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Writer's pictureKari

Anatomy of an Anxiety Attack: How to Gain Control

Updated: Sep 28, 2020

If you suffer from anxiety, I can relate. At one time, I never knew when the attack would come. They seemed to have no rhyme or reason, like a storm that comes out of nowhere. One minute I’d be happy and content, excited that I felt good enough to get out of the house, then in an instant I’d be paralyzed with fear that I was going to pass out. The attacks would come when I was alone or in a crowd of people, or driving. I would have to pull my car over and sit through the attack, only to go back home again, drenched in my own sweat. Anxiety would come in the middle of the night and wake me from sleep. I had all of the mental exams a psychiatrist could administer, and I was told I had a mental illness, called Generalized Anxiety. Prolonged (six months or more), severe ongoing anxiety that interferes with daily activities. It described me very well. What I knew was I had mental anguish. Waiting for the next attack to happen victimizing me in my own body. I worried about everything from dying alone to having to file for disability, which I ended up having to do (after a failed neck surgery, and being diagnosed with fibromyalgia and lupus). I was given lots of medication, not actual advice on lifestyle management. I joined the more than three million other people with anxiety paying and fueling the $4 billion dollar industry of pharmaceutical medication.



My mother encouraged me to go to a counselor. I tried several before I found a Christian counselor who really met my needs and was the right temperament for me. She gave me a sheet that outlined what I had been experiencing called Anatomy of an Anxiety Attack, and helped me to understand what my body was going through so I could take measures to reduce the effects. Little did I know, but this was the start of me changing my story of anxiety and despair, to empowerment and positivity. What I learned was that I could control my outcome, so I became a master in Anxiety 101.


Anxiety is the feeling of fear, worry or unease which most people experience occasionally. Stressful or unfamiliar situations and events that cause these feelings are what is called anxiety triggers. Triggers can range from getting ready to take a test, socializing, being bullied, financial difficulties, bereavement, becoming a parent, being diagnosed with an illness, to experiencing post-traumatic stress syndrome triggers.


The first body function to happen when anxiety rears its ugly head is a release of cortisol and adrenaline, the stress hormones. I thought there was nothing that could be done once my body had the response, but there is. Once the body triggers cortisol, the fight-or-flight hormone, if left unattended the following body responses occur during an attack:

ANATOMY OF AN ANXIETY ATTACK

1. Adrenal release – Glands release the stress hormones adrenalin and cortisol, which can take up to two hours for the body to utilize them. We can learn to remain in the parasympathetic nervous system “rest and digest” rather than allow our sympathetic nervous system “fight or flight” to gang up on us.

2. Racing thoughts – Our body efficiently helps us evaluate threat quickly to make rapid decisions. If the threat isn’t real, our thoughts can feel out of control. (We can train to change our thought process and learn to reframe our perceptions.)

3. Quicker, shallow breaths occur and the feeling of dizziness overwhelms us – We have a change of breathing, which becomes shallow and quicker, exaggerated by the feeling and need to curl into ourselves, shoulders curling in, rib cage compressing and we can’t get a decent breath. (We can change the way we breathe and move through the anxiety.)

4. Vision changes – We hone in on what is threatening us, and if there is no real threat, we feel a “tunnel vision”, which gives us an “out of body” sensation.

5. Senses heighten – Each sense is more magnified, movements toward us seem forceful, noises seem louder, smells stronger and chronic pain intensifies.

6. Face flushing and excessive sweating – Blood vessels constrict or dilate to control blood flow. The face feels warm and flushes and we feel like our heart is rising out of our chest. Some experience face or body sweating, as the body tries to regulate itself in the moment.

7. Dry mouth – As we breathe through our mouth from increased shallow breathing, and we have fluids redistribute throughout the body, we can experience a dry mouth.

