Wednesday, January 1, 2014

5 Ways to Help Your Loved One Through a Panic Attack

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.

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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!




80 comments:

  1. One thing that helped me a lot, was a watch/timer. I would tell myself, "Ok, this is only going to last a few minutes. Not more than 15." So I would just watch the time go by, and sure enough the feelings would stop before the 15 minutes was up. (Note: this worked FOR ME. Not saying it will work for others. :) )

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  2. Thank you for posting this, Jen! I've had a generalized anxiety/panic disorder since I was a child, but wasn't diagnosed until I was in my 30's. I can't count the number of times well-intentioned friends have made my panic attacks worse with attempts to help me. I usually need to either go for a walk or get by myself to get my breathing back to normal, which helps my heart rate slow back down. People used to hover, hug and hold me, bombarding me with questions and trying to comfort me. Drove me crazy, made my panic worse, and then they'd get mad at me for pushing them away. Sigh. But thankfully I'm better able to tell people what I need in the midst of my panic, and the folks in my life now are much more responsive and respectful.
    I've seen signs of anxiety and panic in my young son, and we're working on teaching him how to manage it now, so hopefully he won't be as crippled by it as I was when I was younger.

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  3. The ice trick might be a good thing for me. I used to get panic attacks occasionally when I was in college, and I started getting them again over the last 2 years. It's been a couple months since I've had one but I need to remember the ice. I think that fortunately, for me, my own husband hasn't seen me have one, so I don't have to wonder if it's worrying him.

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  4. Thank you for posting this- I've been having trouble coping with my husband's attacks. He used to have them once a year, but this year things spiraled out of control and now they're weekly occurrences. He's on meds, but they still happen and I always feel so helpless. Hopefully these tips will help, and I know it definitely won't hurt.

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  5. As always, I appreciate these posts as a chronic anxiety sufferer. I agree with the tips outlined above, I also find that doing something to distract me helps- usually playing a game on my phone or reading on my e-reader helps to distract me long enough to get the attack under control. Ironically, I rang in the new year last nite with a nice big panic attack. It took me until almost 2 am until I calmed down enough to go to sleep. I think I will try the ice trick next time- I've never heard of that one before. I'm all for non-meds solutions so this may be a good one for me to try. Thanks again Jen for sharing, it's incredibly helpful to know how many other people out there who understand this affliction! ((hugs)) Nicole S.

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  6. My mother suffered from panic attacks all through my life. As much as I have sympathy for the people who suffer from them, this almost sounds like an endorsement. Where's the support for the "anchor" as you call them? Or that final tip: Say thank you to the person who is getting you through who you're putting a lot of expectation on?

    All of these tips basically instruct the loved one to halt anything that might be important to them to help the person having irrational anxiety. Please know that while it must be very stressful to be having a panic attack, it's no picnic being the one more or less expected to carry the sufferer through. The near constant pressure that someone you care about is going to trip a switch and go into panic mode is incredibly stressful. And can be very emotionally draining. It can also get very frustrating to be have someone else and their anxiety constantly a the focus of your life. While it isn't intentionally self serving, after decades, it does get wearing.

    I get that this is intended as ways to help someone get to the other end of an attack faster. Like it or not, panic attacks are very "me, me, me." The anchor-person and their feelings basically don't matter while the suffering person is having an attack. When it's your graduation you're late for, or you're missing out on another birthday party, or you see your parent miss another Christmas concert, or walking out of another movie... At least acknowledge that you are impacting the life of someone else. Please at least appreciate the inherent sacrifices you're constantly asking them to make on your behalf.

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    1. I'm so sorry your mom's issues had such a negative impact on your life. These tips are meant for the support person, it's true, but I would hope that all of my fellow anxiety sufferers already know to express their gratitude - when someone throws you a lifeline while you're drowning, only a monster neglects to say "thank you." I have no doubt it is wearing on the support person, but I hope through education and helpful tips like these a couple can learn to make the strain bearable - together.

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    2. I think you probably have a different perspective on this subject than most people which, while valid, perhaps isn't what this post is about. I read it as being one person helping another who is (when not suffering an attack) on equal footing emotionally, mentally, developmentally, etc. In your case, you were a child forced by circumstance, familial duty, et al, to help a parent, rather than an adult *choosing* to help a friend, colleague or romantic partner. It's more complex in your case because it was her job to care for you, and because of her condition, she couldn't always do so. To make matters worse, it sounds as though (based on your comments) she wasn't seeking help from adult sources (doctors, counselors, what-have-you) when she definitely should have been, especially with a dependent child in her care.

      I'm terribly sorry your childhood suffered due to her condition, but you need to understand that anxiety and panic attacks are absolutely not "me, me, me." External causes (crowds, small spaces, over-stimulation, etc.) are usually what trigger panic attacks. Even when they are triggered internally, (worrying over something small, for example) they tend to be linked to other people, places and things. The most important thing to remember is that someone who is in the midst of a panic attack is no more in control of the situation than say, someone who is having an asthma attack.

      Nobody has an honest-to-goodness panic attack because they're looking for attention. Sometimes there are seemingly silly or irrational triggers, other times systems get overwhelmed and shut down, kind of like when a computer crashes. (As an example, I passed out while taking my cat to the vet yesterday. They were trimming her claws and prescribing medicine, so nothing remotely stressful or medical was happening. The vet left the room to take a call, I was fine one minute and woke up on the floor the next. I have no explanation for what happened, and all I have to show for it is a massive knot on my forehead and a cut on my nose from where the glasses on my face hit the floor--and fortunately didn't break.) Once an attack is over, the sufferer should absolutely thank whoever was there to help, (I'll be baking brownies for the vet and her assistant in the next day or so) but they may not actually be capable of doing so during an attack. They aren't overlooking your own needs or plans because they don't care, but because they can't care. Through no control of their own, a more immediate need is taking precedence. They're not saying "oh, who cares what so-and-so had planned," it's more like, "holy-mother-of-#$@$%@ what's going on and why can't I make it stop." The event you were heading to or present at may have been the trigger, but once panic sets in, all that just blurs into the background, and the only thing the sufferer can focus on is survival mode.

      The person may not be in any real physical danger, (although, that's debatable since, as Jen mentioned, heart rates tend to soar, and blood pressure can also rise to dangerous levels) but the fight they're fighting is every bit as real as a person's struggle to breathe during an asthma attack. Would you make a similar comment on a post regarding asthma, or cerebral palsy or cancer, complaining about how the sufferer's physical illness is disrupting your plans? If that idea makes you uncomfortable, then the same should be true for mental and/or emotional illness; they're both equally real.

