms down, and then starts to stop triggering off panic attacks so easily over time. You might even end up wondering why you used to be so scared of the physical fear symptoms.
"They can certainly feel scary; but they can feel less frightening when you know why they're coming on.
"A lot of people worry that they're about to have a heart attack when their hearts start beating extra powerfully. Some people feel as if it's beating in their throat, and that it feels about to burst. But that's just being caused by the heart pumping blood around the body extra fast, so it can be felt more in some of the big blood vessels it's going through. It does that automatically when panic symptoms come on, so as to make sure there'll be more blood in the parts of your body that you'll need like your arm and leg muscles, if you need to run away or fight. Blood brings oxygen to various parts of the body, which they can use for energy. The feeling in the throat is just the arteries in the neck working extra hard to transfer the blood through them quickly.
"Fear of the panic can actually make the panic attacks worse. It's no wonder people are scared of them, because they feel so horrible. But if you can somehow learn to let them pass without being scared of them, they'll likely fade away more quickly, because fear of them is like fuel for them, - it stirs them up so they get stronger and take longer to die down. When they stop seeming so scary, the opposite will happen, - they likely won't last as long or be so bad.
"Some people get over their fear by thinking back over their lives, to work out what caused it, and then analysing whether whatever it was really needed to cause a long-term fear reaction, or whether they still need to be afraid of it. For instance, the author says a woman was scared she'd have a heart attack and die during a panic attack, but lost her fear of that happening when she got over the fear of death she'd developed some time before, so the idea of having a heart attack didn't scare her so much.
"But if lots of things bring on fear sensations, such as all the places in the town that are similar to ones where panic attacks have come on before, then it's easier if rather than trying to analyse why each of those places seems scary, people try to reassure themselves that they don't need to be scared of each of the physical fear sensations they have. If the sensations stop feeling scary, the fear of those places will stop too, because fear itself won't seem so scary.
"It's different if the fear's been brought on by something serious that needs sorting out in other ways, such as if a person became a crime victim in a certain street, and they then started panicking every time they went there. But if it's just the result of an over-sensitised nervous system sending out danger signals by mistake, like it can be if panic attacks are triggered off by a person just being somewhere that the brain recognises as similar to one where a panic attack came on before, then it's best to just deal with the symptoms themselves.
"A common symptom of anxiety is finding it hard to take a deep breath. It's caused by muscles in places like the chest tensing up so much. People can instinctively start breathing really quickly to try to get enough air when they're really anxious; and while that's what they'll need to do if they're going into combat or something, because they'll need extra oxygen, which is supposed to give them extra energy to fight an attacker, if they don't need to use it, they'll just quickly breathe it out again, and that actually causes the lungs to breathe out too much carbon dioxide, which comes out with the oxygen they can't use, because they don't need to fight.
"Surprisingly, the body does actually need a bit of carbon dioxide, because it helps it release oxygen into the muscles and around the system to help give people energy, according to what I read. Breathing out too much of it at once can cause symptoms like giddy feelings, and pins and needles in the hands. But that's uncomfortable rather than harmful; and breathing can get back to normal if the system's calmed down, which it can be if you take really really really slow breaths, or even if you breathe into a paper bag for a little while, - which you probably wouldn't want to do in public, understandably, but which you might be willing to try if you're having a panic attack in a private place, - so you're breathing in the carbon dioxide you breathed out along with oxygen, - although it's best not to do that for all that long, in case you end up getting more carbon dioxide than oxygen in the end, because you'll be breathing in the air you breathed out.
"Or holding the breath to the count of ten can help. Breathing very very very slowly, especially if you take longer to breathe out than you take to breathe in, can halt the suffocating sensation panic can cause, by reducing the speed you lose carbon dioxide at.
"But you can be reassured by knowing that during the episodes of breathing too fast, the body's still getting all the air it needs, even though it might not feel like it. So the panic attacks don't cause any real harm.
"It might seem surprising that the symptom of anxiety and panic attacks that makes people breathe really fast would be an advantage in a situation where they really did have to run away or fight, and that it would enable them to take in more oxygen to give them energy, because breathing fast can be what brings some of the horrible symptoms on.
"The reason it can lead to unpleasant symptoms is because people normally have panic attacks in places where they don't need extra oxygen pumped to the arm and leg muscles, which is what the body does with it, because they don't need to run away or fight, so the body breathes it out quickly again; but then people can feel as if they're not taking in enough air, and that can make the panic worse as they gasp for breath, while they can feel suffocating-type sensations. It feels as if something much worse will happen than really will, since a panic attack won't deprive people of so much oxygen it could damage their health or anything. They'll still be taking a lot in. But making an effort to breathe a lot more slowly will calm down the horrible symptoms.
"Another technique that can help is to do some vigorous exercise when panic comes on, to simulate the amount of activity you'd do if you were actually having to fight someone for your survival or something, which is what panic symptoms come on for. It might seem daft to try to do exercise while you're experiencing all the horrible panic symptoms, because they might seem to be reducing your ability to do things like that; but if you try exercising, - provided you're actually in a situation where you can at the time, of course, which I know you probably often won't be, - you might well find that the panicky feelings quickly go away, because you'll be doing what they're intended to help you with.
"So if you're at home, you could maybe try running up and down the stairs a few times, or dancing to music, or jogging on the spot for a while, or running round the block, to see what happens.
"The therapist who wrote one of these books I've read says there was a woman who came to see him who had problems with panic attacks, and was convinced they meant she must have heart disease, because of the way her heart beat so much faster and her chest hurt, and the way she felt ill during them. Her mother had had heart disease, and she was at the age that her mother had been when it had developed. So she worried that it was an inherited condition. She'd been checked out by doctors, who'd assured her her heart was still working well; but she still worried about it, because of the symptoms she had when she had panic attacks. She thought that even if her symptoms had just been caused by panic up till then, they might still be the start of heart problems every time they happened again, because she worried that they'd become worse, which might mean a real physical problem was starting to develop.
"But since she'd had her last check-up only the day before her therapy session, and she'd been reassured that things were still OK, the therapist felt confident enough to illustrate to her that the problems were almost certainly just normal panic symptoms that would go away if she exercised, by finding a way to cause her to get panic symptoms again, after she agreed to the experiment, and then challenging her to a race up the hill next to his office, which she agreed to, and won. She found that the symptoms disappeared when she started running and trying to beat him in the race, and she was amazed that it happened, and reassured.
