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

Anxiety attack vs panic attack! Is there a difference?

Anxiety attack and panic attack sometimes are used to mean the same thing. But there is a distinction between the two conditions. The most obvious difference between anxiety and panic would be the level of nervousness that is experienced in each but there are also other differences.
On the other side, similarities are also found between them. Here the difference between panic and anxiety will be discussed.
The term anxiety attack is used to refer to an individual who has reached a level where there their nerves have been impaired; and affects their performance and thinking.

Persons, who normally work a 9-5 job, might have experienced this kind of attack. In 21st century living an anxiety is normal. Individuals who has never experienced being anxious might have another type of disorder. But, there are those persons who don’t become really nervous very often; however, this number of persons is small.
Anxiety Attacks Are Insignificant on Many Occasions
If you are in a situation where you want to get out immediately and decided to just leave and probably come back later, you’ve experienced an anxiety attack. Or maybe, you have found yourself so nervous while doing something you’ve vowed not to do it again, this too is an anxiety attack.
However, having a panic attach is being in a situation where the flow of adrenaline throughout the body is so intense you become extremely scared and physical sensations have become disturbing. This is one panic attach symptom. In summary, the physical sensation you have experienced is the difference between an anxiety attack and a panic attack.
Physical Sensations a Panic Attack Symptom
Panic attacks are described by those who have them as a feeling of a stroke or having a heart attack, or may even feel dizzy. The sufferer experiences a terrible cycle because these feeling make them become even more nervous, this heightened nervousness cause adrenaline to flow more throughout the bloodstream, triggering more panic and in turn disturbing physical sensations become more.
Persons having an anxiety attach who decides to leave the event or situations that makes them nervous often times the anxiety will leave. But a panic attack is so intense if the individual don’t leave the situation immediately; they become so overwhelmed that another panic attack will strike.
An anxiety attack is not a disorder or syndrome; it’s a disorder when it causes the individual to change their lifestyle to a substantial degree. So a panic attack is a disorder. Panic attack treatments need to be administered properly or else the condition may worsen.
There are many panic attack treatments out there but not all of them seem to provide the best remedy for all. Each individual’s attack levels differ and therefore it is best to consult a physician or doctor before taking any medication or treatments to curb your panic attacks.

Overcoming Anxiety and Panic – What Works

According to the National Institute of Mental Health, about 40 million American adults are affected by anxiety disorders. That is 40 million Americans who are full of fearfulness and uncertainty.

Gayla Miller, Hopkins County, KY author, suffered with anxiety for 18 years, from age 15 into her early 30s. Gayla told SurfKY News that early on, worrying became a regular habit.
“Worrying was my normal,” said Gayla, “I would worry about something all the time. If there wasn’t anything to worry about, I would make something up.”
Gayla’s worries started morphing into panic attacks. Panic attacks can be characterized by sudden waves of pure terror, a pounding heart, feeling sweaty, weak, faint and dizzy. A person may become suddenly nauseous, feel actual pain in their chest or feel as if they are in a dream-like state. A panic attack creates a feeling of impending doom and a fear of losing control.
Usually, people suffering from anxiety and panic attacks will believe they are having heart attacks or losing their minds. It is a scary and confusing reality for millions of Americans.
“One little thing would go wrong, and I would feel my heart sink to my stomach and my legs go warm and weak. I would literally be in a state of bewilderment,” explained Gayla. “I was a big catastrophizer. Everything was a catastrophe. If things came easy I felt like there was something wrong. If it wasn’t hard, I’d try to make it hard. I was working against myself every day.”
People in this position usually start displaying “safety behaviors”. Safety behaviors are actions that a person will engage in to help him or her feel protected in the event that a panic attack occurs. This includes carrying safe items, limiting travel by sticking to safe places and even latching onto safe people. A “safe person” is usually a significant other that knows about the panic attacks and knows how to assist the person when an attack takes place.
“I got to the point where I had a safe place and a safe person,” admitted Gayla. “My safe person was my husband and my safe place was my home. My world just kept getting smaller and smaller.”
In Gayla’s early 30s she lost a family member and that is when her anxiety went through the roof.
“It was ridiculous after that,” Gayla remembers. “There were other things going on in my family at that time too. At that point, I was living in a constant state of alert.”

