Almost grad student looking for panic/anxiety help

[erin.hpd]

Hi anyone that reads this. I am a 24 year old that is about to start a PhD program for economics. I have had anxiety for as long as I can remember, but over the last couple of years it has really escalated and I have developed a panic disorder.

The issue that I'm having is: I'm going to start school in one week and I'm terrified. My fear is causing frequent panic attacks and I have a moderate to severe level of anxiety at all times. I moved 700 miles from where I got my undergraduate degree, so this is a new place and new school.

Some specific things I'm struggling with are:

1) Mindfulness activities and yoga really help out, but I'm so preoccupied lately that I often forget (or choose not) to do my healthy start to my day. Any advice for motivation or tips on other morning activities that can help reduce anxiety during the day?

2) After trying too many medications, I have found that they aren't for me. But, this last week I have found myself considering xanex or something like it for panic attacks. That option just isn't for me. My common panic attack symptoms are: difficulty breathing and swallowing, tight chest, hyperventilating, feeling like nothing is real/disconnected from reality, feeling like I'm going to pass out, overwhelming feeling that something is wrong and that I'm going to die. Any tips, opinions, advice for calming yourself from a panic attack?

3) My anxiety and panic has caused me to stop driving. I would love to drive again but every time I try I get so anxious that I feel like I'm going to pass out. This has been going on for a year. Again, any tips or advice?

There's a lot more I would love to talk about, but this is a bit of an emergency situation. Thank you so much in advance for any and all advice.

[Nowuccas]

Hey erin,

"The Quick Guide to Stopping Panic Attacks", (by another forum member) is at http://anxietyforum.net/forum/showthread.php?9512-The-Quick-Guide-to-Stopping-Panic-Attacks&highlight=admin

My previous post about panic attacks follows:

"There are some differences between anxiety and panic attacks. While books are written on this topic, the following will attempt to summarize some basics here for a brief overview".

Anxiety Attacks:
An anxiety attack, sometimes referred to as a panic attack, is an unforeseen periods or incidents where there is a sudden fright or fear of intense proportions. These attacks focus on fears that are most often not rational; however the person with the disorder believes he or she is in terrible danger or at extreme risk. Most often these anxiety attacks occur all of a sudden; i.e. they are not planned nor do they come with any type of warning mechanism built in for advance action. Results are that
the person suffering the attack will feel about to faint or near death's door. People who suffer anxiety attacks report the following symptoms, listed in no particular order:
Discomfort or pain in the chest, Vertigo or
Dizziness, Upset stomach / Nausea, Loss of
Control, Loss of Mental Stability, Stress,
Cold or hot flashes Heart palpitations or
near heart attack, Shallow breathing, Shakes / Trembling.
Anxiety disorder is characterized as having anxiety feelings that are "always there / all inclusive," make people want to isolate themselves from society and hamper everyday activities with others.

Panic Attacks:
On the other hand, a panic attack does not carry with it that "always there" association. In fact, panic episodes generally burst forth, peaking after roughly 10 minutes or so, then ending after about 25 minutes. During a panic attack, 4 of the symptoms listed below (in no particular order) generally make an appearance:
Hyperventilation, Shallow breathing, even to the point of
suffocation sensation...
Increased heart rates Tightness of chest, Chest pain or discomfort,
Shakes / Trembling / Sweating Choking
sensation, Upset Stomach / Nausea Vertigo,
Paresthesias (numbness or tingling sensations),
Surreal feelings, Loss of Control, especially
of mental faculties, Death coming on, Numbing,
Cold or hot flashes.

The Difference:
The main difference between anxiety attacks and panic attacks is in the duration of the attack and how intense it is for the person with the affliction. While anxiety attacks are less hi-stress, they tend to last longer than the power-packed panic stressors".

If panic, learn an anti-panic breathing method before another attack, so you are proficient.

Advice from a clinical psychologist about panic attacks is to breathe in to the count of 3: ( count: one thousand one; one thousand two; one thousand three) each takes around a second to say to yourself, in your mind, and out to the count of 3. Keep repeating this until the panic subsides, (up to 25 minutes) which will deal with the hyperventilation aspect. Learn to recognise the thoughts which trigger attacks; challenge and reprogram as shown*.

Also learn, and employ either Progressive Muscle Relaxation ( http://www.drcoxconsulting.com/managing-stress.html ) or acupressure tapping / EFT, whichever you find most effective.

