Mental Health U
Mental Health U is a podcast dedicated to demystifying and destigmatizing mental health issues. If you or someone you know is struggling with depression, anxiety, trauma, or some other mental health issue, then this podcast is for you.
Mental Health U
Overcoming Panic Attacks
Welcome to Mental Health U, where I, Bill Emahiser, extend a warm, understanding hand to those grappling with the tempest of panic attacks. Picture this: the world around you tightens, your heart races, and the fear of impending doom engulfs you—this isn't the plot of a thriller, but the harrowing reality of a panic attack. Our latest episode shines a light on this intense mental health struggle, as I share not only my clinical expertise in anxiety disorders but also an intimate account of my journey through personal adversity and subsequent battles with panic. We're here to explore the depths of panic attacks, decode their symptoms, and arm you with robust cognitive behavioral strategies to reclaim your peace of mind.
This heart-to-heart conversation is both a source of solace and a toolbox of techniques for anyone touched by the shadow of panic. As we traverse the unpredictable terrain of mental health, our discourse will reveal how to distinguish discomfort from danger and potentially eradicate panic episodes from your life. I draw upon my own experiences and specialized training to offer you a narrative of resilience and recovery. Join us in this informative quest to understand and take control of your mental health, where the ultimate victory over panic is not just a possibility but a palpable reality.
If we practice over and over, we can teach our brain through experience that discomfort does not equal danger. When our brain recognizes that, you're going to have fewer, less intense panic attacks and you might actually be able to eliminate the occurrence of panic episodes altogether. Hello and welcome. I'm your host, Bill Emahiser, and you're listening to Mental Health U, the podcast dedicated to demystifying and destigmatizing mental health issues. So if you or someone you know is struggling with depression, anxiety, trauma or some other mental health issue, then this podcast is for you. This episode is proudly sponsored by Unison Health, dedicated to making lives better through compassionate, quality mental health and addiction treatment services. Learn more at unisonhealthorg. If you'd like a strategy to beat panic attacks, you're in luck. Today we're going to talk all about panic attacks, what they are and what you can do about them. You might be asking yourself, bill, why should I listen to you when it comes to panic attacks? And that's a great question, and I appreciate your inquisitive nature.
Bill Emahiser:Over the past few decades, I have specialized in the treatment of anxiety disorders, panic attacks, obsessive-compulsive disorder. I've trained with the International OCD Foundation and I've had special training sessions at the University of Pennsylvania in Philadelphia, with the emphasis on cognitive behavioral strategies, specifically exposure and response prevention. For the past decade, my practice has focused entirely on helping folks with these mental health issues to get on the road to recovery. And how about some lived experience to boot? About a decade ago, I had a sudden and unexpected loss. My wife at the time was killed by a truck driver under the influence of drugs. He ran a stop sign and my wife was pronounced dead on the scene. Three months later I began to wake up in the middle of the night with the sweats shaking, my heart pounding, hyperventilating. I just couldn't catch my breath. I had thoughts that I was dying, that I was having a heart attack. I literally felt that I was going to die, that there was this impending doom. After going to the local ER, tests were run and the results well, I was physically healthy, my heart was in great shape.
Bill Emahiser:My diagnosis grief and panic attacks. I have to say I was dumbfounded how I, the therapist who helped other people with anxiety and panic, how was I experiencing panic attacks? That was something that happened to other people, not to me. And then I started thinking is this what my clients experience when they're having panic attacks? It was a miserable experience that I wouldn't wish on anyone. It gave me a whole new perspective on panic attacks in general, as well as a great deal more empathy for the clients that I served. The good news was that I knew exactly what to do to overcome my panic, and I'm happy to report that, after employing the strategies that I had learned through my specialized training, I've been panic-free for the last nine years. It's my best hope today that I had learned through my specialized training I've been panic-free for the last nine years. It's my best hope today that I might be able to share a bit of information that might be helpful for you or a loved one suffering with panic attacks.
