Panic attacks in performance anxiety

Why Panic?

Panic is the body’s normal response to danger. Imagine yourself walking across a highway. You suddenly notice a car speeding directly toward you. Instant physical and chemical changes in your body enable you to sprint to safety.

But now imagine this same feeling of panic with no apparent cause. Dr. R. Reid Wilson says: “Panic attacks are produced when panic deceives the brain into thinking there is imminent danger. Here you are, standing in the aisle of the grocery store, not bothering a soul. Flip. On goes the Emergency switch. ‘Red alert! All systems prepare for battle!’”

Only those who have experienced such attacks can fully grasp their intensity. American Health magazine describes it as “an adrenaline rush that screams through your body for five minutes or an hour or a day and then departs as quickly and mysteriously as it came, leaving you limp, exhausted and dreading the next one.”

The Roots of Panic

Panic attacks usually begin in young adulthood and affect more women than men. What causes them? There is no clear answer. Some say that sufferers are biologically predisposed because of an abnormality in the brain’s limbic system. Many feel that this condition can be inherited, while others claim that the brain’s chemistry is altered by stress-inducing factors.

In some cases the attacks are induced by memories of traumatic experiences, such as war, rape, or child abuse. One survey revealed the percentage of incest survivors with panic disorder to be 13 times higher than that of the general population. Indeed, while panic attacks and other syndromes are full-fledged problems in themselves, they can also be what writer E. Sue Blume calls “spokes with incest at the hub.”

Of course, not all panic attacks are induced by trauma. But Dr. Wayne Kritsberg cautions that when such is the case, “treating the secondary consequences of the abuse—rather than healing the original trauma—will not solve the problem permanently. It would be like taking cough syrup to cure a case of pneumonia.”

Can It Be Cured?

Panic attacks can be brought under control. Many whose fear of panic keeps them housebound have been helped by exposure therapy. In this treatment a patient is exposed to the situation he fears and is helped to stay there until panic diminishes. Those with heart trouble, asthma, peptic ulcer, colitis, or similar illnesses should consult a doctor before attempting this treatment.

Relaxation techniques can be employed to alleviate the buildup of anxiety.a Some of these are discussed in the accompanying box “Calming Skills.” But do not wait for the onset of panic. These skills are best practiced during low-anxiety periods. When mastered, they can diminish or even prevent future attacks.

Panic thrives on perfectionism and low self-esteem. “While I was having anxiety attacks, Mr. Negative ruled my life,” says one sufferer. “I told myself that because I had anxiety, I was inferior to others and therefore unlovable.” Reversing such attitudes can reduce anxieties that lead to panic.b

There is great value in confiding anxieties to a trusted friend. Talking them out can help the sufferer to distinguish problems that must be endured from problems that can be solved. Not to be overlooked is prayer. Psalm 55:22 says: “Throw your burden upon Jehovah himself, and he himself will sustain you. Never will he allow the righteous one to totter.”

Rather than a single, mountainous problem, it is often the accumulation of small, seemingly insignificant distresses that induces panic—much like the way running too many individual electrical appliances on the same circuit can blow a fuse. One solution is to write down each problem on an index card and arrange them from the simplest problem to the most difficult. Tackle them one at a time. Writing out your distresses changes their makeup from what you fear and avoid to what you can see and resolve.

Some are aided by taking prescribed tranquilizers or antidepressants. However, a caution is in order. “I do not feel that medication alone is the answer,” says counselor Melvin Green. “It should be used as an adjunct while seeking the answer. . . . Drugs may allow you to be more functional, and that can give you the opportunity to seek other help to deal with the causes of agoraphobia and work toward your recovery.”

A Spiritual Problem?

“I thought Christians weren’t supposed to experience anxiety attacks,” says Brenda, “because Jesus said ‘never be anxious.’ I concluded that I must not be relying on God enough.” Yet, the context of Jesus’ words at Matthew 6:34 shows that he was not discussing panic disorders. Rather, he was emphasizing the danger of being more concerned with material needs than spiritual ones.

Indeed, even those who put spiritual interests first may be afflicted with this disorder, as the following experience of a woman from Finland shows.

“My partner and I, both Jehovah’s Witnesses, were engaged in door-to-door preaching. Suddenly, I felt dizzy. My thoughts were blocked. Nothing seemed real, and I feared I would lose my balance. At the next door, I completely lost my grip on the conversation.

“This terrifying experience took place in 1970. It was the first in a series of strange spells that would plague me over the next two decades. Repeatedly, I would find myself in a misty world, unable to think clearly. I would feel dizzy, and my heart would pound. I would stumble over my words or lose them altogether.

“I was a young, energetic, and happy full-time minister of Jehovah’s Witnesses. How I loved helping others to understand the Bible! But these attacks were a constant torment to me. I wondered, ‘What is wrong with me?’ A neurologist diagnosed my condition as temporal epilepsy. For the next ten years, I took the medication he prescribed. Still, I wondered why it had such little effect. I came to accept my condition as something I would simply have to endure.