Give the Meridian Tapping Technique / EFT a good tryout, to see if it helps you. It is free via mercola.com or www.tapping.com (13 free videos), or www.eftuniverse.com or www.emofree.com or one of the many YouTube videos. Google: "YouTube; EFT videos".
Professionally instructed is generally preferable (Google: therapists; EFT; [your location] ). - There is a version for use in public places at http://eft.mercola.com (if you like, you can claim to have a headache, as you employ the acupressure massage / tapping on your temples, but you would then be restricted to subvocalising: saying it to yourself in your mind: "Even though I suffer from anxiety / panic attacks, I deeply and completely accept myself)."

* REPROGRAMMING:
Use the Technique for Reprogramming Negative Thoughts: It's important to regularly monitor, and deal with a negative internal monologue (self talk), or mental process, such as disturbing thoughts, images, impulses, or emotions, by the process of (a): recognising it, and (b): challenging it immediately. Technique For Re-Programming Negative Thoughts: When you notice something negative, such as: "I can't do this/ am never going to get over this!" or: "Why am I always so useless/such a loser?" or even an image, emotion, or a memory; recognise that it is being generated from the negative part of your mind.

After identifying and labelling it, visualise a large, red, flashing, "STOP!" sign, and/or possibly a stern faced person wagging an index finger at you in a negative manner, then say to yourself as forcefully as you can, even aloud in a big voice, if alone: "I know this tactic: GO AWAY FOR A WHILE !!!" You may want to use either: "ruse", "ploy", "game", or "trick". In the case of an image, visualise a large "STOP" sign, or your preferred version.

Some people go so far as to keep a wide rubber band in their pocket, then put it around their wrist, when they catch themselves backsliding, stretch and release it, as a method of reprogramming their mind sooner, but I don't regard it as being strictly necessary. Remember to remove it, afterwards, if you use this method. Try replacing a negative thought with a positive affirmation of your choice, like: "I am a unique individual, with my own set of skills, and good points", or "I may not be perfect, but I'm doing the best I can, right now".

I'm aware of the opinion that inflicting pain doesn't prevent fear, but the intention is to reprogram, and establish a different way of thinking, by commitment to repetition. It usually takes around 25 to 40 repetitions to establish a new habit.

"Even if we have some vague idea that we are not our feelings or our thoughts, when we are experiencing painful feelings or painful thoughts, we believe we have to feel them or think them just because of the fact that they are occurring to us. But painful feelings can be indirectly controlled by physical action, and changing our present thoughts for different thoughts (since feeling occurs as a result of thinking.) Painful thoughts can be directly controlled by choosing replacement thoughts for the ones that are troubling us. Sure, it takes some practice to change a habit. But it can be done. Of course it can't be done if we choose to believe that it can't be done. But, since the choice is ours, why not choose to believe it can be done, and do it?"

Read: Change How You Feel by Changing the Way You Think by Dennis Greenberger and Christine Padesky, & Change Your Thinking by Sarah Edelman, & "Feeling Good." The New Mood Therapy. Harper Collins.1999. ( updated sequel to his US bestseller about treating depression & anxiety; very comprehensive), by David D. Burns, M.D. Hypnosis is merely a heightened state of suggestibility, in which you are better able to communicate with your subconscious mind; view http://myfavoriteinterests.com/hypnosis/ about what it is, and isn't. 85% of people are suggestible to some degree; 15% - 20% highly so, and 15% - 20% aren't much at all, so you could either preferably seek professional hypnotherapy, or, if not an option, hypnosisdownloads.com has one about stopping negative thoughts.

Check out http://www.wikihow.com/wikiHowTo?search=stop+negative+thoughts such as: "How to Get Rid of Negative Thoughts: 9 Steps", & "How to Use Switchwords to Clear Negative Thoughts: 5 Steps".

"I cannot always control what goes on outside. But I can always control what goes on inside" - Dr. Wayne Dyer*.

