Panic Disorder And Relaxation Techniques

Introduction

Panic disorder is a mental health condition that falls under the umbrella of anxiety disorders. Anxiety is a natural feeling of unease towards a perceived dangerous or stressful situation. It helps us to stay alive by creating a feeling that prompts an action to avoid danger or threat, fight or flight. Whilst normal levels of anxiety can be helpful to our survival, it becomes a problem when it is disproportionate to the stressful or dangerous situation, or has no obvious cause.

Panic disorder is the most severe form of anxiety and features intense mental and physical symptoms, which can happen frequently and suddenly with no obvious trigger.

It is important to learn effective relaxation techniques in order to reduce the frequency and severity of panic attacks. By understanding your panic disorder, you may recognise triggers and learn to pre-emptively engage your relaxation techniques so that the anxiety doesn’t reach a full-blown panic attack.  

Understanding panic attacks

Signs and symptoms of panic attacks

There are multiple possible symptoms experienced during a panic attack, mostly physical. These usually last between 5 and 20 minutes but can last longer. Symptoms can include:

• Racing heartbeat
• Feeling faint or dizzy
• Sweating/chills/hot flushes
• Nausea
• Chest pain
• Shortness of breath
• Trembling or shaky limbs
• Choking sensation
• Numbness/ pins and needles/ tingling in your fingers
• Churning stomach
• A need to go to the toilet
• Ringing in your ears
• Feeling disconnected from your body
• Intense feelings of fear or dread¹

Triggers of panic attacks

The triggers to a panic attack may not be obvious, to even the person experiencing them. Furthermore, triggers will be completely subjective, meaning that they will be particular to you. Your trigger may not concern someone else in any way. Panic attacks can be triggered by certain places, situations, chronic stress or events.

There are factors that will influence or increase the likelihood of a panic attack such as illicit drugs or alcohol, excessive caffeine or poor diet. 

Benefits of Relaxation Techniques for Panic Disorder

Reducing anxiety and stress levels

Panic is the most extreme form of anxiety; therefore by reducing your anxiety and stress levels, you will reduce both the frequency and the intensity of the panic attacks. 

Decreasing the frequency and intensity of panic attacks

Studies have shown that regular aerobic exercise decreases the frequency and intensity of panic attacks.²

Once you’ve established which relaxation techniques work best for you and practice them regularly, you become an expert in proactively engaging these strategies to reduce the intensity of panic attacks. Also, the knowledge that you are able to manage your own panic reduces the chances that you will have a panic attack. It is often the case that people experience about having another panic attack. 

Improving overall mental and physical health

Eating healthily and exercising will improve your confidence, reduce stress levels, release tension and improve your overall mood. Looking after your mental health will increase your tolerance to stress and reduce the risk that you will focus on negativity. 

Relaxation techniques for panic disorder

Deep breathing exercises

During a panic attack, people tend to hyperventilate, which upsets the balance between oxygen and carbon dioxide in our bodies. It is important to focus on controlling your breathing to avoid feeling dizzy or faint and in turn, if you control your breathing, your body will feel more relaxed. 

Progressive muscle relaxation

This is a two-step process whereby you first tense particular muscles in your body and then release the tension, taking note of how your muscles feel when you relax them. This helps to reduce stress and anxiety levels.³

Mindfulness meditation

This is giving your complete attention to the present moment. This can help you to feel calmer but can also have the opposite effect. When someone is having a panic attack, the inclination will be to immediately focus completely on their heart rate and physical symptoms. Therefore, it is important to be mindful of external stimuli to detract from those physical symptoms. Mindfulness-based treatments are not recommended for social anxiety.

Visualization techniques

Also known as guided imagery, can help you relax when you feel stressed. It involves creating an image or scene in your mind that you find comforting or relaxing. 

Yoga and stretching

Yoga can help promote both physical and mental relaxation, which can reduce stress levels and anxiety, which reduces the frequency of panic attacks. 

