There’s only so much preparation you can do for yourself when you live with a panic disorder. Unless you’ve found yourself a way to live attack free (therapy to remove triggers, hormone or nutrient replacements to fix imbalances etc, keep in mind, we don’t all have these options), you know full well that at some point another one is going to hit.
And another, and another… and another.
There are two main important things to consider when managing self care with heightened anxiety and panic attacks. The first is handling the day to day actions and buildups that can influence how our disorder may play out. The second is coping and caring for ourselves after an attack hits.
In two recent posts I mentioned the difference between anxiety and panic attacks and I covered a little bit of the basics on prevention and preparation when dealing with both of them as well. While there are a lot of similarities in how to handle a lot of the pre-symptoms, I find that especially once an attack hits, things couldn’t be more different so talking about my experience with panic on it’s own just made a lot more sense.
I said previously that “a panic attack is like walking into someone else’s kitchen and there already being a pot of boiling water splattering all over the place on high heat. I don’t know how it got there, who put it there or why it’s there but I’m still the one who hast to deal with it. There is little to no warning and I’m in an unfamiliar place, but I can’t help feeling like I’ve been stuck in this situation before.”
Unlike an anxiety attack that I can feel coming on for minutes, hours, even days, a panic attack is all of a sudden just there, taking over. Yes I do feel signs that I’m more likely to have one in the near future but they definitely aren’t clear and there is very little to nothing I can do to reverse anything I’ve done to make having an attack more likely (which makes it very different for me than anxiety attack prevention).
Because of this, there isn’t a lot of ‘prep-work’ type care I can speak of that specifically aims to lower panic attacks or makes them go away all together. Of course following the basics from Panic and Anxiety Attack Management 101 about Prevention and Preparation wouldn’t be a bad idea. Just because there’s nothing I’ve found to stop my panic disorder in it’s tracks doesn’t mean it isn’t worth putting the effort in to decrease the amount of attacks or to lower stress and just in general take care of myself so I’m more capable of handling it all when they strike (and strike hard they do).
Panic attacks hit from nowhere, the lead up to them isn’t as much the problem. It’s during….and it’s afterwards. There’s a battle going on between managing what’s going on in your brain that is FUCKING TERRIFYING and the almost out of this world physical symptoms that this “trick” your brain is playing on you is doing to your body. As I’ve said before, this can be a highly individual thing, so I can only go from my personal experience here. What I go through during an attack and how I try and manage it.
First thing I feel when an attack hits is HEAT. My head starts to feel like the top of a kettle that’s about to blow the whistle. Along with that comes a sort of blindness, I can see but it’s like looking through goggles or like someone else is controlling my body and I’m just a spectator watching from the inside back of my head. If the attack is severe enough I will get up and run. Yes, literally run. If it is milder, I may just flinch, sit up (if I am sleeping or laying in bed) or grasp for something (usually Mr. Mango since I find him comforting…more on that later). In the past, this all would have happened before my mind would have had a chance to catch up.
Somewhere during all this the mental part of the panic has kicked in. Just saying fear of death doesn’t cover how intense the feeling is. It is not conscious and it is not rational. A complete flash of I AM GOING TO DIE is all that my brain will process (not everyone with a panic disorder has thanatophobia, but it is common). For a few months it was joined by an image from a nightmare of my daughter getting hit by a car, years ago there used to be images of astronomical catastrophes flashing with it, but my brain always focused only on the fact that I was going to die and that brought me intense terror.
When I was 11 and this all started happening it would take hours of crying, begging, trying to explain and eventually passing out, out of exhaustion before I would ‘get over’ an attack. At the time handling the mental and emotional damage it was doing was a much higher priority than working on the physical after effects that for the most part were ignored because of how long I stayed upset.
I am now 29 years old and while I do still have attacks that leave me crying and upset I do understand that there’s a lot more to it than treating my phobia. In fact treating all the physical symptoms faster afterwards is going to help much more than focusing on the deep dark mental places my brain chooses to go during an attack.
First off, I cool down. If I managed to actually run somewhere…this is probably already done cause I’m probably half dressed and out of bed. If not, I take off a layer, grab some cool water or an ice pack or something. This always seems to help calm my breathing which in turn usually helps with my extremely elevated heart rate as well. Once I start thinking about all the physical symptoms and calming them down, I am no longer focusing on the panic, I’m focusing on self care. The longer I stay on edge, irritated and upset the more likely it is I will have a repeat panic attack and the harder it will be to move on.
Next really depends on what time of day it is. Unlike with anxiety attacks where I always feel wiped out and need a nap after, panic attacks generally give me so much nervous energy that attempting to sleep or even rest right after is just going to make me more anxious or jittery (again leaving me open to more problems). Still if its 2am finding something that will lead to sleep is better than getting up and making a quadruple batch of cookies. At night I usually turn the TV on so that my brain can focus on words and sounds that it isn’t creating while playing a pointless app on my phone. Distraction keeps me from focusing on panic related triggers. Pretty much, this has just taken a lot of practice. Nights are still the worst.
During the day there are a lot more options. If I feel up for it, time outside always helps. Working with my hands, crafts, planting, things that take thought and lots of steps but aren’t too difficult (no frustration). Sometimes I don’t feel up for much and I’m drained and THAT’S OK. I’ll play an online RPG, read a good book or just listen to my favourite music. After a panic attack is not the right time to work through triggers, phobias or other issues. It’s too raw and I’m still recovering.
If I’m too nauseous from it all to eat I don’t try but If I’m able to have a little something, it can be a huge help. I’ve never had my sense of taste trigger an attack so having a little treat has always been a great way to help recovery, pillow mints, chocolate chip cookies and sliced cucumber are my go tos. I associate them all with good memories and it’s amazing how eating can keep our minds occupied.
Then it’s really starting all over again to try and stay as stress-light as possible, get sleep (HA) and focus on the time when my brain and body aren’t being evil. I don’t think I’ll ever be panic attack free, but I’m a long way from being that 11 year old girl in constant terror, even during weeks like this where the attacks are frequent and forceful.