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What Causes Anxiety?

What causes anxiety is one of the most common questions that anxiety sufferers ask themselves. It is also not an easy question to answer. Anxiety attacks are merely an over reaction of one of the basic parts of the human being. People who "have anxiety" are in fact the same as everyone else but with part of their brain working overtime unnecessarily. So the question "what causes anxiety?" should be replaced by "what causes unnecessary anxiety?".

Unnecessary anxiety may be caused by several things. Most people believe that anxiety is learnt, caused by unresolved trauma, or genetic. In truth, most people's unnecessary anxiety is not likely to be caused by one individual thing, more likely it will be caused by a combination of the above.

Anxiety responses can be learnt. If as a child you often felt car sick but were travelling with unsympathetic people then cars may well come to have a very negative association that appears as anxiety. There may well be a genetic factor here, as some people may be genetically programmed to learn faster. This can be seen as a good thing in many areas of life. Some people will argue that in this case the best approach is to "unlearn" the anxiety reaction through exposure with cognitive therapy.

Never let it be said that there is a genetic cause of unnecessary anxiety that can not be cured. This is not true. While genetics may predispose us to something they don't make it inevitable. If you are genetically prone to feeling a lot of anxiety, you can learn to react to these anxious feelings in a different way. Ultimately the anxiety itself is harmless, and the less you react to it the less you will feel it.

What are Panic Attacks?

A panic attack is a sudden and strong feeling of overwhelming fear and apprehension often including one or more of the following: dizziness, shortness of breath, temporary vertigo, feeling of not being able to swallow, palpitation (noticeable or increased heartbeat), sweating, trembling, feelings of extreme temperatures, being convinced that death, going crazy, or loss of control is imminent and chest pains.

Many people rush to the emergency room or casualty department after their first panic attack convinced they have had a heart attack or a stroke. If you think you have had, or are having a panic attack you should be given a thorough check-up by a medical professional to rule out a physical cause for your symptoms.

What is Panic Disorder and What Causes It?

Panic Disorder occurs in one out of every 75 people and usually appears during the teens or early adulthood.  Many times Panic Attacks can be triggered by a stressful event along with a physiological response.  There is a connection with major life transitions which are potentially stressful: such as graduating from college, getting married, having a first child, and so on. There is more risk of it occurring if there is a genetic predisposition; or if a family member has suffered from panic disorder; or when a person is experiencing a time in his/her life that is particularly stressful.

A panic attack is a sudden surge of overwhelming fear that comes without warning and without any obvious reason. It is far more intense than the feeling of being 'stressed out' that most people experience. Symptoms of a panic attack include:

  •      racing heartbeat
  •      difficulty breathing, feeling as though you 'can't get enough air'
  •      terror that is almost paralyzing
  •      dizziness, lightheadedness or nausea
  •      trembling, sweating, shaking
  •      choking, chest pains
  •      hot flashes, or sudden chills
  •      tingling in fingers or toes ('pins and needles')
  •      fear that you're going to go crazy or are about to die

What is Panic Disorder?

Panic Disorder is a label given to a person who either frequently has panic attacks or who lives their life in fear of having panic attacks and is thus in some way disabled in their social or professional life. The fear of having a panic attack is important, because it is this fear, rather than the attacks themselves, that causes the major impact on life.

Panic attacks have evolved/were designed to feel exceedingly nasty. The idea is that they give you the impetus to fight or flee. Panic Attacks are of course completely harmless despite being unpleasant. Panic Disorder is highly treatable.

Common Misperceptions:

Panic attacks themselves are completely harmless but there are two common misperceptions that regularly do the rounds:

1) You might have a heart attack. Actually a normal adult heart could sustain string palpitations for much longer than a panic attack can last. There is no evidence that a panic attack does any short or long term damage to the heart.

2) You might faint. While you may feel faint and slightly dizzy during a panic attack it is highly unlikely that you will faint. The reason for this is simple. Fainting is caused generally by a loss of blood pressure, where as in a panic attack blood pressure tends to rise a bit.

Panic attacks feel so bad because they are trying to make you escape a perceived threat.

What Disorders are associated with Panic Attacks?

In modern medical and psychiatric terms people who suffer from panic attacks are usually put into one of two categories:

1) “Panic Disorder” is the term used for people who have panic attacks seemingly without cause, coming as it were out of the blue. People are diagnosed with panic disorder if they have had two or more panic attacks or if they have had more than a month of severe worry about suffering from another panic attack

2) Phobia or Agoraphobia. If a panic attack is related to a specific situation then a simple phobia will be diagnosed. Often sufferers of Panic Disorder become afraid of having panic attacks away from home, and begin to avoid going out, going out alone, or going to some places. In these cases agoraphobia is diagnosed.

How common are Panic Attacks?

Very common, possibly as much as 10% of people with have some of the above at sometime.

How is the prognosis, what are my chances of recovery?

Very good. Medication and therapy have high success rates.

What’s the best therapy/treatment for panic attacks?

Panic attacks can be treated although far too many people suffer in silence. There is nothing wrong with having a panic attack; it doesn’t mean you’re weak or defective.
In fact most people experience some kind of panic in their lives. The most important thing is to seek help! The best therapies for panic attacks seem to be based on the Cognitive Behavioural Therapy model.