"Another anxiety symptom some people get when they have panic attacks is what feels like a lump in the throat, or as if the throat's swollen inside. Again, it's just caused by muscle tension, although people can worry it means there's something worse than that wrong with them. But they can be reassured that it doesn't mean that if it eases off when their anxiety eases off.
"Another anxiety symptom that can worry people - one I've briefly mentioned already, - is giddiness, where they feel unsteady and light-headed, or even get the impression that things around them are moving when they know they're not really. Physical problems can sometimes cause that, such as wax pushed too far into an ear, since the ears help with balance, and something like that can stop them doing that so effectively, which can cause dizziness. So it's worth getting checked by a doctor. But often the giddiness will just be another fear symptom, partly caused by the muscle tension it causes interfering for a little while with the efficient working of some of the muscles that give people the ability to balance well.
"Yet another fear symptom people can suffer from is feeling sick, or even being sick. People can sometimes be really put off eating because of that. But of course, you need to eat to stay healthy. Eating little and often instead of trying to eat a lot in one go can help, or eating at the times when you feel calmer, since anxiety can come and go throughout the day, and it can disappear altogether for a while if you're absorbed in something enjoyable, or if something good happens. If you can sometimes do something that really interests you before you eat, so there's a chance you'll forget yourself for a while, eating might be easier. And if you can accept the nauseous feeling as an anxiety symptom that'll fade as your anxiety does, and if you can be resigned to waiting till it goes away, that'll make it more likely to fade over time.
"You might be worried about your weight dropping because you haven't felt able to eat much for a while; but your body will soon regain weight once you start again.
"If someone makes worried comments about how thin you look, you could try and imagine yourself floating above the comments, so they don't affect you.
"People with anxiety problems can be scared of what new fear symptoms might come on next. But adrenaline always does the same kinds of things to people, so no horrible new unexpected ones are likely to come on.
"And if you've only experienced some of the anxiety and panic symptoms, it's apparently unlikely that the others will start coming on, since whichever of the symptoms you've got will be the way your body naturally reacts to adrenaline, and it will always react the way it always has, pretty much.
"The anxiety symptoms could take a few weeks to start to fade after people start trying out the new techniques for dealing with them, because over-sensitised stressed nerves take a while to calm down and stop automatically triggering off the symptoms at the slightest provocation. But the symptoms will fade after a while as the nerves get back to normal."
Becky continued, "It'll probably be very hard to just accept the fear symptoms at first. So don't get discouraged if it is. It'll be enough at first to just think about accepting them, imagining what it would be like to just be able to tolerate them. In time, it'll get easier to accept them for real. The fear might take some time to go. But imagining accepting the symptoms, even though you're still scared of them, will make them ease off in time, because the very act of doing that will make you feel a bit more relaxed, so the tension that's causing the fear symptoms will gradually fade. And when it begins to, your hopes will rise that the torment's going to end at some point; and your increased optimism will help the tension ease off too, so your fear symptoms will diminish even more.
"It can help even more if you can try to think more positive thoughts when panic comes on. For instance, it's natural to worry that you're about to die or faint, or do something embarrassing like running away for no good reason, or that you'll go insane; but if you know that nothing truly catastrophic's happened before when you've had one, it might be possible for you to think more positive thoughts instead, such as, 'I know what this is, and I can get through this', or, 'This is horrible, but I know it'll pass if I use techniques to calm myself down', or, 'I know nothing really bad's going to happen, because it never has before', or, 'My body's just acting up yet again, because it's making the mistake of thinking there's something to panic about when there isn't really', or, 'I'm going to concentrate on counting slowly while I breathe in and out, because I know that'll help the symptoms calm down'. You might be able to come up with some good calming thoughts of your own.
"Another calming technique is to imagine that you're an outsider observing what's going on, naming and describing and analysing the symptoms you're getting, such as thinking, 'This is a panic symptom.' 'This is a result of breathing too fast', or, 'This means part of my brain thinks there's a reason to panic, but there isn't really', and so on.
"Or you could try to imagine your problems from the perspective of someone who had a completely different life experience, say an alien looking down on earth from high above, seeing the country you live in as just a tiny blob on earth, and not even being able to notice the things that seem to be significant enough to you to cause you panic.
"Concentrating on distracting yourself with something during a panic attack can cause the symptoms it brings on to subside as well, partly because you won't be unintentionally stirring them up more by worrying about them. And also focusing your attention on something else will take your mind off the distressing symptoms, so you won't be concentrating on thinking about how bad they are, which is bound to scare you so they get worse. So your brain will likely decide there's less need for the panic signals to be fired off than it thought there was.
"But distraction, and using breathing techniques to relax, and anything else you do to try to stop the panic, should be thought of as just convenient and useful techniques, not as essential, because panic would still subside without them, and if you think you can't do without them, you might panic more if for some reason you have to one day. So it's best to gradually get used to not using them.
"But they can come in handy. As for distraction, some techniques include concentrating hard on counting the leaves on trees, or the paving stones on the pavement if you're walking down the street, or counting tins or cereal boxes on the shelves if you're in a supermarket, or reciting a favourite poem or song, or counting back from a hundred in sevens, or something like that.
"Or you could do something more energetic, such as briskly walking up and down the aisles in a supermarket as if you're looking for something, or walking fast if you're in the street, maybe looking at the time every now and then as if you're in a hurry; or if you're at a party, offering to help with the clearing-up might help, or offering to get someone a drink.
"But staying in the situation rather than running away's the best way of reassuring the emotional part of your brain that there's no danger really. Running away, even if it's the fear that the brain itself is sparking off that gives you the urge to, will confirm to it that there's a good reason for you to be fearful in the situation you're in, so it'll likely spark off the panic symptoms again next time you're there.
"But still, since people can't help themselves sometimes, don't feel too bad if you do. It's just a natural reaction, spurred off by the brain. But if you can calm yourself down, and then go back to the same place and do what you were doing there with no more problems, it'll help the emotional part of your brain begin to learn that the place isn't dangerous after all so it doesn't need to set off alarm signals there.
"But if you can't stand to go back there for a while, don't worry about it; just treat it as a signal that it might be worth using any calming techniques you know more in similar places from then on, starting if possible before panic feelings can even be sparked off.
"One thing that makes public panic attacks so stressful is that the person having them can feel scared that the urge to run away from the situation they're in will be too strong for them to control, and they will, and then people around them will judge them as crazy for having done it. But panic attacks are actually pretty common, so a lot of the people who see a person doing that might have had some of their own, or know someone who has, so they'll understand, and will have a good idea of what's really going on, and will be more likely to sympathise than be judgmental. And a lot of other people might just forget it ever happened soon.