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    3. If this post sounded like an "endorsement," then good. In a way, it should. One of the things that makes suffering from an anxiety disorder so difficult is the shame that accompanies it. It's embarrassing to be suffering, it's embarrassing to ask for help and it's embarrassing to seek treatment. Half the doctors out there don't even recognize it as real, and even fewer members of the general public treat panic attacks that way. So, any article, or blog post that says "what you're feeling is real, what you're feeling is valid, and you don't have to be ashamed" is very welcome to those of us who suffer from anxiety and/or panic attacks. Posts like this one can also help reassure people who are lucky enough not to understand what it's like. Make no mistake, you ARE lucky. Do another person's panic attacks seem irrational to you? Great! Can't understand why someone can't shake a depression? Fabulous! It means your body and mind are working as nature intended. Consider yourself lucky in the same way that you consider yourself lucky for being healthy or having a roof over your head: with the acknowledgement that not everyone is as fortunate.

      I understand that yours is a special case. The person who was supposed to take care of you couldn't, and you had to care for her instead. Perhaps, though, the place to go from there is to take your own advice and seek help for yourself. Find a professional who can help you work through your resentment and learn to get past it. Not everyone who is suffering from anxiety is causing the people they love the same kind of anguish, and most sufferers do express their gratitude to those who help them get through it. The language in your post is very general, as though everyone who suffers from panic attacks behaves like your mother did, and every person who supports them feels resentful and put-upon, when I *think* what you're describing is your own experience. Based on your second comment, it sounds as though you what you're really calling for is the need to seek professional help. I'm just suggesting that perhaps by indirectly blaming the sufferer for something beyond their control, you're actually moving away from what appears to be your ultimate goal: to encourage people to seek help, so things can improve for everyone involved.

      Please take this in the spirit in which it was intended. Your situation and experience is unique, but so is everyone else's.

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    4. Hello Anonymous,

      I want to echo the people above who have encouraged you to seek professional help to deal with the lingering anger and resentment you're feeling because of your experiences with your mom. When someone trips dramatically and lands on your foot, the person tripping is likely to get all the attention - and not unreasonably so - but it doesn't eliminate the fact that NOW YOUR FOOT HURTS. Even if the person apologizes after the fact, it doesn't make the pain magically disappear. If this person has trouble walking and regularly lands on your foot, eventually you probably want to visit a doctor to make sure you don't have any lasting damage (broken bones! tendon damage! flat feet!) due to all the inadvertent foot-stomping that's been going on. Otherwise, it leads to seeing posts about what people can do to help others who struggle with walking and shouting BUT WHAT ABOUT MY FEET, which isn't helpful for either group, and just increases the stigma around adults who have mobility issues.

      That said, I know from experience that anxiety (like anything else, really) can be used as a tool to control others. My ex's uncontrolled anxiety left everyone around her walking on eggshells, trying to avoid doing anything that might set her off. It took me a long time to identify her overall behavior as abusive, and the way she failed to treat her anxiety as one more tool in her arsenal of power and control. (DISCLAIMER: Most people who have anxiety problems are not like that! Most people are not having anxiety attacks AT you, and are at least as upset that they are late to/missing yet another important event/movie/concert/family vacation as you are (if not more so, because they blame themselves for it). An abuser tends to use whatever tool or tools are most effective in controlling their victim.) However, if you DO have someone in your life who is using their own mental health issues as a way to control you, I double the suggestion to pursue professional help to work on establishing healthy boundaries and/or getting them out of your life.

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    5. I'm not the OP (but still Anonymous, lol), but I get where he/she is coming from.

      Above, someone asked if it would be the same response if someone suffered from "asthma, or cerebral palsy or cancer." In these cases a patient would be under the care of a doctor. Their symptoms would be managed as best as their doctor(s) would be able to. However, most people who suffer from anxiety never seek help. They expect their families and partners to basically be the medical professionals who help them. So the point the OP makes is a valid one. If you suffer from anxiety you owe it to yourself and your families to seek help. You would not expect your partner to treat your cancer. Do not expect them to treat your anxiety or any other mental illness.

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  7. I would add that the most important and difficult thing is to maintain the quietly sympathetic/supportive attitude, but it is critical. Also, at a time when your loved one is relaxed and willing to talk about it, ask what they think helps them most, but realize that they're also figuring it out as they go. They may not have complete answers and they may get it wrong themselves, sometimes. There are times a quick hug WOULD help me, but times I need space. That's hard for everyone, so patience is essential from both sides. Most of all, I just need to know you don't mind helping me when I feel helpless.

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  8. Jen,
    These are great tips. Another good tip would be to help your loved one breathe normally. Often, but not always, when your heart rate soars like that, your breathing is going to become erratic. Having someone there to remind you what a normal breath is like can certainly help. My husband will hold my hands in his, tell me everything is okay, and help me regain my breathing. This also helps create a focal point for me that takes away some of the outside stimuli that are making the attack worse.

    I actually stopped taking my anxiety medication a few weeks ago (under doctor supervision, of course). I know many people are very against medication, but it can help a lot. I went off mine because I'm pregnant and there is inconclusive evidence about being on that medication and complications in the third trimester. I learned a lot of tricks to handle anxiety when I was on my medication, and I think I'm better prepared for it now. I'm a mental health counselor, which means that I can't actually prescribe medication, so I promise you I'm not plugging for some pharmaceutical company when I talk about medication. But sometimes it helps. It can provide that momentary stability that you need to help you collect your thoughts and learn those important lessons, especially if your anxiety is really bad or fairly constant (which I suppose would be really bad, wouldn't it?). And, as I like to remind everyone, medication for anxiety doesn't have to be forever. It's not like it's insulin; you can stop taking it when you feel like you don't need it (under doctor supervision; please don't try to take yourself off any long-term medications!). I think we forget that, and assume that once we start a medication we'll be taking it for the rest of our lives.

    And I know there are a lot of readers here who also suffer from anxiety, so I'll also say this, because I think we forget it's an option: You can always seek counseling. Counseling isn't for "crazy" people; it's for people who need to talk and to learn about themselves. And if you have anxiety, learning how to handle that anxiety can be the most amazing experience in your life. It's very empowering to take control of your fear. Trust me on that one. :)

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    1. Sabs, thank you for this comment. I REALLY REALLY HATE the taboo against mental health care and medication in the United States. Very happily, I do not suffer from anxiety, but I've struggled with depression for many years. I am in therapy and I have been on medication when it was really bad. IT HELPED. I think the infamous American "pull yourself up by your bootstraps" mentality has a lot to do with how many people suffer from mental difficulties and don't seek help. No one would expect someone with a broken arm to somehow get better on their own, yet this is what we collectively expect so many people suffering from anxiety, depression, attention-deficit disorder, etc. to do. While there are certainly people out there who are over-medicated with mental health medication, that is easy to avoid by going to a reputable doctor who doesn't just whip our her/his prescription pad at the slightest provocation (another great reason to seek therapy and not just medication).