Music therapy

Music can reduce the amounts of stress hormones we produce such as adrenaline and cortisol, which can relieve symptoms of anxiety.⁴

Incorporating relaxation techniques into daily life

Creating a self care plan

Everyone’s self-care plan will be different. It’s about what will work best for you. What do you enjoy doing that helps you to feel better? It may take some time to figure this out and will mean some trial and error, but eventually, you will create a self-care plan that is specific to you and will support you when experiencing mental distress.

It could be taking time out when you notice your stress levels increasing. You may choose to read a book or go for a run. Every now and then, it is a good idea to take time out to focus on yourself, taking note of how you are feeling and if there is anything you can do to make yourself feel better.

Ensuring a healthy diet and regular exercise will go a long way in improving your mental well-being and reducing panic attacks.⁵

Identifying potential stressors and triggers

When working with a psychological therapist, they may be able to help you identify what your triggers are throughout the course of the treatment and help to implement a relapse prevention plan based on your triggers and techniques that work in managing panic.

It is also a good idea to keep a diary or journal, recording in it times when you’ve experienced panic attacks. Documenting what happened immediately before (what you were thinking or doing), what happened during the panic attack (if you can remember) and what helped to curb your symptoms, will be helpful in reducing the number of panic attacks and knowing what works best to manage them.

Practising relaxation techniques regularly

It is important to create a habit of relaxation techniques and self-care so that it becomes second nature. The more you practice something, the better and more effective that intervention will be. This will lead you to become proficient at managing your own anxiety.

Professional support for panic disorder

When to seek help

If you’ve experienced symptoms of a panic disorder, consider seeing your doctor for an examination. They will ask you some questions about your symptoms and possible triggers, which can be difficult to talk about, but it is the best way to start getting help. Your doctor should also do a physical examination to rule out any physical cause for your symptoms. 

Types of therapy available

Types of therapy available for managing panic disorder fall under 3 categories: self-help, psychological therapies and medication. Ideally, a combination of all three will see the best results for recovery.

Self-help techniques will help you develop techniques that work for you specifically and fit well into your life. Cognitive behavioural therapy (CBT) is a time-limited psychological therapy that is guided by a specialist professional and will give you the tools you need to move forward beyond the treatment. Some people manage without the use of medication. However, antidepressants have shown that they can reduce the severity of panic attacks.¹

Medications for panic disorder

NICE guidelines (National Institute for Clinical Excellence) in the United Kingdom advise antidepressant medication for the treatment of panic disorder, specifically SSRI antidepressants. If these antidepressants are not suitable for you, your doctor may look at medications such as imipramine or clomipramine, which belong to the tricyclic group of antidepressants. Tricyclic antidepressants have shown to be effective, albeit, not as effective as SSRI antidepressants; however, are not licenced for use in panic disorder.⁶

The UK advises against the use of antipsychotics, sedative antihistamines and benzodiazepines. These medications promote safety behaviours, whereby the person uses a “quick fix” to manage their anxiety or panic, and whilst effective, these medications create a physical and psychological dependence, which can add its own complications.

In the United States, the FDA (US Food and Drug Administration) approves the use of benzodiazepines such as Xanax (also known as alprazolam) and Klonopin (also known as clonazepam) for use in treating panic disorder. They do recognise the dependence these medications can create and recommend short-term use only.⁷

Summary

Panic disorder is the most severe form of anxiety disorder, in which the person experiences intense physical and psychological symptoms that cause feelings of fear and dread. The triggers are not always known, especially if you’ve recently started to experience panic. But with help, you can learn to recognise triggers and learn an effective way to manage your panic disorder to reduce the frequency and intensity of your panic attacks through relaxation techniques.

You may find initially that medication is helpful, but eventually, you will find what techniques work best for you, and by looking after yourself, the chances are that you will not require medication for too long.

Whilst all the relaxation techniques discussed here may not be helpful, some of them will be, and by practising them regularly by incorporating them into your daily life, you will be able to manage your panic disorder.