"And if you have a panic attack, you don't have to worry that you're getting seriously mentally ill; it's just a common natural reaction to too much stress.
"After a panic attack, it can sometimes help if you can think through the possible reasons why you had it, such as if there was a build-up of more and more stress in your life till it could have tipped over into panic, - since it's apparently quite common for that kind of thing to happen, - or if you had a panic attack in a similar place to the place you had your most recent one in before, which could mean that the part of your brain that sends out alarm signals on impulse when it senses something similar about a person's surroundings to a situation they were in when they got frightened before in case they need to be alerted to danger there got the impression that there was danger in places like that, so it started sparking off fear signals in similar places. Or it could be that you felt fear symptoms, and worried about them so much because you know how bad they can get that your anxiety quickly rose till it turned into panic. And so on.
"When you understand the likely reasons why things are happening, and know that the reasons why don't really mean there's something seriously wrong, it can be reassuring, so it could help your fear symptoms subside."
Becky continued, "One reason for reassurance is that the physical sensations of fear are just natural bodily reactions, not a sign that something catastrophic's going to happen, even if people feel like it is. A couple of books I read explain the reasons why they cause the horrible sensations they do:
"They say the reason people can feel a tightness in their chest when they panic is because the body's causing it deliberately, because it's using a mechanism it uses when the emotional part of the brain signals that there's danger that might mean they have to run away or fight, - whether it's mistaken or not, - that tightens the chest muscles, which causes people to start breathing more quickly, which is what it wants to happen, even though their breathing will be shallow, partly because of that. It causes people to breathe faster so as to make them take in more oxygen, some of which gets sent to the muscles, especially the ones in the arms and legs, because oxygen can be used for a kind of fuel, to give people more energy to fight or run away if they need to; and it also aids the body in healing more quickly if it gets injured.
"People will still get sensations of tightness in the chest that make them instinctively start breathing too fast though, and other fear sensations, when there's no danger, because the emotional part of the brain can't distinguish between physical danger where a person might actually need to do that, and stress brought on by a lot of worrying, or situations it's come to instinctively designate as threatening because the person panicked when they were in them before, so it's come to assume there must be danger there.
"And the heart starts beating more quickly when people panic, to transfer some oxygen that's just been carried from the lungs into the bloodstream to the arm and leg muscles more quickly than it normally would, since that's where the emotional part of the brain thinks it'll be needed, to provide energy to help the person fight off danger or run away.
"People can sometimes feel a sharp chest pain when they panic, so it's no wonder if they get scared they're having a heart attack. But it's often caused just by the strain on the chest muscles that's caused by the fast energetic breathing the person's doing.
"People can also feel as if they've got choking sensations and shortness of breath, and a dry mouth. The sensation of having to gasp for breath and the choking sensation are caused partly by the throat muscles tightening up with tension. They won't close off completely, so it'll always still be possible to breathe. But the sensation can still be frightening. And breathing in so much air quickly can dry out the mouth and throat, that can cause a feeling like a lump in the throat, and sometimes cause difficulty with speaking. Making efforts to breathe very slowly and steadily can calm down the system, so the symptoms start to fade.
"People can also sweat more when they have panic attacks. According to a couple of the books I read, that's partly because the heart and lungs working harder, and the muscles tensing for action, are quite strenuous activities, that warm up the body in the way exercise does, so it sweats to cool down. The emotional part of the brain's priming the body for the intense physical exercise it would actually need to do if a person really was in danger and needed to fight or run away, even though it doesn't feel at all like it when a person's panicking. And since exercise warms the body up quite a bit, it sweats to counteract the effects by cooling it down a bit. I think sweating cools a person down a little bit because the air evaporating the sweat somehow cools down the body a bit.
"And also, according to one of the books I read, sweating makes the body more slippery, which would make it easier to escape the grasp of an attacker. After all, the emotional part of the brain doesn't distinguish between the threat of an attack and panic for another reason, because of the way it's made.
"And the reason people can feel numbness and tingling in their hands and feet when they're having a panic attack is partly because the body directs bloodflow away from them into the arm and leg muscles that might be needed to give people more energy to run fast or fight, and the resulting effect in the hands and feet can be like the effect of the feeling of pins and needles, or part of them going numb, which people sometimes refer to as them falling asleep, that's caused by not enough blood flowing to certain body parts, - the kind of thing that sometimes happens because a person's been sitting with crossed legs so they're putting pressure on parts of them, so not enough blood's getting through to their feet. It's not dangerous if it only happens for a little while.
"It's also caused by breathing so fast, which causes a slight build-up of carbon dioxide in the bottom of the lungs, which can cause dizziness or light-headedness, as well as somehow causing tingling sensations in the hands and feet. Breathing much more slowly and steadily soon puts things to rights though.
"One thing that tends not to happen during a panic attack though is fainting, even though some people are scared of doing that, because the heart rate and blood pressure rise during panic, while they both fall before people faint.
"People can also feel sick or as if they've got an upset stomach while they're panicking. That happens because the blood that was helping their stomach digest food is directed away from the stomach into the arm and leg muscles so as to give them more oxygen for energy, and so the body doesn't have to use up its resources on things that don't matter in the moment, like digesting food, but it can instead send them where they might be needed; but that means that the stomach's temporarily deprived of some help it needs to digest food, and its acidity levels change somehow as a result, so it can feel the effects, which might cause sensations like butterflies in the stomach or stomach cramps.
"Another fear symptom people can sense is that their vision's more acute than normal, and they can become over-sensitive to light, so it causes them some stress. They can become over-sensitive to noises too. That's because their body's automatically trying to give them extra help at detecting threats lurking in their environment that they might be better at seeing or hearing if their senses are more sensitive than normal. It's a pity the emotional part of the brain doesn't distinguish between genuine threats and just overly-stressed nerves, but that's just the way it's programmed.
"But the sharpened awareness of sounds and sights that could just be ignored otherwise can lead to people feeling irritated. And it can be partly - although not fully - what causes another fear symptom some people get, because it seems so abnormal, which is a sense of unreality, that can make a person feel as if they've become disconnected from what's going on, where they can feel as if they're watching everything going on around them as if it's part of some kind of dream, not something they're actually a part of. Or they can feel as if they're detached from themselves, with their minds and bodies kind of separated, as if their bodies don't really belong to them, as if they're going through the motions of things, but not really being part of themselves. They can feel as if they're going to lose control of themselves or collapse, because they don't feel in control of their senses. People can worry that the sensation means they're going mad. But it's just a natural anxiety symptom.
