Posts Tagged ‘Psychologist’

Panic and Anxiety Attacks – Where Do They Come From? What Causes Them? A Psychologist Explains

Most people with panic disorder aren’t ever quite sure why they had their first panic attack. There is a reason for this. (A panic or anxiety attack is severe anxiety. Panic disorder is the fear of having attacks, fear of the effect of the attack and a significant life change as a result of an attack or attacks. I am using very specific terms, an attack and a disorder are not the same thing.) Because a panic attack is such a terrifying and intense experience people naturally think there ought to be an equally powerful cause or reason; something that would be severe enough to evoke such a reaction. But attacks often seem to drop right out of the blue, completely unexpected. That’s why it’s hard to put your finger on a specific cause. If there was a clear cause then the attack probably wouldn’t become panic disorder. An attack might be an occasional thing when it is connected to things you are worrying about. It can become a panic disorder because it doesn’t seem to make sense and feels unpredictable. To develop panic disorder you have to start fearing having a panic attack. When people write online about panic attacks they are usually talking about panic disorder.

Sometimes the hidden cause of an anxiety attack is purely physiological. For example, a heart arrhythmia can cause a general fight-or-flight response. Different things can signal your body to go into the prepare-for-danger mode. Sometimes it might be reaction to a medication. It can be an allergic reaction to something, it could be a virus.

Sometimes there is a trauma in the past and there is some similarity with your present circumstances not obvious in the moment. The brain remembers trauma in a general or impressionistic way. It doesn’t have to be exact, just close. If you’re terrified of snakes then a stick in the weeds might be close enough.

But most of the time, it is the result of a “perfect storm” of stress. No single element is fully responsible or strong enough; rather it is the accumulation of many things. It is set off by the proverbial “straw that breaks the camel’s back”. What causes the first attack is very important but it is what you do next that actually determines whether this is a single episode or a disorder.

Any and all kinds of anxiety involve the fight-or-flight response. Every single symptom of a panic attack is the result of the fight-or-flight response. In other words, these strange symptoms are actually normal physiological reactions from your nervous system to prepare you for danger. It is how they are interpreted that makes them seem so different. If you’re zooming down the interstate and have to slam on your brakes the fight-or-flight response makes perfect sense. But, if you’re sitting in your car at a stoplight and you are not aware of anything dangerous then the fight-or-flight response seems threatening, overwhelming and bizarre. In the first situation, the fear is directed toward avoiding hitting cars in front of you. Your body’s reaction makes total sense. In the second situation, your fear is directed toward how you are feeling (terrible!) and that it makes no sense. Since there is no apparent external danger you may think you are either sick or mentally unstable (you are not). Something subtle happens right then. You become afraid of your body. The fear from this point forward, only requires your fear about yourself. You, up there in your head, is not in control of the you below in your body (actually not the case but seems this way).

This emotional ambush is the heart of what goes wrong. The fight-or-flight response, technically, is not something that you choose; it’s your body’s automatic response to danger. Although it happens in a split second, the neurological sequence is 1) react and then 2) think. Nevertheless, the danger response normally fits the situation so that it feels under your control and expected. In other words, it seems congruent with the circumstances and even if you didn’t have time to choose it you would have (unless it is a result of an obnoxious friend who jumps out from behind a door to scare you, in which case you think about going into the “fight” part of the response:-)). The beginning point for a panic disorder, on the other hand, seems extremely incongruent with the circumstances, unexpected and therefore, out of your control. It is this feeling of being out of control that provides the fuel for an ongoing problem. Once you begin to believe that your panic has control of you rather than you having control of it, then you are under its grip.

The necessary treatment for panic disorder, whether medical or psychological, is to restore your sense of control over your own body. I will describe those treatments in a companion article.

Thank you for reading my article. I am a psychologist in private practice in Charlotte, NC. In spite of what anyone thinks, psychologists and their families have as many problems as anyone else. My daughter had a panic disorder and I was desperate to find her resources. I got her all kinds of help but wanted something to explain anxiety and give her a map to overcome it that would make sense to her. There was nothing useful that I could find. So we created something that is completely new. A colleague and I have created an audio program for kids ages 6-12 (maybe a young 13) to help them with anxiety. At the risk of bragging, it is really good. Seriously. We hired professional actors, artists and sound engineers. If you have a child, you know more than half the battle is getting them to pay attention. Would you do me a favor and look at our site? If you don’t need it you may know someone who could use it. (I have to pay all these people!!) Thanks!