      Kudos as well to Jen for this great post and for opening this discussion! :)

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  9. Jen, you've outdone yourself. This is so amazingly helpful, I hope it goes viral & everyone who could benefit from seeing it, does. You opened up in a way that takes great courage, and I thank you for that. I've had a few panic attacks, and at the time had NO idea what was happening, or how to deal with it, nor did the people around me. To have some simple suggestions, that I can use for myself and share with those around me, will be of enormous benefit. Just the simple affirmation that "this will pass" is a huge help, because it's really hard to get through when you can't see the light at the end of the tunnel. Thanks again for sharing.

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  10. I get them occasionally, and I know someone else who gets them, too. I probably know more people who do, but, like most mental health things, it isn't talked about a lot.

    Because lots of panic attacks are caused by what is going on now or what will be happening, it feels immediate and unavoidable, causing major anxiety. Like number 3, by distancing the thing that is causing it from yourself, you can calm down and get a better sense of perspective ("it won't be that bad" or "I don't have to go if I don't want to").

    In order to get distance, what I find helps for me most is space. Either physically (removing yourself from the situation if the surroundings are causing it) or mentally. Or both. By mentally, I mean thinking of a place that you know well and where you have been relaxed. Usually a vacation spot works well, but things like gardens, camps and the like work well too. Try to picture or get the person with the attack to picture details (it doesn't matter if it's accurate, it just needs to be specific). Things like the sounds, the way the air feels or the way the light falls on water or plants can preoccupy the mind with trying to picture something it usually doesn't. And that something just happens to be calming.

    However, I'm a nature-loving introvert, so it might not work for everyone, but I'd encourage anyone who struggles with panic or who wants to help someone who struggles with it to try it, because there's a chance it might work.

    And a note to the Anonymous above me: I get where your coming from, but the whole issue of panic attacks is that you can't prevent them and you can't stop them. If someone is not being thankful for helping you, that's not the best display of manners, but they may be ashamed about it and not want to talk about it after (letting them know it's okay to talk about it may lead to them letting you know their thankful). And as stupid as this sounds, it may be that if they know you are annoyed or frustrated with them when an attack strikes, this may escalate the panic. Generally, people who suffer from panic attacks may not feel good about themselves, so just be careful in how you approach your asking for acknowledgement. But yes, you do deserve a "Thank you", because emotional support is a great help.

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  11. Jen, your posts about this and especially your posts about Disney World have made such a difference for me! I am going to Disney at the end of the month....with an nice tool kit of ways to have a good trip without fear. Thank You!

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  12. Wonderful tips! I don't get panic attacks per se (thank heaven) but I have generalized anxiety that can escalate into a similar fight-or-flight freakout and several of my friends are prone to panic attacks, so I've been on both sides, and I think these can all apply to many different individual flavors of anxiety. Thank you. <3

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  13. Jen thanks. I know of more than a few people who have anxiety attacks and this info can't hurt.
    for anonymous: Hugs. I am sorry you had to go through that with your Mom. I am sorry she never said she was sorry. I am sorry you mussed so much because of it. But i suggest you take the time to get counseling for your anger in dealing with it for your sake. I was abused as a child. I was hurt and angry. But at some point I realized it didn't really matter what happened to me bwfore. What mattered was the choices I made. I have been able to live my life much happier since that. It's not easy and bad things still happen. Some things from the bad time still upset me and blindside because I'm human. I give myself permission to hurt and then pick myself up. Sometimes by myself, sometimes with other people to help and occasionally on prescription meds. What ever it takes to get me out of the past and looking forward to the future. I hope you find the peace you need inside you Much live.

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    1. That's supposed to say MUCH LOVE! but much living is good too. LOL

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    2. Thank you for the acknowledgement. Perhaps I'm telling others what I could never tell her, because I didn't want to hurt her or cause her additional stress. It was just the two of us, and I was her anchor. And she WAS grateful. And so sorry when her panic curtailed my life. And if she could have chosen she wouldn't have done it. But thankfulness and gratitude will never get back all the things I missed, or was late to, or the experiences I didn't have because I held her hand and talked her down. Don't get me wrong, she was a wonderful mom. But the experience has left a scar. And if I came across as impatient, it is only because this part of the blog, the "my panic" parts, hits very close to home. Because it's the same "me, me, me.". Focus on me, think about me, help me, miss out for me, make sure it's okay for me, stay close to me... I guess I wanted to add a perspective from the other side. All the love in the world won't eventually prevent resentment when you are expected to live in service to another. Please, if you suffer from anxiety, get help. Actively seek treatment. We love you. And we will be there, even when you ask too much, because that's what love means. But it comes at a cost to us, the anchors. You may be feeling the anxiety, but we're hurting because of you and love you too much to tell you.

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    3. Wow. If this is still such an issue for you that you have to go off on Jen for posting about something that the majority of her readers can identify with and have expressed gratitude for being so open about it, then yeah, then please, take your own advice and talk to someone. Because you came off as incredibly bitter and insensitive. Not a good look.

      I get you, I do; my mother was/is paranoid schizophrenic, and it was just the two of us for most of my life. I was just a kid (and this was a long time ago, before there was any real help to be had for that particular affliction), and I had to keep her from freaking out constantly, keep us from being put out on the street, or arrested or attacked. It was no walk in the park, and to this day, I simply cannot stand the presence of someone with whimsically changing moods, those who you never know from one time to the next if they'll be a complete jerk or a total sweetheart. But that's on ME, I don't go onto the blogs of people with schizo affective disorders and tell them to shut up about themselves, especially if what they have to say helps others.

      My husband made a vow to love me through sickness and health, and I vowed such to him. Every time I have an attack and he helps me through it, I not only thank him, but I ask him why he does it, why does he put up with me and my crap, why doesn't he divorce me and do better with his life? And he reminds me of that vow, and that you don't ditch someone you love just because they're sick, and that it's OK, he still loves me, no matter what.

      I was just starting to believe him. Now I shall be filled with doubt all over again, wondering what he *really* thinks and feels about me. Happy New Year to you, too.

      Storm

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    4. Hey, the way you talk about your husband says you two really love each other. He probably feels the way you would if you had to help him if he had your anxiety (just as supportive and loving as you would be with him!) Don't let this fill you with too many doubts, ok? Not everyone gets resentful from helping a loved one. Sorry to weigh in randomly, I just felt I had to say it. Hugs!

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    5. Clearly a nerve was struck. The response was out of line with the comment, Storm. You lashed out and are clearly ready to blame a stranger for your own insecurities, which isn't a great look either.

