How to Con­quer PANIC AT­TACKS

In­ex­pli­ca­ble feel­ings of mor­tal ter­ror strike 6 mil­lion Amer­i­cans. Here is one woman’s jour­ney back to re­as­sur­ance.

Reader's Digest - - Psychology - BY BON­NIE MUN­DAY

T’S SIX O’CLOCK ON A SEPTEM­BER evening in 2001, and I’m driv­ing our mini­van on a Toronto high­way, head­ing to din­ner at my par­ents’ house. My hus­band is in Ber­muda, where he has landed a two-year con­tract; he’s look­ing for an apart­ment so I can join him. Now it’s just me and my lit­tle black poo­dle, mak­ing the half-hour drive I’ve made hun­dreds of times.

The news is on the ra­dio—top story, the re­cent 9/11 ter­ror­ist at­tack. It seems I can’t get away from the shock­ing sto­ries and im­ages. As I ap­proach a bridge, my heart sud­denly starts beat­ing rapidly. Then my legs turn to jelly.

You’re go­ing to drive off the bridge,a voice in my head warns. Now my arms are numb. You’re about to lose con­trol and die. I’m ter­ri­fied. My hands grip the wheel; I just want to make it over the bridge and to an exit. I do; then I pull into a park­ing lot and start to cry. What is hap­pen­ing to me?

I TRIED DRIV­ING on the high­way a week later— and again, panic drove me to the first exit. Af­ter that, I took only smaller, slower roads. Weeks later, I moved to Ber­muda, where we did not have a car. I was so re­lieved. I hadn’t told my hus­band about the episodes; I knew he loved my in­de­pen­dence and strength, and I felt ashamed of be­ing so weak.

To get around, we had a mo­tor scooter that I rode on the back of, or I’d take the bus when I went some­where on my own. I did this of­ten over the first cou­ple of months, but one day as I rode the bus into town to do some Christ­mas shop­ping, my heart started rac­ing. Sure enough, next came the sweat­ing, my legs turn­ing to jelly, and the feel­ing that some­how I’d lose con­trol or “go crazy.”

I hadn’t reached my des­ti­na­tion, but I rang the bell to exit and, in tears, walked home, where I felt safer. A few days later, I tried the bus again, and the same thing hap­pened. The thing that had forced me to avoid high­way driv­ing was now forcing me to avoid pub­lic tran­sit. It was time to come clean. That evening, I told my hus­band what had been go­ing on. He was sym­pa­thetic; I shouldn’t have kept it bot­tled up, be­cause it felt good to let it out. But he was as mys­ti­fied as I was. We searched on­line for “fear of high­ways” and “fear of pub­lic trans­porta­tion” and got lots of hits, which is when we learned that the episodes were ac­tu­ally clas­sic panic at­tacks.

Ter­ri­fied, I grip the wheel. I make it over a bridge, then pull into a park­ing lot and cry.

UN­LIKE FEAR, which is a re­ac­tion to an ac­tual threat, panic is in­tense fear in the ab­sence of real dan­ger. Suf­fer­ers of­ten re­port re­cent stresses, such as get­ting mar­ried or di­vorced, chang­ing jobs, or fi­nan­cial or health prob­lems. For me, the stres­sor was my up­com­ing move. Plus, I’d not been sleep­ing well. Sleep­ing poorly can make us more sen­si­tive to anx­i­ety-re­lated events, such as rapid heart­beat; panic at­tacks oc­cur when the brain iden­ti­fies those events as sig­nals of ex­treme peril.

“Hu­mans are hard­wired to sur­vive,” ex­plains Eilenna Denisoff, a clin­i­cal psy­chol­o­gist and di­rec­tor of CBT As­so­ciates in Toronto. “The fight-or-flight re­sponse al­lows us to run faster, jump higher, if we’re be­ing chased. Phys­i­o­log­i­cally, then, the brain’s re­ac­tion to the rapid heart­beat ‘dan­ger sig­nal’ is to move blood from the limbs to pro­tect the core.” (This ex­plains the feel­ing of limbs turn­ing to jelly.) The per­son isn’t ac­tu­ally in dan­ger, but the brain mis­reads the signs as in­di­cat­ing a need to flee.

Be­cause the symp­toms make you feel like you’ll die, the first at­tack can lead to panic dis­or­der, says Denisoff. “Your brain looks for sit­u­a­tions when you should be fear­ful or feel trapped.” You be­gin to fear the fear.

IT WAS TIME to tackle this; I wasn’t about to let some­thing in my mind ter­ror­ize my life with­out try­ing to fight back. I’d read that it helped to talk about it. So when I was back in Toronto for a visit, I told my best friend and her hus­band about the panic at­tacks.

Lindsay looked at Todd with wide eyes, then said to me, “Todd went through that a few years ago!”

