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Panic Disorder Test
There is nothing physically wrong with you, the symptoms of panic and anxiety are harmless if experienced appropriately. However, long term effects of stress may damage your health. Read more.
I’m a doctor of psychology and have experienced both anxiety and panic attacks. My purpose in telling you this, is to normalize your experience, as you may feel alone with what is happening
Anxiety, in one form or other, will be experienced by most of us at some stage.
The problem is we do not speak about it – there is still stigma. I want to break down that stigma.
In order to for me to ensure that you fully understand the symptoms that you are experiencing, I first need to explain your nervous system. It’s a bit long winded, but it is really important that you understand.
The following is a copy of a webinar I did recently on panic attacks, and I would recommend watching it to answer some questions about anxiety.
The course I refer to in the video can be found here
Your nervous system
The Autonomic Nervous System (ANS) is made up of
The sympathetic nervous system SNS, and
The parasympathetic nervous system PNS
Coronary blood vessels
Heart beats faster
Bronchial muscles relax
Heart rate slows down
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You are normally not aware of the operating of the autonomic nervous system, ANS. It works away, in the background, away from your conscious thought.
It works with no effort on your part, like a reflex, adapting and responding to your immediate environment.
It is useful to understand how it works, if you want to understand anxiety and the symptoms that we experience.
You may be more familiar with the sympathetic nervous system, being called, “fight or flight.”
It is activates when we perceive are in some sort of danger.
Example: If, late at night, you see a crowd of young teenagers coming toward you.
They are loud and not familiar to you. This scenario might activate the SNS to prepare you to either run away or stand and face whatever happens. You are getting prepared for danger.
Activation of the sympathetic nervous system
- Release of adrenaline and noradrenaline
- Increase heart rate and blood pressure
- Increases blood flow to skeletal muscles
- Inhibits digestive functioning
When the young teenagers come closer and you see they are members of a local community, collecting for “bob – a – job” week, you immediately relax.
You do not consciously decide to relax, you relax as your parasympathetic nervous is activated – rest and digest
Parasympathetic nervous system activation
- Lowers heart rate, breathing and blood pressure
Let me explain in more detail.
When we are relaxed and ready to kick back and unwind from our day, the parasympathetic nervous system (PNS) enables us to do this, by relaxing our body, slowing down the heart rate and blood pressure.
When this happens we can easily relax into our favorite armchair and feel content. This is why some people refer to the PNS as the rest and digest system. Our body slows down and is able to concentrate on digesting our dinner and the removal of waste from the body.
This is not how we want to feel when meeting a bull, as we are not in a state to deal with it.
This is the beauty of the the sympathetic nervous system (SNS) (also know as fight or flight), it takes control of everything you need in the blink of an eye.
One second you are relaxed and content, and the next your heart is pounding out of your chest and you are no longer in that sleepy relaxed state. You are wide awake.
Does this sound familiar? Exactly like panic attack symptoms? Often you can feel ok, and then, out of the blue, your chest hurts, your heart is pounding.
With anxiety, you may have chest pain, difficulty relaxing or sleeping, your mind is racing and you have tummy troubles. With panic attacks, you may struggle to breathe, be sweating, shaking, and think you might die.
Although distressing, it is just your autonomic nervous system thinking that it has detected a threat and activates your SNS to help you out.
Your sympathetic and parasympathetic nervous system are part of the autonomic nervous system (ANS). The ANS responds automatically when needed.
Think of your brain as constantly scanning wherever you are for possible danger. Once it detects something, anything, that might cause your harm, it protects you by activating the SNS when you need to be alert and ready to take action.
- Once this happens, your mind is sharper, you become more focused.
- Your bowels and bladder can empty making you lighter and able to run or fight.
- Your senses and vision are no longer sleepy, but sharp and taking in more information.
- Blood gets diverted to your heart to help it pump faster
It then activates the PNS (the rest and digest) when the danger has passed to allow you to relax.
This necessary and adaptive system is responsible for the anxiety symptoms that you experienceIf you experience them in front of a bull, you would expect that to happen.
