Panic Disorder: When The Fire Isn’t Out

 

Panic disorder is like a fire.

At worst – a raging inferno.

Your body becomes sensitised and responds to everything as if it’s a threat and each fearful response releases more stress hormones into your body. It’s like throwing petrol onto a fire that’s already out of control..

So, you work your backside off to get better and in time those do flames die down. The panic attacks reduce and are less severe or they stop altogether. You’re no longer in fight or flight mode 24/7. You sleep better. You feel better. You think you’ve recovered.

So, you stop doing the things that helped you to feel better..

This is where you make a big mistake because those embers are still burning away..

The fire isn’t completely out.

The way it works is this: Your body has been sensitised for a long time and even though you feel better, you still have a higher than normal level of stress hormones knocking around in your body. These are the burning embers, if you like. Meaning that it doesn’t take much for the fire to be rekindled. Then a few months down the line you wake up at 4am with your heart thumping in your chest. You feel sick and dizzy and the full weight of despair punches you in the face.

There’s Fear, suitcase in hand, with a big smile on it’s fugly face.

HEY HEY HEY!! I’M BAAAAACK! DID YOU MISS ME?

Fear doesn’t wait for an answer. It’s already pushed it’s way past you and before you know it the little shit’s sitting with it’s size 10 feet up on your imaginary sofa.

WTF?! How did this happen?!

Here’s how..

You went back to your old habits and for a while your body tolerated it because you were less sensitised, but when you have been nervously exhausted it really doesn’t take a lot for things to get out of control again. The good news is that there are signs that let us know us that our stress levels are increasing.

  1. Increase (or return) of addictive behaviours
  2. Increase in obsessive compulsive behaviours.
  3. Rumination
  4. Tensed muscles
  5. Inability to complete tasks.
  6. Seeking reassurance.
  7. Completely losing your shit over trivial stuff.
  8. Living in the past or the future, never in the present.
  9. Avoidance behaviour.
  10. Insomnia.

These are all signs that anxiety is flaring up. Those embers are now flames but it doesn’t have to escalate into a full-on inferno. Recognising these warning signs gives us the chance to address our stress levels BEFORE things get out of hand.

The Fab Five.

Five important steps that will put you back on the road to recovery.

  1. Diet
  2. Relaxation exercises
  3. Thoughts
  4. Sleep Hygiene
  5. Acceptance

Diet

Have you lapsed back into poor eating habits by eating crap? By crap, I mean sugar-laden or fatty foods? or caffeine? The foods that made you feel shite when you were poorly?

A reminder.

Eating such foods releases CORTISOL into the body. Cortisol is a STRESS HORMONE.

If you want to get your cortisol levels down – you have to watch what you eat and drink. Boring, I know, but it depends on how much you want to kick this anxiety shit out of your life?

Relaxation

When was the last time you did some relaxation or meditation? Chances are you’ve gone from doing it religiously every day to when you can be arsed or never at all. It’s good practice to do some kind of relaxation EVERY DAY, even when when you feel better because it helps to keep the stress hormones down. Mindfulness lowers cortisol levels. FACT.

Thoughts

Be aware of your thoughts. Are your thoughts in the past or in the future? They should be mostly in the present. Thoughts about the past can produce pain if your dwelling on painful events whereas thoughts about the future can produce fear because the future is unknown. Fleeting thoughts about either are fine, necessary even in order to make plans. The problem is when you are living in the past or the future (or both) instead of the present.

Sleep Hygiene

How are you sleeping? If it’s poorly. What are you doing differently? Are you on social media before bedtime? Or watching stimulating TV? If so, remove all the electronics and read a book. A really boring book and aim to be asleep by 10pm.

Are you ingesting caffeine (inc chocolate) after 3pm? If so, stop. Caffeine is a stimulant. All you are doing is ramping up the stress hormones.

Are you lying there thinking about problems? If so, try mentally put those worries into imaginary balloons (or whatever you like) and watch them float away. You can address them the next day when you can actually do something about them. You can’t do much in your rollers and nightie, can you?!

Acceptance

Acceptance is the most important of them all.

You must accept every bewildering symptom.

You must accept every bewildering thought.

You must accept that you will have crap days.

You must accept that you will have some monumentally crap days.

You must accept that the road to recovery isn’t short.

You must accept that you need to keep doing the things that made you feel better EVEN WHEN YOU FEEL BETTER.

It’s called MAINTENANCE.

As long as you fight against your anxiety, you will never beat it and I do mean, NEVER. Those embers will keep on glowing with the potential to flame up at the slightest bit of stress.

Fear is the firestarter – the twisted firestarter. Deprive fire of oxygen and it will be extinguished. Deprive Fear of stress hormones and it becomes powerless. Make no mistake, Fear will try to knock on your door again and again but each time you will become more adept at seeing him coming..

The day you no longer react WITH FEAR to Fear, is the day you’ve well and truly beaten that nasty little shit and with time (and effort) you will put that fire out completely.

 

 

Why Inactivity Doesn’t Help Anxiety.

Today, I’m talking about cortisol.