Common Questions:

Q: Am I going mad?

"Am I going mad" is one of the most common fears of people who start to have panic attacks. A panic attack is a perfectly natural bodily mechanism 'going off' inappropriately. People often experience their first one at a time of high stress, or perhaps in conjunction with hormonal changes within the body. If you are thinking "Am I going mad?", it's a pretty good indicator you are not!

Q: Do I have to take medication to get rid of panic attacks?

No you do not. Although some medications can be useful in the short term if panic attacks are very frequent and severe they are not a long term answer. Appropriate brief psychotherapy incorporating Cognitive approaches, relaxation techniques and 'deconditioning' is the most effective. This sort of therapy will enable you to stop your panic attacks and inoculate you against future attacks.

Q: Why have I suddenly started having panic attacks?

There can be many reasons, but the most common is high general levels of stress, which mean that the 'panic tripwire' is much tighter, and therefore easier to set off.

Q: How can I stop panic attacks?

Essentially, to stop a panic attack, your body needs to relax, which is fairly obvious. To stop panic attacks your anxiety levels need to come down, and particularly in situations that currently cause anxiety or panic, but it is sometimes a little more complicated than that. Conditioning factors can make this more difficult.

The Core Beliefs that Fuel Anxiety and Panic Attacks

Although people having panic attacks often feel as if they are the only ones in the World with the problem, the thoughts that accompany panic attacks are usually very similar. Here are the most common ones we encounter.

Panic Thought 1: I might die from a heart attack

Although it may not feel like it at the time, the heart is designed to react in the way it does during a panic attack. It can feel unnatural because this type of heart activity is usually reserved for vigorous activity, when you don't notice it as much. However, unless you have a heart condition, it is not usually a threat to the heart. If you are worried about this, see your medical practitioner.

Panic Thought 2: I might die from suffocation

It may not feel pleasant, but you are less likely to suffocate during a panic attack than at any other time because you naturally take in more air. The shortness of breath you may feel is due to your body increasing its demand for oxygen, or because of hyperventilation.

Panic Thought 3: I'm having a stroke

When you don't understand what is happening to you, it's perfectly natural to try and explain in it terms you understand. However, strokes have nothing to do with panic attacks, so you can relax about that! However, if you are worrried about it, see your medical practitioner.

Panic Thought 4: I'm scared of fainting

Fainting is not an option when being chased by a wild animal, in fact it could be fatal, so it is highly unlikely that panic will cause fainting. And what if you did faint? How bad would it be? The end of the world? Worse than death itself? Probably not. Fear of fainting often comes about due to the sense of dizziness which accompanies hyperventilation, sometimes part of panic. We'll look at what you can do about that in a minute.

Panic Thought 5: I'm having a nervous breakdown, or going 'crazy'

If you were really going insane would you be aware or worried about going insane? You already know that the anxiety, panic, or 'fight or flight' response is a natural mechanism, so this one doesn't even figure.

Panic Thought 6: Losing control

When having an anxiety attack, it can feel like you have lost control. In fact, all that has happened is that control has shifted from your conscious to your unconscious mind, so things are still being regulated, just differently.

Panic Thought 7: Feeling so weak that you cannot move or might fall down

The feeling of weakness is caused by the shaking we mentioned earlier. In fact, you are stronger when panicking than at any other time as your large muscles are being supplied with plenty of oxygen.

Panic Thought 8: Believing that you are going to be embarrassed or humiliated

How many times have you actually been humiliated or embarrassed by a panic attack? If you ever have been, was it really that bad? During an attack, it is very common and quite natural to worry that your body can't take what is happening. The fact is that panic is a short-term response. The worst part of a panic attack only lasts a few minutes although unpleasant anxiety feelings can persist for longer. It is similar to a fire or emergency drill for the body. If you have panic attacks then at least you know that your anxiety or fight or flight response is in good working order.

The AWARE Technique:

The 'A' in aware stands for 'Accept the anxiety. Decide just to go with the experience. Fighting anxiety, getting angry or scared just fuels the fire. After doing this course, you know a panic attack is a perfectly natural response, so although it can be frustrating, there is nothing to be afraid of.

The 'W' in aware is for 'Watch the anxiety' Observe it without judging it to be good or bad. Remember - you are more than just your anxiety.

The next 'A' in 'aware is for 'Act normal'. Behave normally and continue doing what you intended to do. Breathe normally focusing on extending the out breath (se 7:11 breathing). If you run from the situation your immediate anxiety will of course decrease but this may lead to an increase in future anxiety. Staying in the situation helps 'decondition' the panic response as your mind gets the message that it is not really threatening. This is why people often say that the first few minutes of public speaking are the worst. If you continue for longer than a few minutes then the mind gets the message that it's not really that threatening.

The 'R' in 'aware' is for 'Repeat the steps'. Continue accepting your anxiety, watching it and acting normal until it goes down to a comfortable level.

And finally the 'E' in 'aware' is for 'Expect the best'. What you fear may never happen. You will surprise yourself by the effective way you handle situations when using the 'AWARE' technique.

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