Bill Emahiser:So it kind of makes sense that we might start with what is a panic attack. Well, if you've ever experienced a panic attack, there are few things more intensely frightening and uncomfortable. A panic attack is defined by the DSM-5 as an abrupt surge of intense fear or intense discomfort that reaches its peak within a few minutes. It also includes four or more of the following symptoms Shortness of breath, sweating, pounding or accelerated heart rate, feelings of choking, feeling dizzy, feeling unsteady, lightheaded or faint, tingling sensations in your extremities and your fingers, chest pain or discomfort, chills or heat sensations, nausea or abdominal distress, trembling and shaking, feelings of unreality or being detached from oneself, fear of going crazy, fear of dying.
Bill Emahiser:Panic attacks can be part of any type of mental health issue, so you could have a panic attack associated with a depressive disorder or schizophrenia, ocd, with panic attacks. There's also a diagnosis called panic disorder and that includes panic attacks, and it's characterized by the fear of having recurrent, unexpected panic attacks and persistent fear or concern about additional attacks and their consequences. It's important to note that panic attacks can be expected or unexpected. Expected or stimulus-bound attacks are those that are activated by an obvious trigger or cue, and these triggers or cues could be due to a phobic situation, such as the presence of spiders or elevators or clowns or really any situation that when you're in that situation, it causes high anxiety and the panic attack tends to occur. But it could also occur because of disturbing thoughts or images. Unexpected or non-stimulus bound attacks occur out of the blue and without rhyme or reason. You could be completely relaxed or even sound asleep and experience a panic attack. These unexpected attacks are the type associated with panic disorder.
Bill Emahiser:Despite the intense, overwhelming discomfort, the larger problem with panic attacks are the consequences. While the intense fear and discomfort is what many of my clients report to me to be the main issue. It's really the escape and avoidance behaviors that cause the most problems. If left unchecked and untreated, panic and other anxiety-related issues will literally shrink your world. In an attempt to minimize the risk of having an attack, you might find yourself avoiding situations that could lead to meaningful interactions with friends or family or missed opportunities to improve the quality of your life.
Bill Emahiser:I once worked with a student who changed his major in college so that he didn't have to give a speech due to the fear of having a panic attack. He later graduated spending tens of thousands of dollars with a degree in a field that he hated and he became depressed. The avoidance of the panic attack that one speech that he had to give led him to abandon the field and the degree that he was passionate about had to give led him to abandon the field and the degree that he was passionate about. And I can tell you countless of stories of folks I've worked with that have had their lives upended in an attempt to avoid the intense discomfort of a panic attack. People who have missed saying goodbye to loved ones before their passing, missed vacations, missed seeing their children play in sports, all in an attempt to avoid the panic attack. But there's good news While panic attacks are intense and extremely uncomfortable, they're not dangerous. And this is really hard for folks who experience panic attacks to hear, because it feels like you are literally dying. But not one person has ever died from a panic attack. And there's more good news Panic attacks are treatable and recovery is real.
Bill Emahiser:There are wonderful evidence-based therapies that can help people overcome panic attacks, and I would strongly suggest that you seek out a therapist that includes a therapy called exposure therapy as part of their treatment. Typically, a counselor or social worker trained in cognitive behavioral therapy, acceptance, commitment therapy or some other form of behavioral therapy will include exposure exercises that can help decrease or eliminate panic attacks. Mental Health? U is brought to you by Unison Health. Unison Health making lives better. So what is exposure therapy and how does it work? Well, the easiest way is to give you an example and demonstrate what exposure therapy might look like.
Bill Emahiser:I once met a man who came to my office suffering with severe panic attacks. He had been to the emergency room about seven or eight times in the past two weeks Now. This gentleman reported that he was overwhelmed by his anxiety and panic. He was so frightened that he needed his significant other to take him everywhere and anywhere outside of the home. Every time he started to experience the symptoms of panic, he started to feel like his heart was racing or he was having a difficult time breathing. He would do what most people would do, and that's immediately go to the emergency room. Now, each time he went to the emergency room, the doctors told him the same exact thing he wasn't dying, as he thought. Instead, he was experiencing panic. The doctors told him that his heart was healthy. There were multiple tests run, including EKGs, echocardiograms and batteries of blood work to confirm and rule out their diagnosis, and he had also gone to several different hospitals, all getting the same information.
