I know this is an odd post to ring in the new year, but the holidays mean stress, and for some of us, stress can mean anxiety attacks! Please note these tips may be triggering.
I thought I was doing fine the morning John and I were to leave for our trip last week. I zipped up the suitcases, got dressed, packed a snack bag for the road... and froze just inside the front door, unable to step outside.
Dread hit me in a slow queasy rush, my palms began to sweat, and I felt light-headed and jittery. The thought of getting into the car for 12 hours loomed over me like some kind of night terror, and all I wanted to do was run back to my room and lock the door.
I've learned to put a name to my particular flavor of anxiety: agoraphobia. Like most people, I used to think agoraphobics could never leave the house, but that's an extreme example of only one potential aspect, and every anxiety sufferer's mileage will vary. For example, my Mac dictionary defines agoraphobia as "an extreme or irrational fear of crowded spaces or enclosed public places," but massive crowds don't bother me at all - unless they prevent me from moving or reaching the door. I think of it more as "escape anxiety;" I always need the option of an immediate and easy get-away.
Despite my freeze-up that morning we were on the road within an hour, and I felt great the whole drive, no meds required. I think that's because John has learned just how to support me during my attacks, which speeds up my recovery and gives me more confidence going forward. And since I've had several e-mails asking about it, here are the 5 best tips I can offer for helping someone you love through an anxiety attack:
1. Give them time.
Pressure will only add to the panic, so try to be as relaxed as possible. You're going to be late? Then be late. Your loved one comes first, and needs to know that. (On average I need at least 10 or 15 minutes for the initial adrenaline rush to dissipate.)
2. Give them space, but don't go far.
Nervous hovering is incredibly bad, but a gentle presence that's ready and willing to help is good. John will sit nearby and play on his phone, so I don't feel watched or pressured, but I still know he's there. Every few minutes he'll ask how I'm doing, but without pressing for in-depth answers.
3. Minimize external stimulation.
Turn down the music, pull off the road, walk away from the crowd, etc. Remember that a panic attack is a fight-or-flight adrenaline response, so it's not unusual for someone to retreat into themselves during one, closing their eyes and becoming less responsive. (During my worst attacks I look like I'm asleep. Is it any wonder so many folks fail to recognize one? )
I know it's tempting, but do not try to hug someone having a panic attack, and keep your questions limited to an occasional "are you Ok?" and "can I get you anything?"
4. Tell them it's going to be Ok.
Be careful not to patronize or scold, but remind them what they're feeling is temporary. Remember their fear is both real and physical, so they just need an anchor through the tumult. It's not rational or logical, so don't try to reason it away; just be as reassuring and confident as you can. (If you get scared, their own fear will feed on that.)
Sometimes it helps to distract the person by talking about something else. Try telling them about your day, or a funny story. Just don't expect any interaction, and know when to zip it.
5. When the time is right, give a little push.
This is the trickiest one of all, so proceed with sensitivity and caution. However, when you feel your loved one is ready (ie his eyes are open and he's starting to interact with his surroundings again), try a little firm guidance. Something like, "Ok, we're going to walk to the car now. It's going to be fine, I promise. Let's go."
If your loved one resists, try one more round of encouragement. If he still resists after that, though, stop. Some attacks take a lot longer to recover from, and you can only rush things so much.
I still had that sense of dread that morning, but after a little recovery time I let John nudge me through the front door... and almost immediately felt better. Somehow John knew I was ready before I did, and that confidence carried me forward. This isn't always the case, though, so don't expect too much too soon.
And one final tip, for extreme attacks: if your loved one's heart rate tends to zoom out of control, try fetching a bag of ice or a cold cloth and have them hold it on their hands and face. This will help slow their heart rate, and also give them something constructive to focus on. (Back when I first started having attacks my heart rate would shoot from 60 to 160 in under 10 seconds, so that ice trick helped a LOT.)
I can only imagine the helplessness John first felt watching me go through my initial panic attacks, so I hope these hard-learned tips will help some of you out there with your own loved ones.
Here's to a 2014 free of fear and brimming with belly-laughs - and more Sherlock episodes, like, NOW, if you please!