8. Gastrointestinal discomfort – As fluid and oxygen leaves the stomach and organs, for the major muscle groups, (so we can run from the threat, whether it is real or not) we can have gastrointestinal discomfort. Our digestive system shuts down. Over time, this phase of anxiety can create irritable bowel syndrome (IBS), and if left unattended irritable bowel disease (IBD).

9. Cold hands, feet and nose – Blood vessels contract to force blood to major muscle groups.

10. Bladder urgency – Bladder muscles relax in response to stress.

11. Sweaty palms and body – Sweat keeps the body cool and regulated to allow for possible maximum exertion without overall heating, making the body more efficient.

12. Major muscle tension – To be ready for fight or flee muscles tense and may tremble or shake.

13. Body tightness – Skeletal muscles tighten poised to help us leave the threat, which can create tension in shoulders, neck, forehead, jaw, arms and legs. Headaches and muscle soreness may result. (Even in times of less stress, our bodies become conditioned to remain tight. There are techniques to help us avoid undue physical stress.)

14. Numbness or tingling – Cardiovascular changes can result in these feelings in the body’s extremities due to decreased blood flow.



Whether you experience occasional situational anxiety (such as the Covid-19 type), generalized anxiety (severe ongoing anxiety for six months or more that interfere with daily activities) or experience full blown panic attacks, the self-help strategies are the same. Knowledge and action are empowerment. I have experienced all three, and still have anxiety from time to time, and have to remind myself that I do have control and tools to change the outcome. Charles Swindoll’s quote “Life is 10% what happens to you and 90% how you react to it”, really helped me shift my thinking. I recommend his books. Look up his quotes on Google, they are quite profound.


Having anxiety should never make you feel ashamed. Deciding to confront that this is happening to us, researching how to utilize self-help methods that work for us as individuals and asking for help when needed is courageous. Early on in my health and wellness career, I purchased a ‘Successories’ plaque and have had it on my desk ever since. It is called The Essence of Compassion, “Resolve to be tender with the young, compassionate with the aged, sympathetic with the striving and tolerant with the weak and wrong…because sometimes in your life you will have been all of these”. Sometimes we have to be compassionate and empathetic with ourselves (without allowing ourselves to take on the victim role) to elevate our own situation or health.


The climate in the United States is to do more, have more and be more. We work and play harder than ever. The 2019-nCoV, (2019 novel coronavirus), or Covid-19, increased our isolation, created job and career upsets, food insecurity and financial hardships and created the perfect storm for anxiety. I hope to shed some light on possible ways to utilize self-help methods to help those who are experiencing anxiety for the first time, have increased anxiety or have been trying to handle their anxiety alone.

If self-help techniques do not work, or there are thoughts of suicide, it is important to reach out for help immediately. I am so glad I asked for help, I wouldn’t be the person I am today, if I hadn’t.

If you, a loved one or a friend needs immediate help from a trauma or an anxiety specialist, go to PsychologyToday.com or call 1-800-273-TALK.


NOT TAMING THE BEAST

So, what if I am stressed? A little anxious occasionally, or all day, every day, relentlessly……. this too shall pass. If anxiety becomes the norm, it is time to make a change. Try self-help options first, but if they don’t work, it may be time to get some help. Don’t let yourself self-sabotage and avoid. Here’s what can build up over time.

1. Repressed immune system.

2. Trouble sleeping.

3. Excess blood sugar and weight gain.

4. Gastrointestinal stress.



CALMING THE CHAOS

The definition of chaos is behavior that is so unpredictable and in the state of utter confusion. It describes our world right now. Change, change, change. If anything, Covid-19 has created the perfect storm, in a media driven world. Covid-19 has become a trigger for some of us. And some of us have increased anxiety.

The definition of a trigger is a cause (an event or situation) to happen or exist. So, if you didn’t have an anxiety trigger before the Covid-19 era, you may have one now. Depression usually refers to the past. Anxiety is usually future based. Most of us have some uncertainty to our future, in one way or another, or are affected by someone else’s uncertainty. Now is a good time to master techniques to separate you from your anxiety.