‘What the chuff’s cortisol?’ I hear you say. ‘ It sounds like a mouthwash!’

No, that’s Corsodyl.

Cortisol is released by the adrenal glands in response to fear (or stress) as part of the fight-or-flight mechanism. Normally, it’s released into the body when the fight or flight button is activated, like when you have a near miss in the car or you can’t find your purse at the checkouts in Tesco. Once the danger is passed, cortisol subsides and the body returns to normal. When somebody has panic disorder they become sensitised and their fight-or-flight mechanism responds to EVERYTHING as if it’s a threat. Put it this way. I once had a panic attack while watching Mary Berry on TV. I mean, who knew that Mary Berry could be so bloody scary? Maybe it was the way she was chopping her carrots?

We’d be forgiven for thinking that we should be lying in bed or sitting in a chair all day because our bodies are burning calories without doing anything and in any case, we feel too tired to do anything. Right?

Wrong.

The worst thing you can do when your cortisol levels are sky high is sit on your arse because anxiety LOVES inactivity. Why? Because it means that it has your undivided attention. Rest is good. We need to rest but only if that rest includes sleep or doing relaxation exercises. Lying on our beds, tormenting our minds with unhelpful thoughts isn’t restful. In fact, we are KEEPING THE CORTISOL FLOWING.

We need to break the cycle.

We need to DO stuff that distracts the mind from our fruitcake thoughts.

The idea is to bring those cortisol levels down, so go for a run or a long ramble. Take a gentle walk or do some light housework. Have a potter round the garden. Don’t those weeds need pulling up? Paint a picture. Knit a crap scarf. Put a shelf up. Mop the floor. Clean a window. Whatever you fancy as long as it distracts you from your thoughts of doom.

‘I can’t do it. I have no energy’

‘I’m too tired’

‘What’s the point?’

‘Just leave me TO DIE’

The point is that you will feel BETTER for doing it. No matter how retched you feel when you start, you will feel better for doing it because you will have distracted yourself from those unhelpful thoughts. Each time you do this you are bringing those stress hormone levels down. Do you see?

The trick is not to think about doing stuff because you will only talk yourself out of it.

‘I’m too tired today. I’ll do it tomorrow’

Tomorrow will come with the same old excuses but meanwhile those stress hormones are running riot – like a room full of two year olds. Don’t think about going for a walk. Just DO it. Tell yourself that, yes, you feel like crap but you will feel better for it when you’ve been. Get your coat. Open the door. GO.

Even at my very worst, I understood that going out made me feel better. I have walked down the street retching into my hand. But I kept walking and when I got home, I felt better than I did before I went out. It works. It REALLY does. Trust Mrs Fruitcake because she knows her shit. By Mrs Fruitcake, I mean me.

Cortisol & The Mornings

Not the name of a band. I’m talking about cortisol and it’s role in waking us up..

Normally, cortisol levels rise during the early morning hours and are highest about 7 a.m. This is where you start to wake up. It’s a gradual process..

Normally, cortisol level diminishes throughout the day.

Normal goes out the window with anxiety disorders. With a lot of us, there is no gentle start to the day. Our day starts with some bastard standing over us with a megaphone, screaming, ‘WAKEY WAKEEEEEEEEEY!!’ – metaphorically speaking, of course.

See, what happens is this. Normally, people have really low levels of cortisol in the evenings but after a day’s worrying, the anxious person’s levels are sky high before they even try to sleep. We toss and turn for hours, then finally fall into anxious sleep. Then our bodies try to wake us up. Our heart rates increase, blood pressure goes up and hormones go FULL ON NUTS around our bodies in order to rouse us from sleep.

Think of it this way. The non-anxious person’s morning cortisol is the long distance runner. His pace is slow but steady only gathering momentum in the final few laps. The anxious person’s cortisol is Usain Bolt. Nuff said?

This waking state can feel really uncomfortable because we are sensitised.

THIS is why so many people with anxiety feel worse in the mornings.

THIS is why most of my panic attacks happen on waking.

I’ve found that lying in bed after waking up suddenly at 5am isn’t the best idea. Even if I manage to fall back to sleep, the chances are that I will have dreams of the ‘orrible kind. It’s best to get up and go and do something. I find that having a piece of toast and a cup of herbal tea helps to sort out low blood sugar levels.

It’s also worth thinking about what you are eating (and drinking) at night because if you are are eating a heavy meal late at night, you are asking for trouble as digesting food requires the body to work it’s arse off. The heavier the meal, the harder it has to work. Yes? However, going to bed hungry is just as bad. A well thought out snack an hour or so before you go to bed will help to stabilise blood sugar levels. By snack, I don’t mean crisps. I’m thinking more along the lines of a milky drink and a plain piece of toast.

Here, I will sneak in a little note about what you DO before bedtime. Are you watching horror films or psychological thrillers? Are you listening to upbeat music? If you are, you are ramping up the stress hormones. An un-sensitised nervous system will cope with Freddie Kruger at 10pm. At worst it will result in a bad dream but when you are sensitised, you are adding fuel to the fire, so be mindful of what you are doing in those few hours before bedtime. Think, ‘winding down’, not winding yourself up.