[Nowuccas]

DRIVING ANXIETY/PHOBIA:
Systematic Densitisation Therapy, and Cognitive Behavioural Therapy have been shown to be effective in the treatment of fears/phobia. Also worth considering are hypnotherapy, particularly from a reputable professional hypnotherapist, and EFT. Give the Meridian Tapping Technique / EFT a good tryout, to see if it helps you. It is free via the searchbar at www.mercola.com "EFT" & "EFT therapists" or www.tapping.com (13 free videos), or www.eftuniverse.com or www.emofree.com or one of the many YouTube videos. Google: "YouTube; EFT videos".
Professionally instructed is generally preferable. - There is a version for use in public places at http://eft.mercola.com (if you like, you can claim to have a headache, as you employ the acupressure massage / tapping on your temples, but you would then be restricted to subvocalising: saying it to yourself in your mind: "Even though I have a fear of driving, I deeply and completely accept myself)" or wording of your choice.

Check out http://www.wikihow.com/Special:LSearch?search=driving+anxiety such as: "How to Overcome a Driving Phobia: 9 Steps"
Anyone from any country should closely examine the advice at the following websites, before beginning their search for a suitable therapist: http://1-800-therapist.com/index.html and http://www.metanoia.org/choose/

Recommended reading:
Fear of Driving, by Daniella Brodsky, & How to Stop Anxiety & Panic Attacks: A Simple Guide to using a specific set of Techniques to Stop Panic Attacks, Agoraphobia, Social Phobia, Fear of Driving or Flying and Stress, by Geert Verschaeve, & Overcoming Specific Phobias - Therapist Protocol: A Hierarchy & Exposure-Based Protocol for the Treatment of All Specific Phobias (Best Practices Series) by Edmund J. Bourne, & The God of Driving: How I Overcame Fear and Put Myself in the Driver's Seat (with the Help of a Good and Mysterious Man) by Amy Fine Collins, from your bookstore, Amazon.com or BarnesAndNoble.com
My previous posts about generalised anxiety disorder and panic / anxiety attacks may be viewed at http://anxietyforum.net/forum/showthread.php?33964-New-to-the-site-and-looking-for-help&p=223989#post223989 and http://anxietyforum.net/forum/showthread.php?34755-Panic-attacks-that-last-for-hours respectively.
If you suffer from panic attacks, learn, and become proficient in an anti-panic breathing technique, such as the one shown. With anxiety attacks, there are a number of approaches, including pulling over to a safe place, and employing the EFT, or Progressive Muscle Relaxation, but it's probably not wise to use them if driving.

Begin by driving up and down your driveway. Later, go up and down the street. Then around the block. Then a short distance, in off peak hours in daylight, where there is light traffic. The idea is to build confidence, and gradually increase the distance, and the amount of traffic you have to cope with. Leave peak hour, highways, long distances, and especially night driving until later on. Consider having a friend, or relative along when tackling a new stage.

Ensure you can park alright, and that the vehicle is prepared; make a checklist if necessary. Can you change a tyre/tire? Are you a member of the auto association, or do you have the phone numbers of those who can assist in the case of breakdowns, and a charged cell/mobile phone? If going somewhere new, (not having sat. nav.) get, or make a map, (Google: maps is quite comprehensive) with approximate distances to turns, and plan it beforehand. It can help to either have someone else drive, while you study the route, and the visual cues, or to have them give you instructions. If lost, go back the way you came until in familiar territory. Being prepared may provide you with a degree of reassurance.

Hypnosis is merely a heightened state of suggestibility, in which you are better able to communicate with your subconscious mind. 85% of people are suggestible to some degree; 15% - 20% highly so, and 15% - 20% aren't much at all, so you could either preferably seek professional hypnotherapy, or, if not an option, hypnosisdownloads.com has ones about overcoming fear of driving, and fear of the driving test, and instant-hypnosis.com has: Driving Exam Success and Improve Driving Skills.

Take a course in defensive driving; always scan the road for dangers, and know what vehicles are around you when changing lanes, and especially during turns.

I note that on the anxietyforum.net home page http://drivingfearhelp.com is recommended.

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Doctors and psychiatrists are often reluctant to prescribe benzodiazepines such as Xanax, Ativan or Klonopin due to their addictive nature, very long weaning off periods and the fact that some people source them solely to onsell at a profit.