      This is how one person felt, and their feelings are no more or less valid than your own. And just because you may not like what they have to say, doesn't mean they either have no right to say it or that there isn't something to be learned. And I'm a little saddened to see the in-group behaviour on this blog. In a discussion about a mental illness, I would have thought the perspective of people coping with a loved one suffering would be valued. (Particularly as they are hardly suggesting something radical here. Mental illness takes a toll on the people around you, just like coping with someone's physical illness. Only there are a lot more supports in place for people coping with a physically ill person.) But because they suggest something that brings up insecurities, you're ready to throw them off the ship, as it were. But to blame them for their feelings is no better than someone blaming you for yours. I would have thought better of people who know what that's like.

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    6. What a load of condescending crap. THERE. THAT is "lashing out". I was more polite than I should have been before, because this is not my blog, or it would've been worse.

      I never said that the feelings expressed were in any way invalid, in fact I commiserated with having a mentally ill mother that I had to take care of, and never got any thanks from her, either. What is inappropriately thoughtless is to come into the comments section of someone's blog post about how difficult it is to have anxiety and how the people that love them can help and tell the author that she's selfish and thoughtless to those who love her, just like all people with anxiety, and that because this one aspect of this blog, which helps so many people, brings back bad memories it shouldn't be discussed anymore. Comment after comment about what a self-centered burden and drain we are... you're goddamn right it hit a nerve. The LAST thing a person with anxiety needs to hear/read, besides "Suck it up and get over it" is "You put stress and hassle on everyone you know and no one really wants to deal with you". That more than anything keeps people from even admitting they need help, much less getting it. It would have been enough to simply mention "Hey, don't forget about the part after it's over, when you thank the person for helping you"; the rest was jerkassery. Note the amount of people coming in here to thank her, as opposed to the number of people who agree how awful we are.

      "...But because they suggest something that brings up insecurities, you're ready to throw them off the ship, as it were. But to blame them for their feelings is no better than someone blaming you for yours. I would have thought better of people who know what that's like."

      And I would think that someone that knows how fragile people with anxiety can be would have been able to make their point a little less hurtful and a little more understanding of our need to support one another. Whatever.

      I don't expect this post to remain long, but there it is. All the response I plan to give. DONE.

      Storm

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  14. Jen, thank you so much for this post! I get panic attacks pretty often, and my boyfriend and I keep building our toolbox of what to do when I panic.

    I'm going to Disneyland this weekend, and at least one day I will be by myself. I've made a list of things from your blog to hopefully keep me from panic as I am in a crowded place all alone. Eep.

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  15. Thank you so much for posting this, as someone who has had to deal with panic attacks for the past nearly 20 years it is easy for me to dismiss them….however I now have a loving husband who is – now some four years into our relationship – still trying to deal with them. The thing about them for me is that I am used to them (not getting rid of them but knowing what to expect) and so they are a bizarre and yet worrying normal part of my life, but for him they are an anomaly within the normal day – the other side to his normally sort of (for someone with a mental health problem)stable wife – and one that he has very little if no control over. I know what it is like from the inside but I have no idea what it must be like for him to see me lose control and panic to the point of passing out on occasion all the while not really know what he can do to help me. I have tried to explain to him the best way that he can contain – and I use this word in relation to keeping me grounded during the experience – the situation and me, but I find it difficult to tell him to leave me alone so to have something for him to read which tells him what I can’t is perfect for me. So thank you I know that there are a lot of people who will appreciate this post and not just those who have to help someone having the attacks.

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  16. Jen, Thank you so much for posting this. It really helps me help AnnaMay to hear an adult who can verbalize it more than she can. I feel like I just got a peek inside her brain. I love the info about shutting down. AnnaMay actually will go to sleep in the situations that are the worst. I remember when she was 3 before we knew she had anxiety. We took her to the circus and she was upset and then she curled up and went to sleep. I knew she was uncomfortable and tried to tell the people we were with but they looked at me like I was crazy. She was peacefully sleeping. But I could just feel it. Now if she does that I know it is time to get out! I have never heard anyone else explain it until now though.

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  17. I so love your honesty about your anxiety. It's actually because of you that this past year I figured out that I have anxiety issues. I always just assumed it was my introversion and dislike of people that kept me from wanting to go places, but when my husband and I decided to attend GenCon in August I went back and reread some of your posts about attending cons and realized what was really going on with me. I was able to prepare myself and my husband based on how Jon helps you thru cons, and I got thru it holding my husband's hand and letting him guide me when the crowd got too thick. When I needed a break I'd go sit in the hall while he went to play games and would call to check in on me occasionally. The only time I truly panicked was when I couldn't manage to go with him to meet Walter Koenig.
    Now that I understand I have anxiety I tell my husband that he has to keep me grounded because I could very easily see myself getting worse. I considered canceling my own NYE party last night, but my husband reminded me that my small group of geeky friends were definitely worth spending the evening with. I think these tips will definitely be useful.

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  18. I think that "escape anxiety" pretty much nails what I have.

    The only thing that hits me worse is if someone tries to sedate me. I have injured people over this. Including one dental assistant who thought that it was funny to dance around the room singing "they are going to knock you out". Little 5'1" me picked her up and threw her out into the hallway. The dentist almost fired her for tormenting me over something that was already in my file. I had my wisdom teeth pulled under local by a very sympathetic dentist. But, I was not unconscious and vulnerable, so, yay!

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    1. Yes, I feel the same way! Anything that interferes with my sobriety; from drinking alcohol to taking meds that make me woozy, can trigger my anxiety. I think it's my control-freak nature; feeling *out* of control - even if it's just from being really, really tired - can make me uneasy.

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    2. I have the same fears as you, Ann and Jen. I hate the idea of being sedated or impaired in some way. I never really feared that until a particular set of circumstances happened and after that I've been working to try to get better. In a way, part of me is glad I'm more careful about what I put into my body, and who I trust to be around me when I'm vulnerable. But I definitely wish I wouldn't freak out over being sleepy! I have no idea what I'm going to do if I need any actual medication or even local anesthetic. I have issues with both of those things!

