Panic attacks are ruining my life

Dear Laurie,

Your call for help concerns me, because you are heading towards 'agoraphobia', the situation where fear of a panic attack imprisons a person in her home. But THERE ARE THINGS YOU CAN DO. Like many other psychologists, I have managed to help panic attack sufferers in as few as 3 sessions. A panic attack feels TERRIBLE, but you can conquer a 30 year history of them. Other people have. You need a 3-prong attack:

1. FIRST AID: A terrified person tends to breathe rapidly and shallowly, with the chest. This is a way of pumping in oxygen, necessary when you are facing physical danger. However, in the absence of vigorous activity like running or fighting, it quickly depletes the carbon dioxide in the blood, and this in turn leads to many of the symptoms of the attack: near or actual fainting, spots before the eyes, rapid heartbeat. When you feel that a panic threatens, BREATHE SLOWLY AND DEEPLY, so that your stomach rises and falls. It helps to carry a bag around, e.g., a brown paper bag; when the panic hits breathe into the bag, then breathe in the air from it. This may look strange to others, but it increases the carbon dioxide concentration of your blood -- and the panic attack is beaten for now.
2. KNOWLEDGE: A Panic Attack is NOT LIFE THREATENING. The symptoms are those of extreme fear, not those of a heart attack or stroke. Of course, you already know this, but others reading this mightn't. It helps to read up on the symptoms of heart attacks and strokes. They are DIFFERENT. A Panic Attack is NOT A SIGN OF GOING CRAZY. Laurie, you are not crazy. It is true that you are in the grip of something and therefore 'out of control' of yourself, but the symptoms and feelings are very different from those of any mental illness. They are exactly the same as those of a person in extreme physical danger. They occur in response to A SIGNAL YOU ARE MISINTERPRETING. THEN THE FEAR IS MAINTAINED BY WHAT YOU THINK ABOUT YOUR FEELINGS IN RESPONSE TO IT. The fear is real. It is not an illusion or a hallucination. You are not crazy. You are caught in a loop: fearing the fear, and therefore being in fear.

   A panic attack is not a sign of weakness. Anyone can have them, in the right (well, wrong) circumstances. I once had one while watching my daughter stand on the bottom rail of a wrought iron safety fence, at the top of a very tall tower. I had the unreasonable feeling that, regardless of the laws of physics, she could topple over the fence (which was above her chest height) and fall to her death. I knew this was unrealistic, but could not stop an extreme fear reaction. Fortunately, I knew enough to bring myself out of it, and it has never recurred. Had I been less knowledgeable about psychology, I might now have a full-blown phobia.

3. CURE: You can control it. Just knowing the above facts can help a person get rid of panic attacks, EVEN IF THEY HAVE BEEN A PROBLEM FOR MANY YEARS. When you feel the next panic attack coming on, say to yourself: "This will be uncomfortable, but it cannot kill me. It's not a sign that I'm going crazy. If I can stop being scared, it will never come back. Anyone can have a panic attack." Paradoxically, the best way to beat a panic attack is to INVITE IT. The panic attack is a fear of fear. It WILL NOT COME if you can pluck up enough courage to say within your head: "Come on, you wretched panic: hit me! Go on! I'm not afraid of you!" If it helps, have a trusted friend with you for support. The panic will be helpless against you, will not be able to touch you, AS LONG AS YOU REFUSE TO BE AFRAID OF IT! Let it come!

   If this proves too hard, you can be helped by a longer process called 'Systematic Desensitization'. This is a highly effective 'Cognitive-Behavioral' technique, and is described in detail in my e-book, 'Anger and Anxiety: Be in charge of your emotions and control phobias'. It is a slower and steadier way of facing the fear, and thereby banishing it.

   Good Luck,

   Bob Rich