Transcription:
Panic Attack vs. Anxiety Attack

Melanie Cole (Host): If you've ever suffered a panic attack, you know how ultimately debilitating they can be. Welcome to Bryan Health Podcast. I'm Melanie Cole, and I invite you to join me today as we discuss recognizing anxiety, panic attacks, and ways to cope with, or treat the symptoms. Joining me is Jill Johnson. She's a Licensed Independent Mental Health Practitioner and a Licensed Alcohol and Drug Counselor at the Bryan Independence Center. Jill, I'm so glad to have you with us today. And as I said in my intro, they can be debilitating, these panic attacks. Can you tell us a little bit about the difference between anxiety, anxiety disorders and panic attacks as we're facing these unprecedented times, we all feel anxiety right now. And then we add on the holidays, which kind of take it over the top. Tell us a little bit about what we're feeling now. Is it normal? And the difference with things like panic attacks?

Jill Johnson, LIMHP, LADC (Guest): Sure, thanks for having me on Melanie. Let me just talk before I get into the panic attack. Cause I think, you know, everyone should know when they're having a panic attack, cause it has strong symptoms, but first like about anxiety. Anxiety's, just very normal. We all have anxiety. We should embrace anxiety. We need anxiety. And I know it's kind of a loose term these days, and overused a little bit, but normal anxiety is good. It serves its purpose. It helps us to get motivated, to prepare for things, in dangerous situations, it keeps us safe. What's happening is our fight flight freeze system.

And our body is getting activated and it's telling us we have to do something, something's coming up, we need to do something. Normal anxiety. Great. It keeps us in line and productive during the day, but then it can get to a debilitating point where we're not able to function at work, in our relationships, or at school or being productive and going out and doing things.

So we want normal anxiety. That's good. Let's keep that. The debilitating type is when it turns into a disorder and it probably needs some type of treatment or some self-care to alleviate it. Now, when it comes to panic attacks. Those can come on very abruptly. There could be no trigger associated with it. But it has a very strong, physical component with physical symptoms along with some emotional symptoms. And I'll walk through some of the physical symptoms. And this is like, where you'll know you're having a panic attack, but it almost feels like you're dying. You have the accelerated heart rate, you know, chest pain, shortness of breath. You might feel tightness in your throat or like you're choking. You could be trembling, shaking. Sometimes there's numbness in your face or your fingers are tingling. Sometimes you can get very nauseous or feel like you're about to faint or be dizzy, so strong physical components of it.

And then along with the mental side, with a panic attack is this you're anticipating the worst, just feelings of dread wherever you are. You might feel trapped. You might feel like you're dying or losing control. So it's just a lot of fear and distress. So the physical symptoms are the strongest and that is, you know, most people feel like, they're going to die. They're dying because they can't breathe or their chest is tight. So a lot of times they'll go to the emergency room and they'll do all these tests and everything and figure out, nope, you're just having a panic attack and just need to control the breathing. Or maybe there's some medications and you're on your way. So like, if you're having a panic attack, like I think you'll know it because you'll basically feel like you're gonna die.

Host: Well, that's so interesting. And women, especially, as we're hearing more about heart disease and heart attacks in women, and we get chest pain all the time, we have a lot of stress. We're the caregivers of society, right? And then we get told, oh, well, it's probably not a heart attack. Or we think to ourselves, it's not heart disease, it's just stress or you're having anxiety, or you're having, how do we know the difference? As you said, a lot of people end up in the emergency room, but if we get that chest pain, if we get that pulsating heart rate. If we get those palpitations and the sweating, I mean, that's all the same symptoms of a heart attack.

Jill: Yeah. I mean, it could be and that's why, I wouldn't stop anybody from going to the ER, if they really feel like that they're dying or they can't breathe or anything. But if you've had one before, then it's good to know. Like, okay that was a panic attack. Now I know better about how to treat that, which it could be going to the ER, but a lot of time it's like, if you can focus on just getting in one place and slowing down your breath and just focusing on slowing down your breath and see if some of those other symptoms go away in your chest.

Or the numbness and tingling or anything like that and see if you can control your breath and those go away. And if do, then yes, most likely you've had a panic attack. Now if that chest pain is lingering and that tightness in your throat doesn't go away. You know, I would say, yeah, get checked at the ER, you know, you don't want to mess around and think, oh, it's just a panic attack when it really is a heart attack.

