Anxiety and panic attacks are serious mental health problems. Over the past twenty years, neuroscientists, especially those who study the autonomic nervous system (ANS), have learned a lot about why we worry. Fortunately, the research has also produced more effective techniques to deal with these issues.
Our increased understanding of the neurology of panic has revealed that panic is not limited to anxiety attacks. It is present at different levels along a spectrum. Things like losing one’s temper over a minor frustration or being “triggered” result from panic.
Not surprisingly, recent scientific advances have led to an increased appreciation of the wisdom of Eastern practices such as yoga and meditation. In turn, this increased appreciation has led to incorporating these ancient exercises into the treatment of anxiety,
In light of these developments, here is a summary of the findings and their practical applications.
The ANS and Panic
The increased attention given to our ANS is the key to our increased knowledge of panic. As you probably know, the ANS controls many bodily functions of which we are not aware or conscious. For example, the ANS tells our heart to beat, our stomach to digest and our lungs to breathe.
In addition, through our five senses, the ANS constantly takes in data from our environment. Its primary function is to keep us alive and protect us from danger. It takes in data and analyzes threats outside of our conscious awareness. In times of danger, it will cause the body to react physically even before we recognize a problem.
Our ANS scans for danger through hearing, seeing, physical sensation, smelling, and tasting. When aroused, the amygdala sounds the alert to tell the ANS to prepare the body for an enhanced response. It increases breathing and heart rates and releases adrenaline and cortisol, called stress hormones.
These physiological and hormonal changes increase the body’s strength, speed and reaction time to deal with the threat. Understanding and Treating Panic Attacks | One Medical
Expanding our Understanding of Panic
In addition to bodily changes, threats perceived by the ANS are experienced emotionally on a spectrum ranging from anxiety to fear to terror. These sensations differ widely in intensity and the interference they create in accessing our prefrontal cortex, i.e., our ability to think and problem-solve rationally.
Typically, we define panic as a sudden, overpowering fright. It can also be acute, extreme anxiety,a sudden, unreasoning terror that is often accompanied by a fight-or-flight response. In extreme cases, a total shutdown and collapse occur.
More recently, we recognize that panic also includes anger responses, i.e. the fight side of the sympathetic ANS response. People who suffer from PTSD or other forms of abuse talk about the experience of being triggered. In addition to sudden and inexplicable fears, triggers can provoke unexplained angry outbursts.
Indeed, many folks, especially men, who were seen as having a “bad temper” or an “anger problem” in fact suffer from a form of panic. As a result, this expanded understanding of panic has created more useful ways to subdue and control unpleasant outbursts and frightening episodes. Why Do We Panic? | Scientific American
ANS Informed Tips for Dealing with Panic Attacks
— Realize: Your body “panics” before you feel it. Notice muscular tension.
The key to controlling panic-related problems is to identify them as soon as possible. An important fact to remember is that our body reacts to stressful situations before we consciously realize it.
Specifically, stress expresses itself in the body as muscular tension. Many feel this tension as tightness in their chest. Others feel it in other places, such as their neck, shoulder, back, gut, jaw, or throat. A crucial step in dealing with panic is interpreting this tightness as an alarm signaling fast-approaching trouble.
— Identify and stop the exposure. Physically separate yourself from the source of distress.
After recognizing your body’s stress alarm, the next step is to stop the exposure to whatever triggered the reaction. You may or may not recognize the source or reason for the reaction. In any case, stop whatever you are doing and get to a private place.
If you are on the phone, hang up. If you are speaking with someone, excuse yourself and withdraw. If you are listening to some programs on the radio, television, computer, or phone, turn it off or change the channel..
— Interrupt the physical reaction.
The next step to returning to normal is interrupting the panic reaction. Here are two techniques: panic | Pastoral Counseling Syracuse NY (revmichaelheath.com)
CHANGE THE TEMPERATURE — When panicked, a sensation like a temperature change can help break the reaction. Splashing cold water on one’s face or holding an ice cube in each hand can quickly interrupt the unpleasant experience and redirect your conscious attention elsewhere to a non-threatening place.
CHANGE YOUR BREATHING: Panicked breathing is rapid, shallow, and not fully exhaled. Intentionally slowing down the pace, deepening each breath, and fully exhaling signals the all-clear to the brain and shuts off the release of stress hormones.
— Re-establish calm. Shifting from a Sympathetic to a Ventral Vagal Emotional State.
After the panic moment is reduced and a sense of calm is restored, a period of 10-15 minutes is needed to refocus your mind. Practices like yoga or meditation can help clear your mind of concerns about the past and worries about the future and help you focus on the present moment.
INTENSE EXERCISE: Working out or even a brisk walk for 20-30 minutes can release the body’s endorphins, which help wash the cortisol and adrenaline stress hormones out of your system and help you feel better.
PROGRESSIVE MUSCLE RELAXATION]: Progressive relaxation exercises, where you slowly tense and relax each muscle, are very effective in producing a deep state of relaxation. A sequence takes about 15 minutes to complete, leaving you tranquil and stress-free. First-Aid for Anxiety | Pastoral Counseling Syracuse NY (revmichaelheath.com)
Other activities like listening to music and dancing are good ways to hit the emotional reset button and eliminate anxiety. The Vagus Nerve: Exercises for Calmness and Connection | Blog (fullyfunctional.com)
With a little practice, these skills will become second nature, and you can employ them to short-circuit disabling moments of panic. Many find that using these techniques, along with the help of a therapist, is especially effective. With time, your confidence will grow, and anxiety and panic will become one less issue to worry about.
Rev. Michael Heath, LMHC, Fellow AAPC September 19, 2024