"According to one of the books I read, it's part of the body's defence mechanism against feeling emotions that are too strong to cope with, so it kind of numbs out. But it can be caused just by breathing too fast, the way people often do when they're feeling strong anxiety or panic. Slowing the breathing right down can make the symptoms subside. A lot of people with chronic anxiety are in the habit of breathing too fast a lot of the time, not just when they're panicking, but most of the time while they're awake. Breathing too fast deliberately for a couple of minutes could bring the symptoms of feeling unreal on. So a person who has bouts of that kind of thing could be reassured if they experimented by breathing really fast for a couple of minutes till they came on, and then breathing really really slowly till they subsided. Not that that would be recommended for a person with anxiety, unless they were being supervised by a therapist, since the symptoms might be pretty worrying.
"Sometimes people are helped with feelings of unreality by doing things that help to ground them in reality again by engaging their senses, such as listening to music. But it's a feeling that can hang around for ages, so a person might have to often do things to get rid of it, till their anxiety itself fades.
"Other symptoms people can experience when they have strong anxiety or panic attacks are a heavy feeling in the legs, aching in the chest, and trembling. One book I read said all those symptoms are caused by the muscles tensing up in preparation for working extra well if they're needed. If you deliberately tense up a muscle for some time and then relax it, say by clenching your fist tightly and then relaxing it after a while, you might notice it's caused the area you tensed up to tremble. Or it can happen if you carry something heavy for a while and then put it down. ... Well, that's happened to me anyway, after I've been carrying something heavy. I suppose I could just be a wimp. But it seems it can be a consequence of tensed-up muscles. I read that it can sometimes be caused by fast shallow breathing too. And then if that kind of breathing goes on for a while, it can tire the body out, so people can feel weak.
"It could help you to reassure yourself that it's almost certain that nothing's going catastrophically wrong with you when you have panic attacks if you can memorise what's causing all the panic symptoms, and often refresh your memory about them, so you can remind yourself of them without having to make an effort to remember them when they come on, so you can reassure yourself that they're just natural and normal, not something strange that must mean something's horribly wrong. You could even tell the emotional part of your brain it's made a mistake when the fear symptoms start to come on, telling it it's triggering off the symptoms when there's no real need. After all, panic symptoms are often just an exaggerated stress reaction, after stress has been building up and up in a person's life for a while.
"People can feel as if they're losing control of themselves when they have a panic attack, because the strong feelings of fear they experience are designed to give them a strong urge to run away or fight if they have to, but most of the time when they panic, they won't want to do either of those things, so they'll be having to fight the strong urge to escape that their body's giving them, which they often won't understand the cause of; and that can be hard, and they won't always succeed in resisting it. Some people have done things like left their shopping trolleys in the supermarket and run out of the door, because their fear has given them such a strong urge to escape. Maybe you've had urges like that yourself. But your fear might fade once you recognise that your brain's making a mistake in setting it off.
"When your fear symptoms are strong, it'll be hard to remind yourself of all the reasons why they've come on, because strong emotions and sensations are too distracting and scary for people to be able to think clearly while they're happening.
"But it might help if you write a list of all the symptoms you normally have and their causes when you're feeling a fair bit calmer than you do at your most anxious, and then you could often look at them when you're feeling fairly calm, so you can memorise them, so when your fear symptoms come on, they'll more easily come to mind, and reassure you that what's happening is just that your brain's setting off your body's ordinary fight or flight responses, in the mistaken assumption that there's danger to be escaped from, when it's really just that you're feeling really stressed, or for some other reason, such as that the emotional part of your brain's instantly matched something about the situation you're in with one you were in before when you had a panic attack, so it mistakenly assumes that since you had such a strong panic reaction there, the situation you're in now must be a sign that you're in the same kind of danger you must have been in then, even though the panic attack you had before might have just been brought on by too much stress or worry that made you more and more anxious till the fight or flight response got triggered off.
"Panic attacks don't last very long if a person recognises them for what they are, and just lets time pass till they subside. What keeps them going for longer is when understandably, they worry about how bad they're going to get, and what might be going wrong with them, such as whether they're having a heart attack, or whether they won't be able to get enough breath, as well as worrying about such things as disgracing themselves by being sick in public, or running away when there's no danger around. So they can frighten themselves, which can lead to them breathing faster, which brings on more of the panic attack symptoms.
"One thing that brings fear symptoms on is exaggerated worries, such as worrying about not being able to cope, and no one being willing to help. It can help to challenge those worries when you notice them coming on, - provided you're calm enough to do that at the time, - by answering them back in your mind with statements you know are more realistic, such as that you're getting better at controlling your panic symptoms, if you are, and that most people are likely to be concerned rather than scornful if your panic does get bad in public, and that it would be a shame to let it limit your life by making you scared to go out and enjoy yourself, and so on.
"Over-dramatic thoughts can often come on automatically, because the feelings and fear sensations that come on when panic starts are so horrible they can convince people their feelings of fear must be signs that something bad will happen, so they naturally start worrying about them. Really though, the feelings are often just caused by the emotional part of the brain starting them up by mistake, because it's come to assume there must be danger if the person's in a situation where they panicked before. So it can be like a vicious circle, with feelings causing fearful thoughts, and then the fearful thoughts being so bad that they cause worse feelings, and then those feelings being so bad that they cause more fearful thoughts, and so on."
Becky carried on, "The more people's anxiety rises, the harder it'll become for them to reason with themselves about how they're not really under threat even though their fear's quickly getting worse. What can help is if when they're feeling quite calm, they think through the thoughts that normally come into their minds when their fear comes on, and think of reassuring replies to them, which they'll hopefully remember at times when they really need that reassurance, so they can do things such as responding to the worry they might often have during a panic attack that they're going to go insane by telling themselves that panic's never done that to them before, so it's unlikely to start doing it now, especially since they're getting better at controlling it. They can plan to use each of their replies when the panic does come on; the replies will be easier to think of if they've been rehearsed a fair bit in advance.
