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Panic Attack Treatment Philly

Panic attack treatment Philly: What is a panic attack? A panic attack is an episode of feeling intense fear. Panic attacks can be triggered by an environmental cue or can happen spontaneously. Physical symptoms that make up a panic attack include chest pain, heart arrhythmia, sweating, difficulty breathing, hyperventilating, shaking, nausea, stomach pain and the tightening of muscles. When experiencing a panic attack people often feel out of control, feel as though they are losing their mind or fear that they will die. The panic attack symptoms peak within about five minutes. These episodes are often so terrifying, they cause people to fear and worry about when they may next get a panic attack.

Ruling out Medical Issues. It is important to rule out any true medical problems, especially if you have experienced heart attack like symptoms during your panic attacks.  You need to know from a medical professional that you are not experiencing heart attacks, but instead are experiencing anxiety.  Once you have ruled out any true medical problems, and you know you are experiencing panic attacks keep reading to learn how to manage your panic attacks.  Familiarize yourself with the techniques below to learn how to manage your panic attacks before they manage you!

10 Things to Do During a Panic Attack in Philly

  • Acknowledge & Accept Your Anxiety. When you first begin to feel anxious, acknowledge this feeling. Simply say, “I am feeling a bit anxious,” or “I'm experiencing some chest tightness and am feeling worried.” Acknowledging and accepting your anxiety will help you tune into what is actually going on with you physically and emotionally instead letting your unrealistic fears take hold of you...”I'm going to have a heart attack if I don't get out of here!” Often attempting to ignore your anxiety will make you only more anxious, especially if your symptoms begin to build.
  • Remind Yourself The Panic Will Pass. One of the biggest mistakes people experiencing acute panic is that they try and make the panic go away.  A more effective approach is to learn to outlast the panic.  The better you become at being able to ride out the panic, the less scary panic attacks will become.  If your panic attacks feel less scary, you will also be less likely to experience them. When you're in the midst of a panic attack, it is difficult to think about it ending. However it is very helpful if you can remind yourself that the panic attack will end.  Once you know the typical length of your symptoms you can tell yourself, “This will pass in X minutes.”  Use your past experience with panic attacks as evidence to you that the panic attack with pass.  To identify how long your panic lasts keep a log of every time you experience a panic attack.  Note where you are when they occur, what happens just before and clock the number of minutes and seconds that it lasts.  Recording information about each episode helps you identify patterns.  Predictable panic attacks almost by definition are less scary.  At least you know how long it will last and what to expect next! This makes your self talk more accurate and therefore more calming.  During an episode remind yourself that your past panic attacks have always ended and that this one will too.
  • Think of the Worst Thing that Could Happen to you in Philly. Entertain the idea of the worst-case scenario. When you can confront the worst possible scenario, you may be able see the situation more clearly. For instance, you are driving to your friend’s house and begin to feel as though you might have a panic attack. You think of the worst-case scenario: “If this continues to escalate, I'll have to pull over to the side of the road for a few minutes until it passes. That might make me a bit late to my friend’s house.”  If you are by yourself, imagining the worst-case scenario may be difficult to do.  In this case call a trusted friend whom you can share your worst-case scenario with.  They may prove to be a helpful sounding board.  If you do not want to speak with anyone, or you are unable to get a hold of anyone, write your thoughts down in the moment.  When writing make sure to exaggerate and entertain the full smorgasbord of your fears…”I’ll crash my car and it will explode into a fireball and I’ll die!”  The next day revisit your writing and determine how realistic these fears are.  See if you can identify what is likely to happen?
  • Give Your Fears a Reality Check. As mentioned before, when having a panic attack it is common to experience the fear of dying or of losing your mind. When you feel this way, it is easy for irrational thoughts to cloud your thinking...”I'm going to die right here, alone!” or “I'm completely loosing it, I know it! I'll lose my job, have to go into a hospital, lose my house...” When these types of irrational and exaggerated thoughts pop into your head tell yourself “STOP.” Give your fears a reality check. Remind yourself that you're not dying or losing your mind. Remind yourself that you went to the doctors and they did not find a medical cause to your panic attack symptoms.  You're having a panic attack. It will be frightening for a few minutes but it will pass!  Also, when you begin to experience your panic attack symptoms experiment to see if you can get them to move from one part of your body to another.  For instance can you get your racing heart to shift to sweaty palms?  The more you are able to move this energy to different parts of your body, the more you are able to be in control.