But the key is if you can get yourself calm and focus on your breath and see if those symptoms can go away, in five, 10 minutes or so, then it's probably just a panic attack. And also the emotional part is a key component to know if it's a panic attack because, that fear and that worry, of dread or feeling trapped, those are keys to know like if those aren't rational or real, this is probably a panic attack. Lingering symptoms, I would say yes. Go to the emergency room. Get it checked out.

Host: Can we talk a little bit please about when you say controlling your breath, you've said this a few times, but people don't always know what that means. So if you see someone, if someone you love, if you're a parent and you see one of your children, one of your teenage children or kids in their twenties, or a friend of yours or in yourself, if you are having a panic attack, you say controlling your breath. What are the first things we do? If we see someone having a panic attack, if someone we love is experiencing this, or if we are experiencing it ourselves, how do we calm down? How do we slow it down? How do we control our breath?

Jill: Yeah. So if I'm at work and I've dealt with a lot of clients that have had panic attacks, what I want to do is just, get them to sit down And the last thing you want to do is bombard them with questions. Like what's going on, why, what happened?

It is just let's get that breath under control. And sometimes I'll just breathe with them and ask them to follow with me, like big breath in. Big breath out, and just kind of repeat that with them or do that with them or watch them do it and not say much. And usually that can just slowly start creating a pause where that breath gets a little bit less rapid and slowed down.

Host: Does lighting matter in that case?

Jill: Lighting?

Host: Yeah. I mean, should we try and get them into a sort of a darker room? Should we try and turn off all the sounds. If there's music playing in the background, I'm just trying to get a sense for listeners. If they're in this situation and they sit the person down, should they be like saying, come on, let's go into your room for a minute and lower the lights or let's turn the music off or the TV's off, or the computers off, any of those things that are going on around them.

Jill: Absolutely. I think that very much can help. We want to be away from people cause nobody wants a panic attack in front of people. So if we can separate ourselves from as much stimuli that's going on in the environment, even if it's a corner in the back of the room or sometimes just in the bathroom, but no you're right. Less stimulus is better, private area to breathe and calm down. Yup, turn the TV off and just anything to help them just focus on their breath. Even if it's closing your eyes and just with my clients, I do it with them, and I'm not talking much, but, I'm just going back to the breath. Let's slow that down. And it can take some while, but that's a great idea is like let's get some of the outside stimulus turned down or get to sort of a more private place,

Host: There's so much of the outside stimulus these days. I mean, everybody's got music on, or they've got, I mean, we keep music on in my house all the time, but it's calming music or dancing music, something that we like to hear that makes us happy. But in this day and age with the headphones and everybody's always on their phones, to remove yourself, or the person from that situation. Now give us some other good practices to relieve stress and anxiety. Because if we know that we're someone who's prone to getting a panic attack, a full-blown attack, then we know these things are a part of our lives. What are some other things that we can try that can hopefully prevent them from happening?

Jill: One of the things about if you've had a panic attack, it's almost sort of now ingrained in you that there's more worry about having a panic attack. It's not anxiety about other stuff. It's now I'm having a lot of anxiety that I might have another panic attack. So, panic attacks are more reactive in the moment, then we need to do some things just to get calmed down. with any anxiety disorder, proactive treatment is the best way to do that. And we can get into the different treatment parts or things that help. My biggest thing that I teach all my clients, whether they're having anxiety or not is start practicing some mindfulness meditation, 10 minutes a day, guided, or however you want to do it.

Because practicing that every day really starts to retrain your brain to be in touch with the here and now. And where you are at because anxiety is usually just worry, worry, worry about the future, or worry, worry, worry about the past? And we want to stay kind of mindful and in the moment we are, as much as we can. And mindfulness, meditation is a great way to do that.

Host: Well, it certainly is. And what about things like, I mean, you do this every day with people and deal with anxiety. What about things like yoga and acupuncture, exercise, even diet. Can those things help with just this underlying anxiety? Or is it really besides the things you've mentioned, meditation and calming things, cognitive behavioral therapy, therapy, things that we need to do to help ourselves with those underlying causes?

Jill: Well, if you've been diagnosed with an anxiety disorder, the gold standard of treatment is medications plus therapy. Cause it's, and sometimes medications alone can be okay, but medications combined with therapy is your best bet. Or sometimes it's just therapy. And there's all different kinds of things out there.

Therapy, it changes with what kind of disorder that you have. So there's just not an anxiety disorder. There's usually categories underneath it, like generalized, where there's just persistent, excessive worry, and fear about like almost any situation you are in where are you feel like it's threatening, but it's really not that threatening.