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  19. It bothers me how Panic Attack and Anxiety Attack are used as same things. Scientifically and personally, they're both very different.
    Panic Attacks render the logical thinking brain completely useless (OMFG, I AM GOING TO DIE! is pretty much the only thought the brain is capable of once Panic takes over) and any motor function is pretty much in the same useless state. Anxiety attacks have an emotional trigger (whether internal thoughts or external circumstances), cause physical sensations (sometimes will still be able to move around and potentially leave), with the ability to still mostly think semi-clearly without being speechless.
    I've had to explain this difference to my parents about myself (after my traumatic brain damage), and my brother's now ex-gf who suffered both types and hers were almost indistinguishable.
    Her panic attacks would cause her to cry uncontrollably and almost scream in terror, and she couldn't be talked back down to reasonable mental state, and we'd just have to wait.
    Her anxiety attacks caused her to cry in short sobs, shake as if she were freezing, and she could be touched and held and talked to, to come back down.
    My panic attacks I'd be unable to move anything except my eyes, sweat uncontrollably, and be rendered deaf and mute.
    My anxienty attacks make me feel extremely cold and tingling pins&needles all over, all my muscles want to tighten me up into a ball (digging fingernails into palms, pulling knees into shoulders, pushing my head straight down to my chest, arms curling over chest), and that makes it difficult to breathe since my diaphram contracts inward as well, I can still be talked to and talk back (with difficulty getting my jaw to untighten), I can be touched to help accelerate me out of it, but only certain people's touch helps me and other people touching me does nothing. I have fast dissolve instant acting Clonipon as like a big red emergency "SHUTDOWN/SHUTOFF" button, and it helps tremendously when I notice an anxiety attack coming on, or when one hits me too fast and I can't cognate my way out of it like my therapist taught me. Been free of Panic attacks for years after Cognitive Behavioral Psychotherapy, anxiety attacks are mostly under control from said therapy and meds, and only occur under extremely emotional circumstances (circumstances I have no control over) 3-4 times a year.

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    1. Wow, I've never heard of panic attacks being different from anxiety attacks; I've only seen and heard the words used interchangeably. I know for myself I had a huge mental block at first about using the word "panic" - that can be a loaded term for someone who prides herself on strength & self-control. "Anxiety," on the other hand, felt more... I dunno... respectable somehow. Now I use them interchangeably, to push myself out of my comfort zone, and to admit to myself that yes, I do panic, and no, that doesn't make me weak.

      Your attacks are the most extreme I've ever heard of, no doubt because of your physical injury, although it sounds like most of your symptoms are still a result of a massive adrenaline release. Maybe it's a matter of degrees; get the adrenaline/fear response high enough, and higher reasoning shorts out. No matter what the trigger, though, at least it sounds like support & treatment are about the same!

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    2. You make many valid points, Nate, and your definitions are certainly accurate. However, in my case, I have found that they usually accompany each other. For instance, I'll have anxiety about something going on (like having to move an entire house worth of stuff in less than a day) that will sometimes just build and build ("This is impossible! We've barely made a dent! WHY ARE THEY MAKING US DO THIS?!") until it becomes a full blown panic attack with all the attendant physical shutdowns. Or, conversely, I'll have a panic attack and just barely have the presence of mind to think "WHY is this happening AGAIN?! WHY DO I SUCK SO MUCH?!", and then my mind just leaves and I can't keep the panic from increasing or taking over. So since they often arrive to mess up my mix at the same time, I tend to think of them as the same thing, but you're right to point out the differences.

      And yeah, Jen m'girl, once again I'm feeling you: it was/is much less humiliating somehow to call them anxiety attacks, because I'm supposed to be this loud mouth brassy Klingon dame that people think is the out-going life of the party, I can't have people know I PANIC, I mean REALLY. Better they should think it's my well known temper than that I'm mentally ill. Stigma is a stanky bitch whose odour lingers.

      My Vulcan and I have recently found a code-phrase for me to say when I need to get out of/away from someone/place that is distressing me (and don't want to outright say "I'm freaking OUT!"); "HUSBAND! GET YOUR COAT!" an old Brit-ism for "I'm angry/annoyed as hell and we're leaving, NOW".

      Cheers, thanks a lot,

      Storm

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  20. Thank you for sharing all this! It makes me feel like I've been the right kind of support to my husband when he suffers a panic attack. He's always very good about telling me I helped (and why) after an attack subsides, but sometimes I feel like I'm a broken record just repeating everything. I guess he really does need to hear the same things each time, including me reminding him to breathe.

    Now if I could help with his feelings of guilt & shame that he feels afterwards for involving me - there is no reason for guilt & shame! I'm just doing my job. =)

    I'm so glad you have John to help you through the difficult times! He's a good husband and you two make a great team.

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  21. Thank you for sharing this. My husband and I both suffer from anxiety and are each others best support system. It is not always easy but we manage. Sometimes it feels like the rest of the world does not understand what a person with anxiety attacks goes through. Thank you for bringing attention to the problem. I hope you and John have a very blessed New Year.

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  22. My daughter has anxiety and has these kinds of attacks. She is 8, so it is difficult for her to articulate what is going on. I definitely feel a little helpless in the face of them. Add to that that many people see them as a behavior issue and evidence of bad parenting, and by the time they pass we are both wrung out. I've heard muttered comments about getting her under control when they have happened in public. It is very difficult and it scares me a lot when I think about the future for her.

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  23. I wish people I know knew this. They mostly don't care. I haven't left the house for over a year. I do go out to the front porch. A trip to the end of the driveway to the mailbox is a victory.
    My husband either yells at me, or most often simply ignores me. I'm glad your husband cares about you, and I'm glad that you know your husband cares about you.

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    1. I'm so sorry, Betty. I hope you're getting the help you need, and that you're able to find better support & friendships online. (I've found my online friendships are often more of a lifeline than my IRL ones, so I'm glad we live in a time where we don't *have* to leave the house to find folks with similar struggles, and who understand what we're going through.)

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    2. Betty, I don't know you, but I love you. I've been there, right up to the bit about the mailbox. But I have a husband that understands, and you've made me even more grateful for him than I already was. Please forgive me if I'm speaking out of turn, but how can your husband not care? How can he verbally abuse someone who is his partner and is clearly not doing well? I'm sorry, but I don't think he's particularly well himself. It breaks my heart that you can't rely on him for help.

      Is there truly no one in your life that has noticed this happening, or are you like I was, being careful to hide it from them so they won't think badly of you? Is there nowhere in your area that you can reach out to for help, a clinic or community center, or your place of worship? I promise you, I swear it on my bat'leth; there ARE people to help you, people who have devoted themselves and their lives to helping you. I couldn't leave the house, but I Interwebzed around until I found my local county mental health clinic (they help whether you're insured or not, sliding scale based on ability to pay), talked to someone for a while, and got someone to take me down there. Sure, I'm still weird and I still have my funny turns where I just can't cope with the outside world, but overall, they helped me SO MUCH.

      The depression and despondency of this illness can be daunting and dispiriting (Jeez, that's a lotta D's!), and can make it hard to believe there is help, much less that you can find it. But it's there, somewhere; one thing we all have going for us now compared to even 10 or 15 years ago is AWARENESS and ACCESS. Please, don't give up; it can and does get better.

      Your New Pal,

      Storm

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    3. Thank you Jen...you bring much happiness to many people.
      Storm...I don't know why he does that. It is heart breaking. I think many things...he just doesn't understand...even though I try to explain to him...and no matter what I think of, I end up thinking that he just doesn't care. I guess that's the bottom line. My husband comes from a family that doesn't know the word "we" or "us". It's always me, mine, or I. It's as if I don't exist. Lately it's been easier to not exist than to fight for attention.

