Riding the Wave: How to Cope with Anxiety and Panic Attacks
What is the wave of anxiety and how can I ride it?
The fight-or-flight response that we all have, is something which, when our cavemen ancestors lived in constant danger of being attacked by wild animals, kept them from harm. However, this primitive part of all of our brains still creates feelings in response to things that don’t warrant such a reaction.
When we feel flooded with anxiety and panic it can leave us feeling out of control and overwhelmed. The wave of symptoms one experiences are very physical, so much so that it is not uncommon for people to think they are having a heart attack because of cardiac sensations such as a racing heart, shortness of breath and hot and cold sweats.
These symptoms occur because your nervous system has been flooded with the stress hormones such as cortisol and adrenaline which kick start our fight-or-flight threat system. The misattribution that these physical symptoms indicate a life-threatening ailment or other negative consequence (such as I will become so overwhelmed I will pass out or make a fool of myself) serve to further fuel the panic feelings. In therapy, we call this a vicious cycle.
Given how frightening these symptoms can be, it's not uncommon for panic attack sufferers to begin to fear the onset of future attacks. This is often referred to as ‘fear of the fear;.
Panic feelings can start when bodily sensations are misinterpreted or if they are heavily focused on. The feelings can show up with a change in your emotional state (anxiety, anger, excitement) or some innocuous event such as drinking coffee (causes palpitations), getting up suddenly from sitting (dizziness, palpitations) or exercise (breathlessness, palpitations). These feelings will show up from time to time, or for some this can feel too often.
A key component of riding these waves of feelings is how we choose to respond to them, no matter why they arrived in the first place.
Physical sensations that would be processed as normal, not alarming, or not registered at all by non-anxious individuals, are often selectively attended to and perceived as more dangerous than they really are and interpreted as an imminent physical or mental catastrophe.
It can help to reframe these as normal everyday feelings which come and go. The less you engage with them, the quicker they will go. Noticing the feeling, labelling it (such as “this is just my threat system miss-firing like a faulty alarm”) and then carrying on in spite of it, you are not fuelling it further but allowing it to run its natural course. The feelings will go if you learn to ride them rather than fight them.
It is helpful to identify the things we are doing during panic attacks to try to solve the problem, because often it can be that, that is causing the problem to stick around or become worse.
Try to consider the behaviours (including the behaviours you engage in, in your mind) that might be part of the problem. Behaviours such as mental review, mental debate, checking and scanning your body, and seeking reassurance from others are part of selectively attending to and keeping your focus on the feelings of anxiety. These behaviours, either overt or covert in nature, will be playing a big part in keeping your threat system high and the perception of anxiety as a danger to you.
Are you mentally arguing/debating about the sensations and what they mean, or why they arrived and when will they go?
Are you checking the physical sensations to monitor if they change or get worse?
Are you assuming the worse and considering what might happen if they don’t disappear?
Are you planning strategies for the worse case scenarios or running through safety-seeking options in your mind?
Are you seeking reassurance from others or trying to repeatedly reassure yourself?
Ask yourself, when you engage in any of the above strategies, do they typically make the anxiety better or does it stick around for longer?
The more we look for danger (in this case symptoms of anxiety which are being perceived as a physical problem), the more danger we see, the more anxiety symptoms we get and the more convinced we are that something physically bad is happening or will happen. We call this a vicious cycle.
A mental debate about the symptoms such as ‘why can’t I feel them now, maybe they will come back, and what if they are worse next time?’, ‘what if the feeling never stops and it causes me to go mad?’, ‘what if it happens when I’m at work and people notice and think less of me?’. This paradox is one which we also see when people try to control their thoughts. The very thing we are doing to try to help ourselves, in fact, makes the problem worse.
You can gain control of your panic attacks by trying not to control them.
A strategy for coping with anxiety is to practice riding it out, rather than trying to resist or fight it. By recognising the feeling and carrying on in spite of it, you are allowing it to run its natural course. The feelings will go if you learn to ride them rather than fight them.
Panic attacks are not dangerous, they feel that way, and therefore can feel extremely frightening. They will not cause you to do anything you don't want to do, they will not cause you to "go crazy”, they will not make you stop breathing, they will not kill you and they WILL always go away.
With this knowledge, you are in an informed position to have a go at a different approach. To acknowledge the feelings (rather than ignore them or try to block them out), but not focus on them or engage in a fear-focused mental debate causing an unhelpful viscous cycle of anxiety and panic.
3 Steps for Riding the Wave of Panic and Anxiety
ACE - Acknowledge. Come Back. Engage
Acknowledge. The next time you notice an increase in anxiety, or symptoms of panic, pause, take a slow breath. Take a moment to recognise that your threat system has shown up, and label what you are feeling. This can give us a moment to defuse the feelings enough to be able to more fully access our wisdom, and therefore creating power over these feelings. The wisdom to know these feelings can not harm us and they will pass.
Come back to the now and your surroundings. I often call this ‘dropping anchor’. Come back to the facts rather than going on a journey with your fears. Do not try to push or battle these feelings or thoughts away. Practice an alternative response.
Shift your attention externally. Involve yourself in your external surroundings. Look up, look around, pay attention to what is going on around you. Listen to the different noises near and far, loud and quiet. Notice colours, sights and textures. Engage with all of yours senses.
Engage. Move your attention to actively engage in a valued driven activity. Do a task that uses your hands. Make a good old cup of tea focusing on the noises of the boiling water, the warmth and flavours. Have a conversation with someone and really pay attention to what they are saying. Sing along to some music. The aim is to engage fully in the present moment.
This approach may not come easily to you and will take some time and repetition to learn.
If you are struggling to manage these feeling or have a long history of having panic attacks you it may be very helpful to talk with one of our online therapist who will be able to guide you through a personalise programme to overcome these feelings.
Alternative strategies such as self talk, telling yourself to calm down during a panic attack, can sometimes lead to further worry about feeling unable to calm down, which can cause it to take longer to ‘ride' out the wave of anxiety feelings.
Slowing your breathing down can help, but shift yourself attending outwards to your surroundings and drop anchor for a moment. Once you have done a few slow breaths, shifting your attention to the external environment around you can help prevent further monitoring of your symptoms, which can have a paradoxical effect.
Learning to shift the focus of attention from internal scanning and mental debate toward and the scanning of bodily symptoms onto the external environment really can help you ride the wave of anxiety back to the shore.
You don't have to try to make the panic feeling end, it will end by itself when you stop fighting it. Put your weapons down, pick up your surf board and learn to surf the waves.
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