1. The fastest way to calm down is through breathing techniques. We naturally hold our breath during a scary movie. We naturally hold our breath if we watch someone else swim under water, when someone cuts us off in traffic or if we are in pain. What we don’t do naturally is breathing techniques, to increase oxygen to our brain, tame our thoughts and to change our mind. Here are some breathing techniques to try:

a. Zen Breath Counting – Focuses our energy on our breath, helping us concentrate and relax. Count each exhale, until you reach 10 to 20 times. If you lose track, just start over at one. Do this for 3 minutes working up to 10 minutes.

b. Pursed Lips – Using the diaphragm (make sure your belly is moving, rather than shallowly breathing only in the rib cage), breathe in through the mouth, then puckering up the lips, then breathing out from the pursed lips. This prolongs the exhale, giving the body more time to absorb the oxygen.

c. Alternate nostrils – Press your right thumb gently against your right nostril, then breath in through your left nostril. Release the thumb, close your left nostril with your right ring finger, and then breathe out through your right nostril. Repeat this process, inhaling on one side, switching your finger placement and exhaling through the other side as you alternate nostrils. Try this 3 - 5 times for a calming effect.

d. Double Your Exhale Time – Close your eyes and breathe in for a count of 2 through your nose, then exhale to a count of 4. Do this for 3 times, rest and repeat. Once you have mastered this, you won’t need to count, the longer exhale will become normal for you.

e. Take an on-line beginner yoga class or a beginner tai-chi class. These focus on breathing and relaxation to calm the mind.

f. Learn meditation and/or guided meditation. Meditation is all about the breathing and learning to relax the mind. Guided meditation is with the assistance of audio or a trained practitioner.

2. Crowd out the foods that can cause inflammation (which can also inflame the brain) with healthy foods that sooth inflammation.

a. Inflammatory foods: Avoid highly processed foods, high in sugar and refined carbohydrates, fried foods and foods that are loaded with additives.

b. Anti-inflammatory and soothing foods: Crowd out the inflammatory foods with turkey, salmon, dark chocolate, asparagus, sauerkraut (and other pro and pre-biotic foods), citrus fruits and cherries, broccoli, avocado, oats, cashews and chamomile tea.

3. Taking time to stretch every hour or two can relax tense muscles that have learned to stay tight. A simple roll of the shoulders, and then lacing your hands behind your neck and pressing your elbows back, expanding the chest will invoke a deep breath and reduce tension immediately.

4. Exercise. Even if it is just marching in place during a commercial or an intermittence. Taking a walk in your neighborhood, will increase oxygen to your brain, throughout your body and limbs. Create a time and place to exercise daily. If you can walk in a natural setting, the woods or any outdoor activity is very helpful in managing stress and anxiety and is a good way to reset your mindset.

5. Do something different and fun. Be creative. Find an adult color book and create a color landscape. Dress your dog in a toilet paper outfit. Create funny, outrageous foods. Get out of your comfort zone.

6. Change the way your brain is thinking. By changing patterns, we expand our thoughts. If watching the evening news or exploring Facebook has become a negative, eliminate the negative for a few days. Go on a social media diet. Silence your alerts, get rid of unnecessary apps.



POSITIVE THINKING FUELS POSITIVE RESULTS

It is important to understand that there is a biological reason for negative emotions; they are important to our survival. It would be remis to suggest that anyone ever try to completely wipe out negative emotions. We need them, but here is why it’s so important to be more deliberate about positive affect. We have a lot more architecture in our brain devoted to danger and threat detection than we do for reward. So, it is more necessary to give positive emotions a fighting chance because of the important boost they give to productivity, effectiveness and overall well-being. We need to be on the lookout for things that give us positive effect more deliberately.

Training our brains to rephrase our perceptions is very effective for reducing anxiety. I like to remind myself that what I allow myself to think, to say and to act on can be healing or can cause strife and anxiety. There’s a phrase from an unknown author that reminds me often to guard my thoughts; “Watch your thoughts, for they become words. Choose your words, for they become actions. Understand your actions, for they become habits. Study your habits, for they will become your character. Develop your character, for it becomes your destiny.”