Panic and Anxiety Attacks – Where Do They Come From? What Causes Them? A Psychologist Explains

Most people with panic disorder aren’t ever quite sure why they had their first panic attack. There is a reason for this. (A panic or anxiety attack is severe anxiety. Panic disorder is the fear of having attacks, fear of the effect of the attack and a significant life change as a result of an attack or attacks. I am using very specific terms, an attack and a disorder are not the same thing.) Because a panic attack is such a terrifying and intense experience people naturally think there ought to be an equally powerful cause or reason; something that would be severe enough to evoke such a reaction. But attacks often seem to drop right out of the blue, completely unexpected. That’s why it’s hard to put your finger on a specific cause. If there was a clear cause then the attack probably wouldn’t become panic disorder. An attack might be an occasional thing when it is connected to things you are worrying about. It can become a panic disorder because it doesn’t seem to make sense and feels unpredictable. To develop panic disorder you have to start fearing having a panic attack. When people write online about panic attacks they are usually talking about panic disorder.

Sometimes the hidden cause of an anxiety attack is purely physiological. For example, a heart arrhythmia can cause a general fight-or-flight response. Different things can signal your body to go into the prepare-for-danger mode. Sometimes it might be reaction to a medication. It can be an allergic reaction to something, it could be a virus.

Sometimes there is a trauma in the past and there is some similarity with your present circumstances not obvious in the moment. The brain remembers trauma in a general or impressionistic way. It doesn’t have to be exact, just close. If you’re terrified of snakes then a stick in the weeds might be close enough.

But most of the time, it is the result of a “perfect storm” of stress. No single element is fully responsible or strong enough; rather it is the accumulation of many things. It is set off by the proverbial “straw that breaks the camel’s back”. What causes the first attack is very important but it is what you do next that actually determines whether this is a single episode or a disorder.

Any and all kinds of anxiety involve the fight-or-flight response. Every single symptom of a panic attack is the result of the fight-or-flight response. In other words, these strange symptoms are actually normal physiological reactions from your nervous system to prepare you for danger. It is how they are interpreted that makes them seem so different. If you’re zooming down the interstate and have to slam on your brakes the fight-or-flight response makes perfect sense. But, if you’re sitting in your car at a stoplight and you are not aware of anything dangerous then the fight-or-flight response seems threatening, overwhelming and bizarre. In the first situation, the fear is directed toward avoiding hitting cars in front of you. Your body’s reaction makes total sense. In the second situation, your fear is directed toward how you are feeling (terrible!) and that it makes no sense. Since there is no apparent external danger you may think you are either sick or mentally unstable (you are not). Something subtle happens right then. You become afraid of your body. The fear from this point forward, only requires your fear about yourself. You, up there in your head, is not in control of the you below in your body (actually not the case but seems this way).

This emotional ambush is the heart of what goes wrong. The fight-or-flight response, technically, is not something that you choose; it’s your body’s automatic response to danger. Although it happens in a split second, the neurological sequence is 1) react and then 2) think. Nevertheless, the danger response normally fits the situation so that it feels under your control and expected. In other words, it seems congruent with the circumstances and even if you didn’t have time to choose it you would have (unless it is a result of an obnoxious friend who jumps out from behind a door to scare you, in which case you think about going into the “fight” part of the response:-)). The beginning point for a panic disorder, on the other hand, seems extremely incongruent with the circumstances, unexpected and therefore, out of your control. It is this feeling of being out of control that provides the fuel for an ongoing problem. Once you begin to believe that your panic has control of you rather than you having control of it, then you are under its grip.

The necessary treatment for panic disorder, whether medical or psychological, is to restore your sense of control over your own body. I will describe those treatments in a companion article.

Panic and Anxiety Attacks – Where Do They Come From? What Causes Them? A Psychologist Explains

Most people with panic disorder aren’t ever quite sure why they had their first panic attack. There is a reason for this. (A panic or anxiety attack is severe anxiety. Panic disorder is the fear of having attacks, fear of the effect of the attack and a significant life change as a result of an attack or attacks. I am using very specific terms, an attack and a disorder are not the same thing.) Because a panic attack is such a terrifying and intense experience people naturally think there ought to be an equally powerful cause or reason; something that would be severe enough to evoke such a reaction. But attacks often seem to drop right out of the blue, completely unexpected. That’s why it’s hard to put your finger on a specific cause. If there was a clear cause then the attack probably wouldn’t become panic disorder. An attack might be an occasional thing when it is connected to things you are worrying about. It can become a panic disorder because it doesn’t seem to make sense and feels unpredictable. To develop panic disorder you have to start fearing having a panic attack. When people write online about panic attacks they are usually talking about panic disorder.

