One of reasons people have panic attacks is that anxiety can become a “vicious cycle”. The following diagram shows this process visually:
The process often starts with a thought or perception that there is something frightening or dangerous nearby.
This is often an unconscious thought, i.e., the person having it is not aware of it. Like all unconscious thoughts, it may not be something that the person consciously believes. For example, a person walking into a party may have the unconscious thought, “They are going to laugh at my outfit,” in spite of the fact that he knows there is nothing wrong with how he is dressed.
Whether the person is aware of the thought or not, his body reacts to the thought. The body’s normal reaction to danger is to increase heart rate and speed up breathing, so that is what happens. This is the well-known “fight/flight/freeze” response that is hard-wired into all animals, including humans.
This is where the vicious cycle can start if the person thinks to himself, either consciously or unconsciously, “There is something wrong with me!”
Often people with chronic anxiety problems have become afraid of their anxiety or afraid of the symptoms of fear (e.g., racing heart or fast, shallow breathing). People who have problems with anxiety or panic attacks often become hyper-attuned to signs of anxiety, and the first indication of anxiety can set off alarm bells in them.
When a person reacts to his body sensations with a thought like, “What if I am having a heart attack?” or “Oh, no, I am going to have a panic attack!” he becomes more afraid, and his body reacts by speeding up his heart rate and breathing even more. This, in turn, makes him think there is really something wrong, which increases his body’s fear response. So his thoughts feed his fear-based feelings and vice-versa.
Notice that much of this process may be completely unconscious. In other words, the person is quite unaware of some or all of the thoughts and feelings involved in the escalating anxiety.
Usually people try to deal with anxiety by “talking themselves down”. A person says to himself, “Relax. There is nothing to be afraid of here.” This usually doesn’t help much, because the body/mind interaction that is happening is primarily not a conscious process, and conscious thoughts don’t have much immediate affect on unconscious thoughts.
So what does help? Interrupting the cycle via the body. This is generally done with relaxation exercises. The simplest one is to force yourself to breath slowly and deeply with the diaphragm (sometimes called “belly breathing”). It is fairly difficult for anxiety to keep escalating when you are breathing this way. Consciously breathing in this manner also focuses your attention on breathing, rather than on your fearful thoughts.
Often when I tell people this they respond that this doesn’t work for them. Usually they believe this because they made a half-hearted attempt to do it once or twice when they were in the middle of escalating anxiety or a panic attack.
The key to success here is not what you do when you start feeling anxious; rather, it is in what you do before you become anxious.
If you are having anxiety problems, you probably have lots of practice at becoming anxious, to the point where it is a habit pattern. To counteract that, you must practice relaxing and calming techniques until they also becomes habitual and easy to do. You can’t learn to do this while you are panicking. (Actually, you can’t learn much of anything while you are panicking.)
I will address relaxation techniques in another post.