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    4. I'm just gutted to read your response to Storm, Betty. You deserve better. Many hugs to you from cold Iowa.

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  24. I wanted to share my experience with panic attacks in case it will help someone who is reading. I've suffered from depression most of my life (I'm 55), and for the past 10 years have been taking the drug Cymbalta. Two years ago I started eating an extremely healthy diet, and found that I was feeling better and better, and I was able to decrease the amount of Cymbalta I was taking to a very low dose. I talked to my doctor about stopping the Cymbalta altogether, and she had me wean off of it, but as I was to find out, much too quickly. After the last of the Cymbalta was out of my system, I experienced what I can honestly say was the WORST thing I've ever experienced, a full blown panic attack! I had no idea what was happening to me, my heart was pounding and I KNEW I was going to die! Mentally, I went to a place I've never been, and it felt like I was in hell! Luckily, my husband was home (this happened late at night). He didn't know what was happening either so he quickly grabbed his computer and searched for Cymbalta withdrawal symptoms, found out that panic attacks can be a part of it. Then he searched for what to do when someone is having a panic attack. He had me lie down on our bed and started talking me through some slow, deep breathing exercises. He assured me that these attacks only last for about 10 to 15 minutes, that it would end, which was very helpful to me. He did some "visualization" exercises with me (something like "imagine yourself lying in a hammock between two palm trees on the beach, with the warm ocean breeze blowing over you", I suppose you could use whatever you know is soothing to the person having the attack). Anyway, I got through that attack. Over the next few days I continued to have attacks, although not as severe as that first one; also I think because I now knew what was happening I was better able to deal with it. One thing I did to help myself was to put some very soothing music on my Iphone (for me that was soothing classical music), and when I felt the panic welling up I put my headphones on and listened to the music while doing breathing exercises). I had also contacted my doctor and she gave me a prescription for a mild anxiety med. Unfortunately the experience shook me to my core, and not knowing how long these panic attacks would last, I went back on the Cymbalta. After a few days back on it the attacks went away completely. I would prefer not to be taking ANY medications, and come spring I'm going to try again to wean myself off of the Cymbalta, this time MUCH more slowly. Unfortunately the makers of Cymbalta do NOT make this easy; it's going to involve counting out grains from the capsules to do it slowly over several months. To those of you who's panic attacks are a regular part of life, I offer my deepest empathy! I can't even imagine living with it on a daily basis.

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  25. My mom recently went through a nervous breakdown due to a lot of different factors, and since then she has been having the anxiety attacks and similar to your escape anxiety she also can't handle overly large crowds for long. We have learned walmart is a bad place. And I am actually learning my brother has the same problem with large crowds though not as bad. Usually he can walk from the very crowded frozen section to the almost deserted fresh foods section and he is ok. I felt horrible when i realised for him it was a real thing and he wasn't just jerking my chain about being a misanthrope *(he's not a misanthrope by any stretch of the word, so imagine my heart break when i see my brother have a "mini" Panic attack in walmart Christmas eve). These tips will help me a lot as i navigate this new territory. Thank you for posting them and for this blog and blah now i am crying at work.. your blog does that haha (in a good warm and fuzzy way though)

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  26. Thanks so much for this! My 23yo daughter who lives with me has lots of problems with anxiety. Your post helped me realize that when she looks frozen, she is dealing with physical symptoms.

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  27. Thank you for posting this! My husband has frequent panic attacks and I never know what to do...always trying to figure it out. I have also noticed that changing the stimuli helps -- we just learned that really bright lighting can set him off. It seems strange, but it is definitely a trigger for him. Traveling is also a big issue for him and we are working on it. Thanks again for all your anxiety posts.

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  28. Thank you so much for this post. I'm in the entertainment business and will (hopefully) spend a large part of my life working with actors, technicians, audience members, etc. The more I know about how to care for people with various levels of anxiety, the more helpful I can be as a stage manager and a friend. Thank you. Thank you. Thank you.

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  29. Thank you for opening this discussion - the post is excellent, and the comments are very helpful, too.

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  30. Thank you for this! I suffer from GAD and a little bit of social anxiety. My mom and my sister are my biggest supporters. They've seen me at my worst and know what to do in the midst of a panic attack. I've been able to conquer so many obstacles because they give me that shoulder to lean on.

    Having anxiety is not something I wish on anyone. It takes a lot to get out of bed sometimes, and the panic attacks just make it worse. It is helpful when your loved ones can help you through them. Having that support really makes a difference.

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  31. I have many friends who suffer from anxiety, and your post is spot on as to how they tell me to help them through their rough spots. Thanks for posting it!

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  32. Thank you for this. My husband frequently worries that he doesn't know how to handle my attacks (general anxiety disorder, panic attacks with agoraphobia, and depression - whee?), but it looks like he already does several of the things you list. The ice trick is a really good one - I'll have to remember that.

    I really appreciate that you're keeping this discussion going - it's been a huge help for me the last year or so, when my symptoms started getting worse. Thank you.

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  33. Our chiropractor just gave us a great tip to help with my spouse's panic attacks. She gets them for a different reason and hers can then lead to vomiting, etc, but maybe this would still help for you?

    As soon as you start to panic, tap with 2 fingers on your chin 10 times, hard enough that you hear the sound. Then do this 10 times on your sternum in the middle of your chest. Then tap with 2 fingers on the web between your thumb and index finger on your opposite hand. Repeat this sequence 2 more times.

    It's not perfect, but it's already stopped two panic attacks (and slightly decreased the third) in the last month. It also stopped one that my MIL was starting to have last week. A big part of this is that it distracts your brain in several ways, so it somewhat halts the automatic pathways that the brain is going down.

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  34. I have both anxiety and panic attacks. I have been blessed not to have a full blown panic attack in years, though. My husband tries to be supportive, but just doesn't understand. Most of my anxiety is centered around the unknown. Where will we be, what will happen, will I fit in, where will we park. The parking one especially. I stay home a lot because I am afraid of not knowing where to park. My husband wants me to see how it's irrational. I KNOW it's irrational, but it doesn't much matter to my mind and body. When I have panic attacks all I really remember is how terrified I was. My system just freaks out and I have to get away or hide or run, but I physically can't do any of them. All I can do is hysterically cry for no discernible reason.

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    1. Girl, I feel you; I make my husband drop me (and hopefully another person) off and meet up with me when he's done. It only benefits both of us; I don't freak out, and he doesn't have to hear me yell about how we're never going to find parking and we're going to be SO late and miss EVERYTHING. This is policy is also helpful when I'm dressed up and wearing monstrous heels.

      Now, if I could just get one of those bullhorns that cops have on their cars so I could yell at traffic to GET OUT OF THE DAMN WAY! I'd be all set.