Sometimes the hidden cause of an anxiety attack is purely physiological. For example, a heart arrhythmia can cause a general fight-or-flight response. Different things can signal your body to go into the prepare-for-danger mode. Sometimes it might be reaction to a medication. It can be an allergic reaction to something, it could be a virus.

Sometimes there is a trauma in the past and there is some similarity with your present circumstances not obvious in the moment. The brain remembers trauma in a general or impressionistic way. It doesn’t have to be exact, just close. If you’re terrified of snakes then a stick in the weeds might be close enough.

But most of the time, it is the result of a “perfect storm” of stress. No single element is fully responsible or strong enough; rather it is the accumulation of many things. It is set off by the proverbial “straw that breaks the camel’s back”. What causes the first attack is very important but it is what you do next that actually determines whether this is a single episode or a disorder.

Any and all kinds of anxiety involve the fight-or-flight response. Every single symptom of a panic attack is the result of the fight-or-flight response. In other words, these strange symptoms are actually normal physiological reactions from your nervous system to prepare you for danger. It is how they are interpreted that makes them seem so different. If you’re zooming down the interstate and have to slam on your brakes the fight-or-flight response makes perfect sense. But, if you’re sitting in your car at a stoplight and you are not aware of anything dangerous then the fight-or-flight response seems threatening, overwhelming and bizarre. In the first situation, the fear is directed toward avoiding hitting cars in front of you. Your body’s reaction makes total sense. In the second situation, your fear is directed toward how you are feeling (terrible!) and that it makes no sense. Since there is no apparent external danger you may think you are either sick or mentally unstable (you are not). Something subtle happens right then. You become afraid of your body. The fear from this point forward, only requires your fear about yourself. You, up there in your head, is not in control of the you below in your body (actually not the case but seems this way).

This emotional ambush is the heart of what goes wrong. The fight-or-flight response, technically, is not something that you choose; it’s your body’s automatic response to danger. Although it happens in a split second, the neurological sequence is 1) react and then 2) think. Nevertheless, the danger response normally fits the situation so that it feels under your control and expected. In other words, it seems congruent with the circumstances and even if you didn’t have time to choose it you would have (unless it is a result of an obnoxious friend who jumps out from behind a door to scare you, in which case you think about going into the “fight” part of the response:-)). The beginning point for a panic disorder, on the other hand, seems extremely incongruent with the circumstances, unexpected and therefore, out of your control. It is this feeling of being out of control that provides the fuel for an ongoing problem. Once you begin to believe that your panic has control of you rather than you having control of it, then you are under its grip.

The necessary treatment for panic disorder, whether medical or psychological, is to restore your sense of control over your own body. I will describe those treatments in a companion article.

Panic and Anxiety Attacks – How Do You Overcome Them? What About Medication? A Psychologist Explains

Panic Disorder is the fear of panic and anxiety attacks. (See my companion article, Panic and Anxiety Attacks – Where Do They Come From? What Causes Them? A Psychologist Explains.) Panic disorder happens when someone is ambushed by a panic or anxiety attack out of the blue that appears to make no sense and seems unpredictable resulting in a profound loss of control. The necessary and effective treatment for panic disorder, whether medical or psychological, is to restore your sense of control over your own body. In this article, I am going to address medical treatment. In the next article, psychological treatment.

You will find a lot of online opposition to the use of medication for issues deemed psychological. There are risks and plenty of concerns about medications (not helped by those terrifying fine print documents written by attorneys inside the package! What! this thing says it could cause my leg to fall off!) While I disagree with the naysayers for the most part, I do agree that ultimately medication won’t solve the problem. However, if someone is in the grip of multiple episodes of panic or overwhelming anxiety symptoms then medication is a gift. I know this from working with hundreds of clients helped by medication. (Psychologists cannot prescribe medication, so I don’t have a financial or professional benefit from saying this.) In some situations, withholding from your child or avoiding medication yourself can unnecessarily perpetuate the “loss of control” and allow the anxiety to build momentum. The longer anxiety goes without successful treatment the stronger it can get (not always but often enough).