If mornings are worse for you, you could try exercising?

Work with the adrenalin. Go for a run and get those endorphins going. If elective sweating isn’t for you – or if you find it too stimulating – go for a walk or do some relaxation techniques. Experiment and see what works for you. Just don’t fear the sensations. Your body is doing what it should, it’s just that you are sensitised.

It won’t always be like this.

Creative Commons Image Via Pixabay

 

A Few Tips To Ease Your Anxiety Symptoms

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In the three years that I have had GAD (General Anxiety Disorder) I have trawled the internet and read countless books searching for ideas to ease my symptoms so I thought it would be a good idea to share what’s worked for me.

So, in no particular order..

Sugar

While diet doesn’t cause anxiety it’s fair to say that certain foods, like sugar, do aggravate the situation and making a few dietary changes can greatly improve symptoms.

When you have an anxiety disorder you can become hypersensitive to your body. Even small amounts of sugar can have a detrimental effect on the body because it’s absorbed quickly into the bloodstream. This causes an initial energy surge but once it wears off the body has to increase the production of insulin in order to remove the sugar from your blood stream leaving you feeling like a bag of shite. Cutting down or eliminating refined sugar from your diet will address the imbalances which trigger panic attacks and will improve your body’s ability to cope with stress.

It’s a good idea to learn bout how much sugar is in the foods you are eating. There is a smart phone app called Food Smart which allows you to scan the barcodes to see exactly how much sugar is in a product. It’s been quite the eyeopener!

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Mornings

Our bodies naturally release cortisol in the morning as we wake from a prolonged period of sleep. This is known as the ‘cortisol awakening response’. Non-anxious people wake gradually over a few hours whereas anxiety cases (like moi) get woken abruptly with the cortisol screaming “WAKE THE EFF UPPPPP ARRRGGHHH!!!”

Imagine having Slipknot waking you up at 5am with their screamiest song (plus scary masks) and you’re somewhere near.

Normally, cortisol is present throughout the day but at a decreasing level, the lowest being in the evening preparing us for sleep. It will spike during short term stressors like an argument or a near miss with the number 57 bus then subside again. The anxious person has consistently high levels of cortisol throughout the day which is unpleasant to say the least.

The best thing I’ve found on waking is to get up and move about – even if it’s 4am. I find that walking helps to burn some of that excess energy off. Lying there only makes me feel crap and if I try to doze off, I only end up having insane dreams of headless horses or toilets that don’t flush. Freud would have a field day with me, no?

I blog. I clean. I use the energy to my advantage and GIVE ANXIETY THE FINGER!

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Dr Google Will See You Now

Not everybody who has anxiety will have health anxiety but a good number unfortunately do.

Me, for one.

The problem is that anxiety presents with such a plethora of symptoms that it’s hard to believe that you’re NOT dying of something particularly nasty but instead of making an appointment with a GP, the cyberchondriac makes an appointment with Dr Google whose diagnosis is usually terminal. The sufferer then curls up into fetal position and awaits certain death only moving as far as their PC in order to post on anxiety forums which are full of threads like..

‘Pain In My Toe. Cancer?’

And..

‘I’m dying’.

Occasionally some desperate sod will upload graphic pictures of his/her poo for reassurance that they are not dying but as much as I understand and empathise with health anxiety, I really don’t want to see someone’s toilet massacre on my PC at 6am!

Or ever.

My advice would be NOT to Google your symptoms but if you really must then type the word ANXIETY alongside whatever symptom it is.

Instead of trawling though pages about diseases you imagine you have.. spend a good few hours researching the condition you DO have? Learn about anxiety and why the body reacts the way it does. Educate yourself!  It will also remove a lot of the fear and once you’ve done that you’re on the road to recovery.

Google isn’t all bad though because you will find great anxiety websites and podcasts.

The Anxiety Guru and Anxiety Slayer  are two excellent podcasts which are informative and help to normalise anxiety symptoms. Well worth looking up.

Exercise

In my opinion, the WORST thing you can do with anxiety is sit on your backside and do nothing. That’s a sure way to keep you in the anxiety/fear loop forever and ever, Amen.

There is a link between being physically active and enjoying positive mental well-being. It causes chemical changes in the brain which positively alter your mood. Even a fifteen minute walk can make you feel better. ANY exercise is better than none.

I walk as much as I can and do yoga. I ALWAYS feel the benefit during and afterwards even if I might not feel like doing it to start with. It’s the knowledge that I WILL feel better that has me reaching for my coat or yoga mat no matter how crap I feel.

Your body WANTS to move. It NEEDS to move to keep all your bits functioning effectively.

You have all these stress hormones whirring away inside you and they need to be diffused so work with them and SHIFT YOUR ARSE OFF THAT SOFA! Go for a walk in the sunshine or a jog if that’s more your thing. Put some funky music on and flick the duster about. Whatever floats your boat. JUST DO IT!

Be well and think positive thoughts.

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