My panic attacks have made me lose confidence

I’ve had a few panic attacks over the last few years but I had a really bad one a couple of months ago and I’m finding it hard to get back to feeling confident and unafraid.
I feel that I need to see a counsellor and wonder if you know how I can go about finding one who will be sympathetic and able to help with this sort of problem. GD
FIONA SAYS: TALK TO YOUR GP
I suggest you start with your GP, as practices usually have a counsellor attached to them.
If not, then your doctor will certainly know where to refer you.
If you would prefer to find one for yourself, the British Association for Counselling and Psychotherapy (BACP) has an online directory.
Go to bacp.co.uk and click on “seeking a therapist”, then enter your postcode and details.
I should add, though, that any kind of attack like this is worth talking over with your GP just in case it is linked with a medical condition

INNOVATIVE HEALTH: Anxiety and panic in COPD

Jan Lundstrom of the local Huff-n-Puff support group for those with Chronic Obstructive Pulmonary Disease asked me to speak at one of their meetings recently. He indicated that panic and anxiety were major issues for those with this disease, and any helpful hints I could provide would be appreciated. While researching the topic, I ran across a great little e-book by Dr. Vijai Sharma, a psychologist, yoga expert, and a COPD patient himself who was diagnosed in 1994. Dr. Sharma's free e-book, especially his "Emergency Tip Sheet" for panic control is a must read for anyone with COPD. Here I will summarize the techniques he recommends for use when anxiety and shortness of breath strikes.

1. Monitor your breath. At the first sign of shortness of breath (SOB), tell your body to relax. Start pursed lip breathing (PLB) immediately. PLB involves breathing in through the nose and slowly blowing the breath out through the lips with pressure -- like the pressure you'd exert when blowing up a balloon. This will help to expel the carbon dioxide that is trapped in the little air sacs in the lungs. Focus your mind on something in front of you and count to measure your inhalation time compared to your exhalation time. The goal is to make your exhalation twice as long as your inhalation.

2. Take the medications, inhalers, duo-nebs, etc. exactly as prescribed by your doctor. Remind yourself that although very unpleasant, the panic, anxiety and SOB caused by the biological emergency response of your body does not mean that you will never catch your breath again. Believe in and expect a positive outcome. Silently say reassuring words to yourself such as "I've survived this before, I will survive it this time, I can handle this, I am becoming calm and relaxed."

3. Be aware that just as your body has a biological emergency response, it also has a biological calming response which you can learn to employ. Did you know that the first flush of adrenaline, if not compounded by further panic thoughts will, in just 90 seconds, have run its course? By thinking calming thoughts, you will be able to stop pumping more new adrenaline. Adrenalin that was already released in your system, causing the panic symptoms, will eventually be neutralized. Acknowledge the panic symptoms, but do not focus on them or try to fight them. Fighting them only makes it worse. I've heard that what we focus on grows, and what we resist persists... so attempt to focus on relaxation.

For maintenance, learn a relaxation technique and practice it two or three times a day for 15 to 20 minutes. There are a number of techniques: meditation, guided meditation, yoga, Reiki, and progressive muscle relaxation to name just a few. Aroma therapy and music therapy may also help with inducing relaxation. Becoming more aware of your body and mind through these practices will help you catch the advance signs of an anxiety attack before it becomes severe.

With these relaxation tools, you will be able to bring about the calming response in record time. Jan from Huff-n-Puff would also want everyone to know that if you suffer from SOB, talk to your doctor about a Pulmonary Function Test to determine the status of your lungs and Pulmonary Rehabilitation to help maintain the lung function you have for as long as possible.

Reference: Dr Vijai Sharma http://mindpub.com/copdhome.htm . Sharon Weaver, R.N., is a certified emotion code practitioner and reiki master and teacher in Alamogordo with The Innovative Health Network. To contact her directly, call 430-1557 or email weavsk@yahoo.com or reikienergyworks.net.

Bipolar Symptoms Stronger When Anxiety Disorder is Present

People who suffer from an anxiety disorder in addition to bipolar disorder are more likely to have severe symptoms of bipolar, such as suicidal behavior, more manic episodes, and more depressive episodes, according to new research led by Regina Sala, M.D. at the New York State Psychiatric Institute of Columbia University.
Individuals with both disorders were also twice as likely to be admitted into an emergency room for their bipolar-related depression.
According to the study, about 60 percent of people with bipolar disorder have experienced an anxiety disorder at least once in their lifetime, and 40 percent have had two or more anxiety disorders in their lifetime.
Researchers looked at the symptoms and treatments of 1600 adults with bipolar disorder who were part of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).
Compared to individuals with bipolar disorder who never had anxiety, people with both disorders were also more likely to have substance abuse problems and social problems, such as problems at work.
The authors believe that that early detection of anxiety disorders in people with bipolar disorder is necessary. Treating the anxiety disorder may help ease at least part of the burden of bipolar disorder.
The study is published in the Journal of Psychiatric Research and was supported by grants from the Alicia Koplowitz Foundation and the National Institutes of Health

When should one get treatment for anxiety?

By Luisa Dillner/London

It’s normal to feel anxious – and these days there is plenty to worry about.
Being scared sets off an automatic response in our bodies. We are flooded with adrenaline and other stress hormones, which increase our heart rate and prepare us to either run for the hills or stand our ground and fight.
But if you feel anxious most of the time, or are overwhelmed and have panic attacks in certain situations (such as getting on a plane or going into a crowded room), then you may need help.
The Problem
Anxiety symptoms include helplessness, rapid breathing, sweating, trembling and feeling hot. A panic attack is an acute disorder where these symptoms are amplified: hyperventilating causes tingling around the mouth, while a fast heartbeat feels like chest pain.
People often seek medical advice when anxiety interferes with their life or impinges on other people. It is usually the unpleasant physical symptoms of anxiety that make people get help. So how can you know if your anxiety levels are healthy, or if you should see a doctor?
The Solution
Anxiety is part of the human condition and treatment is only needed if you can’t cope with it yourself by talking to friends and reducing factors that will make symptoms worse.
There are many disorders that anxiety is a part of, such as agoraphobia (the fear of going out), specific phobias (eg of heights) and obsessive compulsive disorders, where symptoms have lasted for six months. Going to your doctor if you have strong anxiety symptoms may reveal an underlying mental or physical health condition (anxiety can accompany asthma, diabetes and heart disease), which is a good reason to speak to someone. Keep a diary of when you get symptoms to help identify what brings them on.
Britain’s National Institute for Health and Clinical Excellence (Nice)’s guidelines on anxiety recommend that you don’t take benzodiazepines(minor tranquillisers that calm you but are addictive), and instead suggests psychological treatments such as cognitive behavioural therapy, which equip you to rethink situations in order to deal with them.
Psychological therapy for panic attacks involves explaining what physically happens. For example, overbreathing means a drop in carbon dioxide and a metabolic shift in the body. This causes tingling, so if you breathe into a paper bag it reverses the shift and stops the symptoms.
Relaxation programmes teach people how to breathe and relax their muscles when anxious.
Medication may be suggested if you have symptoms of depression and beta blockers are used to stop your heart pounding. But behavioural therapies are by far the best place to start.- Guardian News and Media