"One panic treatment is encouraging people who are recovering from anxiety to go into the situations they're frightened of, so they can prove to themselves that nothing catastrophic will happen. It'll probably be best if they build up gradually to going into the ones that are the most frightening for them though, such as by going into the least worrying ones first, and going into more and more worrying ones till they're going into the ones that stress them out the most, if there actually is a difference between the way they feel in them.
"But before that happens, it helps a lot if people who try that are reassured that things are unlikely to get as bad as they think they'll get. For instance, panicking doesn't lead to loss of sanity or heart attacks, even if a person feels out of control while they're panicking, and it feels as if their heart's really pounding. Once a person's become more confident that nothing catastrophic will happen to them, it'll be easier for them to face the situations where they panicked before, knowing it'll be easier to stand up to their fear if it comes on again, - although it's less likely to, once they understand it better so they're not so scared of it, since after all, being scared of the fear symptoms, and not understanding why they're causing the problems they're causing, are things that make them worse.
"And learning techniques for diminishing panic can help, such as breathing very very slowly and steadily when panic comes on, which can calm down the body so it reduces the fear symptoms, - although such things should be seen only as handy techniques, not as a way of avoiding catastrophe, such as if people do them when they have a panic attack, and then they think it was a good job they did or they might have had a heart attack, or they might have gone mad, - since if they think that, they'll always be scared that panic will do those things to them if they don't use the techniques, so their fear of the panic will never go away.
"Once they recognise panic as just a harmless but grossly unpleasant over-reaction of the brain and nervous system, it can seem less threatening, especially when they start to anticipate that their panic might come on in certain situations, but they know that if it does, it won't cause catastrophic physical problems or send them mad, but it'll just mean their nervous system's over-reacting to the stress they're under, or that part of their brain's mistakenly interpreting things as dangerous when they aren't.
"If they can get into the habit of thinking that, and reassure themselves that panic doesn't cause permanent problems, but it's only temporary, and it's just the brain and nervous system over-reacting to things, it'll reduce the amount they panic at the thought of panicking, so their panic will likely come on less often, because worries about panicking can increase the anxiety that makes it more likely to come on, so worrying about it less can reduce it. And when panic does come on, it'll likely seem less terrifying if it's recognised as just the body mistakenly setting off fear symptoms, rather than a sign that something's seriously wrong.
"And the more people become confident that they can cope with the panic symptoms, the less their minds will be unwittingly stirring them up by worrying about them, so the less bad their panic attacks are likely to be, because they'll at least no longer be accompanied by fears of dying or going insane and such things, which can stir them up more. And signs of the physical symptoms coming on won't seem so ominous and scary, so they're less likely to lead to full-blown panic.
"The more a person starts to be able to go to the places where they used to feel fear and panic without feeling so much anxiety, the more memories they'll build up of not being that scared there, and those will increase their confidence about going there again. And going there with increased confidence will be like retraining their brains to stop automatically setting off alarm signals when they're there, because their brains will start to stop making the mistake of associating those places with danger, so they'll start to stay calmer.
"Part of what stirs up panic is feeling scared that it'll be impossible to cope with it, which leads to more fear of it than people will have if they understand it better, so they're more confident about being able to tell what's really going on, and they've learned how to calm it down better.
"When a person's worked up with emotion, it's easy for them to think of all the things that could go wrong, but forget positive things, for example if a person worries about having a panic attack while visiting relatives, while forgetting that they've always been sympathetic when that's happened before, and that medication has reduced the severity of their panic symptoms, and that visiting their relatives might actually be really enjoyable, so it would still be worth going.
"One thing that can begin to help reassure some people is if when they're feeling fairly calm, they estimate the real probability of something terrible happening the next time they have a panic attack, or when they're next in a situation they've got a phobia of, partly by thinking about all the other panic attacks they've had, and asking themselves if they had a heart attack or went insane then, and asking themselves what they could do in future in situations they're scared of to feel more confident. If nothing catastrophic has happened before, they can use that knowledge to reassure themselves the next time they begin to think panic seems to be coming on.
"And if their panic attacks have grown less severe recently because they've been using techniques or medication to control them, they can reassure themselves because of that as well. And they might also be able to reassure themselves by thinking about all the times in the past when they felt sure something terrible would happen but then nothing that bad did, and by thinking about what kinds of resources they actually have to cope with situations they're scared of, such as the techniques they've learned to keep anxiety from becoming overwhelming in them.
"Knowing the real causes of the physical fear symptoms will likely make them a lot less scary, because it'll be a reassurance that they don't mean something's seriously wrong.
"Having said that though, it's worth getting medically checked over, just to make sure there's nothing wrong with your heart, and to see if you've got a physical problem that would cause symptoms that are like anxiety , such as an overactive thyroid. I think there are a few medical conditions that cause symptoms like it, where it can turn out that most of a person's anxiety problem's caused by a physical condition."
Becky continued, "One thing that can bring on panic attacks is the memories of how bad they've been before, because whenever a person gets a symptom that feels as if one might come on, or even if they just worry that one might, or if they're in a place or situation that reminds them of when one did, it can increase their fear symptoms to more worrying levels, which increases their anxiety, so it actually makes it more likely that one will come on. And the panic attack symptoms can get worse so quickly that it feels as if the panic has just come on out of the blue, for no discernable reason, especially because when a person's reminded of a situation they've been in before where they had a panic attack, the reminder doesn't have to be a conscious thing they mull over; the subconscious part of the brain that assesses things immediately before a person even thinks about them can take it as a signal to spark panic symptoms off without the thinking part of the brain having much to do with it.
"The part of the brain that does that is meant to protect people, and it does sometimes. For instance, if a person's crossing a road and a car suddenly comes zooming out of nowhere, their brain will likely automatically make them start running to the other side of the road, without them having to spend time thinking something like, 'Oh no, a car's coming fast; I'd better run so it doesn't hit me'. If people had to think like that before they ever took action, a car would probably hit them before they finished thinking such a thing; so the brain's protecting them, by sparking off the adrenaline that makes them want to run, and quickly giving them the urge too.
"The problem is that the mechanism in the brain that enables people to have the ability to do that can start sparking those kinds of urges off at the wrong times, because what it uses to learn to give people signals to get out of danger quickly can cause it to make mistakes sometimes, so it can learn inaccurate things, like learning from a time when someone, say, had a panic attack when they were really stressed before an exam, that exams must be a danger, since after all they caused such a strong reaction before; so it can spark off panic sensations the next time the person needs to take an exam, because it'll be interpreting the situation as something dangerous that needs to be got away from.
