A GP doctor friend who had a weekly column for a women’s magazine told me how influential his column turned out to be with patients.
“Whatever I write about and however obscure,” he told me, “The number of patients who come in the next week believing they have that same condition is far higher than the week before I mentioned the complaint.”
I’m reminded of this when I see the rising number of references to panic attacks on both social media and in newspapers and specialist magazines. Commissioning editors and medical “influencers” seem to think there’s a growing problem.
As a practitioner, I’ve recently been told by colleagues of clients who have come to therapy after experiencing panic attacks for the first time. I don’t know why it surprised me to hear they were having their first such incidents at 30+.
When I reflect on it, I suppose I’d imagined something as serious as that would present at an earlier age but what if there had been a lot of warning signs which had not been noticed? Could a panic attack be their body’s way of telling them they can ignore no more?
A friend who did not consider herself a nervous person told of the first and only time she had a panic attack.
The woman, in her 40s, told of how one moment she had been fine, looking in the rear-view mirror as she joined the left-hand lane of a busy overpass and accelerated smoothly forward.
The next second she could hardly breathe. She told of how her mind went completely blank and she had no idea what to do next. For an infinitesimal moment she froze and, had she stayed that way, something catastrophic might have happened.
Ironically, this woman is someone who is mentally very strong. It’s probably because of that inner strength that she managed to override her frozen state and avert a crisis.
Looking back, she said she recalled how she was crouched over the steering wheel with her hands wrapped tightly and immovably around it. She was unaware of the rest of her body but supposed she must have kept her foot on the accelerator because the car continued to move forward.
But she had no actual knowledge of how she did it, or what had caused it. All she was aware of was that it had happened and she was shocked and was very afraid it might happen again. (Fortunately for her, it didn’t.)
She was so concerned about what had happened that she told a family member who insisted she go to the doctor (to add a bit of light relief to this, I should add that that was in the days when you could get a speedy appointment with a doctor) so, feeling scared herself, she complied. She took a list of what was going on in her head at the time. These included not sleeping, terrible fears of impending doom, financial worries, oh, and an abusive relationship. She’d forgotten about that one.
To the rest of us, and to the doctor, she was a bodyful of anxiety. In a sense, the panic attack was not a surprise. The surprise was that it hadn’t happened much earlier.
I was reminded of this person and the panic attack while wondering what can be done to prevent something that has such potential to be so shattering. How do we stop anxiety moving from low(ish) level angst to a full-blown attack?
There’s a 5-4-3-2-1 grounding technique doing the rounds as a way of bringing you back into your body when it’s in crisis mode. There’s also the deep breath in through the nose for four seconds and then exhaling through the mouth for eight. Anything that helps calm the nervous system and slow the heart rate is great, but I can’t help wondering how easy it would be to remember when you’re in the throes of your own out-of-body experience. The exercise requires you to be making full use of your logical and learned prefrontal cortex whereas you’re actually in thrall solely to your instinctual and paralysed amygdala, where the fear is so great it’ll pay no need to logic.
As ever, the key is awareness. Don’t ignore the symptoms. When you start to feel something’s not right or at least different from what you’ve been feeling, take note. Are you sleeping okay? How’s your concentration? What about your mood? Are you uptight or easy to anger, or something different from how you usually are? Is there anything you can think of that’s playing on your mind more than it has before? Don’t dismiss the feelings intended to alert you to forthcoming distress. Go for a deep dive inside yourself to see if you can discover the root cause. It will have started somewhere. Take time to work out when and see what you can do about it. If in doubt, speak to someone. Your body is alerting you to a problem that will take over your mind unless you allow the feelings in. Don’t leave it, it won’t go away.
There’s an African saying that’s doing the rounds at the moment. It’s a light-hearted expression for a heavy subject: How do you eat an elephant? One bite at a time. Alternatively: The longest journey begins with the smallest steps. Time to get started.