If you are experiencing any of the symptoms mentioned, when it is not necessary, think of your brain as being set to a higher alert to danger than you actually need.
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Many people feel that they can’t breathe properly during a panic attack or when experiencing high anxiety.
It may feel like you are gasping for breath or can’t get enough air into your lungs.
You may also feel like you are suffocating or being smothered.
Normally you don’t have to think about breathing, you do it automatically. The autonomic nervous system makes sure of this.
The key to restoring your breathing to normal, is being able to calm down your nervous system.
During high emotions the sympathetic nervous system produces a “fight or flight” response, as explained above. It is trying to protect you from danger (although there is no danger there.) It is the sympathetic nervous system that causes your breathing to change. It may also speed up and cause rapid shallow breathing.
You hyperventilate. You are still breathing. Your breathing has just changed rapidly and it feels uncomfortable, but you are still breathing.
Having difficulty breathing is one of the most frightening symptoms of panic attacks. The important thing to understand is that this response is due to you getting a fear response in situations where you do not need. Your nervous system has become over sensitized.
Chest pain and tightness
This can feel like someone has put a belt around your chest and tightened it.
It can also feel like something is pressing down on your chest, or squeezing it . Your heart may be beating out of your chest.
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Chest pains such as these are usually why people, like yourself, attend their doctor, afraid that something has happened to their heart.
If you have been given the all clear, the pain that you are experiencing is down to breathing too fast (hyperventilation). Anxiety causes our heart to beat faster than is needed and we overwork our chest muscles, which leads to the sensations that you experience.
Chest pain may cause you to feel alarmed and fear that you are having a heart attack. This fear often makes you panic more.
As explained previously, you hyperventilate during a panic attack. When you hyperventilate on a regular basis, you are over breathing. You are using the chest muscles more often than normal. If these muscles are over worked too often you will begin to feel chest pain.
Dizziness and Feeling Lightheaded
As you breathe in normally, you are breathing in oxygen and breathing out carbon dioxide. When you are breathing too fast or overbreathing during a panic attack, the levels of carbon dioxide in your blood starts to lower (as you are breathing it out too quickly.)
When this happens, your blood vessels will start to constrict which leaves you feeling dizzy.
This is one of the more frightening panic attack symptoms as you may feel that your heart is about to give up.
Your autonomic nervous system controls, amongst others, your breathing and your heart rate. You don’t have to think about it. Your nervous system is explained above.
During high emotions such as a panic attack, your sympathetic nervous system responds to prepare for fight or flight. It is the sympathetic nervous system that is causing your heart to race.
Although unpleasant, it won’t harm you.
Muscle tightness and pain
Again this is due to breathing faster than is necessary. Carbon dioxide drops which results in tingling and tightness.
Think of it this way. This response is very adaptive when necessary. If you fall and damage your leg, where part of your leg has been cut open, your body will immediately get a stress response and your muscles will immediately tighten.
This is very helpful around the area where your leg is cut, as it applies something like an automatic tension to the area.
Your body is trying to protect you, although getting this symptom when nothing has actually happened to you is understandably worrying.
During a Stress Response the large skeletal muscles contract, in the neck and shoulder muscles, to prepare you for action.
This is what causes your neck, back and muscles to ache. It can also give you a headache.
Fear of dying or losing control
You might have found that your thought processes have changed since experiencing anxiety or panic attacks.
Typically thoughts include:
- I’m going to die
- I’m going crazy
- I’m going to lose control
- Something terrible is happening
- I’m going to have a heart attack
It’s natural to think thoughts such as these in the beginning. The symptoms you experience in your body, come from a primitive part of your brain. It reacts first, and thinks later. If your brain thinks you are in danger, it will not wait for you to think about it and decide what to do. Rather it reacts for you, trying to keep you safe.
Development of an anxious brain
We get into trouble, when we use our more modern part of the brain, the part that thinks and analyses. When you feel anxiety, when there is no danger present, you start to think about it and try to work out what happened. Nothing happened, it was just the primitive part of your brain reacting as your nervous system is overworked.