      Cheers, thanks a lot,

      Storm

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  35. first of all, thanks for posting this, I'm going to keep this bookmarked. Thankfully, _most_ of my anxiety attacks are pretty mild. Unfortunately just reading some of these posts on how bad they can get has triggered a bit of anxiety. I feel blessed and cursed at the same time.

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  36. Thinking back to when I saw you at your book-signing up here in Ottawa, I can't imagine what kind of strength it took for you to do that roadshow. Thank you for doing so, and for sharing these insights. I've shared them broadly because I do know others (including my daughter) who struggle.

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    1. I think I was more surprised than anyone that I did so well on the road, although by the time we got to Ottawa we were on our 3rd or 4th tour & fairly comfortable with the routine. (Plus we drew strength from your Beaver Tails & poutine. Ha!)

      That said, I actually had a panic attack *during* a show that trip (in Texas, of course! Bad memories of John's illness, I guess) and was convinced I would faint right there in front of everyone. My vision tunneled, but I kept talking and pacing, and somehow even John claims he couldn't tell. So, yeah, I guess you can see why I'm such a happy homebody these days. So glad we saw you in Ottawa, though! That was one of our favorite stops - your city rocks.

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  37. Aww. I don't have agoraphobia, but I do have anxious freakouts (could they be mini-panic attacks?) when I get stressed; I fly off the handle and get all freaked out and just REACT. This is really good advice. I will keep it in mind for myself and for others, to remind myself that it IS okay and to help them if they need it.

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  38. Thank you. It's good to know how to constructively help.

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  39. Thank you for sharing. I know it must be very difficult to do, but that's why we like you-you are honest and authentic.

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  40. I think it's great that you are so open about this - you have a wide audience and letting people see that they are not alone in anxiety is a huge gift. Luckily for me, I only get mild anxiety and can generally use tried and tested ways of getting myself out of it, but I can understand how debilitating it must be, especially if your loved ones cannot comprehend what is going on. Keep up the good work - in sparking the above discussion alone, I am sure you have helped several people to feel a bit better about themselves.

    And Sherlock is back - new episode was aired New Year's Day, next one on Sunday here in the UK - I'm sure you can find a way to access them!

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    1. "Sherlock" is coming to PBS on January 19th, right after "Downton Abbey"! Anybody that calls my house on Sunday nights is going a get a right earful, and no mistake! :)

      Cheers!

      Storm

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  41. I know, I don't comment for months and now you can't get rid of me. I say unto you: HA!

    I'm going to show this post to my Vulcan when he gets up in a few minutes, mostly so he can see how terribly clever and compassionate he is, because he does pretty much every thing on your list, even the Cool Wet Rag Trick. And he had to learn it all through 13+ years of trial and error, because no one else was clever and compassionate enough to provide this list, as you have done. And he may even pick up some new tricks; he loves to learn.

    Any time you even start to start to feel badly about yourself for your illness, just think of all the people you've helped with this blog. Girl, can you even begin to guess just how many? You're kinda like The Doctor, you know; you've helped SO many people in SO many ways, don't think for a second that if you ask us for help, we won't answer, Sweetie. ;)

    Your Pal With A Bat'Leth And An Attitude,

    Storm

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  42. The new ATLANTIC magazine has an article by an editor who suffers terrifically from anxiety. Worth reading--much of what you say he confirms with his experience. I am not so much a panic attack sufferer as a person with GAD (generalized anxiety disorder). I look fine on the outside, I fake people out (I have such a great sense of humor! I laugh all the time!) but inside the misery awaits, especially if I don't have a lot to do on a particular day. The need to get ready for a large family Christmas kept me going quite well through December, but with the pressure off, I slump. It's so maddening and embarrassing. I SHOULD be able to stop this on my own, right? The Inner Critic starts in, and now I'm worthless too. Hm. I didn't mean to do more than mention the article in ATLANTIC, but it feels kind of good to articulate the state I'm in. Thanks for telling the world about your experience. It's nice not to feel so alone.

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  43. Thank you for sharing this! My husband is great about my anxiety attacks, but this list is perfect for those who want to give support while an attack is happening.

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  44. Hugs are actually somewhat bracing for me, whereas gentle nudges tend to just ramp me up even higher. But everyone responds to things differently. And i find i really appreciate it if others just ask if there's anything they can do to help, which allows me to feel a little more in control. Still, thanks as always for these posts. :)
    Incidentally, i've also been realizing that a lot of my anxiety issues may be a matter of sensory defensiveness, which can get misdiagnosed as all sorts of other things because it's recognized more by occupational therapists than by psychologists. Perhaps others might find it helpful to look into research on the condition as well, since it's treatable without medication?

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  45. This so resonated with me. My attacks are much more infrequent now, but they were common as I was about to finish up graduate school. For me, they took the form of my heart pounding and an inability to swallow that would strike suddenly while driving. I remember telling my husband when I would feel one coming on, "tell me everything is going to be ok." It's amazing how much that helps, even if you have to feed someone the line. :)

    I also saw your response to another commenter above, about how it relates to feeling out of control, to which I can only say a resounding YES. I think maybe that's why I've had fewer since becoming a parent--I have had to work on accepting (with great difficulty) that there is so very very much that is beyond my control. It brought it home to me viscerally, I mean, since we all know it intellectually. But that doesn't do a bit of good in the moment, does it?

    Anyway! Thanks for your honesty and your willingness to be open about such things. It means a lot.

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  46. My wife is surfing from panic attacks and I was so disturbed. Everyone’s opinion was, I should leave her or left her alone but I wasn’t able do that such cruel thing so I decide there’s nothing like a man can’t do then studied about ways to help panic attacks . Now she is almost perfect and your five ways to help are really helpful. I really appreciate your blog. Please keep writing to help people. Thank you

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  47. I think one of the most important things support people can do is not just reminding the anxious person that things will be OK, but that THEY are OK.Panic attacks can be really demoralizing, and the anxious person might wonder what is wrong with them, why they can't control themselves or do what they view as simple things correctly. I'm sure most people on this forum can be harshly self-critical sometimes. Harsh self-criticism isn't truly beneficial for anyone, but when you're anxious, it can either offset or exacerbate attacks.

    And yes, you will probably find yourself repeating things--over and over again. Even if your loved one has to hear it literally thousands of times, that doesn't mean it's not getting through. Say it again. "You're OK. You'll be OK. You're good enough."

    If your loved one is basically not responsive, you might try changing stimuli like giving them hot water to put their hands in or ice to grip. That will snap them out of the worst of an attack. It's physiological: the brain has to focus on the new stimulus instead of the attack. I don't know if this will work for everyone--for some, it might make them more anxious, but I know that during a bad panic attack I don't have the presence of mind to go pick up some ice.

