A Journey Within and Beyond Panic Disorder

We all know the experience of panic – a sudden fear so powerful that it takes us over. A terrible dread that pushes anything else in our experience out to the periphery. We feel agitated, urgent, incapable of returning to normal until a specific danger or worry is resolved. During a panic, fear is our only reality. Heart palpitations, nausea, sweating, dizziness, and shortness of breath seize our bodies. These physical reactions are overpowering. Panic overrides logical thinking. It does not help to have someone say, “Don’t panic!” because panic is already underway in the body, warranted or not.

The panic reaction will need to be borne out until it subsides. We are unable to do much more, when gripped by panic, than wait for it to pass, perhaps doing instinctively soothing things like taking deep breaths, splashing water on our faces, or hugging a loved one as we wait for our nervous system to regulate itself. For some of the population, panic is a blessedly rare, short-term state. We experience panic on occasions when panic is appropriate. We feel panic when someone or something important to us is in danger when a situation we are responsible for seems to be veering out of control, and immediate action is required of us to fix it.

For people who do not have a special story with the topic of panic, panic at the moment may even help us take needed action – grab the small child out of the street, say what needs to be said when it needs to be said. People who do not have panic issues will not feel overwhelming fear once the danger is past. Not so for the growing portion of our population who suffer from what is known as panic disorder. These among us have an extraordinary challenge – they are subject to the panicked state taking them over at any time, out of nowhere.

Panic can seize their bodies into its paralyzing grip even when there is nothing discernible to be terrified of – no auto accident, no lost child. Rather than being useful for any quick action at the moment, panic immobilizes them. To boot, the state of feeling is often prolonged. Panic attacks may go on for hours and hours, tormenting the sufferer in vicious cycles of thought that turn and turn in circles. In addition to the physical discomfort of shallow breath, dizziness, and flighty feelings, people often believe that they are dying or going crazy. That is why some heart attacks turn out to “just” be panic attacks – panic attacks feel like death. Panic is toxic to the body, mind, and spirit, and it feels that way as well.

A woman with panic disorder feels she is at the mercy of her panic attacks because she does not know how to end them. Typically, the panic is so uncomfortable to her body, mind, and spirit that she develops an intense fear of the state of panic itself and may shut down her outer world as a way of avoiding potential triggers. She may skip anything that she suspects could set her off, be it public speaking opportunities or simply stepping outside of the house. The fear of having another panic attack is part of the disorder itself, like a snake eating its own tail. Many women with panic disorder become ensnared in addiction.

That is because anxiolytics, or substances that induce relaxation, such as benzodiazepines and alcohol, are extremely addictive, and even more so for women with panic. These substances are deadly, especially when used in combination and ways not prescribed. A woman with panic disorder has a nervous system that is easily triggered into the fight-flight mode and which, once there, does not easily find its way back to peace. She needs help: how can she learn to calm down and experience the peace she craves as a baseline model? Some therapies and approaches help reset a woman’s nervous system and retrain her from modulating her own panic response.

Integrative, Holistic Panic Disorder Therapy Programs for Women

Healing from panic disorder typically involves becoming aware of and neutralizing triggers through some cognitive work. Deep problematic thoughts, like “I am not safe,” “I am in danger,” “I’m dying,” can be corrected. They can be reprogrammed, rewritten into thoughts that make her feel safe: “I am capable,” “I can handle this situation.” This is accomplished through gradual cognitive retraining. EMDR therapy and other trauma-based panic disorder therapy programs can help with deep reprogramming. Trauma-based panic disorder therapy helps neutralize the emotional charge of (often unconscious) memories of previous overwhelming situations.

Trauma-based panic disorder therapy helps find the part inside that keeps pressing the panic button and helps that part heal, feel loved, and come to see that she is safe now; she does not need to press that button anymore. Simultaneously, panic disorder therapy and healing require getting in touch with the body and helping it have experiences of prolonged, sustained, complete safety. Many women with panic disorder have lost touch with this feeling, if indeed they ever felt it, and are haunted by feelings of being in some survival-related danger, which can include:

    • Fear of abandonment by loved ones.
    • Fear of rejection from social groups.
    • Fear of invasion of her body boundaries.
    • A deep fear of not being safe and intact is not supported and sustained on the other.

