How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Steve Your Own Question

Dr. Steve
Dr. Steve, Psychologist
Category: Mental Health
Satisfied Customers: 370
Experience:  19 years conducting therapy; book author; newspaper columnist; former co-host of radio show
Type Your Mental Health Question Here...
Dr. Steve is online now
A new question is answered every 9 seconds

Hello, my question is concerned with an issue of coping when

Resolved Question:

Hello,
my question is concerned with an issue of coping when having panic attack. I do know all the recommendations: stay in place, don't run, do the abdominal breathing, etc. Well, it does work, but only to a certain extend - I still get full-blown panic attacks. Any other tips and recommendations?

Lena
Submitted: 4 years ago.
Category: Mental Health
Expert:  Dr. Steve replied 4 years ago.

Hi Lena:

 

Great question. Panic attacks seem to be becoming more common, so your question is quite timely. Too, it sounds as though you have been down the road of therapy (both self-guided or with a professional) and are onto some good suggestions.

 

The one aspect you did not mention is controlling your thoughts during the attack. Activating the parasympathetic response through physical exercises like the ones you mentioned is absolutely essential, but often times a person in the throes of a panic attack is also going haywire between their ears - in other words (and I did not mean to be glib), the anxiety is being shot up because of intrusive thoughts that basically convince the person that they are either in grave danger, or (literally) that they are going to die.

 

So to answer your question directly, I would recommend going through some mental visualization exercises meant to encourage relaxation. Find the scenario that works best (and fastest) with you, and begin to take control of your mind while you are doing the breathing and stopping. Arrest any thoughts which drive anxiety ("I am going to die," "I am having a heart attack," "I cannot stop this attack," whatever it is for you). And this sounds rather simple, but it takes some practice.

 

Lastly, it seems that folks who tend to bottle their emotions up are more prone to panic attacks. So if you are an internalizer, I would also recommend finding safe outlets for the anxiety or tension you experience throughout the day. Allow yourself to relieve the pressure rather than continuously shaking the sealed soda bottle.

 

And remember, all the technology in the world still has not identified what exactly is the mechanism that triggers these sympathetic arousal attacks. You may be dealing with them for awhile, although the current research seems to show that the attacks lessen in duration, frequency, and intensity as you age.

 

I do wish you well. If you are satisfied with the response, please hit "Accept." This is the only way I receive credit for my answer. Thanks-

Dr. Steve

Dr. Steve, Psychologist
Category: Mental Health
Satisfied Customers: 370
Experience: 19 years conducting therapy; book author; newspaper columnist; former co-host of radio show
Dr. Steve and other Mental Health Specialists are ready to help you
Customer: replied 4 years ago.

Hi Dr Steve!

 

Thank you for the answer.

 

You clearly hit the spot there: intrusive thoughts. Well, I'm having those even when talking on the phone during the p. attack. And I'd like to know how to battle/replace those.

Obviously, I'm aware of the principle: try to replace a negative thoughth with a positive one, like "I'm petrified of this awful attack" - " It's okay to have a panic attack", "I feel dizzy and mighth faint" - "You've never fainted before", etc. The major problem here is that I do not believe it myself, it is not okay to relax or to accept the panic attack, and even if I've never fainted before, there are no guarantees that I won't faint now, at this particular moment.

I believe, you might be sensing not only the in-build negativism in my line of thought, but also some bizarre need of making logical conclusions and reasoning with myself ad absurdum about the same subject. How can I go about that?

 

Visualisation is an issue, undoubtably. I know that one must imagine a pleasant place/situation, where one had been genuinly happy and relaxed. Well, I do not recollect any. It allways has some sad/ regretful/over-intense emotions attached to it. Shall I mobilise my hyperactive imagination and fantasise some dream scenario?

 

Best regards,

Lena

Expert:  Dr. Steve replied 4 years ago.

Hello again, Lena:

 

Here is where your therapist may have dropped the ball. A couple thoughts:

 

(1) When you are practicing thought replacement, you cannot replace a profoundly negative thought with a positive one - it is just too far away from your reality, and will therefore be rejected (as you mentioned). I have clients begin with a very simple neutral statement: "I'm okay." Other therapists will advise the following: "I'm strong enough." But again, you're asking too much to shoot for a statement that is a light year from where you are at. The process takes a bit of rehearsal, and a willingness to withstand a few failures along the way.

 

(2) As for visualization, many clients are in your exact predicament... namely, they have trouble coming up with a positive image. The one I give to them is to imagine they are on a raft bobbing on the sea. There are a number of reasons I use this one (fear of water notwithstanding!), but in general a safe image should (a) incorporate all 5 senses, and (b) be a place where the client also feels some node of relaxation.

 

If you are satisfied with the response, please hit "Accept." That is the only way I receive credit for my answer. Thanks-

Dr. Steve

Dr. Steve, Psychologist
Category: Mental Health
Satisfied Customers: 370
Experience: 19 years conducting therapy; book author; newspaper columnist; former co-host of radio show
Dr. Steve and other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education
 
 
 

Related Mental Health Questions