It's just kind of irrational beliefs we have. Or there is social anxiety, where you're fine most of the time, but then social situations comes up and boom. Now this is debilitating, so the therapy treatment kind of depends on what disorder you kind of fall under. And then, if there's phobias and things, exposure therapy's a different type of treatment, but what I like to say is overall, really, we just need to change our relationship with anxiety and not see it as all bad.

We need to embrace it and then build some tolerance to it. That's kind of what exposure therapy is about, but the mindfulness, meditation is more you have all these thoughts going through your head and with mindfulness you start to learn how to notice those thoughts, but not become those thoughts and react on those thoughts.

And it takes a lot of practice. But if you can just do it for about two months, 10 minutes a day, you're not going to fill it immediately, but you'll start noticing that, okay, I have worry worry. I don't have to become that worry. I can stay present in the moment that I am and just notice that and not become that worry.

Host: It's true. I think that we have to separate our anxiety, our panic, our thoughts, our worries, because we all have those from what we are and what we're doing. Just as you say now, before we wrap up, when is it important that we see a counselor such as yourself to help us to identify the underlying causes so that we can work through some of these issues that are causing us this heightened anxiety? Tell us a little bit about what you do and how you work with people. And when you feel it's so important that people reach out for professional help.

Jill: Well, I will say as a counselor, I think that you don't have to wait until things get bad, to get a therapist and start working with a therapist. I think everybody should have a therapist because life is crazy right now. But definitely it's worth getting into therapy when your anxiety is preventing you from doing things in life that you want to do and you need to do. Social situations or work I mean take for instance, like, let's say today, okay, this is my first podcast and I'm having some normal anxiety about it, which makes me prepare and read over what we're talking about and get prepared for it. So that's normal, but if I would have called in sick today, because I had so much anxiety about this podcast and everything like that, that's a sign where it's debilitating, it's worth going and seeing somebody to work on that because it's interrupting the things that you need to do during the day.

Host: Really a great point that you make when it starts to affect your function and your function ability. Really like you say, if you would have called in and canceled, because you were nervous. And why would you be nervous about doing a podcast? These are easy and fun, as you can tell. Now, as we wrap up best advice, Jill, for ways that we can relieve our stress and anxiety, really things that we can do, just give us a small list because we are all going through, as you said, so much, right now. Give us some proactive and reactive ways of treating and dealing with general anxiety and panic attacks.

Jill: Well, I'll do the reactive side first, which is making sure that you're controlling your breath. Like some grounding things, you know, knowing where you are right now, that you're not in danger, nothing's threatening. So reactive ways are and it's best to talk with somebody, but, just to find a way to get in the here and now and know you're safe. Proactive ways, self-care, and that has so many components about it that I can't go through all right now, but are we getting enough sleep? Are we eating somewhat healthy? Are we eating at all? Exercise too, is great proactive ways, to release some of that built up energy that we have in ourselves. And then again, I think yoga was mentioned, but, just sitting down and taking 10 minutes a day to not have anything to do, but focus on your breath and breathing. To me, that's the best proactive thing you could do to help prevent anxiety attacks or panic attacks. But I do recommend talking to people, recognizing that your fears are probably irrational and overblown. Not just keeping it all inside to yourself, there's no shame in sharing. I have anxiety right now. Like I'm having these thoughts and someone else just, you know, okay. It really probably isn't that bad, let's talk through it. But self-care is such a big thing. Really your physical self-care and then going into emotional self-care, taking care of your mind and where your mind goes, trying to stay in the present moment.

Maybe controlling or watching how much alcohol intake and stuff you have, changing your environment if it's pretty stressful and full of a lot of conflicts, it's okay to say no to things, you know, and take care of yourself.

Host: What a great place for us to end this. That is the best message, it's okay to take care of yourself. What a great message. Jill, thank you so much for joining us today and giving us some real world ways, things that we can do right now today to really treat and deal with our general anxiety and also to give us really the red flags of when we should seek professional help. Thank you so much. Certainly a podcast that we can all listen to and use right now. I'd like to thank our Bryan Foundation partner, Union Bank and Trust. And of course you can go over to our website at bryanhealth.org for more information, and to get connected with one of our providers.

And that wraps up this episode of Bryan Health Podcast. Please remember to share this show with your friends and family, on your social channels, because we're learning from the experts at Bryan Health together. And we certainly can all use this great information right now.

I'm Melanie Cole. Thanks so much for listening.