“After some time I came to realize that my illness wasn’t epilepsy, and my prescription wasn’t working. Even routine walks were an insurmountable task. I dreaded encountering anyone along my route. It took all my strength to attend Christian meetings. I often sat sweating and dizzy with my hand on my temples, my heart pounding, and my mind blank. Sometimes my whole body felt tense and cramped. At one point I was sure that I would die.

“My ministry helped to sustain me, although it was no small miracle that I could continue it at all. Conducting a Bible study was at times so overwhelming that my companion had to take over. Truly, our preaching is a team effort, and in the end it is God who keeps making it grow. (1 Corinthians 3:6, 7) Sheeplike ones hear and respond despite the limitations of the teacher.

“One day in March 1991, my husband showed me a booklet about panic disorder. The symptoms described were just like mine! I read more on the subject, attended lectures, and made an appointment to see a specialist. After two decades, my problem was finally identified. I was on the road to recovery!

“The majority of those with panic disorder can be helped with the right treatment. Friends can be a great support when they are sympathetic. Rather than heap guilt on an already troubled soul, a discerning companion will realize that the person with panic disorder is not purposely antisocial.—Compare 1 Thessalonians 5:14.

“As I review the past 20 years, I am grateful that through it all I have been able to remain in the full-time ministry. It has been a blessing well worth the struggle. At the same time, I realize that, like Epaphroditus, some must relinquish privileges of service because of poor health. Jehovah is not disappointed with such ones. He does not expect more than a person can reasonably give.

“Living with this disorder has taught me not to take myself too seriously. It has enabled me to sympathize with others who have limitations. But above all, it has helped me to get close to Jehovah. Throughout my ordeal I have repeatedly seen him to be a genuine source of strength and comfort.”

[Footnotes]

a Christians avoid techniques that involve hypnosis or self-hypnosis. However, there are some visual and meditative exercises that clearly do not involve emptying the mind or surrendering it to the control of another person. Whether to accept these treatments is a matter of personal decision.—Galatians 6:5.

b For information on reversing negative thoughts, see Awake!, October 8, 1992, pages 3-9, and October 22, 1987, pages 7-16.

[Box on page 22]

Calming Skills

Calm breathing. Panic attacks are frequently accompanied by hyperventilation. To relax your breathing, try this exercise: Lie on your stomach. Count to six as you inhale; count to six as you exhale. Next, try the same deep breathing while sitting down. Then, try it standing up. Breathe deeply from the diaphragm, and practice this daily until it becomes natural. Some benefit by imagining beautiful surroundings while doing this exercise.

Calm thinking. ‘What if I collapse?’ ‘What if no one is there to help me?’ ‘What if my heart gives out?’ Catastrophic thoughts fuel panic. Since these thoughts are usually of future disasters or past attacks, try concentrating on the present situation. “To focus on the immediate is instantly calming,” says Dr. Alan Goldstein. Some suggest that you wear a rubber band around your wrist. When catastrophic thoughts arise, snap it and tell yourself: “Stop!” Interrupt anxiety before it has a chance to escalate into panic.

Calm reacting. If panic befalls you, don’t fight it. It’s just a feeling, and feelings need not harm you. Imagine that you are at the ocean watching the waves. They rise, they peak, and then they dissipate. Panic flows in the same fashion. Instead of fighting the wave, ride it out. It will pass. When it is over, do not overreact or overanalyze. It is gone, like a sneezing spell or a headache.

Panic is like a bully. Provoke him, and he will attack; do not provoke him, and he may go away. Dr. R. Reid Wilson explains that calming skills “are not designed so that you can better ‘fight’ panic or ‘banish’ panic at that moment. Instead, consider them ways of passing the time while panic tries to pick a fight with you.”

[Box on page 23]

Agoraphobia, a Fear of Fear

Many who suffer panic attacks develop agoraphobia. While it has been defined as a fear of public places, agoraphobia can more accurately be called a fear of fear. Agoraphobics fear panic so much that they avoid all places where previous attacks occurred. Soon, only one “safe” place remains—usually home.

“Imagine that you are leaving your house,” says writer Melvin Green. “Suddenly, from out of nowhere, appears the biggest man you ever saw. He has a baseball bat and, for no reason, hits you on the head. You stagger back into the house, not believing what just happened. When you are feeling better, you peek out the door and everything seems normal. You start down the path again. Suddenly he is there, and again you are struck. You get back into the house where you are safe. You look out the back door . . . He is there. You look out the windows . . . He is there. You know that if you leave the safety of your home, you will be hit again. Question: Would you leave?”

Many agoraphobics liken their feelings to that illustration and feel that their condition is hopeless. But Dr. Alan Goldstein gives this reassurance: “You are not unique, you are not alone. . . . You can help yourselves.”