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When you’re overwhelmed by anxiety, it can feel like you’re drowning.  Figuring out how to manage your anxiety can be really difficult, and you don’t have to do it on your own.  Trying some of the things I’m writing about today might help.

As discussed already in this series, any anxiety you feel is a message warning you to pay attention to something.  Trying to get rid of your anxiety is like silencing an alarm system on your house:  If it’s installed to alert you about danger, why stop it from doing that job?  Controlling anxiety is not a realistic goal because it’s like disarming that alarm system altogether (see previous posts Part 1 and Part 2 for more information.)

Managing anxiety is a better goal since you don’t have to worry about turning it off.  You only need to learn how to identify anxiety for what it is and recognize how it shows up in your body.  When it’s helpful, use it.  If it’s not helpful and it’s keeping you from doing what you need to do, you can learn to manage it.  There are several ways to manage anxiety, and many women have success practicing meditation, mindfulness, yoga, cardio exercise, journaling, or learning new coping skills or routines.  Sometimes women cannot manage their anxiety no matter what they do, and that’s when I recommend talking to your primary care physician (PCP) in addition to pursuing mental health counseling.  I also advocate you find a PCP who knows about a woman’s body and takes your concerns as a woman seriously.  You may need to put in some effort to find a good PCP who will really listen, dig into your symptoms and run appropriate tests, and demonstrate understanding of how your past or current trauma, relationships, and stage of life is affecting your mental health.  Sometimes your doctor will prescribe medication to help with managing anxiety.

As a counselor in private practice, I always recommend you seek mental health counseling for unmanageable anxiety in conjunction with any medication your doctor prescribes.  The good doctors I’ve coordinated with work holistically, like I do.  Working holistically means working with you in your entirety as we get to the roots of your struggles – not just focusing on how you think, or if you exercise, or what you eat.  Really good health providers are in this line of work to help you heal, not to force medication or behavioral methods on you that may or may not work.  We work with ALL of you, not just separate parts.

I’m going to talk about some of the ways I help women manage anxiety, particularly the types we discussed previously in Part 1 and Part 2, over the next several days.  In today’s blog post, let’s talk specifically about panic attacks, acute anxiety, and ways you can manage them.

MOVEMENT

If you’ve ever experienced a panic attack (some people call it an anxiety attack), you wouldn’t wish it on your worst enemy.  Especially when it comes out of the blue and you have no idea why it’s happening.  And that’s the thing about panic attacks, they tend to happen when you’re not doing anything particularly stressful.  Symptoms of a panic attack include:

  • *Chest pain or discomfort
  • *Shortness of breath or difficulty breathing
  • Sweating
  • Heart palpitations, rapid heartbeat, pounding heart
  • Trembling or shaking
  • Nausea, stomach/abdominal discomfort
  • Dizziness, lightheadedness, faintness
  • Numbness or tingling sensations in your body
  • Chills or hot flashes
  • Fear of going crazy or losing control
  • Fear of dying
  • Feeling disconnected or detached from your body or your surroundings, or feelings of unreality (depersonalization and derealization).

*NOTE:  The Women’s Heart Foundation states that heart disease in women is often mistaken for panic attacks, so it is absolutely necessary that you receive appropriate medical tests to rule out a heart attack, heart disease, or other medical issue when experiencing any of these symptoms, but especially when experiencing chest pain/discomfort.

I’ve had panic attacks, and I know a lot of women who’ve experienced them.  Sometimes a panic attack happens once or twice, and you’ll never get another one.  Other times, panic attacks occur over and over, and you start to live your life in fear of it happening again.  Here’s a helpful article and infographic showing the differences between heart attack and panic attack, but make sure to visit your doctor if you’re experiencing symptoms like these.  If your doctor has ruled out heart disease/attack, and you’re getting panic attacks and don’t understand why, here’s a way to manage them:  MOVE.