When Todd was 28, he’d just taken over the fam­ily busi­ness and was feel­ing very stressed. One evening when he was at a restau­rant, his heart started pound­ing fast; he thought he was hav­ing a heart at­tack and went to his doc­tor.

The doc­tor said, “It sounds like you had a panic at­tack.” He re­ferred Todd to a psy­chi­a­trist, who gave him a pre­scrip­tion for Ati­van, an an­tianx­i­ety drug taken when panic symp­toms

start. Todd took the med­i­ca­tion and avoided restau­rants, but then a panic at­tack hit when he was in an air­port lounge.

He learned re­lax­ation tech­niques, in­clud­ing deep breath­ing. Even­tu­ally, the fre­quency of the at­tacks less­ened, then dis­ap­peared, so he stopped the med­i­ca­tion. Todd told me, “The drug was key, and read­ing up on panic at­tacks re­ally helped.” He gave me his copy of Liv­ing with Fear: Un­der­stand­ing and Cop­ing with Anx­i­ety by Dr. Isaac M. Marks.

BACK IN BER­MUDA, I dared to get back on the bus—with the book in my hand­bag. When my heart started rac­ing a few min­utes into the jour­ney, I opened the book to the dog-eared pages ad­vis­ing that panic wouldn’t kill me. That re­ally did calm me.

For the next two years, I kept panic at bay this way. Even af­ter we moved back to Canada, the land of high­ways, I treated my­self not with ther­apy or med­i­ca­tion but by al­ter­ing my be­hav­ior.

For nine years af­ter mov­ing home, I re­lied on my hus­band to do all the high­way driv­ing. Then we bought a cabin. My hus­band would fix it up for weeks at a time while I worked in the city. The house was three hours away and it wasn’t on a bus route, so if I wanted to go on week­ends, I would need to drive. Fi­nally, it was time to find a psy­chol­o­gist.

PANIC DIS­OR­DER can be treated with an­tide­pres­sants long-term and with beta-block­ers for im­me­di­ate re­lief of symp­toms. But ex­perts rec­og­nize cog­ni­tive be­hav­ioral ther­apy, or CBT, as the best treat­ment. It re­solves anx­i­ety by chang­ing the un­der­ly­ing be­liefs that tell you the pan­icky feel­ing is it­self dan­ger­ous.

In my first ther­apy ses­sion, I prac­ticed deep breath­ing—a long, slow in­hale through the nose, a long, slow ex­hale through the mouth. “This will be your tool to calm your­self when you feel pan­icky,” the psy­chol­o­gist ex­plained.

A week later, we started imag­i­nal ther­apy, a form of ex­po­sure ther­apy. The doc­tor asked me to imag­ine driv­ing the least scary high­way route near my home, rat­ing my anx­i­ety level from one to ten with each step.

“One,” I said, men­tally back­ing out of the drive­way, then “two” as I turned onto the next street.

It jumped to eight when I reached the road lead­ing to the on-ramp. My heart was pound­ing; I was start­ing to sweat. “Do your breath­ing,” she said.

She asked whether I’d ever kept some­thing in my purse for when I felt un­well. In fact, I had pep­per­mint gum

I took a deep breath and grabbed the keys. My heart pounded as I got on the high­way.

for stom­ach up­sets. “Good,” she said. “Imag­ine you’re chew­ing a piece of gum.”

Now the mo­ment of truth: In my imag­i­na­tion, I ac­cel­er­ated and merged into high­way traf­fic. “Ten.”

My legs turned to jelly, and I had that aw­ful feel­ing that I’d lose con­trol. “It’s OK. Keep breath­ing,” my ther­a­pist ad­vised. “It’s only about half a mile to the first exit.” Mo­ments later, I saw the exit ramp in my mind, and I be­gan to calm down when I reached it.

My re­lief turned back to fear when my ther­a­pist said, “Your home­work is to do that for real this week. Re­mem­ber your breath­ing. Bring your gum. It won’t be much dif­fer­ent than do­ing it in your mind.”

SO ONE TUES­DAY AF­TER din­ner, I took a deep breath and grabbed the keys. Just like in ther­apy, my heart pounded as I got on the high­way. But, us­ing my new tools, I made it to the exit with­out my phys­i­cal symp­toms es­ca­lat­ing. I was over­joyed.

We did imag­i­nal ther­apy over four more ses­sions, each time tak­ing a tougher or longer route. Each week I was able to do it for real, though I al­ways re­turned home on reg­u­lar roads.

But fi­nally, on a home­work ses­sion that in­volved the scari­est route yet, I ex­ited the high­way panic-free, then said to my­self, “What the heck—let’s give it a go.” I looped around and got back on the high­way to­ward home. I haven’t had a panic at­tack since.


Bon­nie Mun­day above one of the Toronto high­ways where she ex­pe­ri­enced—and con­quered—her at­tacks

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