Panic Attacks: Understanding the Vicious Cycle of Anxiety

Panic Attacks: Understanding the Vicious Cycle of Anxiety

Maybe you recently experienced your first panic attack, or maybe you have been dealing with this issue for quite some time now.

Either way, you know that you can’t simply “think positively” to ward off a panic attack. Telling yourself over and over again that there’s nothing to worry about won’t necessarily work either.

And while you might be able to avoid your triggers sometimes, this method isn’t foolproof, either. Sometimes, you don’t even know what set off your panic attack—the cause is a mystery, and you don’t know how to get to the root of the problem.

Why is it so hard to break the cycle of panic attacks? Because your (totally natural) fear of experiencing another panic attack can actually make you more susceptible to them. Here’s how this cycle of panic perpetuates itself.

The Build up of Anxiety and Triggers That Lead to a Panic Attack

Maybe something in your environment triggers a painful and traumatic memory of a past experience. Or maybe you notice the symptoms building out of nowhere.

Suddenly, you have shortness of breath. Your heart feels like it is racing. You begin feeling chest pain and struggle to verbalize what’s wrong.

Am I dying? What if I’m having a heart attack? Will I black out? you wonder. Although nothing is physically wrong with you, it’s impossible to “think your way out” of these symptoms, and you experience a panic attack.

A panic attack does not feel the same for everybody who experiences one. However, many people report worrying that they might actually be dying. Some even go to the emergency room because they are caught off guard by a feeling of impending doom combined with their physical symptoms. It is typical to experience overwhelming fear and a sense of complete loss of control.

People will also react differently to panic attacks. Some may try to remain calm and wait for it to be over, while others will cry. If someone is in a crowded space, they will usually try to leave if they are able since a sense of claustrophobia can make their symptoms worse. As dizziness is also a common symptom, they may feel that they need to sit or lie down. They might also feel like they’re going to vomit.

Anxiety About Future Panic Attacks

The symptoms of a panic attack can fade on their own. Generally, someone suffering from a panic attack does not need immediate medical attention. This does not mean that what they’ve experienced can be dismissed as something that was “all in their head.”

While some who went through their first panic attack might feel confused or uncertain about what happened, one trend generally holds true for all: they will be nervous about the possibility that it can happen again. This is a completely normal human reaction to experiencing such an event.

Unfortunately, though, the mounting anxiety over a future panic attack can actually make one more likely.

This is why people who experience panic attacks often feel like they are trapped in a cycle. Worrying about a panic attack means that you are dealing with higher levels of anxiety. Therefore, you’re more vulnerable to experiencing another panic attack. And with every additional panic attack, those feelings of anxiety only grow stronger.

Breaking the Cycle of Panic Attacks

How can you finally free yourself from this cycle? Panic attacks have one thing in common- they all end.  Anxiety tricks you into believing that there is danger when, in reality, your symptoms are extremely uncomfortable but not dangerous.  When you are able to stand up to the anxiety, you will be able to break the cycle.  It may be time to turn to a therapist for professional help. Having someone who is willing to work alongside you and be patient with you as you process your fears and anxieties can make all the difference in the world.

A therapist can also help you determine what may be triggering your anxiety and panic attacks. Equipped with that knowledge, you can work together on strategies to prevent them or how to use coping techniques to minimize them and eventually overcome them.

Are you struggling to break free from the cycle of anxiety and panic attacks? You do not have to go through this journey alone. Seeking professional health could be the right step for you. If you would like to know how I could help you, please feel free to contact me.

Treating Panic Disorder and OCD with Exposure and Response Prevention (ERP)

Treating Panic Disorder and OCD with Exposure and Response Prevention (ERP)

There are many different approaches to treating and managing panic disorder and obsessive compulsive disorder (OCD).

While these two conditions are not the same, there are some similarities in commonly prescribed treatments. One such method that therapists can utilize for both conditions is exposure therapy and response prevention (ERP).

Exposure therapy may sound like an oxymoron. After all, how can exposing yourself to the things you fear most actually be an effective therapeutic treatment for a mental health condition? While it may sound contradictory, this method is actually quite sound.

Here’s how using exposure therapy under the guidance of a qualified therapist can help people with panic disorder and OCD.

The Basis of Exposure Therapy with Response Prevention

So, what is the basic principle behind exposure therapy? In general, people with OCD or panic disorder do their best to avoid the situations that trigger their fears. This is a completely rational response to fear. And in the short term, it is the easiest way to protect yourself from what you’re afraid of.

Exposure therapy, however, aims to eliminate that urge to avoid certain situations. Throughout the course of treatment, you will ideally learn that the thing you were fearing doesn’t pose a real threat or danger after all. And, if you’re dealing with OCD, you also will slowly let go of your compulsive need for certain rituals before facing specific situations.  By choosing to stop the compulsions (i.e. prevent the responses), you will learn to habituate to the anxiety feelings and decrease the intensity and frequency of the obsessive thoughts.  The ERP approach allows you to break free from the vicious cycle of anxiety.

What’s Wrong With Avoidance?

We all go out of our way to avoid things that make us feel anxious or afraid sometimes. So, if we all do it occasionally, how bad can avoidance really be?

When avoidance becomes your sole strategy for dealing with a particular fear, and it begins to interfere with your everyday life and holds you back from doing what you love, another approach is necessary. Avoidance is a form of temporary relief, but it does not actually improve your overall quality of life in the long term. Eventually, it can lead to the development of other harmful behavior patterns. Over time, avoiding the fear or participating in compulsive thoughts or rituals actually increases your anxiety and may lead to extreme responses such as never leaving the house.

Getting Started

How can you begin exposure therapy sessions? It starts with the therapist working closely together with you to establish a trusting relationship and identify exactly what you fear. They will also discuss what you may view as your “worst-case scenario.”

Essentially, the goal of this collaboration is to target exactly what you’re most afraid of happening. To prepare for the treatment phase, the therapist will use everything they’ve gathered to put together a careful, step-by-step plan (also called hierarchy of fears) for gradual exposure.

How It Works

Over time, the therapist will slowly expose you to what you fear. This may include imaginal (thinking about your fears) or in-vivo (in real life).  The in-vivo exposure will take place in a completely safe environment with the support and company of the therapist. You will never have to enter a chaotic situation during treatment where you have to face your triggers with no support.  The idea is to start with less distressing fears and gradually move up to more fearful situations as you gain confidence to face your anxiety.

In these scenarios, you’re not supposed to make any efforts to avoid or minimize your exposure to the trigger. Of course, this can be very difficult. But with their therapist’s support it can get easier. And that’s exactly why they’re there.

Ultimate Goal

By the end of the treatment course, the ultimate goal of exposure therapy is to ensure that you no longer feel the need to avoid the trigger. Alternatively, if you have OCD, you will recognize that you will be safe without performing rituals and mental compulsions or responses. Through consistent exposure therapy followed by response prevention, you can begin to see that the situation you thought was so dangerous is not the threat that your mind built it up to be.

Ideally, you will slowly stop practicing avoidance in your daily life.

Exposure therapy is not a method of erasing memories of traumatic events or telling a person that their fears don’t matter. To the contrary, proving to them that they are capable of facing these triggers without being harmed is the ultimate goal.

Do you suffer from panic disorder or OCD? Are you interested in trying exposure therapy and response prevention (ERP) to see if this approach can help you in your healing journey? As a trained CBT and ERP psychologist, I can help you decide if ERP would be helpful for you. Feel free to contact me to discuss the benefits of exposure therapy and next steps.