Panic attacks

I have had quite a few requests recently for information on panic attacks from younger Christian people so I thought I should have a go at explaining things and putting them in a bit of context - so here goes. But before you scan this at high speed to find out the terrible news - there isn't any, and no you aren't going mad! Try and just relax as you soak in a bit of story and a splash of science. 

I didn't realise that my first panic attack was actually a panic attack until nearly 10 years later. I still remember it really clearly. I was on my gap year teaching in North Wales and it was my first real experience of being away from home. As an outwardly confident and mellow young person I had no context for understanding my panic attack as anything other than it being a serious heart attack. I woke up in my bed in the middle of the night, I could hardly breath and my heart was racing in my chest. It was beating so hard I thought it was going to explode. At the same time my skin was clammy and cold, beads of sweat ran down my face and a terrible, horrible dark fear gripped my mind.

I stumbled upstairs in the darkness, waking up another young teacher who was working in the same school. He took one look at me and went white himself, which made me feel even worse. Within a few moments we were off to the hospital, where to my amazement I was pretty much ignored. I couldn't understand why I wasn?t on the bed being taped to machines and zapped with electrodes. Instead the doctor put an oxygen mask over my face and went away for fifteen minutes. When he returned from dealing with some less serious stabbing or heart attack he came back took off the mask and sent me home. The only explanation I was given was that I had panicked in my sleep.

Did you know that 10% of the population experience occasional panic attacks and an even larger number of adults in the UK will have experienced a panic attack at one time or another (NHS). It is also extremely common for the individual to head straight to the hospital during or following their first attack. No wonder my doctor looked so relaxed!

The thing I have realised about panic attacks is that there are a cocktail of psychological (mind) and physiological (bodily) responses. When you really understand them they loose some of their power, and you can even learn to stop or minimise them. The really frightening thing about having panic attacks is their unpredictability. Some of us move from the experience of having one or two panic attacks in a few years to something called Panic Disorder, where sufferers might have several attacks per day or night.

Common symptoms experienced during a panic attack are:

* dizziness or feeling faint
* palpitations or increased heart rate
* sweating, trembling or shaking
* difficulty breathing
* feeling of choking or nausea
* chest pain
* numbness or tingling sensations
* chills or hot flushes
* feelings of unreality and detachment
* fear of losing control
* fear of dying
* a sense of great danger and an urge to escape (NHS)

This is not an exhaustive list, so if you are experiencing other sensations don?t be concerned that they aren't mentioned here. Panic attacks are actually a result of what is known as 'the fight or flight' response. We really need this response in our lives; it is what makes us run from attackers or bears or other dangers. If we didn't have it we wouldn't last that long. But if you think about it, the response isn't intelligent it is instinctual - we don't stop to consider if a man's gun is loaded or just a toy, if it is pointed at us we are out of there. Panic attacks are just the 'fight or flight' response kicking in when there is an inappropriate stimulus. Most commonly panic attacks are actually a result of frightening thoughts that trigger a stressed nervous system into panic. This panic then causes another flow of frightening thoughts like, 'I' am going mad', which in turn trigger more attacks. Now the intent of me writing here is not to be expressly medical (I leave that in Rob's safe hands). Instead it is to try and make sense of some of these things as a pastor, so please bear with me.

When I was in my late twenties I experienced several panic attacks in one week. It was as if my previous ignorance to them had stopped me from worrying about them, but now I was conscious of what was happening and it really frightened me. The first thing I did was to go to the internet and read about them. This I realised later was a big mistake, there is a lot of helpful information on the net but there is also so much sensationalist rubbish. My trawl of the net left me extremely stressed, I thought that I was going to loose my mind and be stuck in some twilight world that was punctuated by horrible panic attacks. Needless to say the result of this exploration increased the number and frequency of the attacks.

If you are in that place right now, I really sympathise. I know it is horrible, but I also know that there is real hope, it is an experience that can be overcome. I have not had a panic attack for two years now, but even if I did, I know it would be alright! It's funny being a vicar because you are never sure how much of yourself you are supposed to express. I guess I'm maybe saying too much about myself, but I realise that when I was in the thick of it, all I wanted to know was that there were people who had been where I was, but weren't there anymore.

I don?' know what is worse with panic attacks, the feeling of fear or the experience of the physical symptoms. Whichever you find hardest to cope with, you can be sure they are both there. If we fear the fear, we get the symptoms and if we fear the symptoms we get the fear. The bottom line is that fear is the result and the initiator of the symptoms.

Do you know the verse in the 1 John 4:8, 'But perfect loves casts out fear.' It is a lovely verse, but perhaps it appears a little idealistic when you are suffering from panic attacks. Well have another think about this verse, it actually has a lot to say. The mistake that is often made about this verse is interpreting the concept of love with human undertones. The perfect love that God offers is a distant cousin of our notion of romantic love. The perfect love of God is a superlative love, it incorporates acceptance, justice, security, trust, sanctuary and peace. The fear that it replaces is that of the future, of the past and of the present. Panic attacks and particularly Panic Disorder, where people have a regular flow of attacks, are caused by stress and fear. In light of this there has never been a better time to press in to the perfect love of God.