  • Stay in the Present. Instead of going down the “what-if” road and proposing frightening hypothetical future situations for yourself to worry about, “what if I pass out here and die!” “what if I get fired because my coworkers think I'm nuts,” stay in the present. Staying in the present will help you more realistically gauge what is happening in your body. You will be able to reign in your exaggerated thoughts and focus on the reality of what is happening. Another way to keep yourself in the present is to tell the person you are with that you are experiencing a panic attack.  Allow the other person to talk you through the panic attack.  If you are able to share your panic, your panic may dissipate faster.  The person you choose to tell may not be the best support for various reasons.  However, teach this other person what they can do for you in the future to help you through a panic attack.  If you arm this person with skills to help you they will be more likely to assist you during a panic attack.
  • Focus on a New Scene. Visually turn your attention to something else. If you're outside, look at the trees. What color are the leaves? Which way is the wind blowing? What is that bird doing in the tree? The point is to direct your attention elsewhere besides your anxiety and feelings of panic.  Be sure to select visual stimuli that will not escalate the panic.  When you are not in the midst of a panic attack determine what visual stimuli is relaxing or meaningful to you.  It is also important to have different visual stimuli for different settings.  For instance if you have a panic attack outside in a park, it may be easy to find something to direct your attention to, like birds splashing in a puddle.  However, your potential for relaxing visual stimuli becomes significantly decreased if for instance you are in your cubicle at work or in line at the grocery store.  It might be helpful to have an image you can picture in your mind for these cases.  Or perhaps carry a relaxing photo in your wallet.
  • Tune Into Something Else. Just like the suggestion above, the point of is to direct your attention elsewhere. While some people find that visual simulation works best for them while other people find music or certain sounds relaxing. Find a song that is particularly soothing that you could play during a panic attack. Try meditation music or relaxing sounds like waves crashing, or birds chirping. If you are in a place where your selected music is unavailable to you at the time of the panic attack, concentrate on the natural sounds around you. Do you hear crickets chirping? Kids laughing? A car passing? Again, directing your attention to something else is easier in some settings like being in a park versus being in the subway or in court while you are trying a case.  If you are able to, excuse yourself and take a break for five minutes.
  • Feel What is Around You. Direct your attention to something you can feel. Try the worn bottoms of your jeans, your dog’s ears, a favorite trinket, the air from a fan. Focus on how this object feels. Does it have any relaxing qualities? Similar to the suggestions above, the purpose of this suggestion is to shift your attention.  Your mind is causing the panic, and thus by redirecting your attention to sensations you are retraining the brain to direct its energy elsewhere during panic.
  • Concentrate on Your Breath. When people experience panic attacks their breath rate usually increases and some people even begin to hyperventilate. This will impact your body’s ability to receive oxygen and release carbon dioxide.  When you begin to experience panic attack symptoms tune into your breath. How has your breathing pattern changed? Take slow, deep breaths that expand your belly (not your chest). People often breathe from their chest, known as thoracic breathing, when under stress.  This type of breathing pattern can actually decrease your body's ability to oxygenate blood, which will in turn increase your heart rate and increase muscle tension, fueling the symptoms of a panic attack.  When experiencing a panic attack focus on breathing from your belly, known as abdominal or diaphragmatic breathing.  This type of breathing will reduce muscle tension and anxiety because it naturally causes your body to relax.  Notice the pause in-between your breaths. Continue to take these slow, deep belly breaths until the panic attack passes.
  • Move. While you should not flee the scene of your panic attack, most people find it helpful to physically move out of the space that they are in when they begin to have a panic attack. This does not mean to sprint out of the grocery store. Instead, as calmly as you can, walk out of the store. Continue walking, preferably to a safe space. If you are not somewhere familiar, this safe space might be your car. Other people find it helpful to keep moving rather than confining themselves to one space.  If you are able to, try a quick jog.  The goal is for movement to distract your brain.  Obviously some settings are more conducive to others to walk or jog, like for instance during a meeting for work.  If you are unable to jog or walk, try curling your toes, tapping your finger against your leg or if you are able to, stretching.