"The brain can be retrained to see situations as less threatening if the person knows what's going on and can use techniques to calm their fears though, such as reassuring the emotional part of their brain that sparks off feelings like that that things aren't that bad really, and carrying on.
"The brain can react quickly because it has the ability to instantly help people understand a lot of things, by immediately matching things in their environments to things they've experienced before, which is often worthwhile, but not always; for instance, if you smell a neighbour's dinner cooking, you might instantly think it smells appetising, because it reminds you of a dinner you had a year ago that you really enjoyed. So you might start craving something like it, and enjoy it if you have something similar.
"But the same mechanism in the brain that gives people the ability to do things like that matches situations people feel stressed in to other situations where they felt really stressed or fearful before; so, for example, a shop that has similarities to one a person had a panic attack in before, which might actually have been brought on by stresses in their lives that had nothing to do with the shop, might nevertheless spark off feelings of panic when the person's in it, because the part of the brain that instantly matches things up will match it with the shop where they had a panic attack before, and bring on panic symptoms again, because it's mistakenly assumed that the panic must have meant that places like that must be dangerous.
"So the person will feel terrible, and might gradually start wanting to avoid all kinds of shops in case they have a panic attack in them, especially because the emotional part of the brain will take note of what's different about each place a person has a panic attack in, and add it to its list of things that signal danger, because it will interpret the panic attack that it has itself in reality brought on as meaning there's danger there. So people can start having panic attacks in more and more different environments.
"For instance, if a person's first panic attack came on in a book shop, their next one might come on in a library, because the emotional part of their brain sets off alarm signals because of its similarities to the book shop; and their next panic attack might come on in a school, because their brain's matching up things there with things in the library, and setting off alarm signals again. So people can get upset by that, not realising why they've started having panic attacks in those places, so they can start avoiding all kinds of places like the ones where they've had panic attacks before, to avoid the horrible fear symptoms, with the result that their quality of life goes down a lot, especially if the instant pattern-matching part of their brain starts assuming that places where they had panic attacks before like shops must be so dangerous that they only has to pass one for panic symptoms to be sparked off, so they start wanting to avoid the town altogether, because the fear they feel in it is such a horrible sensation.
"It can be even worse than that, because the emotional part of the brain picks up on even small similarities, and can spark off panic feelings the next time it matches something to them, such as if a person starts having a panic attack in a school, and just before it happens, someone walks in wearing a fur coat, and the person who's just starting to panic worries about what that person's going to think if they see them having a panic attack; and then a little while later, they could be in a completely different kind of place, but then they see someone there wearing a fur coat, and the emotional part of their brain sparks off a panic attack, because of the coat's similarity to the one the person in the school was wearing, which instantly reminds their brain of the alarm the person started feeling the last time they saw one like it, so they feel alarm again.
"Even if the person having the panic attack doesn't consciously remember that they saw a person with a fur coat on in the school, the emotional part of their brain will remember. So they can be bewildered as to why the panic attack's coming on. They can even develop a phobia of fur coats because of the fear reaction they feel when they see someone wearing one, not understanding why, and thinking it's daft, but not being able to control the fear symptoms when they see one.
"Or to give another example, a person who hates having to pass a vicious-looking dog on their way to work can discover that their brain's sparking off fear symptoms when they pass any dog, because the subconscious pattern-matching part of it's misinterpreted all dogs as being possibly dangerous, as if it's being over-protective of them, so it's started sending them fear signals whenever they pass any dog, as if to warn them that any dog could be dangerous. Then it could even start setting off alarm signals when they pass people who look like dog owners they recognise, and when they see dogs on television, and so on. So the person can develop a full-blown phobia of dogs, and panic symptoms that they don't even understand, because the fear feelings are being sparked off by the emotional part of their brain in situations that the thinking part of their brain wouldn't recognise as dangerous."
Becky carried on, "One possible cause of phobias is thought to be that people were feeling fear symptoms for some reason that might have had nothing to do with it in the presence of something that the emotional part of their brain came to associate with the symptoms after that, so it still triggers off very unpleasant alarm signals whenever they're in the presence of it after that. So then they get scared or worried whenever they anticipate having to be close to it, because they know the fear will come on again.
"Social phobias such as fear of speaking or eating in public, or fear of being with other people in public, can sometimes be brought on by the experience of having a panic attack in public, that was partly brought on because of people's worries about what people who saw them looking possibly incompetent or anxious would think of them. Then their anxiety in future situations can get worse and worse, partly because of their fear of certain panic symptoms returning in situations like it, that they're scared of not being able to cope with. It's understandable that people can think they can't cope with panic symptoms, because they can be so bad.
"For instance, it can really stress a person out for some time if they once had a panic attack while they were eating, for some reason, and it made them get the choking sensation that people having panic attacks often feel, that's brought on by muscle tightness in places like the throat, and the feeling that the body's gasping for air, that's brought on because not enough carbon dioxide's remaining in the system for long enough to help release oxygen into the arm and leg muscles where the body wants it to be, so it thinks it needs more, because the part of the brain that triggers off emotions thinks it's important to use them to run away or fight, but the carbon dioxide's being breathed out too quickly, because an automatic bodily reaction to anxiety that increases people's rate of breathing's making them breathe it out too fast for them to use it.
"But after an experience of panic like that, a person might subconsciously associate the feeling of choking with eating in public, so the thought of eating in public might scare them.
"Or if anxiety's caused a person to be tongue-tied while they were speaking in public before, and their physical fear symptoms have often contributed to their difficulties by actually making it harder for them to use their tongue, they might dread it happening again, especially if they've felt humiliated by it; so they can become scared of what people will think of them if it happens again, especially if they've felt other observable panic symptoms before, such as shaking, and they worry about doing that again, because they're scared of what people will think if they do, especially if they've seen or heard something before such as people whispering to each other and smiling, and they had a suspicion that they were making fun of them.
"Fear symptoms might be especially likely to come on if they're already stressed about something else, so it doesn't take much more to set the anxiety symptoms off.
"People can often forget what happened at first to trigger off their phobia, but still have it, because their fear symptoms have started being automatically triggered off when they anticipate being in situations where they have to speak in public, and then even more when they're actually in them. And they might worry and worry about what people will think of them if they make a mess of things, which will stir up their fear symptoms even more, although they often won't realise it's the worry that's doing it. They might just think of their increased fear symptoms as confirmation that there really is a good reason to be scared, because people often assume their anxiety feelings are telling them something important that they really need to take notice of, which is very understandable, but it's not always the case.