    I'm a college student who get frequent panic attacks. I have a really solid support system in my friends, but anxiety has still taken a huge toll on my life, mostly because for a long time I considered anxiety the result, and not the cause, of my problems. I felt very inadequate because I didn't truly understand my behavior.

    I don't really see a difference between panic and anxiety attacks for me. It's all basically circumstantial, unless I'm so generally anxious that day that practically anything can set me off. I'm fortunate in that I can usually be talked out of things.

    It's also important to remember to be compassionate with yourself as a friend/caregiver. It's not easy to take care of somebody who's having a panic attack, especially when you don't get them yourself. Panicky people are, obviously, nerve-wracking and taxing to be around. Yes, panic is very me, me, me, but I know that I'm more grateful (and often guiltily indebted) to the people I depend on. I think the hardest thing is trying to help someone you don't see helping themselves. If you find yourself stuck in that situation (haven't we all?), please know your limits.

    Great blog post, great comments :)

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  48. Thank you so much, Jen. I had a panic attack on a shuttle bus that was (very slowly... and after stopping at every single d**n hotel in the French Quarter) taking my for-less-than-24-hours-at-that-point husband and I to our honeymoon cruise ship in New Orleans. It was triggered by the fear we'd miss the boat (we almost did), and I was a crying, shaking mess. My husband was a champ, calling the cruise line to advise them of our situation/ask if we were still okay, letting the shuttle driver know we REALLY needed to get to that boat, and distracting me from my crazy. I would still think things that didn't help, like, "The other people on this bus think I need to be in a mental ward," "He deserves to have a non-crazy wife," "I need to get off this freaking bus- I could walk there faster than this," etc, but he was my rock, and kept me from having to be taken off the bus by EMTs. We have a deal in our relationship- Only one person is allowed to freak out at one time, and that has helped us so well! It helps the calmer person keep it together and banish unhelpful thoughts, at least until the freaker is past the brink.

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  49. I get them on occaision too. Just went through a brief one a couple of weeks ago. I went through a wave of panic attacks last summer. Let me tell you, your advice on letting someone know that everything will be ok really really helps. I no longer have my parents in my life and let me tell you, a doctor or my husband telling me that suddenly calms me down. Bizzare

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  50. Thank you Jen for the share! I have a friend who is recently suffering full blown anxiety attacks (though from the great information above may be on the verge of a panic attack) and does not have a lot of support. She recently just barely made it to my house so she had someone around as she fell into one. And thank goodness I seem to have done most of this correctly! She already knew the ice trick, I happen to have one of those large flexible ones for muscle injuries, I suggest investing in this one. I also sent her this link so she can pick up some times or at very know that she isnt that abnormal.
    To Anoymous with the mom that suffered, coming from someone who has been forced to give up a lot of things to help support her single mother who sees no end in sight; I understand you. However, when it is someone you love who you do not want to see suffer as a general rule most people will not build up the resentment that you have. Like others have mentioned, I believe you should seek a professional to speak to. You have every right to feel that way but you also dont want it to affect your life forever. I had to tell myself to just let things go, I cant fix stuff over night nor can I change my entire life in a day. So enjoy what you can, work on what is obtainable and say F it to the other stuff.

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  51. This advice is really helpful. Thank you for being willing to share about your experiences in a way that reaches so many people - the best thing about the internet can be that people no longer have to feel so alone.

    You may be interested in looking into an intervention that can be powerfully helpful to people with many forms of anxiety - just look up "Rapid Resolution Therapy." (I'd put in the link, but I'm too much of a novice commenter to do so correctly.) RRT is a technique that focuses on communicating with the automatic/unconscious parts of our brain which have been responding in unhelpful ways (such as shifting into fight/flight mode when it is not necessary) rather than the logical/conscious parts of our brain. This makes it particularly helpful for symptoms of anxiety. As a psychologist, I've learned about many types of interventions for anxiety, and RRT is by far the most powerful and effective approach I've seen (just to be clear, I am not affiliated in any way with the clinician who developed the technique - I am recommending it simply because in my work I've seen it dramatically help people who had been feeling stuck for a very long time). It is designed to produce results rapidly, with a single session being sufficient for most people. Also, the guy who developed the technique bears a lot of resemblance to an old-school Dr. Who, so that alone makes it worth checking out....

    My husband and I both very much enjoy Epbot - thank you for sharing your creativity and enthusiasm!

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  52. I pinned this, although I can't remember how many years it has been since my last panic attack. They never happened when a family member was at home with me. So I didn't have anyone pushing me and I wasn't about to go anywhere. It was just an overwhelming sense that someone I loved was in grave danger of being seriously hurt or killed if I didn't do something. However I was unable to move at all for a few minutes. When I could move again, I was trembling violently and couldn't decide what to do next! I had to talk myself down from the heightened sense of anxiety by rationally and systematically reasoning on who might be in danger and rule them out logically, because I was unable to speak yet. It worked the first time, so I tried the same remedy each time after that. I hope the attacks won't happen again, but my family and friends will be able to read and follow your directions on my pinboard. Thank you!

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  53. Walking outside and smelling an alcohol pad (I get super nauseous which makes me panic more) helps me a lot!

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  54. My husband is a veteran and usually attacks me when I tell him I'm having a panic attack. He usually says something along the lines of "It's all in your head, you don't know real suffering." What should I do when I need comfort or someone to talk to during a panic attack? I don't think any of my family or friends would provide good feedback and I don't want them to worry. I moved out to the mountains with my husband and have been a bit lonely which I know contributed to the panic attacks. I just know if I told my parents they would be very upset and I don't want that at all.

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    1. Ouch, I'm so sorry to hear this; fighting anxiety completely on your own isn't something I'd wish on anyone. It might help to educate your husband, though. Getting a medical professional to sit him down & explain panic disorder would be ideal, but barring that, try sending him links online or books on the subject. Discuss it with him when you're NOT panicking, so you can try to have a calm conversation, and explain that your symptoms cannot be "willed away" any more than a soldier can just decide to stop having PTSD.

      If your hubby doesn't seem receptive to any of that, then you need to find support elsewhere. This is not a battle to be fought alone, if at all possible. Trust your family and your closest friends. If they are upset it is only out of concern for you - and they could provide exactly the moral support you need! You might also consider seeking out a therapist, who would be a fantastic ally and another voice of reason in explaining things to your husband.

      I know the holidays are stressful, so please hang in there. There is always a place for you to talk and vent and share right here online, among more friends than you can count. Don't be afraid to tell people when you're hurting, and remember, you're not alone.

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  55. This is an old post, but thanks for it. My husband had developed panic attacks in the last year and they are really difficult to know how to respond to. Especially because they always happen at the WORST time, when we ARE under real pressure. Like in the middle of going through airport security, for example.

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