How to manage Anxiety & Panic Symptoms

(From the Pegasus NLP Newsletter Issue 21: 30 April 2001)

Gavin had come for assistance with his panic state: "I feel terrible. I sweat and tremble a lot. I've a  constant thumping in my solar plexus and lump in my throat. My heart is fast and loud. And, worst of all, my thoughts are always racing – as if they have a mind of their own. It all started about a month ago, completely out of the blue, and it's really scaring me.”

Understand why they occur

This was some years ago when I worked as a psychotherapist. Gavin (not his real name) was, quite naturally, scared of these severe and unfamiliar symptoms. For this reason much of the first two consultations were devoted to enabling him to recognise how the symptoms had not come 'out of the blue' but were a natural result of how he had been living, thinking, and reacting.

Once he got this connection clear in his head he felt less scared of what was happening. He was a little less scared of his symptoms and sensations. Now he no longer felt that something awful was happening to him. But he still needed ways of reducing the symptoms – for his comfort and as a convincer that he could influence the symptoms rather than be a victim of them.

So we began to look at how he could manage the symptoms and deal with their causes and I gave Gavin some ways of becoming actively involved in his own improvement. I've listed these below.

Tip 1: writing freely

In panic or anxiety states negative or critical self-talk often contributes to our symptoms and, when it appears out of control, can be quite scary.

Writing Freely is a useful self-management technique for dealing with this 'racing mind' state since it enables us to recognise the typical themes of our self talk,, challenge our 'awfulising', and develop a degree of objectivity about our feelings. The method needs to be used at least twice daily for about 10-15 minutes at a time.

Writing Freely is described in detail here.   http://www.pe2000.com/writing_freely.htm.

There are articles on self talk at http://www.pe2000.com/anx-selftalk.htm and http://www.pe2000.com/neg-hypnosis.htm)

Tip 2: breathing methods

I also taught Gavin two breathing exercises: the Sigh Breath and a version of the Buteyko method. I asked him to practise these every hour during waking hours for the next two days and then to telephone me to report on his progress.

Both methods have a number of benefits. They gave him something to do – so he isn't just a passive victim. They have an immediate beneficial effect which, in very high anxiety states may last for just a few seconds, but is still a convincer that being active is better than being a 'patient patient'. And, with perseverance, the benefits last for longer and longer.

Check the breathing section on the website http://www.pe2000.com/breathe.htm

Tip 3: stay active

When a person experiences anxiety states they may be tempted to stay at home or even stay in bed. Yet it's best to stick pretty close to your normal routine. Go to work, do the shopping, and stick pretty closely to your normal routine.

Perhaps take a temporary break from unfamiliar social situations but do not make the anxiety state a special experience or an alibi for withdrawing from normal life. Remember that it is an uncomfortable and transient state.

In Gavin's case I also suggested that he take a long walk every day to work off the accumulated tension, and the lactic acid resulting from this tension, and to ensure that he did not become house-bound.

Tip 4: avoid caffeine

We really do not need caffeine when experiencing anxiety or panic states. The priority in managing such feelings is to turn down the 'adrenaline tap'. Symptoms such as chest tightness, trembling, racing thoughts, the throbbing sensation in the solar plexus, rapid heart-beat, breathlessness, etc. can all be an indication of too much adrenaline sloshing about in your system.

(Of course, each of these can also be symptomatic of other things as well – so it is wise to first have medical verification that there are no physical problems and then reduce the adrenaline-related symptoms.)

What produces too much adrenaline? The most common causes are physical tension, a racing mind, rushing about, negative self talk, - and caffeine! In the very short-term we may have to put up with the physical tension etc. while we use methods of reducing them. But we consume caffeine voluntarily – even though it should be a 'no, no' while experiencing high anxiety.

So cut out caffeine, as a priority. It is also important to do this gradually to avoid unpleasant withdrawal symptoms. Allow 7-14 days to completely eliminate the drug from your system.

See the article at http://www.pe2000.com/caffeine.htm for more details.

Tip 5: clear thinking anxiety & panic

At the end of the consultation I had Gavin to summarise the facts about anxiety states which we had discussed AND to write these down before he left. He agreed that he would read aloud his list a few times daily. Among the facts we summarised were:

Anxiety states are simply the result of stress, pressure, or a period of disruption or change or upset in one's life. They are not a reflection of one's sanity, or self worth, or age, or ability! Experiencing panic or anxiety states indicates that how you have been thinking, reacting, using your mind, using your body, eating, resting and relaxing, exercising, etc. have not been efficient! Nothing more.

These unpleasant states can continue for months or years. But once we begin actively managing them they become less severe, less prolonged, and less frequent.

If you've been experiencing panic or anxiety states for a long time this is an indication that the METHODS you have been using to deal with them are not very effective – not that you're stuck with the symptoms. Change your self management methods and you will begin to feel better.

Tip 6: find your 'code'

One of the frustrating things about an anxiety state is that there is no 'right way' of getting past it. Nor is there a 'right' tablet, or capsule, or potion. Nor is there a right expert who will cure you. Nor is there an instant fix.

You have to experiment to find what works best for you. It's like trying to use a security key pad to open a locked door. First you need to know the right numbers for the pad. But putting in the right numbers isn't enough. You must also tap them in in the right order. So you have to experiment to discover what methods works best for you and how best to apply these. It is a trial and error process.

Getting past anxiety or panic states requires that YOU take a very active part in your own improvement – every day. Yes, you can be helped by a good consultant. But you, yourself, have to work at it persistently and relentlessly. There is no avoiding this. If you do avoid active involvement in your own improvement you will experience the symptoms for much longer. You have to persevere; not just give up because a particular technique didn't result in an immediate and sustained improvement.

Tip 7: the puppy dog analogy!

When, as he had promised, Gavin phoned me a couple of days after the first session he reported feeling slightly calmer. I had told him the methods would take a week or two to produce real benefits so he was encouraged that even this small improvement had occurred.

On a comfort scale of 1 to 10 he said he'd moved from two out of 10 to four or five. It was not a dramatic improvement and he knew he still some way to go. BUT he now he had his convincer. He was beginning to recognise that HE could influence his own condition… He had hope.

The information and the practical methods had given him something to do. Instead of being a victim of his symptoms he was now actively involved in managing his own state.

Now I had to warn him not to become too optimistic. So that when the symptoms got more severe again, as I knew they would, he'd ride the storm. He didn't want to hear this – but he needed to face reality. Symptoms come and go irregularly when we first begin to manage them and it is critical not to lose our positive attitude when they recur.

It's a bit like teaching a puppy to walk at heel on a leash. At first she'll not respond to your handling but will rush ahead, straining on the leash. Then, very gradually, she will begin to walk at heel, though only for very short periods and then she'll surge forward again.

The key is to remain quietly persistent so that she gets to know you mean business…

However, there is an important difference between this and managing anxiety or panic states. If you don't have instant and sustained success with teaching the puppy you don't lose heart because you're surrounded with visible examples of people who have succeeded! So you have proof that you'll ultimately be successful.

But people who have succeeded in managing their anxiety or panic symptoms are not as readily recognisable. So you have to believe without a lot of visible evidence that you can do it. And you can!

Looking back, Gavin did have a few ups and downs while experimenting with how best to manage his symptoms and get past his 'rocky patch'. But within about a month the symptoms were less intense and less frequent. Later still he send a note to say that he'd finally put the symptoms behind him…

(From the Pegasus NLP Newsletter Issue 21: 30 April 2001.

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