Controlling anxiety and panic attack

Question 1: I have started experiencing anxiety and panic attack during this lock down. How can I control and get rid of my anxiety and panic attacks, when they affect every area of my life?

Human beings are susceptible to hyperventilation. Hyperventilation is a major component of panic attacks. Sometimes, even when we are not especially stressed, we begin to breathe too deeply or too quickly. This causes more rapid loss of carbon dioxide from our blood than we are used to. Most of the CO2 in blood is in the dissolved form of carbonic acid, so loss of CO2 causes loss of acidity and the blood becomes more alkaline. Even tiny changes in the acidity of blood cause big changes in the solubility of calcium: hyperventilation makes less calcium available and can even cause cramps or “pins and needle” sensations especially around the mouth and lips. Lack of CO2 can also cause constriction of the arteries, creating stroke-like symptoms that are truly terrifying. These are real, physical reactions caused by chemistry and NOT “all in your mind”.

Therefore, the best way to stop a panic attack is to hold your breath. One technique is “underwater breathing”: you pretend you are under water and hold your breath until you absolutely need to breathe again, then take another breath and hold it as long as is comfortable, then repeat until the panic attack sensation goes away. The idea is to let carbon dioxide build up in your blood again until the normal acidity is re-established and calcium availability returns to normal. Some people may not have the body awareness to hold their breath during a panic attack that, after all, makes you feel as if you are not getting enough air! It can be difficult, which is why susceptible people may carry a plastic bag to breathe into to “recycle” their CO2 without having to hold their breath. Do not put the plastic bag over your head—just hold it tightly around your mouth and nose and try to slow your respiratory rate. Some people are unable to do this and must take anti-anxiety medications. The unfortunate thing is that repeated panic attacks are themselves a cause of stress and anxiety that they might recur. Teaching people to stop their own hyperventilation puts the power back in their own hands and helps restore a sense of control that drugs cannot. One way to “prove” the validity of the above, if you ever experience a panic attack and can get to an emergency room, is to request an arterial blood gas test. The results will show normal O2, low CO2 and a pH above 7.44.

Finally, people associate the setting of panic attacks with the circumstances of their lives at that moment, blaming the mortal fear due to hyperventilation on the situation, such as being in an elevator, speaking to a crowd, visiting one’s mother-in-law, being outside, driving on the interstate, flying on a plane or whatever other random thing was happening when you hyperventilated. The realization that the terror was, at all times, under your control can be empowering against these phobias. Desensitisation to the situation, by returning to it but practising controlled breathing, may be an effective therapeutic manner.

In case you feel you are not able to control it yourself after practising the above mentioned techniques, do not hesitate to seek professional help. For online counselling support we are there @ www.mindspa.org.in

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