Panicking Should be an Option

Panic attacks are sudden, intense, physical and emotional spikes of Adrenalin that typically last 10 minutes or so. They rise to disorder proportions when someone hands over control to the panic by worrying excessively about when the next attack will occur and making life changes to avoid them.

panic_buttonWhen treating someone with a history of panic, I never suggest or initiate treatment from the perspective of their not panicking again. In fact, I tell them to plan on having it happen again. I explain that we’re seeking success, not perfection, and that a step backward serves as a learning experience enabling them to move two or even three steps forward. And I remind them that although the physical symptoms of panic are uncomfortable and embarrassing at times, they’ve survived each and every panic attack they’ve had, and if they hadn’t, we wouldn’t be having this conversation.

Such an approach, I find, is the first step toward desensitizing every aspect of the panic situation that could trigger an attack. When I suggest that it’s okay to panic, it lowers the stakes, taking the wind out of the sails of panic thus reducing the pressure that clients often place on themselves to keep it from happening again. It’s a win-win – if it happens again, it’s no big deal, if it doesn’t, problem solved.

Another important element of treatment is to reassure the client that they’ll never likely be able to anticipate every possible trigger of panic. Thus I have them prepare to panic and plan how to cope with it. Preparation involves several straightforward steps:

  1. Breathe, breathe, breathe. It matters not the technique one utilizes as long as it’s done correctly and consistently throughout the day to diminish the Adrenalin rush response.
  2. Desensitize. Let’s take the example of someone who is prone to panic when driving on a busy interstate highway: The first step would be to take the next readily available exit and find a safe place to stop the vehicle. The second step would be to place the car in park. The third step would be initiating breathing exercises, popping in a relaxation CD, praying or meditating and imagining a scenario where one is driving along comfortably in control.
  3. Write down the exact steps enumerated in #2 to be taken if or when panic occurs.   
  4. Store it someplace where it’s readily available. Cellphones are great for this as practically everyone has one, particularly when taking to the road.
  5. Do a dress rehearsal via a trial run before resuming normal activity. The plan here would be to access one short stretch of interstate at off-peak times when it would be easy to get off and get home.
  6. Then take it live under customary circumstances with the understanding that if panic occurs, a plan is in place, and that plan can be easily and quickly accessed.  
  7. Evaluate. Commend oneself for having the courage to tackle this; do some self-praise for getting through the situation without panic; decide on what needs changing if results were unfavorable.
  8. Exult. Irrespective of the outcome, chalk it up as yet another survival.
Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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