About Anxiety and Panic

No-one likes feeling anxious and panicky, but it may help to remember that these are very normal and appropriate human emotions brought about by the fact that we are vulnerable, both to our environment and to each other. We fear being out of control or overwhelmed and this makes us anxious, and when we feel that loss of control or being overwhelmed is imminent, we feel panic. Anxiety is a sustained sense of vulnerability; panic more acute, intense and short-lived.

The degree of anxiety and panic we feel is affected by a number of factors:-

· The reality of danger or difficulty

· Our perception or appraisal of that danger or difficulty

· Our perception of our own resourcefulness in the face of danger or difficulty

So, for example:-

· An imminent assignment deadline is a reality

· We may perceive it as a greater difficulty because we are tired and stressed

· We may feel overwhelmed because we tend to freeze under pressure

Or

· Spiders really move fast and unpredictably

· We find spiders repulsive and therefore threatening

· We believe that we would be overwhelmed if a spider touched us

Sometimes we mentally beat ourselves up for feeling anxious and panicky. Of course, it's all too easy, once everything has turned out better than we feared, to belittle the anxiety we felt, precisely because we didn't know how things would go.

In fact, anxiety and the worry that comes from feeling anxious, can have a positive effect, in preparing us for, or prompting us to avoid, unwanted outcomes. Without any anxiety at all, would we bother to write that assignment, lock the door at night or even clean our teeth?

Nevertheless, it is not pleasant to feel anxious or panicky and most of us would prefer to feel this way less rather than more. Perversely, those who feel a high degree of persistent anxiety often add to it by feeling anxious about being anxious - does it mean that they are abnormal? Those who experience panic in everyday situations certainly feel anxious about the next time and can have an attack of panic just because they fear they will.

However, no-one stops anxiety by not wanting to have it. Better to learn to live with being anxious, but not let it rule your life. Feel the fear and do it anyway. Easier said than done, but being brave will make us feel more resourceful and, therefore, less anxious. And if we can persist in being brave about a certain thing and find that it doesn't overwhelm us, in time it may lose its threat for us and that's one bit of anxiety the less to contend with.

How Anxiety Becomes Panic

Anxiety and panic are manifestations of our inborn 'flight or fight' system, which is essential to our survival. Just as physical pain alerts us to disease, so anxiety, panic and alarm alert us to danger. This has an immediate effect on bodily functioning. Our hearts beat faster, our blood pressure is raised, we breathe in a rapid, shallow way our muscles are tensed, while our digestion and sex-drive are suppressed. The greater the anxiety, the more noticeable the effect and in panic it becomes very acute. If the reality of danger is great, then our bodies are ready for fight or flight. But if we are panicking because we feel vulnerable to being overwhelmed and doubt our coping resources, but there is no clear and present danger, then we don't know where to run or whom to fight. Instead, we become increasingly aware of how uncomfortable/unwell we feel . This exacerbates the fear of being overwhelmed or losing control, which adds to the panic and intensifies the symptoms. Panic can appear to come from nowhere at all, but all it needs is a small trigger, such as feeling alone in a crowd, or trapped in a lift or plane, to start off the escalating process. It can feel truly horrible - your heart beating fit to bust, your breathing fast and furious, your head in a complete spin and your limbs becoming helpless and numb. It is just your flight or fight system in overdrive. None of that would feel odd if you were literally in danger and running or fighting for your life.

How To Reduce Panic

If you get into a panic when you ae not in real danger, the remedy is to stop and then reverse the escalation of emotional and physical symptoms. You can do this by breathing deeply, relaxing your muscles, thinking calming thoughts or reminding yourself that you can cope. It is a good idea to practice methods which are best for you when you are not in a panic (see below for some ideas for anxiety and panic management).Once you start to calm down, your symptoms will improve. There will therefore be less need to panic and so even fewer symptoms…and so, you reverse the effect. And then, because you know you can stay in control, there is less anxiety and you are less likely to go into a panic in the first place.