Well that is ok, but what does it mean in practice? It means practical confidence. This perfect love is active, it casts out - it isn't defensive or passive. Many of the people who have talked to me about struggling with panic attacks are living very defensively, trying to avoid another attack. This defensive behaviour means that they are scanning themselves continually for slight physiological changes that might indicate an attack in immanent. As a result they are feeding the fear that will ultimately maintain their condition. You might have heard it said that, 'the best form of defence is attack.' This is definitely true for people struggling with regular panic attacks.

Having become very frightened of my own attacks, I was amazed when my friend who is a trained psychologist came over and suggested that we have a panic attack together! I couldn?t believe that she could have a panic attack at will, and I certainly couldn?t believe that I had any control over when or how these things could happen. We sat opposite each other and on her lead we hyperventilated for about five minutes before I experienced all the same physiological sensations that I had felt before, spinning head, sweating, dizziness, heart beating fast, etc. The self-induced attack reached a peak of intensity before declining as before.

Now obviously this experience wasn?t quite as frightening as some of the spontaneous attacks I had had before. However, it did show me several key things that helped to diminish my fear. Firstly, I realised that I wasn?t going mad, which was a relief. Secondly, I realised that whilst attacks were unpleasant, they were not actually detrimental to my health and were not causing any damage to my brain or heart. Thirdly, I realised that my unwitting hyperventilation when I got stressed or fearful was a major contributor to my attacks. If I could stop hyperventilating then I was deactivating the attack before it could happen (by stopping the over oxygenation of my brain that causes the symptoms). My friend told me that it was impossible to have a panic attack if I was completely relaxed. The final thing that I became confident of was that panic attacks had a beginning, middle and end, they could not continue of forever and a day. This was a great relief and reduced my fear massively.

I began to aggressively challenge my fear, by finding out every weakness in the panic attack enemy. I was searching for its failings and loopholes, anything that gave me an edge over it. Instead of slipping into defensiveness and fear I became resolute that I could move out of this. The perfect love of God was one weapon in my armoury that I knew could not be overcome, it was my security. Behind me I knew some absolutes that I would hold on to for security and peace. I knew that God would not abandon me, that he had won my eternal victory, that I was safe in his hands and that he had plans for my life that would not be thwarted by panic attacks. All this gave me huge confidence when fear came - suddenly I realised that I was not alone but that perfect love could practically cast out my fear.

Combining my spiritual understanding of Jesus?-presence with practical action I began to see a marked decline in my attacks. When an attack came I decided to aggressively relax. Sounds like an oxymoron? Well it isn't! Relaxation I learnt was like a weapon in an attack. I would let all my muscles go loose, soften my breathing and move it into diaphragmatic and steady rhythms. Instead of increasing my terror by willing it to end, I just embraced each attack in the knowledge that it would definitely end. Like a powerful switch this approach ended many attacks as soon as they started. The result of this success increased my confidence, further reduced my fear, and as a result reduced my attacks until the disappeared all together.

Just a little note of caution - I think that many of us exacerbate our problems when we solidify our attitudes into all or nothing categories. You might have noticed that in my introduction I said, 'and if I had another attack, I would be alright.' I realise that I am probably one of the 10% of people who get occasional panic attacks. If I make concrete decisions in my mind like, 'I can not live a happy or valuable life unless I never have another panic attack.' I will live my life in the constant fear of another attack, which massively increases the likelihood of having more attacks, besides ruining my life. Some people who are trying to recover see every attack as a failure, then when they have an attack the feel terrible and believe that it's all going to go downhill.

Try not to live your life or your recovery like this. Embrace every attack as an opportunity to experiment on what stops them. Try to laugh at your attacks while they are happening, make them smaller and less serious than they are now. I know this sounds hard, but believe me it works! Life is a tough journey and for some of us panic attacks can be an additional hazard. Remember that you are a child of God, you are not the sum of your attacks, they do not represent any terrible weakness, or any sinful lack of faith. They are just there right now. It has been ok, it is ok and it will be ok. God is with you, in every moment.

Practical tips:

1) Do go to see your GP to discuss your attacks. Try and go armed with a log of how frequently they have occurred and explain their intensity and length.

2) Avoid reading tons of internet sites - some are just plain wrong. The ones on the Mind and Soul links page are all great and sound, so use them.

3) Don't be ashamed of them. They are common and most people will know what you mean.

4) Pray about them, invite God to lead you away from them. (Be cautious if people claim to have 'broken' them or 'freed' you from them ? they are not spiritual, they are behavioural.

5) Aggressively relax when you feel the warning signs of an attack coming on.

6) Create lots of relaxation space in your life and engage in meditating on the Lord and his peace.

7) Don?t stop doing anything you would normally do because of your attacks or begin to live defensively, instead fly in the face of them.

8) Try not to see attacks as 'setbacks' or 'failures'.

9) Remember that their frequency will decline as your system begins to regard them as insignificant. This will take time.

10) Your stress system is working correctly just not appropriately.

You are a child of God - never forget that he never forgets you.
 

Will Van Der Hart, 24/07/2008