Panic disorder therapy and healing start with creating longer and longer-lasting feelings of deep safety, peace, comfort, and wellbeing in the body. Many panic disorder therapy programs help a woman create feelings of safety for herself, including (but not limiting to):

Panic disorder therapy and recovery also involve getting adept at getting one’s physiology out of the maze of panic once a panic attack is underway through following sensations of safety and pleasure. Grounding exercises, breathwork, massage, trauma-informed bodywork, yoga, and nutritional counseling can support a woman in this body re-education path. Once a woman knows the feeling of safety in herself and is skilled in guiding herself out of the maze of fear back into feelings of safety, she will feel much more empowered concerning panic.

That way, if panic occasionally gets rolling in her system, she can turn it around sooner. Each time she can turn it around, she becomes more confident in her basic ability to get herself out of a panic attack if it should happen. Therefore, she gradually has less fear of situations that might trigger her, as she understands that no matter what happens, she can get herself out of the maze. A woman must learn to do this without the assistance of drugs and alcohol, or she will never be free from them.

At Villa Kali Ma, our panic disorder therapy programs are well supplied with practitioners who understand the body, mind, and spirit connections and how these intersect with the issue of panic. We know how a woman with this pattern can heal herself with support and guidance from loving healers and peers. If you know the hellish state of panic all too well, please know that heavenly feelings of deep peace, safety, and relaxed wellbeing can be yours without substances. We would be honored to help you discover and sustain those good feelings within that are your birthright!

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What is Panic Disorder?

Panic Disorder is a mental health diagnosis listed in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is given to those experiencing repeated panic attacks. 

Panic attacks are acute, very uncomfortable episodes of intense fear that come on suddenly and typically last around 20-30 minutes. Panic attacks have a strong physical component, affecting the body to produce rapid heart rate, shallow breathing, stomach distress, dizziness, and chest pains, among other symptoms. 

At the psychological level panic attacks feel like dying or losing control, and the sufferer may believe something is wrong with their body. A portion of those admitted to the hospital because of suspected heart attack turn out to be suffering from a panic attack. 

Brief, intense attacks of fear including accompanying physical sensations like tense muscles, tightening in the chest, heart pains, difficulty breathing, and increased heart rate may happen once or twice in the life of someone without that being an indication that a person has Panic Disorder. If on the other hand, attacks are recurrent, such that a person feels ongoing dread of another attack, someone may be given a diagnosis of Panic Disorder.

Causes of Panic Disorder

Panic attacks are associated with those who experience anxiety regularly as well as those who have survived trauma, both chronic and acute. Those who have survived life-threatening situations such as childhood neglect and abuse, as well as sexual trauma and sexual abuse, are more likely to have panic episodes. Panic Disorder is twice as likely to affect women than men.

Specific life events such as a death of a loved one or other kinds of shocking experiences may trigger a first panic attack. Panic attacks are so uncomfortable that a single episode of panic may cause a person to fear recurrence to the point that they develop a phobia-like response to the original trigger. 

Specific parts of the brain, such as the amygdala, which are connected with anxiety and fear, have been shown through neural imaging techniques to be activated during panic attacks.

Panic attacks may be understood as a disturbance in a body’s otherwise normal fight-flight arousal system in the nervous system and brain. Trauma plays a role. Although the coupling between a current trigger and bodily harm may not be obvious, the association may be related to a now-forgotten experience during which the body or soul was in fact in danger, and the trigger was a part of that experience. 

An oft quoted example is that if your trauma occurred in a room that smelled of cedar, you may go into panic upon smelling cedar in a different, unrelated context, because your physiology has coupled the cedar smell with the trauma, although the cedar was not the reason the trauma took place.

Drug and alcohol abuse are associated with Panic Disorder. Certain medications, food additives, environmental toxins and exposures may also cause or contribute to panic attacks. Location, high-stress work environments, living in cities, low access to nature and sunlight, insufficient sleep, and nutritional deficiencies play a role as well. 

Those who grow up in families where other people experience panic attacks are likely to experience panic at some point in their own lives. Highly sensitive people, and people who experience depression or other forms of dysfunctional thought patterns, especially distorted, negative self-perceptions and low self-esteem, often experience panic attacks at some point. 

Symptoms of Panic Disorder

Panic Disorder is given as a diagnosis when a person suffers repeated unexpected episodes of panic, in which at least four of the following symptoms appear: 

  • Excessive sweating
  • Pounding heart, accelerated heart rate, heart palpitations
  • Sensation of smothering and being unable to breathe
  • A feeling of choking
  • Trembling and shaking
  • Chills and hot flashes
  • Numbness or tingling
  • Stomach pain, nausea or intestinal disturbances
  • Chest pains or muscular tightening around the heart
  • Vertigo, dizziness, fainting or lightheadedness
  • Fear that one is dying or losing control, intense dread
  • Feeling of disconnection from reality and oneself

An extra difficulty with panic attacks are their sudden onset, that they seem to come on out of nowhere without any notice, and may catch us off guard in situations in which it is socially inconvenient.  