And later, when you are no longer in the midst of a panic attack…There are many strategies that can help you cope with panic attacks that are helpful to use when you are not in the midst of a panic attack.  First, brainstorm all of the ways that your anxiety is normal and often based in reality.  Also record the following specifics about your panic attacks:  What happened just before the panic began?  Where were you?  What physical symptoms did you experience and how did they change over time?  How long did your panic attack last?  This will help you to identify your specific triggers to panic and how you experience them in your body.  Another strategy for identifying triggers is to try and make yourself go into a panic attack.  Identify what factors allowed you to experience a panic attack.  Once you know these triggers you can take preventative steps to limit your exposure to these triggers.  After you learn your typical patterns of panic, practice rehearsing what you will do before a panic attack.  Identify your strategies for staying safe and act them out.  Rehearsal can be done alone or with a supportive person in your life who could provide you with helpful feedback.

Brainstorm visual, audio and sensory stimuli that you find relaxing.  Experiment with a range of stimuli to find what works best for you.  Practice relaxing using the visual, audio and sensory stimuli of your choice so your body becomes conditioned to relax when exposed to these stimuli.  Make sure to arm yourself with stimuli that you are able to have access to in various settings.  Even in the most dire situations, you can use guided imagery, or the imaging of a particularly relaxing scene to direct your attention elsewhere and relax.  You should also practice deep belly breathing.  Try to set aside at least five minutes each day to practice this type of breathing.

Remember...You might not be able to control when you have a panic attack, but you can control how you handle it. Once you have had panic, you are likely to always have panic so you must learn how to cope with panic.  Panic attacks are frightening experiences but they are a whole lot less frightening when you learn skills to handle the panic attack. Use the suggestions above the next time you have a panic attack and learn which ones work best for you.

ABOUT THE AUTHOR

"Alex" Caroline Robboy,

“Alex” Caroline Robboy, CAS, MSW, ACSW, AAMFT, CSTS, LCSW is the founder and executive director of the Center for Growth Inc / Sex Therapy in Philadelphia, a counseling organization that has an office in Ocean City, New Jersey, Richmond Virginia, Alphretta Georgia and 2 offices in Center City, Philadelphia PA.   In her space time she launched the directory sextherapy.com as a resource tool for professionals dedicated to improving peoples sexual health.  Alex has 25+ years of clinical experience working with adults and children. Specifically, she works with people struggling with compulsion problems, personality disorders, neurodiversity (dyslexia, tourettes, sensory issues, adhd, and high functioning autism) anxiety, depression, postpartum depression, shame, trauma, low self-esteem, grief, relationship issues, sexual function & dysfunction, blended families and parenting concerns. Currently, she provides individual, couples, family therapy and group therapy. Lastly, she offers supervision to both staff and therapists outside of this agency seeking their LCSW or AASECT Certification in sex therapy.  Lastly, thru the Philadelphia International Women’s Project, she led a two year sex therapy group for West African women who experienced Female Genital Cutting as well as a sex therapy group for Sudanese women who experienced Female Genital Cutting. 

Ms. Robboy earned three graduate degrees at the University of Pennsylvania; Masters in Social Work, Post-Masters in Certificate Marriage and Family Therapy with a Specialization in Sex Therapy and a Certificate of Advanced Studies in Human Sexuality Education (otherwise known as ABD) as well as a Certificate in Home and School Social Work. Additionally, Ms. Robboy is an AASECT Certified Sex Therapist and Supervisor of Sex Therapy and an ABS Certified Sexologist. Lastly, she is a Certified Imago Therapist. She is currently pursuing certification in CBIT.