If you have had a panic attack, you already know how upsetting it can be. The symptoms are very distressing. They include, but are not limited to, chest pains, a racing or pounding heart, feeling faint, weak, or dizzy, having difficulty taking a deep breath or rapid breathing, feeling sweaty or having chills, and a sense of impending doom or terror. Some victims of panic attacks say that they feel as if they are having a heart attack. When experiencing these kinds of symptoms, a trip to the emergency room is a wise precaution, just to make sure that something more serious is not happening.
Your Body’s Defense Mechanism
Signs of stress can be our body’s way of telling us to slow down. Our bodies are amazing in complexity, astonishingly resilient at times, and surprisingly fragile at others. Its fragility means that the body is equipped with a remarkable defense mechanism – the sympathetic nervous system – that kicks on in moments of crisis. In the jungle, an animal has a split second to decide whether to flee or defend itself, which you may have heard referred to as “fight or flight.” At that moment, the entire body prepares to go into action. Imagine walking into a room and spotting a long snake in the shadows. Your pulse pounds, stress hormones flood your body, and in a fraction of a second, you decide whether to kill it or run screaming from the room. This is your sympathetic nervous system on glorious display – ready to do whatever it takes to save you.
Trauma Can Rewire the Brain
Now, suppose that in the next moment you realize the snake is actually a rope. Crisis averted, you take a deep breath, let out a sigh of relief, and begin to calm down. This is your parasympathetic nervous system switching on, calming your agitated system, counteracting the stress hormones, and helping you to relax. Extended stress damages the body, so we are normally only wired to be stressed when there is a good reason. But unfortunately, trauma can rewire the brain in such a way that our mind behaves as if we are always under threat. This can make it very hard to calm down. Moreover, left unchecked over time, these patterns become entrenched, leaving us predisposed to anxiety and panic. If this continues for more than six months, we may need a prescription for anti-anxiety medication to get it under control, at least at the beginning.
How are Panic Attacks Triggered?
Panic attacks usually require a trigger of some sort, but these triggers can be difficult if not impossible to see. If you have a complicated relationship with your father, for example, and have a panic attack right after learning that he is coming to town, this is pretty easy to spot. But if you are driving down the road and have a panic attack for no apparent reason, that can be more tricky. Our bodies store trauma and if we are not in the habit of releasing it through exercise and processing our negative feelings and thoughts, then it can build up. At some point, the body says, “Um, I’m not carrying this for you anymore” and you may experience a panic attack with no visible trigger. Alternatively, you may actually have a fainting spell. But again, fainting spells and the like can be caused by other more serious conditions, so verification by a physician is a good idea.
Managing Our Anxiety
The good news is that we are not powerless to manage our own anxiety. We can engage our parasympathetic nervous system by sitting down in a relaxed posture, with our hands at our sides, and use slow, diaphragmatic deep breathing. This means breathing by pushing our stomach out (diaphragm), rather than by expanding our ribcage. Try putting your hand on your stomach to make sure it is moving. Don’t force it. The whole idea is to breathe easily. Breathing with the diaphragm signals to the body that it is all right to calm down. It may be difficult to take a deep breath at first, but that’s okay – just do what you can. See if you can slow your in-breath to a three count. If you can do three, see if you can do six. Breathe in through the nose and out through the mouth, pursing your lips slightly as if blowing out a candle. See if you can do it for a minute, then two, then five, then ten, or twenty. You are retraining your body to do something different with anxious feelings and associated thoughts, although it may take a while to feel as if you are making headway.
Non-Medicinal Treatment for Anxiety
The primary non-medicinal treatment for anxiety can be summed up in the three “Rs” – Recognize, Reflect, and Redirect.
- Recognize– We have to realize that we are experiencing anxiety. Because it is unpleasant and uncomfortable, and because we may have built up clever defenses against recognizing it over years or decades, we may be predisposed to be unaware of the onset of anxiety. As a wise man once said, “Anxiety is a monster that grows when we feed it with avoidance.” If your response to anxiety is to flip on the TV, dive into social media, or distract yourself in some other way, your anxiety will probably remain the same at best. When unchecked, anxiety can spiral into a panic attack, and once you have had one it is easier to have another. Sometimes just remembering the last one can trigger another. So, recognizing early that we are feeling anxious is an important first step in managing our anxiety.
- Reflect– Some anxiety is valid and important. The sudden anxiety you feel when you remember you left the gas stove on can motivate you to take life-saving action. However, cycling on the thought that you might forget to turn it off in the future (catastrophic expectations) can escalate into panic if you don’t take steps to stop the thought. Part of this reflection is asking, “Is there anything I can do about this right now?” If the answer is, “No,” then our job is to ground ourselves in the present. I am here, now. That imagined future where I blow up the house is not happening now. There is nothing for me to fix in this moment. At the same time, we can engage in deep breathing, repeating those truths to ourselves: I am here, now. In this moment, there is nothing here for me to fix.