We may avoid more and more circumstances or scenarios which seem like they may be associated with the feeling, without knowing for sure if they are the true cause or trigger. Very often this takes us away from activities, people, and places that we used to enjoy, so the circle of our lives becomes reduced. 

Treatment for Panic Disorders

Panic Disorder is responsive to traditional therapeutic interventions, such as psychotherapies that address thoughts and behaviors (the classic in this genre being Cognitive Behavioral Therapy, aka CBT). 

Through therapies that work with thoughts we observe the ways that specific thought sequences, scripts and schemas lead to panic. Hypnotherapy is also employed to treat panic, wherein a therapist guides you to gradually increase exposure to the panic-inducing trigger, supporting you to develop a neutral response to the stimulus.   

Learning tools for nervous system regulation, such as those provided by Somatic Experiencing and other trauma-healing modalities are especially helpful for panic, as their specific purpose is to create feelings of safety and security in the body. 

Psychodynamic therapies that addresses attachment topics, helping you to form more secure feelings of connection and belonging to others are helpful with panic as well, to reduce the feelings of loneliness and fear that are often triggered by fear of being unsafe relationally. Due to our mammalian nature, secure group belonging and secure bonding to a specific safe person is a strong message of safety to the body that can be internalized even where insufficiencies in this regard existed in childhood. 

Functional medicine and nutritional therapies are advised for treatment of panic disorders as well, to support natural production of beneficial neurotransmitters associated with feelings of peace, balance, safety, and well-being. 

Ways to cope with a panic attack

The following are helpful tricks during an episode of panic: 

  1. Extend the outbreath and shorten the inbreath, for example through the following breath cycle: Breathe in for a count of four, hold for a count of eight, release the breath slowly for a count of eight, then hold for a count of eight. Start again with a short four count inbreath, doing this whole cycle a total of six times. This works to throw a wrench in the panic-generating patterns of the breath, and is very effective on the spot to break the cycle.
  2. Engage in vigorous physical exercise, such as squats, running, jumping jacks, or going up several flights of stairs. Do this until you are very out of breath. This will release the activated fight-flight response out of you, simulates running away from danger, and helps soothe the body instantly.
  3. Do something to gently stretch out your lower back, which will help release your adrenals. Many yoga moves are good for this: forward bends, child’s pose, and dropping to your heels in a squat are all effective. Stay for as long as you need to feel a release, as is comfortable for your body.
  4. Repeat short, soothing phrases over and over, saying them out loud if possible. Such as: “You are safe, you are safe, you are safe. I am safe, I am safe, I am safe. She is safe, she is safe, she is safe.” Prayers, mantras and singing songs on repeat help as well, as singing activates body-soothing pathways through breath, voice, and vagus nerve (connected to releasing fear).

Panic attacks do pass on their own after peaking, and usually do not last for longer than around half an hour. These thirty minutes are severely uncomfortable, no doubt, but knowing they do pass whether or not we do anything at all can be soothing to keep in one’s pocket. 

Likewise, it can be helpful to know that panic attacks do not actually cause damage to you, and though it feels like you are dying and you are in danger, in actual fact these fears and not linked to a current reality, but rather represent a message from the past or the physical body, such that you do not have to take the message of death and danger literally. 

Your goal during a panic attack, therefore, is simply to get through a very uncomfortable but objectively short window of time, somehow, some way (without turning to substances or other kinds of self-harm). 

Preventatively, meditation, journaling, yoga, and cultivating self-awareness help. You thereby develop the ability to witness your panic attacks with observer mode intact internally, where you experience your acute suffering as if watching someone else in a movie but do not buy fully in to its storyline and content. These activities all train the nervous system to be in a state of peace and balance, where panic has no entry point.

Emotionally speaking, you can understand panic attacks as an expression of need, like a volcanic bubbling up through the psyche that is best dealt with with kindness and curious attention but not getting hooked by the story. Learn to relate to yourself compassionately, like a child who is afraid. You can lovingly soothe a terrifying mental-emotional-bodily experience while at the same time staying grounded in the part of you that knows it is a temporary storm that will pass shortly.  

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