About 6 million American adults have panic disorder and it is twice as common in women as men. People who have repeated, full-blown panic attacks can become terribly disabled by their condition. They will start to avoid places and situations where panic attacks have occurred. The National Institute of Mental Health states on their website that about one-third become housebound. Eventually, this condition can lead a person to acquire full-blown agoraphobia, a fear of open spaces.

Gayla continued to go about living life as best she could, but her anxiety was off the charts. She constantly felt bewildered, like she was moving slower than everybody else. Gayla hid her anxiety issues from her friends, family and the people around her.
“Nobody would have ever known,” she admitted. “I put on a real good mask. I didn’t want anybody to think I was crazy. I thought I was the only one.”
Gayla went on to tell SurfKY News that her friends knew she was a “worrywart” but that they didn’t know the full extent of her worry.
“Literally, one day I woke up and I was like, I can not do this anymore. I was killing myself slowly and I knew it,” said Gayla. “That was when I started, what I call, my road to self discovery.”
It was then that Gayla discovered cognitive behavior modification. Gayla’s friend, Robin, was also suffering from anxiety. Robin’s anxiety was so bad that she was having up to five anxiety attacks every day. Robin told Gayla about a program she had been utilizing that focused on cognitive behavior modification. The program had been giving Robin some relief so Gayla gave it a try.
Cognitive behavioral modification is a therapeutic technique developed by a psychologist named Donald Meichenbaum. The therapy focuses on identifying dysfunctional self-talk in order to change undesired behaviors. Meichenbaum’s technique focuses on the things we talk about and the way we talk about them. He considers the intent we put out in the world a direct affecter to our own personal behaviors.
Cognitive behavioral therapy takes place in three separate phases.
The first phase is all about self-observation. In phase one the focus revolves around observing your own behaviors and listening to your internal dialogue. If you are thinking negative thoughts they will consume you. This in and of itself could be the center of all of your anxiety and panic symptoms.
The second phase is all about changing your internal dialogue, your “self-talk”. Once you start picking up on your negative thought process, you can focus on that and start modifying it. Whenever you find yourself slipping into negative thought patterns, you alter that and replace those thoughts with new and positive self-talk. Stop telling yourself that you can’t do something. Start telling yourself that although it may be difficult, you can try. If you start there and recreate your thought patterns, you will be able to stop avoiding and start coping. You have to be willing to experience situations which provoke your anxiety so that you can actually learn to deal with those situations. It is an important step to recovery.
The third phase is centered on learning new skills. The way you respond to anxiety and panic, now that you are becoming aware of your own inner thoughts, gives you a better grasp on your anxiety. You can alter your own reactions in a productive way. When you let negative thoughts consume you it can be difficult to control the way you react to things and situations. Utilizing cognitive behavioral modification could dramatically change your life.
It took Gayla a little over a year to get the upper hand, thanks to CBM.
Once Gayla felt she had cured her anxiety she wanted to share what she had learned.
“I knew there were other people struggling with anxiety,” said Gayla. “I didn’t want to keep it in. I wanted to share it with other people.”

Gayla, now a self-proclaimed “life coach”, stumbled across a SurfKY News article written by Hopkins County lead news reporter, Luke Short. It was titled “Recovering Addict Inspires New ‘Vision’ for Salvation Army”. The article focused on their new “Pre-Hab” program. Gayla was inspired by the article. She immediately called Josh Peyton at the Salvation Army, and after some conversation, it was decided that Gayla might be able to serve the community by offering a couple weekly classes addressing anxiety and stress.