- Redirect – If we are cycling on a negative thought, once we have interrupted it by Recognizing and Reflecting, then we need to prevent the thought being picked up again. This is where redirecting comes in. We choose to focus on something else – the work in front of us, our surroundings, or our favorite positive affirmations or scriptures. An example of this process might look something like this: I’m checking email on my phone and notice, “I’m feeling tightness in my chest; I’m feeling anxious.” I put my phone down, sit on the side of the bed, and begin my deep breathing. I ask, “What am I anxious about?” If the answer is nothing in particular, then it is a good bet that the distraction of the email was allowing my residual anxiety to grow. After calming myself with deep breathing and reminding myself to be in the here and now, I think, “I’m going to put on some calming music and fold my laundry.” Staying in the here and now is helped by external-sensory input. If you listen to music, then think about the instruments, the shape of the melody, or what they artist looked like in the recording studio. Engage your imagination. If you pick up a smooth stone to ground yourself, think about its weight, how it feels in your hand, its smooth coolness, and what it might have looked like out in the wild. Just noticing your surroundings can help to ground you in the present.
Treat Yourself with Curiosity and Kindness
Key to any treatment process is to approach yourself with curiosity and kindness. We all have younger self-states, places in our emotional structure that formed when we were young and powerless. If we were traumatized in these areas, then we probably have strong defenses around them and understandably loathe feelings of vulnerability. When we begin to see the impact of these young parts on our emotional world, our feelings of fear, or of being out of control, then the temptation to pick up the proverbial mallet and beat ourselves up can be very strong. If you catch yourself thinking “Idiot!” or “Weakling!” or “Loser!” when you feel anxious (or have any other feeling for that matter), that is a thought that needs to be interrupted. Put the mallet down.
Make Responsible Choices towards Growth and Healing
Our emotional structure has been formed by what we have experienced, and by whatever we did in response, usually without any road map or instruction. Do I get anxious when my abusive parent is coming to town? Of course, I do. Two of my favorite words are, “of course.” Of course, I struggle to form attachments, of course, I struggle to eat healthily, of course, I struggle with (insert addiction or emotional response here). Of course. The encouraging news is that once we recognize that we are predisposed to some unwanted behavior, we don’t have to be victimized by it anymore. We can begin to change it. And if part of that change is a prescription, then thank God that there are medications available that can help. If you don’t feel guilty taking an aspirin to alleviate the pain of a headache, there is no reason to feel guilty for taking anti-anxiety medication to alleviate the pain of chronic anxiety. Saying that we are anxious because of a lack faith is as nonsensical as saying that we have a headache because we lack faith. There was a silly movie some years ago in which a boss slapped an underling across the mouth, drew blood, and then said, “Stop bleeding. It’s stupid.” We need to stop saying things like this to ourselves as they help no one.
In 1 Timothy 5:23, Paul instructs Timothy to drink a little wine instead of water to ease his stomach discomfort. Asking for help with things of the mind should be no different. I believe that God wants us to be of sound mind to the extent that it depends on us, whether that pursuit leads us to a psychiatrist, a recovery group, or into counseling. Thank God there is help and do what you must to get over your resistance to it. We are intended to exercise our adult agency and make a choice that we think will move us toward growth and healing.
God Loves You and Values You
The self-esteem movement that began in the late 1960s has changed significantly over time, with offshoots into humanism and godless self-actualization, among others. This is unfortunate because feeling good about who we are in a Christian context can get lumped in and thrown out with the rest. So many believers think that it is somehow contrary to God to feel good about who they are. But we are the very image of God – the imago Dei—and why should anyone feel bad about that? Simply by sitting there turning oxygen into carbon dioxide, you are an amazing, unique reflection of the image of God on the earth. Where there should be only the vacuum of space, you intrude magnificently in three dimensions, in glorious manifold existence. No matter what you have done, what has been done to you, what you have thought, how much you give, or how much you serve, none of that has any bearing whatsoever on your value as a person. God not only loves you, but values you enough to go through the agony of the Cross to redeem you. The work is already done. Our work is to retrain our inner voices and stop believing lies. Put the mallet down. Take steps to manage your anxiety. God put in us a desire to see goodness in our lives, otherwise, how would we know to seek Him? It is not selfish to want a better quality of life for ourselves. How we treat others in pursuit of this might be selfish, but the desire itself is good. There are people in our lives who deserve to be seen and known and loved well and that includes us.
Christian Counseling for Anxiety
As a Christian counselor, I believe that we owe it to ourselves and to God to be the best that we can be. If anxiety is holding you back from doing so, or if you find it difficult to acknowledge your anxiety, then Christian counseling can provide a safe space in which to look at it in a sober but positive way and to find expert advice on how to deal with it.
“Rainy Day Blues,” courtesy of Milada Vigerova, unsplash.com, CC0 Public Domain License; “Running to Lift Spirits,” courtesy of GaborfromHungary, morguefile.com; “Fanabe Beach sunset,” courtesy of Tony Hisgett, Flickr CreativeCommons (CC BY 2.0); “Happy Day,” courtesy of Sylvain Reygaerts, unsplash.com, CC0 Public Domain License