Panic Attacks vs. Stress

Recently, I received an email from a participant of a recent workshop. Her question to me is first, followed by my answer:

Hi Dr. Olpin, 

I really enjoyed the presentation you gave a few weeks ago. I had a couple of questions that I was not comfortable asking in a group setting and I thought I would see if you could answer them for me.

 For the past 20 years or so I have suffered from acute panic attacks.Some are triggered by stress and situations, but sometimes they can wake me out of a sound sleep for no apparent reason.  Sometimes they will make me physically ill and leave me exhausted for days.

Over the last year or so they have gotten worse and more frequent. I have also have more constant generalized anxiety. It has really affected my life and limited the things I am able to do.  My question is, do you think panic disorder can be controlled the same way as you were telling us in your presentation on stress or is it an entirely different  problem?

I feel like I can use the guidelines you gave us to talk myself down sometimes when I am feeling anxious before things get out of hand. But if I start right into an acute panic attack it is like falling dominoes….no way to stop it. My husband feels like I should have some control over it . . That I should be able to tell myself I am safe, I am not in danger right now and be able to stop it. What is your opinion on this? I feel like panic disorder is an entirely different spectrum compared to everyday stress and that chemical and genetic factors and past traumatic experiences play a huge role. I feel like I have very little control in stopping the severe attacks.  Any information or advice would be greatly appreciated.

And here’s my response to her

Hi *******.

It sounds like you’re really struggling with the effects of high stress. It must make you feel so out of control when this happens to you, seemingly unprovoked.

Your question is a good one and a very important one. Depending on how it is answered will determine what you should do to try to fix it. And how you try to fix it can either be a pleasant path or a not-so-pleasant one.

I’ll give you the not-so-pleasant answer (the one I wouldn’t give you, but the doctors might). They will tell you that your “problem” might possibly have something to do with your stress, but they will try to “fix” the problem (disregarding the deeper cause), usually through the use of drugs designed to play with brain chemistry and chemicals. Unfortunately, these drugs will do a pretty good job of “masking” the problem so you don’t experience it quite so often or quite so intensely.

That might seem like a good option, given how little you like the panic attacks or high stress. The difficulty that always comes with drugs are the side effects. You’re going to have them. You don’t always know what they’ll be–could be weight gain, changes in appetite, hormonal changes, depression, sleeping problems, unclear thinking or a host of other unwanted problems. They will tell you these side effects are normal and to be expected, but your initial “problem” will be reduced. Then, what often happens is you’ll end up taking more drugs for the side effects of the original drugs (with additional side effects). It frequently turns into a never winning battle.  In my mind, you’ve not solved anything. And it’s very possible by going that route, you’re worse off.

Here’s my answer: Your panic attacks, and your feelings of generalized anxiety, are “symptoms” of a stress response that is all-too-frequently activated without the need for it to be activated (you aren’t in danger). But, as we explored in the meeting, it doesn’t really matter if a threat is real or imagined, your body treats both in the same way–the stress response gets turned on. And a chronically activated stress response results in imbalances throughout the entire body. When these imbalances continue, you get “symptoms” of stress. Your symptoms happen to be panic attacks and anxiety (there may be other symptoms as well). Others get headaches, gut aches, muscle pain, etc.

In our meeting, I kind of focused almost only on the prevention of stress–thinking about things differently, recognizing the absence of danger, etc. But in your case, you also need ways to turn OFF the stress response. And it sounds to me like you need to consider this aspect of stress management as being as important to you as eating well, getting enough sleep, or being physically active. You need tools (not drugs) that will make it so you automatically and quickly turn off the stress, mentally, physically, and emotionally. As I mentioned in the meeting, we need to approach stress from both locations: prevention and reduction. In your case, we need to emphasize the reduction part more.

What we need to do is establish a new “normal”. Here’s a little bit from one of my workbooks:

Create a New Normal

The body is always in one of two states: fight-or-flight or rest-and-repair. It isn’t in both states simultaneously. This fight-or-flight state is one of tremendous physiological imbalance throughout the entire body. Every system, every tissue, every cell in the body, during fight-or-flight, is functioning to help the body survive physical danger by operating at unordinary levels of readiness and activation.