In conjunction with the Salvation Army, Gayla Miller will be hosting seminars on Mondays and Tuesdays. The meetings are free and secular.
“Meditation Monday” will start at 5 p.m. in the Salvation Army Chapel Worship Center. Gayla will lead the group in a 15 to 30 minute meditation session. Following meditation there will be some time for group discussion.
“Tension Tuesday” will begin at 5 p.m. at the Salvation Army Center of Hope in one of their meeting rooms. Tuesday’s meetings will be 45 minutes to an hour long. They are designated group coaching sessions, in which Gayla will discuss cognitive behavioral therapy and offer techniques that help. The group will be able to share details about their previous week with each other in a comfortable supportive setting. Some of the topics Gayla plans to go over include; how to end panic attacks, positive self-talk, counteracting negative thoughts, how to lower your expectations and time management skills.
The group is open to men and women of any age. The material will be spread over the course of four to five weeks so a person looking to join the group can jump in at any time and attend as long as they wish.
Gayla points out that it takes courage to address your anxiety, and fear of that is normal. When a person decides to seek help with their anxiety, that in and of itself, makes their anxiety worse.
“People scare themselves off because the anxiety gets worse, and they are like, I’m not doing it. People freak themselves out before they even get their foot in the door.”
Gayla encourages those suffering to “Feel it and come anyways.”

Gambling and anxiety go hand-in-hand

Commentary by Dr. Anthony Komaroff

Dear Doctor K: I used to gamble once a year, on a trip to Vegas. But lately my lifelong battle with anxiety has gotten worse — and so has my gambling. Are they related? What can I do?
Dear Reader: Gambling and anxiety do often go hand in hand. People who gamble report feeling less anxious while gambling because the excitement masks anxious feelings. This relief can become addictive, and the impulse to gamble can become overwhelming.
So for many gamblers, reducing anxiety by some other means is necessary in order to control the urge to gamble as a way of dealing with anxiety. There are several techniques that can help.
One of the most powerful ways that people can counteract anxiety is by learning relaxation techniques. Relaxing means more than just sitting on the couch watching TV or a movie. Unless the show is completely absorbing, anxious thoughts can keep breaking through.
Relaxation exercises can teach you to identify worry triggers. Then you can defuse them and break the cycle of anxiety. It’s best to do them every day. The more you do them, the more positive effect they will have. There are many types of relaxation exercises, from the deep breathing exercise I describe below, to mindfulness meditation, to exercises such as yoga and tai chi.
The goal of these exercises is to bring about the relaxation response, which is the opposite of the stress response. By regularly practicing techniques that evoke the relaxation response, you can help your body reduce the cumulative effects of stress.
Relaxation-response techniques slow down your heartbeat and breathing. Your body uses less oxygen and blood flows more easily throughout your body.
One way to relax is through deep breathing or breath focus. Find a comfortable, quiet place to sit or lie down. Begin by taking a slow, deep breath. The air coming in through your nose should move downward into your lower belly. Let your abdomen expand fully. Now breathe out through your mouth (or your nose, if that feels more natural).
Put one hand on your abdomen, just below your belly button. Feel your hand rise about an inch each time you inhale and fall about an inch each time you exhale. Your chest will rise slightly, too. Remember to relax your belly so that each inhalation expands it fully. As you breathe out, imagine that the air leaving your body carries tension and anxiety away with it.
When you first start, 10 minutes of breath focus is a reasonable goal. Gradually add time until your sessions are about 15 to 20 minutes long.
If you need more help in controlling gambling as a response to anxiety, you can find more information in the new book “Change Your Gambling, Change Your Life” by Harvard Medical School’s Howard Shaffer, M.D. You can find out more about it at my website, www.AskDoctorK.com.
Other treatments for anxiety also can help. Anti-anxiety medicines and cognitive behavioral therapy (a form of “talk therapy”) are effective treatments for anxiety as well.