Have Mental Health Questions? Ask a Psychiatrist Online
Hello! Please remember that my response is for information only, we are not establishing a therapeutic relationship.
I've had some trouble off and on with the chat this morning. If you don't see a response from me every minute or two, then please say so.
I can start by giving you some information about how panic attacks work --and please know that fears of death/dying are quite common with people who have trouble with panic attacks.
So --first --the brain is wired to get our bodies ready to fight, run away from, or flee danger. The problem is, the brain does not know the difference between real danger and perceived danger.
So --if a bus was coming towards you and you had to get out of the way of it --your body would need to be able to run --so you'd need a rapid heartbeat, more blood to your muscles, etc.
And --you'd run --out of the way of the bus.
I had this incident in october of last year prior to that I had never experienced any anxiety attacks.
And you wouldn't think about what you were feeling in your body (until later, perhaps). BUT --if you are sitting and watching TV, there's no "bus" to run away from!
The information out there says that panic attacks usually start in one's 20's but --I see a lot of people where it starts later.
Anyway, even though you're sitting on the couch --somehow the brain still got triggered.
There's lots of triggers for panic attacks. I've divided them into 2 categories-- External and Internal. External triggers are always linked with Internal triggers. The triggers happen fast, are often subtle, so it appears that the panic attack is "coming out of the blue"
I can give you the general categories, but you'll have to work to find the specifics.
External triggers include anything perceived by the senses --sight/sound/smell/taste and "overstimulation" (too much going on) and "Understimulation" (not enough going on), and for some --flourescent light.
Internal triggers include: thoughts, feelings, memories, body sensations, and fears (of going crazy, losing control, or dying).
Being too hot, tired, hungry are body sensations that can trigger anxiety even relaxation can trigger panic because it's a body sensation.
The triggers are often linked together - I'll give one example.
I've had a few people triggered by their contact lenses --this was a completly new one to me. As these people got tired, it became harder for them to focus using their contacts.
As they had a harder time using their contacts, some thoughts entered, "I'm having trouble seeing."
Then thoughts like, "what if I get in a car accident?"
Then the anxiety would shoot up --"I'm having anxiety" --and it would spiral into a panic attack.
It seems we are having connection issues could you please email me the answers. Thank you.
This is just one example of thousands --but once you identify triggers in any given situation, then you can address them -- in this case, removing contacts.
OK.... will do!!!
It looks like what I said is printed above, so that's good. I will continue here.
Fear of dying can be trickier to address than the examples I gave, because it is an event that we all have to come to peace with in our lives --which is a spiritual/existential issue that we have to grapple with. However, the fear of death that circles around anxiety/panic attacks is not that thoughtful, struggling, grappling that we all must face, it's more of a in the moment anxiety trigger --so I think dealing with it at that moment looks a bit different.
One of the most powerful tools for addressing anxiety is to "Stay in the Here and Now" which simply means, "It's not happening now," and "I will deal with that problem/issue when it happens." It's a very simple concept that's not so simple to implement. Anxiety is always about the "future" (5 minutes or 50 years from now) --something that hasn't happened yet. If we could live completely in the present (no one can constantly by the way) --we would not have anxiety.
Therapy with someone who really understands how anxiety works is a really good idea. Cognitive Behavioral Therapy (CBT) is a very good therapeutic approach for anxiety --you can read about it here: www.mindovermood.com and here www.nacbt.org
You may also want to check out the National Anxiety Disorder Association as well www.adaa.org
Here's a very good book:
Please feel free to follow up --