Positive thinking and positive emotions open our brain for very powerful results. Positive emotions give us a sense of reward and safety. And, unlike negative emotions, positive ones allow our thoughts to wander and create. We are in our most innovative and productive space when we are feeling some sense of positivity about what we are doing. Think about how many ideas you can come up with when there is no threat or risk? Also, think about how much longer you stick with something when you like the way it feels to do it? Positive emotions also act as a sort of eraser to the stress hormone cortisol. Remember, cortisol at high levels in a chronic state can lead to a number of debilitating health issues and can affect memory and cognitive ability. So, we need to give our brain a break from cortisol each day by erasing some of it with positive affect. The negative bias in our brain is huge and to rebalance all we need is 20-30 seconds a few times a day to do that.

Highly successful people take time to actively seek out thoughts and circumstances that put them into a positive state of mind. Here are 7 tips for achieving more positive affect in your day:

1. Take a picture every day on your smartphone of something that brings a sense of lightness, love or makes you laugh. Review your pictures often throughout your week. The positive vibes you get from it will be amazing. It trains your brain neuro-chemically towards positivity.

2. Keep a gratitude journal. And actually, write in it each day. People who write down a simple statement of something that happened to them for which they are grateful, reduce their stress by 33%. Individuals who write in a gratitude journal before bed are more prone to a sense of wellbeing upon awakening.

3. Do one thing each day that positively surprises someone else. Call up an old friend and say hi. Leave a post-it notes on a colleague’s computer screen saying thank you. Compliment someone on their traits like their intelligence, talent and how healthy they look.

4. Do mindfulness exercises or meditation. Dr. Jon Kabat-Zinn has scores of meditation resources on Amazon. The point is to bring calm and focus to your mind: and to reset the stressor chemical cortisol. Every day. Get the free app CALM on your phone and use it to reset several times a day.

5. Keep a laughter file. Take all the jokes and videos that friends and family inevitably send and stuff them in a new file. Each day, read or watch a few. Laughter is the best medicine; it is free and the side effect is happiness and joy.

6. Keep a file of things that warm your heart like You Tube videos or stories of people doing remarkable things. Visit those each day for a few minutes. Go to www.values.com and watch a few of the public service announcements designed to make the world a better place.

7. Don’t discount pets and when that isn’t feasible, view dog or cat videos. Pets can give great relief to refocus our thoughts on love and cuteness. Unconditional love gives our feel-good hormones a chance to flourish. (Oxytocin, dopamine and serotonin)

You can also go to www.authentichappiness.com Dr. Martin E. P. Seligman has a questionnaire to learn more about your own personality traits that affect your happiness quotient.

Here are 6 apps that can help us manage anxiety:

DARE: Break Free from Anxiety, an audio-based app that instructs users on how to confront emotions and deal with anxiety, panic, worry and insomnia. The audio recordings are meant to address specific anxiety-induced situations such as driving, flying, speaking in public, visiting the dentist and many others.

Sanvello: Stress and Anxiety Help. This app uses a science-based approach; known as cognitive behavior therapy (CBT), a common type of psychotherapy – to treat stress, anxiety, depression and other related conditions. The app includes audio lessons, video training CBT activities and daily mood tracking. It also has assessments to help build life skills resilience, monitor emotions and track progress.

Headspace: Meditation and Sleep A hugely popular meditation app. Headspace can help with breathing, managing stress and anxiety, increased focus and achieving more restful sleep. There are daily exercises for mastering the basics of meditation and mindfulness as well as ‘SOS’ sessions designed for coping with anxiety, panic and stress in real time.

Stop, Breathe and Think: Meditation and Man Provides resources to track moods and progress with a daily emotion check-in. The app has guided meditation for both beginners and experts, as well as yoga sessions, and acupuncture videos tailored to mood. The app helps to calm breathing, increase focus and improve sleep.