Medication can switch off the runaway fight-or-flight response or at least settle it down. Once that is experienced, something significant happens psychologically. A sense of control is restored or at least there is hope of that. But there can be a limitation to treatment with only medication. If you have a belief that it is essentially the medication that is providing the control then you will worry the fear will return if you stop. Even the ideal medication will not prevent panic if the fear of loss of control is strong enough. Ultimately, a person has to believe, apart from an external aid, that they can both control and know what to expect from their own body. This is true even if a person stays on a medication. They have to believe their body is in control.

Consider this analogy for the role of medication. My son introduced me to a video game called Halo. I have to admit, I like killing aliens. However, the only way I can play the game is if it’s put on the easiest possible level. Otherwise, it’s just too frustrating because I get overwhelmed by the alien fiends right away, thus enabling a reign of horror and devas…umm…back to reality. Medication puts the “game” on easy. You still have to work through your problem. There’s no drug in the world that will solve it for you. But the medication gives you a chance to get your bearings and develop the understanding you need without being overwhelmed.

Panic and Anxiety Attacks – Where Do They Come From? What Causes Them? A Psychologist Explains

Most people with panic disorder aren’t ever quite sure why they had their first panic attack. There is a reason for this. (A panic or anxiety attack is severe anxiety. Panic disorder is the fear of having attacks, fear of the effect of the attack and a significant life change as a result of an attack or attacks. I am using very specific terms, an attack and a disorder are not the same thing.) Because a panic attack is such a terrifying and intense experience people naturally think there ought to be an equally powerful cause or reason; something that would be severe enough to evoke such a reaction. But attacks often seem to drop right out of the blue, completely unexpected. That’s why it’s hard to put your finger on a specific cause. If there was a clear cause then the attack probably wouldn’t become panic disorder. An attack might be an occasional thing when it is connected to things you are worrying about. It can become a panic disorder because it doesn’t seem to make sense and feels unpredictable. To develop panic disorder you have to start fearing having a panic attack. When people write online about panic attacks they are usually talking about panic disorder.

Sometimes the hidden cause of an anxiety attack is purely physiological. For example, a heart arrhythmia can cause a general fight-or-flight response. Different things can signal your body to go into the prepare-for-danger mode. Sometimes it might be reaction to a medication. It can be an allergic reaction to something, it could be a virus.

Sometimes there is a trauma in the past and there is some similarity with your present circumstances not obvious in the moment. The brain remembers trauma in a general or impressionistic way. It doesn’t have to be exact, just close. If you’re terrified of snakes then a stick in the weeds might be close enough.

But most of the time, it is the result of a “perfect storm” of stress. No single element is fully responsible or strong enough; rather it is the accumulation of many things. It is set off by the proverbial “straw that breaks the camel’s back”. What causes the first attack is very important but it is what you do next that actually determines whether this is a single episode or a disorder.

Any and all kinds of anxiety involve the fight-or-flight response. Every single symptom of a panic attack is the result of the fight-or-flight response. In other words, these strange symptoms are actually normal physiological reactions from your nervous system to prepare you for danger. It is how they are interpreted that makes them seem so different. If you’re zooming down the interstate and have to slam on your brakes the fight-or-flight response makes perfect sense. But, if you’re sitting in your car at a stoplight and you are not aware of anything dangerous then the fight-or-flight response seems threatening, overwhelming and bizarre. In the first situation, the fear is directed toward avoiding hitting cars in front of you. Your body’s reaction makes total sense. In the second situation, your fear is directed toward how you are feeling (terrible!) and that it makes no sense. Since there is no apparent external danger you may think you are either sick or mentally unstable (you are not). Something subtle happens right then. You become afraid of your body. The fear from this point forward, only requires your fear about yourself. You, up there in your head, is not in control of the you below in your body (actually not the case but seems this way).

This emotional ambush is the heart of what goes wrong. The fight-or-flight response, technically, is not something that you choose; it’s your body’s automatic response to danger. Although it happens in a split second, the neurological sequence is 1) react and then 2) think. Nevertheless, the danger response normally fits the situation so that it feels under your control and expected. In other words, it seems congruent with the circumstances and even if you didn’t have time to choose it you would have (unless it is a result of an obnoxious friend who jumps out from behind a door to scare you, in which case you think about going into the “fight” part of the response:-)). The beginning point for a panic disorder, on the other hand, seems extremely incongruent with the circumstances, unexpected and therefore, out of your control. It is this feeling of being out of control that provides the fuel for an ongoing problem. Once you begin to believe that your panic has control of you rather than you having control of it, then you are under its grip.

The necessary treatment for panic disorder, whether medical or psychological, is to restore your sense of control over your own body. I will describe those treatments in a companion article.