Help and advice with anxiety, stress and panic attacks

Exeter doesn't seem to be an especially stressful place to live, but work, bullying, exams or the everyday pressures of life can easily provoke anxiety. We all feel anxious occasionally, but it can feel like it's out of control, constant and draining. Sometimes anxiety seems to come out of nowhere; you suddenly have a panic attack but have no idea why. Let's look at what causes over-anxiety and panic attacks and what you can do about them. Knowing why stress, anxiety and panic attacks happen can help you make sense of how you're feeling. More importantly, it'll help you deal with them.

Your Bodymind

What happens in your mind effects your body and visa versa: Your mind and body are actually one system - the bodymind. Ideally the bodymind works as a unified system, but panic attacks and constant anxiety are examples of what happens when mind and body miscommunicate.

Stress situations are part of life and evolution has given us a way to cope. The stress response is a natural pattern of behaviour that works especially well if you live like our ancestors did. Back then there was a fair chance that you'd face a life threatening situation. A bear emerges out of the woods, a rival tribe attack your village or you fall in the river while fishing. It that ever happens to you, your stress response could be a life saver! Your whole bodymind goes on alert; your blood floods with adrenaline, your heart races and your mind narrows down to focus completely on the threat. Great if you're in a fight or flight situation: you'll have a chance to out run that bear, fight off your rival or swim to the safely of the shore.

Feeling Threatened

But what happens if you feel threatened by meeting your boss, giving a public talk or taking an exam? You can't fight or run away, but your stress response will kick in all the same. Your heart will start to beat faster and suddenly the perceived threat is all you can think about. The first thing to remember is that this is a natural response; your body is doing what seems to be the best thing. More importantly, some part of your mind - your thinking self - has misjudged the situation.

Let's say for example you're going to give a public talk next week. How would that feel? Public speaking has been described as 'a fate worse than death' by some and in the past I've become extremely anxious about it myself. My mind had got the belief from somewhere that public speaking was a highly threatening activity. In reality it's not of course; you're very unlikely to get killed or injured as a result of giving a speech! But if you're convinced that it is dangerous, you'll trigger your stress response. The thinking mind misinforms the stress system: "Warning! Public speaking is really threatening!" Of course the stress response kicks in. And now the trouble really starts: The mind takes note of all the stress reactions and takes that as confirmation; "Public speaking is really threatening!" That starts a cycle of anxiety that can be hard to break.

But the mind is misleading itself, because it mistakenly triggered the stress reaction in the first place. It's like someone who accidentally sets off the fire alarm and then, hearing the alarm, thinks there really is a fire.

Haunted By The Past

If a distressing situation in your past is very similar to one that's happening now, you might expect a stress reaction. Suppose you were attacked by a dog as a child. It wouldn't be surprising if you got anxious when meeting a dog as an adult. But how does the thinking mind come to believe something that's actually quite safe is a real threat? This is where it gets interesting, because what I'm calling the thinking mind has a hidden side: the unconscious. Consciously you may not know why something is threatening to you, because the thinking mind is a tiny part of a much bigger system and your fear is hidden somewhere outside your awareness.

The unconscious is not rational; it works in symbols, metaphors and associations. A traumatic event in the past can become strongly associated with quite different situations though symbolism. So something apparently unconnected to the original trauma can trigger a stress reaction now. The very common fear of public speaking I mentioned above is probably a form of this type of reaction. Perhaps I had the experience of being ridiculed in a group as a kid and the thought of doing a public speech was still associated with that experience.

There is a third possibility. Sometimes we can get confused about the cause of a stress reaction because our conscious mind is in denial. Several years ago there were aspects of my life that were pretty stressful. There were things I really didn't want to deal with or even think about. I started to worry about quite minor things. Did I leave the gas cooker on? Did I lock the front door properly? I didn't want to think about the real cause of my anxiety, but that didn't make it go away. The anxious feelings had to be expressed, so they bubbled out wherever they could, hidden in trivial worries.

Help

Knowing the causes of over-anxiety and panic attacks helps you to get rid of them. Your doctor can prescribe medication that can help, but integrative therapy can deal with the root of the problem. I tackled my anxiety issues with a mix of psychotherapy, CBT, mindfulness, breathing techniques and Focusing. I now draw on all of these in my practice.

• Psychotherapy is especially useful if there's some unconscious knot that needs unravelling.
• Cognitive Behavioural Therapy is recommended by the NHS for the treatment of many forms of anxiety, including phobias and panic attacks.
• Mindfulness is a great way to get your mind and body back in harmony - and keep it that way!
• Focusing is a special way of being mindful, and offers another very valuable path to the wisdom of the body.

Breathing techniques

Finally, I'd like to share three simple and effective breathing techniques. The core principles are the same for all of them;

• breath in through your nose and out through your mouth;
• keep the out-breath longer than the in-breath.

First, The Calming Breath:

The 7 - 11 breath uses the same principle but is suitable for a wider range of situations as it's not really apparent that you're doing it! Take a breath in to the count of 7. Aim to take a deep, full breath, feeling your abdomen moving out as you do so. It can help to bring your awareness to your lower back as you do this. Can you sense a gentle expansion across your back? Don't try to force anything; just notice. Then slowly breath out over a count of 11. If you find a 7 and 11 count too long, shorten both and try 5 - 7 instead. Remember the key principle: Make your out-breath longer than your in-breath.

Some people prefer the 4-7-8 (or Relaxing Breath) developed by Dr. Weil. This is slightly more complicated, but still really easy to learn.

• Put the tip of your tongue just behind your upper front teeth and keep it there for the whole exercise.
• Exhale completely through your mouth, making a ‘whoosh’ sound. See if you can feel your belly pull in as you do this.
• Close your mouth and take a deep breath through your nose while you count to four.
• Hold your breath for a count of seven.
• Exhale completely through your mouth, making a whoosh sound to a count of eight. Again you might feel your belly pull in as you do this.
• This is one breath. Now inhale again through your mouth and repeat the cycle three more times for a total of four breaths.

Here's Dr. Weil showing you the 4-7-8 breath.

Contact me if you'd like more help with stress, anxiety or panic attacks.