Once you have had a panic 'attack', you will be afraid of a recurrence. However, the very fact that you have already survived an attack is your reassurance. You got in a panic….and you came out of it. You may fear that another time it will be worse. In that case a few repetitions can be a good thing, to show you that it doesn't get worse as with anxiety, living with your panics and getting used to them can make them seem a lot less daunting.

Good Ways to Stay Calm

General

Exercise

Taking regular and vigorous exercise is one of the best ways to keep your system in balance and work off anxiety and stress. It uses up all the

'fight or flight 't activity, which otherwise has nowhere to go. It also causes your body to manufacture endorphins, which bring about feelings of happiness and tranquillity. Your anxiety may be linked to depression, and exercise is an effective antidote to depression. Improving your stamina and fitness helps you to feel more resourceful and less vulnerable.

Have good times

Incorporating things you do just for pleasure is important for lessening anxiety. Often when the pressure is on, we omit to build in 'rewards' for our hard work, or fail to enjoy them because of guilt. All work and worry is a good recipe for anxiety.

Sleep well

If only', you may cry. But lack of sleep will add to anxiety by making you feel less resourceful, more overwhelmed and lacking the energy to cope. Student life can be very disruptive of sleep, because of noise, overactive brains, the use of recreational drugs or alcohol and irregular hours. Students sometimes turn night into day and vice versa. If partying/studying/worrying by night is causing your life to run out of control and causing stress, try the following:-

(Boring, but it does work if you persevere)

Go to bed early enough to allow for seven or eight hours sleep, plus some time lying awake.

Have a go-to-bed routine.

Stop studying, do something relaxing.

If you are slow to fall asleep or wake during the night - remember, there is plenty of time.

Set the alarm and get up, no matter how badly you slept.

Stay awake until early bed-time the next night.

Do it all again and keep doing it until you are sleeping regularly and well.

( If you don't believe that you can train yourself into regular sleeping habits, consider how easily you trained yourself into irregular sleeping).

P.S If you are likely to be disturbed by noise, use ear-plugs.

Eat well

Poor nutrition will put your body under stress and lead to feelings of anxiety. Skipping meals will cause your blood sugar levels to plummet and junk-food will make them yo-yo. Caffeine ( in tea, coffee, cola and chocolate), will raise your heart-beat and make you feel anxious. Complex carbohydrates like pasta and rice are relaxing foods, and a good balanced diet, including fresh fruit and vegetables will give you energy and make you feel resourceful and able to cope.

Specific

Breathing

If you can calm panicky breathing, the rest of you will relax. Try this:-

Count for 3 as you breathe in and again as you breathe out. As your breathing becomes steadier, start to elongate the out-breath, by counting 3 for the in-breath, 4 for the out-breath, 3 in, 5 out, 3 in 6 out, going on as long as is comfortable.

Breathe from your diaphragm. Put your hands on your stomach, just above the waist, and feel it expand under your hands as you breathe in, and subside as you breathe out. Keep your shoulders still and relaxed.

Soothing words

Develop a calming 'mantra'. Choose some comforting relaxing words, like 'calm and composed', take it easy', 'serene and confident', or any combination which appeals to you. Say these words to yourself sometimes when you're feeling O.K, and then say them when you feel panicky and stressed. Stick to the same words, so that they can take on a powerful meaning for you. Say them to yourself when the stress passes off, as well, to remind yourself that it does pass, and will again.

Visualisation

Visualise a scene in which you feel relaxed and happy. Bring this scene to mind sometimes when you are feeling O.K, so that you can conjure it up more easily when you're stressed. If you have difficulty picturing a scene, then conjure up a sound instead, such as music or birdsong.

Monitor your anxiety

Have a number scale of 1-10 to rate your anxiety level. Make a rescue plan for a 10 out of 10 score ( this could be:- leave the room, ask someone to help you, go to A and E) , then measure your anxiety out of 10 when you feel it, and remember that you can cope up to 9 out of 10, and get rescued if it hits top marks. Just doing this will probably mean that you never need rescue, and it will help you to see that your anxiety is usually bearable, though unpleasant.