When you’re in panic attack mode, your brain is telling your body that you are in danger.  BUT, you’re not in danger – your brain is sort of playing a trick on you.  Regardless of why your brain is activating false alarms, it’s important you get your body moving so that your mind gets the message, “Oh, okay, we’re moving away from the danger. Good, that’s good.  We can turn the adrenaline down and get back to relaxing.”  No matter where you are or what you’re doing, the key is to get moving.  So walk briskly, jog, jump up and down, do some push-ups or jumping jacks, or just wave your arms around vigorously while marching in place.  Whatever you do, keep moving until your mind and body are in sync again and you don’t feel so panicky.  Here’s a great video from Mel Robbins, author of The Five Second Rule, about how this principle works (NSFW language in the video):  Stop Panic.  **By the way, I am not recommending you read her books or follow her advice, I’m just pointing out that she talks about personal experience with panic and anxiety and understands how movement can help you when a panic attack is getting ready to strike.**

BREATHING & GUIDED MEDITATION

Acute anxiety is a little different than a panic attack.  With panic, your body is full-on triggered and experiencing lots of different symptoms.  Acute anxiety is more like feelings and thoughts of dread, helplessness, severe self-doubt, nonstop worry, straight-up fear, and physical sensations similar to a panic attack but not as severe, sudden, or overwhelming.  Just like a panic attack, it can also strike at any time, but acute anxiety is more likely to happen when you’re facing a situation that is uncomfortable or after you’ve gone to bed and are ready to get some much-needed sleep.  Insomnia and anxiety are like best friends, and you can almost count on anxiety showing up as soon as your head hits the pillow.  Everyone always asks me “why, why does it happen right when I’m trying to go to sleep??”  Well, it’s probably because you’re no longer distracted by work, television, phone, friends and family, or tasks you must complete during the day.  Your mind now has center stage to replay past mistakes or introduce you to future worries.

As much as your mind loves to have the spotlight, there is a way to reign in all those thoughts running wild when you’re trying to relax or fall asleep.  Try corralling them via guided imagery or meditation.  You can use apps like Calm or Headspace for free before signing up for a subscription, or you can use guided meditations that are free on YouTube like The Honest Guys or This Female Voice Guided Meditation.  (I have no affiliation with any of the apps, books, or videos I’m linking to in this blog – they’re just things I’ve used, or that my clients say are helpful.)  You’re just trying to get your mind to slow down and stop thinking so much.

Deep breathing is the arch enemy of acute anxiety and another way to calm your worried mind.  I get a lot of clients who scoff at the idea, or tell me deep breathing doesn’t work for them, so I always ask questions to find out why it’s not working.  Usually the reason is that you’re too worried about “doing it right” which leads to feeling like a failure when a deep breath or two doesn’t achieve any relaxation.

I suggest you clear your mind of any preconceived ideas about how deep breathing is supposed to work.  There is no right way.  You don’t need to worry about if your belly is moving in and out, or counting to 10, or making sure you’re doing “square breathing” or breathing through your nose or mouth.  If this is where you get stuck, then I want you to try the following routine (read it through before starting, or follow it step-by-step a few times until it feels comfortable):

  1. Get in a comfortable position in bed, preferably lying down, but sitting works too.
  2. Rest your arms at your sides, across your chest or abdomen, or palms up on your thighs if you’re sitting cross-legged with bent knees.
  3. Close your eyes.
  4. Focus on your shoulders as you inhale.
  5. Move your shoulders up toward your ears on a deep inhale.
  6. Feel the lower part of your lungs fill up with air as your shoulders move upward.
  7. Now, make a long, slow exhale. Try and always make your exhale longer than your inhale.
  8. Drop your shoulders all the way down, down, down into your chest and abdomen as you exhale slowly.
  9. Inhale again, moving your shoulders up and filling the bottom of your lungs.
  10. Exhale slowly, letting your shoulders drop as far as they can go, relaxing them.
  11. Repeat this inhale-exhale with shoulder move at least 10 times.

This is something I learned to do on my own when I couldn’t get the “deep breaths” exercise to work for me.  I was always too worried about my stomach going out on the inhale and in on the exhale.  Or I wasn’t counting exactly right.  Sometimes I was worried about breathing in through my nose and exhaling through my mouth, but I’d mess up.  I basically just wanted to follow the directions exactly, and I felt like a failure when it didn’t work.  When I started focusing on just making my exhale longer than my inhale, and slowly moving my shoulders in rhythm with both, it gave me space to deep breath in a way natural to me instead of the “right way.”  And I’ve found this way to be helpful with my clients, too.

Hopefully, something in this blog appealed to you, and you’ll try some of the methods.  In the next three blog posts about anxiety (Parts 4, 5, and 6), I’ll talk about underlying trauma and oppression that typically occur in the lives of women who experience overwhelming anxiety, and I’ll go back to the types of anxiety discussed in Part 2 to tell you how to manage them.