In the short run, this imbalance helps us to be fast and powerful, but in the long run, this imbalance leads to any number of negative outcomes. The fight-or-flight response is NOT the state we should be in except very rare occasions. Why not? Because we are so infrequently in real physical danger. But as I’ve mentioned previously, your body doesn’t know the difference between a real threat and a made-up one. It treats them both the same; by activating the fight-or-flight response.

Now, imagine that you’re riding your bike and you encounter an unseen rock. Suddenly, you’re flying through the air and you crash-land on some loose gravel. In addition to the immediate pain, you notice that your hands and arms, your shoulders, and maybe even your face have been injured. You’re bleeding heavily in several places. No bones are broken, but you’re in pretty bad shape.

You immediately go home and clean up your wounds. You successfully stop the bleeding. You apply ice or some “healing” salves, but you recognize that you’re left with cuts and scrapes all over your body.

Now consider that your “symptoms” of stress are like the wounds you sustain when you crash on your bike. The headaches, the muscle pain, and the emotional problems are damage you’ve done because of this ongoing imbalanced state of fight-or-flight. Essentially, you are continually crashing and burning, or trying to repair from the stress.

When dealing with an activated stress response, you may try to “stop the bleeding” by taking medications in all their varieties, but the symptoms don’t seem to go away. Medications may temporarily numb the pain, but the problems persist.

Keeping in mind the metaphor of crashing on your bike, what can you do to heal the problems created by the ongoing stress response?

The correct answer is NOTHING. You consciously can’t do anything to make the wounds go away because you don’t have the know-how to repair the damage. Even if you’d like to think that you can, you really can’t. It simply isn’t within your power. Wound healing is not within the domain of the conscious mind.

Fortunately, your body does know how to heal itself. It knows how to recruit the right cells, chemicals, and healing energies to those spots that are broken and fix them in precise and perfect ways. Your body already has an internal pharmacy that contains all of the healing drugs, knowledge and processes to take the wound from horrible to completely healed. You don’t have to do anything but wait and watch.

This is how healing should always happen, whenever we’re broken. So why doesn’t it?

I mentioned earlier that the body is in one of two modes: fight-or-flight or rest-and-repair.

In fight-or-flight mode, the body is too busy working to survive the dangerous environments. It can’t simultaneously mend all the messes. The inner-pharmacy doors remain closed in fight-or-flight mode. That’s why the problems don’t go away.

In contrast to the fight-or-flight response, we have what’s known as the rest-and-repair state. In this state the body is doing what it needs to do to repair what’s gone wrong. We aren’t busy expending extra energy surviving, so our body goes to work healing, repairing, and regenerating. Essentially, our body turns on all of its healing energies to fix whatever problems have arisen. The inner pharmacy doors are open wide and the body knows how to use the healing chemicals, in the right dosages, with the right timing, without any side-effects.

In this rest and repair state, your “symptoms” of stress go away, not because you are trying to make them go away, but because the real cause of the symptoms—the imbalance brought on by chronic fight-or-flight—goes back into balance. Once balance is restored, the body knows how to remedy the problems.

This rest-and-repair mode needs to become our “new normal” as a way of being if we want to feel better and see our symptoms go away. Feeling relaxed, peaceful, calm, and symptom-free should be how we operate every day.

But in order to get there, we have to consciously take ourselves OUT of the stress response. We have to consciously turn it off! Fortunately, that is within our power. It is what this workbook is all about!

I’d be more than happy to help you with this, if you’d like. No pressure at all. I’m working with several people right now who are having some of the same difficulties you are. And if you’d like, I can do with you what I’m doing with them.

I have a lot of resources, but I usually begin with my workbooks or my online course RELEASE, which I spent the last 3 years building and writing. They read very easily, but they give you the best I know for stress prevention and stress reduction. Once you’re done with it all, I am pretty confident that you’ll feel a whole lot better. At least that’s been my own experience personally and the experience of thousands of people with whom I’ve worked.

So let me know where you would like to start. I usually recommend people start here. 

I hope I haven’t overwhelmed you with this answer to your question. If I were in your shoes, I’d be looking everywhere I could to find some relief (without resorting to drugs). So I thought I would share with you what I would tell me if I came to me with this concern.

I look forward to hearing from you.