If you are not able to dismiss the anxious symptoms or fearful event that caused the symptoms, you might start to replay this over and over in your mind – like a movie, that keeps running in your brain, you keep the emotions associated with the event alive. You start to develop an anxious brain.
Think of it it this way. You have been building up a “pocket of knowledge” in your brain relating to panic and anxiety. Without meaning to do so, each time you experience a sensation in your body, you are teaching your brain to check for possible reasons for the symptoms you are experiencing.
For example, it is difficult to ignore a pounding heart, your brain searches for possible reasons. A pounding heart as a symptom of anxiety is not the first thought that comes to mind. You are more likely to be worrying that something serious is happening to you.
This in turn makes you more anxious, and these thoughts are getting hard wired (so to speak) into your brain to match the type of thoughts listed above, with the symptoms of anxiety that you are experiencing.
Which simply means, each time your heart beats fast, you will worry that something serious is happening to you (as opposed to accepting that it is a symptom of anxiety.)The more you do this, the more likely it is that you will have similar thoughts each time you have a panic attack or experience anxiety.
Even when the symptoms have calmed down, you may have taught your brain to worry about what has just happened by thinking about the last time you had a panic attack and what happened then. Was it the same as this time? Will they ever go away? What if?
By now, your brain has become expert at predicting the worst and giving all sort of negative thoughts and fears.
The key is to start to break down the cognitive aspects of anxiety – that simply means the thought processes associated with anxiety. We start to “misinterpret” the sensations we feel in our body, which makes the experience worse. For example, if you are at home watching TV and suddenly realize that your breathing has changed. That it is hard to catch your breath or you are finding it hard to swallow, if you think;
- something terrible is happening
- I can’t breathe
These thoughts start to frighten you and will affect your behavior. You might stand up, try to change your breathing, or go outside in case you need help. This is sending a message to your brain that something really may be wrong. It is your anxious brain.
If you have an anxious brain, frightening and negative thoughts will be part and parcel of your life. It is like taking an unwelcome friend with you everywhere you go.
Sweating and blusing
When the heart is pumping blood around your body during the fight or flight response, your body cools itself by sweating. Blood vessels move closer to the surface of the skin and causes the redness you see – blushing.
Once you are aware that you are sweating and/or blushing, especially if it happens in front of others, your thought processes become preoccupied with what you must look like, and whether the other person notices. This in turn may make you feel more anxiety. Our thoughts are connected to what we feel and can produce symptoms in the body.
This is quite common in social anxiety, and you can read more about this here.
Insomnia and Sleep Problems
Your mind may be racing at night and you may find it hard to “switch off.” This over activity of your thought processes will keep you alert and make sleep difficult. You may then worry throughout the day that you will not sleep at night.
This worry, is called “anticipatory anxiety.” We make ourselves anxious by worrying about anxiety we might have in the future. In this case, the future is bed time.
If your body is alert at night, once you fall asleep, you may wake up frequently in a startled state, due to adrenal.
Other symptoms include
Trembling and Shaking
Tiredness and Fatigue
Digestive Problems, Irritable Bowel Syndrome
Can the symptoms be due to anything else?
It is always important to go to your doctor to rule out other possible reasons for your symptoms.
Panic attack symptoms can mimic
Heart Problems, and
- Thyroid Problems.
It is always advisable to link in with Doctors and Psychologists who are expert in the treatment of anxiety as for some people, you may be experiencing adult onset asthma or have thyroid problems and this may be the cause of your problems and not panic attacks.
Are Anxiety Symptoms different in men and women?
Women are more likely than men to experience anxiety disorders. Some studies have found that men and women may experience panic attacks differently.
Women are more likely to experience shortness of breath and the smothering sensation that is a typical symptom of panic. They are also more likely to feel ill.
Men report feeling more pain in their stomach and experienced sweating more than women in some studies.
This is not to say that men do not experience the breathing difficulties and that women to not experience increased perspiration during panic attacks. Both men and women, can, and indeed do, experience both.