"Some people really have had the experience of being made fun of or ridiculed unfairly, such as when a child is asked to read aloud in class, and they're a bit anxious, and they immediately develop an anxiety symptom because of that, such as their mouth going dry, so they stumble over their words a bit, and find it more difficult to say them; and then the teacher says something scornful, and then other children laugh. That can make them scared to try again, especially if they're sensitive to feelings of shame and humiliation. And some people can even feel fear symptoms for years at the thought of doing such things as giving speeches in public after that.
"Another cause of phobias is thought to be a kind of learned reaction to things, often from when a child sees a parent reacting in a scared way to something, such as panicking when they see a spider, which can give the child the feeling that there's a good reason to be frightened of spiders, so they themselves can become scared of them.
"People often have no idea what caused their phobia. But the good news is that it doesn't matter, because they can be cured even if they don't know. The brain can be retrained not to spark off fear symptoms in any case. Retraining the brain involves convincing it there's nothing to panic about after all."
Becky continued, "Even if a person knows they had their first panic attack in the place they had it not because of the place itself, but because they were under so much stress at the time, that won't stop the part of their brain that triggers off emotions and stores memories that involve strong emotions from taking note of their physical surroundings and sparking off a panic attack the next time they're in similar ones, as if to signal that the same danger could lurk there too, so a quick escape might be necessary. It triggers off the danger signals too quickly for the thinking part of the brain to let it know what's really going on, and that it doesn't need to do that. The thinking part of the brain gets engaged pretty quickly after the emotional part of it's triggered off the panic symptoms; but by the time it does get into gear, the fear symptoms will already be too strong for them to be easily controlled.
"That system would have been useful in the old days, when there was a lot more danger around, for instance when people hunted fierce wild animals for food, which could easily come out of the forest and take people unawares and eat them. The only way the emotional part of the brain could have sparked off quick enough evasive action would have been to trigger off strong emotions that gave people an urge to run immediately, without communicating with the thinking part of the brain first, because taking time to think about whether any particular animal really was a threat, or whether it might just want to harmlessly scavenge for food in the rubbish, or whether it was from a species that didn't normally attack humans, might have led to a waste of precious time that meant the person left it too late to escape if it really was a threat, and got eaten.
"That part of the brain can still save lives today, as I think I've already mentioned, such as if a person was walking across the road and a drunk driver came suddenly zooming towards them, and they needed to run to the other side of the road fast to escape being hit. They wouldn't have time to think things like, 'That man's driving dangerously! He must be going way above the speed limit! I'd better get out of the way fast!' Thinking things like that would cost them precious seconds they wouldn't be able to afford. The emotional part of the brain sparking off a fear reaction would spur them on to take immediate fast action to get out of the way before they had time to think, which would be what had the most chance of saving their lives.
"But the emotional part of the brain isn't well-adapted to distinguishing between panic that's just brought on because of an overload of stress and panic that's brought on by being in a dangerous place that needs to be escaped from. It treats the two the same, interpreting them both as signifying danger. So it'll register the place where a person had a panic attack as dangerous, no matter what reason they had it for. So it can set off fear symptoms that can lead to another panic attack when the person's in the same place again, or a similar one, because it can mistakenly sense danger, even when there isn't any at all.
"But then when another panic attack comes on because of that, memories of how frightening past panic attacks were can immediately scare a person, because of their worries that the current one will be as bad as the one they had before; and the increased fear that that causes can add to the fear the brain's already sparking off, to make their current panic attack worse.
"And a problem that can make panic attacks worse still is that the fear symptoms and the panic attack itself can be more frightening if the person understandably thinks the symptoms they get during panic must mean something's seriously wrong, like that they're going to have a heart attack, or else that they'll go mad and not be able to control their behaviour because the fear symptoms will be too strong for them to be able to resist the impulses they feel when they're having them, like the urge to run away, when they know there's no real need to.
"Even if they do drop what they're doing and run away though, as humiliating as that might be, they'll still soon likely regain control of their actions. If they worry that they'll lose control for a long time, that almost certainly won't happen.
"And panic attacks don't mean a heart attack's coming on; they're just what naturally happens to a lot of people in states of high anxiety.
"When people have panic attacks, they can worry that they'll faint in front of other people and look like a weakling, or that they'll behave in another way that'll make people think less of them. But when people have deliberately acted as if they're fainting in public situations, such as when counsellors want to demonstrate to their clients who have panic attacks that their worst fears about what'll happen if they do faint almost certainly won't come true, and they've gone out in public with them and pretended to faint to see what happens, their clients have found that people either want to help, or just go about their business, too absorbed in what they're doing or too much in a hurry to take any notice.
"But people's fear can make them conjure up ideas about how dangerous things must be, and theories about why panic attacks must be as frightening as they think they are, since they can feel as if they must be dangerous if they're giving them such bad fear signals, so they'll naturally jump to conclusions about why their feelings are as bad as they are.
"So a person who, say, discovers they have a fear of heights, might start telling themselves that heights always need to be avoided, since they can easily imagine how catastrophic it would be to fall from one. So even in a situation where they're very unlikely to fall from one, such as if they're looking down from one where there's a strong railing there to prevent people from falling, they still might be scared about what would happen if they did, which might reinforce the idea in the emotional part of their brain that being at a height is dangerous, so it might well spark off even stronger fear signals when the person's in another situation where being at a height's scaring them. Or they might feel like avoiding being at heights all the more because thoughts about them being dangerous will start going round in their heads all the more, because their most recent feelings of anxiety will be triggering off the old worried feelings they used to have.
"But if a person can think about how realistic their theories and beliefs really are, it can help tame their anxiety.
"Another example of where anxious thoughts and feelings can make things worse for people than they need to be is where a person might come to feel anxiety and shame after they've had trouble finding a credit card to pay with in a shop, while there's a queue of obviously impatient customers behind them, and the experience puts them off going to the shop altogether, because they're so worried about it happening again, because they worry they'll feel humiliated; so even thoughts of going there start to instantly flood them with anxiety. Still, it can help calm their anxiety a bit if they reason with themselves that it's less likely to happen if they make sure they're prepared, like making sure they know where their credit card is before they go there in future.
"But another example of how it's easy to assume the worst when anxiety comes on is when people who have panic attacks where their hearts pound can be convinced they're in danger of having a heart attack, even when they've had lots of panic attacks before and it hasn't happened. The feelings of fear and dread brought on by the fear symptoms they're experiencing can help convince them that something bad's about to happen.