If you have a bit more time

Muscular or progressive relaxation (5 to 15 minutes - up to you)

Lie down on your bed or the floor, or sit in a chair high enough to support all your weight, and relax your muscles by progressively tensing and relaxing parts of your body, working upwards from your feet. Do this rhythmically, and breathe in as you tense up and out as you relax. Focus on the contrast between the tensed muscles and the same muscles relaxed. Work hard at the tensing up, so that it is a relief to let go, then relax fully.

Autogenic relaxation or self-hypnosis ( much easier than it sounds)

(5 to 15 minutes)

Lie on your bed or the floor with your legs uncrossed and your arms at your side, or sit in a high-backed chair with your hands loosely in your lap. Focus on your breathing and calm it by counting your in and out breaths (see breathing above). Focus your attention on your right arm and hand and register all the sensations experienced there (warmth, touch, tingling etc). Feel your right arm and hand becoming very heavy and inert. When it is really heavy and relaxed, do the same with the other arm and hand, and then let the heavy feeling spread through all your body, so that you lie or sit like a sack of potatoes. When you feel completely relaxed, you could visualise a relaxing scene, or say your calming mantra (see above)

Use relaxation to help you cope with dreaded events (5 TO 15 minutes)

Do either of the above in order to become deeply relaxed. Then visualise yourself in a situation which makes you anxious. Allow the panic to mount a bit, then feel yourself growing strong and confident. Picture yourself being calm and in control. Imagine it for a while. Check that you feel relaxed and do some more relaxation if need be.

Doing this frequently will prepare you for feelings of anxiety and help you cope with them better when they arise.

Applying Remedies To Common Problems

Panic attacks in lectures

Have a rescue plan, which could be to sit near the door or at the end of a row, so that you can leave if it gets too much. You might also ask a trusted friend to sit with you.

Monitor your anxiety levels and remember that you can cope up to 10 out of 10, and implement your rescue plan if it reaches that level.

On entry, calm yourself with calming breathing. You may then be able to go on to do some deep breathing from the diaphragm. This will remind you that you can stay in control . If your anxiety mounts again then do your breathing again. Also use a calming 'mantra'.

Once you feel calmer, try to focus on the lecture. Remember, it is normal for your mind to wander at times. If you get panicky, do your breathing and calming words.

Towards the end of the lecture, you can begin to feel proud of yourself for coping. Be sure to give yourself credit for getting to the end . Make a note of your highest anxiety score. That's probably as high as it will ever reach and you now know you can cope with that.

If you didn't make it to the end, don't waste energy beating yourself up about it. It will probably be harder to try again, but you will know that you can rescue yourself again if you need to.

Don't Give Up. It's Hard, But Feel The Fear And Do It Anyway.

Giving presentations

Lots of people find this difficult. Often with this one, the anticipation is worse than the reality, but for some the anticipation is so bad, they duck the real thing.

You will probably have your material very well prepared, because of your anxiety. In that respect, anxiety can be a help.

Prepare yourself by using relaxation to help cope with dreaded events.

At the event, use breathing and calming words to help you stay in control. Once it starts remember it will soon be over.

Exams
(this can help with other events, such as going out)

Again, it's very common for people to lose their cool and forget everything they know in an exam.

Prepare yourself by using relaxation to help cope with dreaded events.

Have a rescue plan. You may prefer to ask to take your exam in a room apart - this can sometimes be arranged. Otherwise, you could forewarn the invigilators that you may need to leave the exam room. An invigilator would then accompany you, and stay with you until you calm down, so that you can return to the exam if you wish.

On entry, calm yourself with calming breathing, calming words and visualisation. Don't worry if you lose some time. Better to take the time it needs to calm down and then to be able to think straight, than rush at it and freeze.

If you can calm down at the beginning of the exam, you will probably be O.K for the rest of it. But if anxiety mounts, repeat your breathing and calming words. Monitor your anxiety level and remember you have a rescue plan in place if you hit top score.

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Other situations which cause you panic

The remedies described above can be adapted to any panic inducing situation. Whatever your particular demon, you can face it by preparing yourself for it using relaxation, and using calming breathing, calming words, visualisation and monitoring your anxiety at the time. And don't forget to have a rescue plan.