Roots: Panic Attack and Anxiety Relief This app offers short term lessons managing heightened anxiety and controlling breathing along with long term lessons for understanding anxiety and changing the relationship with it. There is also an emergency-contact function to call a friend, family member or local help center for when the user really needs to hear a friendly voice.

MindShift CBT CBT (Cognitive Behavior Therapy) based tools help reframe thinking and encourage taking active steps to alleviate anxiety. This app provides a thought journal to track anxiety-induced feelings and situations, and then it teaches manageable steps and experiments to test and overcome fears. There are also tips to encourage healthy habits and develop coping tools for managing anxiety attacks.


My faith helped me realize that the answers to my “dis-ease” was inside of myself, and only I could make that part of me better. I stopped looking for external relief, and focused on my inside life. I decided to “fit out”. I learned not to worry about what others had, or were, or did or said. I learned how to not give my power to others. I learned that I didn’t need things. One of the greatest documentaries that I have seen is “MINIMALISM: A Documentary about the Important Things”, by Ryan Nicodemus and Joshua Fields Millburn. I recommend you watch this documentary and adjust some of the tools towards your own life. It really showed the values that my husband and I had embraced and helped us weatherproof our finances to withstand the COVID crisis that occurred without warning. We have gone from great debt to being financially solvent. Wherever you are financially, you can turn it around with simple easy to apply techniques, thus reducing your stress and anxiety. Trusting that your financial situation will get better, invokes true financial healing. Having faith towards financial goals helps to achieve them.

The definition of faith is complete trust or confidence in someone or something bigger than yourself. I put my faith in God. To live in faith is truly living without fear (the irrational type of fear). When applied to my life, I began to think fearlessly. It is something I will always be so grateful for. The first premise for Christianity is repentance. Repentance is making things right with others and God. By doing this I set myself free of the blame, shame and misery I was caring around. I forgave myself and moved forward from my past. I began to see my authentic self, choosing to love and be kind to myself in my inner world, living a life of purpose and happiness. Being free of the negative thoughts and language (I was telling myself), good things began to happen. My good relationships grew better and relationships that were not serving me well, ended.

The second premise of Christianity is prayer. Prayer is like counting your blessings. Being thankful and joyful for the good that comes into our lives. Looking towards the positive, positive things happen. A Jewish collection of writings states “We do not see things as they are; we see things as we are”. We create our own reality through perceptions. Therefore, we can get ahold of our inner being. Prayer is often used as “there is nothing left to do but pray” and is used as the last resort. Prayer across different religions is in part the counting of our blessings even when that is such a difficult thing to do. Believers, focus on prayer first, and then when something goes bad, we have a faith that can’t be shaken. By focusing on the good, the bad doesn’t seem so overwhelming. It has changed the relationship I had with fear and anxiety.

Finally, the third Christian antidote to fear is generosity, the righteous act of helping others, which simultaneously reinforces how blessed we are. It is hard to focus on your own problems when you are busy helping someone else. Worry and anxiety will not keep something from happening. Focusing on the moment we are in and being grateful for it is a key to managing anxiety.

I’d like to say that I have beaten “Anxiety”, but I can’t. Anxiety can rear its ugly head and I can give into the fear, but most of the time I have immediate tools and practical applications to fight off fear, reducing my anxiety. I can say that I have become a productive person, someone who can show up for myself and my loved ones. Looking back at the time when my life was filled with anxiety and hopelessness, (you could practically see the storm cloud over my head), nobody could have told me I would be filled with passion and empowerment. Today, it is my mission to help others realize they can overcome anxiety, health risks and chronic illness and that each one of us is worthy of living a calm, pro-active, empowered life. I wish you many blessings with your journey and may you always be able to calm the storms that may find you.

If you, a loved one or a friend needs immediate help from a trauma or an anxiety specialist, go to PsychologyToday.com or call 1-800-273-TALK.

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