"But if they can often consider that it's unlikely that they'll have a heart attack, given how many panic attacks they've already had without having one, it can help to calm their fears.
"If a person worries that they'll have a panic attack in a certain situation, the anxiety the worry about that causes is likely to make their heart race when they're in that situation, which will likely scare them, because they'll think it's confirmation that one's coming on; and the extra fear will make a panic attack more likely to come on. But if they can Think of their fear as just a common over-reaction of the nervous system that's mistakenly assuming there's a threat when there isn't one, it can help to calm their distress, so a panic attack will be less likely to come on. Fear of the horrible fear sensations is what often brings one on. Anticipation of not being able to cope, or of feeling the dreaded fear sensations, is what can really scare people, rather than being in the actual situations where their panic attacks tend to come on.
"It can be similar with things like social phobia: Fear of being judged as inadequate, or making mistakes, or being laughed at for saying something foolish, and so on, can cause people to go into situations they think they need to go into already feeling really anxious, so they're actually more likely to do things that make their anxiety worse, such as if their hands are shaking so they're more likely to spill drinks; and that can seem to them as if it's a confirmation that they're inadequate to cope and that they've done something that'll make people look down on them, so it sets off more anxiety about it. But things can get better for them once they discover that most people are unlikely to judge them as harshly as they worry they will.
"But that shows that often with phobias, the expectation of bad things happening is partly what brings on the anxiety that feels so bad that it makes the people who are suffering from it want to avoid the situations where they're worried that bad things will happen. If they weren't so worried about not being able to cope, or that something bad would happen, but they were more confident when they went into the situation that bother them, they wouldn't be so anxious in the first place, so their fear feelings might actually be less likely to come on, because they wouldn't already be stirred up, so it would take more to make their anxiety feelings spiral into true fear feelings, even if feelings like that do seem to come on suddenly. Feeling confident and well able to cope would still make the feelings less likely to come on.
"But first, a person has to discover reasons why they have a cause to be confident. That might not be as difficult as they imagine it will be though."
Becky continued, "It's possible to retrain your brain not to be so reactive to little stresses in your life. The more anxious you get about all kinds of things, the more the part of your brain that's responsible for setting off panic signals when it senses an emergency will register the things you're worrying a lot about as emergencies, because it takes the amount of stress you're in about them to mean there's something truly serious going on that might even be a threat to your survival; so it starts setting off alarm or panic signals whenever you start worrying about those things again, to give you the urge to take some kind of quick action to get out of the situations that are causing them.
"But since you often won't be able to, or won't want to do something like just getting up and running away, because that wouldn't be appropriate, because you're just being stressed by worries about things that might or might not happen in the future and so on, all that part of the brain's reaction causes is your stress levels to rise really quickly, so you become much more anxious fast.
"But it might be possible for you to use the reasoning part of your brain to calm down the emotional part of it, before it's got you into such a state of fear that that becomes pretty much impossible. And when you've done that enough times, it'll stop firing off the alarm signals so quickly, so you won't get so stressed.
"As I've said before, one way some people apparently find they can take control of their anxiety and calm themselves down is by doing slow slow slow breathing whenever they start to feel more anxious. If you try that, and it causes your fear symptoms to begin to die down, it might then become easier for you to be able to use the analytical reasoning part of your brain to work out why your emotions have got strong so fast, by doing things such as working out what it might be about what's currently going on that might be reminding the emotional part of your brain of something that made you really anxious before, because your current situation's got similarities to it, so it might think it needs to set off alarm signals to warn you about it again.
"For instance, if you're on a bus, and you suddenly feel panicky and have the urge to get off quickly, and you can't think of anything there that you'd expect to scare you, you could look around you, and try to work out what the emotional part of your brain might have picked up on that's making it think it needs to set off alarm signals to alert you to something it thinks you need to take notice of.
"To give an example, maybe for some people it'll be something like a person who's just got on who looks a lot like a boss they used to have, who used to stress them out a lot by yelling at them. If it's something along those lines, and they realise it before they get too anxious to think straight, they could remind themselves that the person who's just got on the bus isn't really their old boss, and that they're not paying them any attention, let alone bullying them, so that proves it's a different kind of situation; and they can remind themselves that the stressful episodes with their former boss are in the past, and don't have to worry them any more, because they won't happen again, so they don't need to feel panicky because someone who looks like the former boss has got on the bus.
"It won't always be possible to work out what's reminding the emotional part of your brain of something stressful and making it spark off alarm signals. But whenever you can, you can try to calm it down by reasoning like that."
Becky carried on, "It's common for people to think they're recovering from panic, only for the fear symptoms to make a reappearance, such as at times when you're a bit more stressed than usual, or if some unpleasant unexpected thing happens that causes your anxiety to rise a lot. Try not to be discouraged if that happens, since it won't mean your anxiety problems are back to stay. And the more you recover from anxiety, the less they'll turn up again.
"And whenever they do, you'll at least know that if you've managed to make them go away once, you'll be able to do it again. And it'll likely be easier and quicker for you to do it that time than it was the first time you tried it, since you'll already be a bit practised at doing it, so you'll have a better idea of how to make them fade away than you had before.
"So if you can take a more relaxed attitude to the fear symptoms, - if it's possible, - thinking something like, 'I'm going to do things to take my mind off them, but if they come, they come', then the very act of caring less than you did before about whether they do come back will make them more likely to subside gradually, because they won't be being stirred up by your anxiety about them. And the more often you have complete breaks from them, because there are times when they don't come on at all, the more your nerves will calm down, so they'll stop triggering the symptoms off so easily, and the ones that do come on will get less intense over time.
"Some people find that their fear symptoms disappear quickly. But often it takes more time, - different lengths of time for different people.
"But the more confident you become that you can recover fully from anxiety, the more that in itself will help your recovery, because worrying about not being able to recover fully, or it taking a long long time to recover, will be one of the things that tenses up your muscles and creates the fear symptoms, so it'll actually be holding your recovery back. It might be hard not to worry about whether you'll really get better at first; but the more little signs of recovery you notice, the easier it'll become to feel more hopeful, till eventually you might even start to forget about your fear sensations for more and more time, and then eventually, life will become normal again."
Becky ended her lecture there.
Related to some of the themes in this book series: Self-Help Articles on Depression, Phobias, Improving Marriages, Addiction, Insomnia, Losing Weight, Saving Money and More