Bill Emahiser:Now I suggested that going to the ER was actually making his anxiety worse, because every time he went to the hospital, he gained reassurance from the doctors that he was not going to die and, with his permission, I suggested that he try an experiment when he started to feel as though he was having a panic attack and that he was dying, that he needed to try something different. Now the look on this poor man's face was sheer terror when I suggested that he refrain from going to the emergency room, or at least let's delay going to the emergency room. By the way, this is not a face that I'm unaccustomed to when I suggest that we try something different, especially when it comes to panic attacks, because they are so intense and overwhelming. Now the client could rationalize that he was perfectly healthy and that the doctors had done their due diligence by testing him every time he had been to the ER in the past two weeks. So he conceded you know, I'm probably not likely to die their due diligence by testing him every time he had been to the ER in the past two weeks. So he conceded you know, I'm probably not likely to die, but it doesn't feel that way when I'm in the middle of a panic attack. And I simply asked him are you getting the results that you want by doing what you've been doing up to this point? And of course, he said no. I then asked him are you willing to try a behavioral experiment? And he was. He was willing to give it a roll, and this behavioral experiment was pretty straightforward.
Bill Emahiser:When he started to experience the symptoms of his panic attack, he was to try something different, and that different response was to delay going to the hospital for 15 to 20 minutes and after 15 to 20 minutes, if he still felt the need to go to the hospital, he could go. But he was to practice delaying going to the hospital for 15 to 20 minutes and he agreed to try this and, as it turned out, this was the beginning of change. He had begun to do something different and, interestingly enough, by waiting 15 minutes he cut his hospital visits by half. A week later he was able to delay 15 minutes and then wait 15 minutes in his car before going to the hospital. He found that waiting actually decreased the frequency, duration and intensity of his attacks, with some additional interoceptive exposures. By the way, these are exposures where we actually practice the symptoms of a panic attack. So if you have a hard time breathing, we will hyperventilate. If you are fearful of your heart rate, we will get your heart rate going by running up and down stairs or running around the parking lot, as odd as that may sound. If part of your symptoms is that you sweat, we will wear a lot of clothes and turn the heat up and exercise a little bit and start sweating. And what we found in doing these interoceptive exposures and by him delaying his going to the hospital, his panic attacks became almost non-existent.
Bill Emahiser:Exposure is presenting you with the stimulus that causes anxiety and discomfort. And, by the way, we also have to eliminate the escape and avoidance and the reassurance. If we practice over and over, we can teach our brain through experience that discomfort does not equal danger. When our brain recognizes that you're going to have fewer, less intense panic attacks and you might actually be able to eliminate the occurrence of panic episodes altogether. It's important to note that panic is triggered deep inside your brain, and we might simplify it and just call it the primitive brain. This area of your brain is responsible for the fight or flight response and, when triggered, it mobilizes your body to respond to danger. The problem with panic is that it's a false signal, a false alarm that your brain is having your brain and your body respond as though you're in mortal danger, like you're going to die, even though you're perfectly safe. That primitive part of your brain learns through experience, which is why trying to talk yourself out of a panic attack is usually not very effective. But practicing, experiencing the safe but uncomfortable situation over and over again, that's what exposure is. It teaches the brain to learn that you are actually safe and that's when we start to experience those fewer and less intense episodes.
Bill Emahiser:So if you need help with panic attacks or any mental health issue, please don't wait to get help. There is no need to suffer. Seek out a licensed counselor or social worker that specializes in treating panic and anxiety. Ask them before you even go do you have any training in cognitive behavioral therapy and do you use exposure strategies? Also, most importantly, find a therapist that you connect with and that you believe can actually help you. The prognosis is significantly higher for any mental health issue if you connect with and have some kind of therapeutic bond or therapeutic rapport with your therapist. That's my best hope that this information was helpful for you. Until next time, have a super fantastic day and I'll see you in the next episode. This podcast has been brought to you by Unison Health. Unison Health is a nonprofit mental health agency dedicated to serving the Northwest Ohio community for the past 50 years.