Other relevant posts:

HERBAL ANXIOLYTICS / ANTI-ANXIETY PRODUCTS: (passionflower, valerian, St. John's Wort, etc.) http://anxietyforum.net/forum/showthread.php?34269-5-Powerful-Tools-You-Probably-Haven-t-Tried-Yet&p=225415#post225415

NON HERBAL NATURAL (NON PHARMACEUTICAL) ANXIOLTYICS: (5-htp, etc.) http://anxietyforum.net/forum/showthread.php?34355-Help-Please!!!/page2

[greenly24]

First, way to go for getting into and doing a doctoral program, especially in something as difficult as economics! That's awesome!! In undergrad, for my math credit, I took a 5 hour pre-cal class just to avoid economics! Anyways, I know you're nervous about starting school, especially in a new place. Unfortunately I think this is just because you don't know what to expect. I'm sure once things get going you'll settle down. Just remember, everyone is going to be nervous, so you're definitely not alone.

Here are my responses to your specific questions:

1) Yoga and prayer or meditation are definitely good. I'm just thinking you may be skipping yoga just because it's summer and you aren't on a regular schedule. Before you start school, decide on a specific time you're going to do yoga (or whatever you choose). Now I know from experience that forcing yourself to wake up early when school is crazy isn't always the easiest thing to do, but you just have to keep reminding yourself of how good you feel afterwards. In law school, I sometimes had Sundays where I didn't feel like I had time for church, but if I made time and went, my week was so much better.

2) I have found that it really is a mind game. I also feel like I can't breathe and I go numb in my arms and legs. Whenever this happens, I just remind myself that this (unfortunately) has happened before, I didn't die then and I'm not going to die now, and that these feelings will pass soon. I also try to consciously slow my breathing because hyperventilating only makes the lightheadedness/dizzy feeling worse. It was difficult to do, but I've gotten better at it and my attacks are shorter now.

3) I haven't dealt with this, but I'm thinking you should take small steps. At first, maybe just try sitting in a car with the windows rolled down so you get a lot of air going through. Then, in the next two or three days, you could get in the car and turn it on. Still I'd focus on what's fun about driving: finding your favorite radio station, putting on your shades, getting the air blowing on you just right, etc. Then you could progress to driving up and down your driveway; have your friend drive you to an empty parking lot and you just drive around; drive around your neighborhood; etc. I would definitely take things slow though. You're obviously getting by without driving, so there's no rush.

Hopefully this helps!

[erin.hpd]

Thank you so much for your responses, they were all really helpful. I appreciate the advice! I was wondering greenly what specific ways you slow your breathing? My breathing is such an issue for me. I tend to fixate on my breath and I think it tends to exacerbate my attacks.

Also, I like your idea of just sitting in the car at first, and remembering how it used to be enjoyable (and mostly boring) to drive. And you're right, luckily I have a husband who is very understanding of my mental health diagnosis and can try to accommodate me when needed. But I would still love to drive again..be able to go shopping by myself again!!

[Nowuccas]

Try diaphragmatic breathing; (belly breathing) check out https://www.google.com.au/search?client=opera&q=diaphragmatic+breathing&sourceid=opera&ie=UTF-8&oe=UTF-8 such as:

Learn the Diaphragmatic Breathing Technique - YouTube
Video for diaphragmatic breathing▶ 3:47
https://www.youtube.com/watch?v=kgTL5G1ibIo
Aug 22, 2012 - Uploaded by CioffrediPT
In this video, Whitney Zweeres, PTA teaches the diaphragmatic breathing technique. This technique can be ...

It's a known anti-anxiety technique.

[greenly24]

I sometimes try the whole "in your nose, out your mouth" thing, which does slow your breathing, but typically I feel like it's too slow to start off with, at least when you're going from rapid breathing to slow. I usually just try to take deep breaths. If you want, you can count to 3 while inhaling and then count to 3 when exhaling. I especially try to breathe out slowly because blowing off all your carbon dioxide too quickly is what makes you feel lightheaded. But like I said, I have to slow my breathing down gradually and sometimes it takes longer than other times.

[DevotedBaker54]

Congrats on getting into your econ program! That's amazing!! I really struggled with anxiety while in school, and I even talked to a social worker often to help with my anxiety.
She told me to take a deep breath in for 5 seconds, hold it for as long as you can, and then slowly let it out for 7 seconds. She said this is something you need to practice while your anxiety isn't bad, because if you only do it while you are anxious or about to have a panic attack, it will probably cause your body to go into panic mode.
That's all I remember about my breathing exercises.
I would like to say that my anxiety pretty much went away once school was over, so maybe there is hope for you!! :)