Anxiety and Stress Relief

What is Anxiety?

2011-12-02T07:25:00.000-08:00

Anxiety is a completely normal feeling that most of us has probably felt in our life. Have you ever had butterfly’s when you are going for a job interview?, or maybe sweaty palms when taking a driving test or some other kind of exam? well these things happen when we feel anxious. Don’t worry these type of feelings are nothing to worry about and in fact it just shows that we are human.

The feelings of anxiety can present itself in many different ways, not just mentally but physically too. It is our body’s way of dealing with fear and worry. Think about this situation for a moment, you have just had a great night out with your friends, and it’s time to go home. You step outside, it’s dark and raining and there’s no-one around. You turn left into an alleyway and suddenly you hear heavy footsteps coming faster and faster towards you. What do you feel? scared? panicky? Kind of breathless? Well this is also anxiety that is making you feel this way.

Whilst in the above situation anxiety is actually a good thing, it is making us aware of any danger that we could be facing. However for some people anxiety can become a real problem. It can overwhelm them and take over their life. They constantly feel jittery and on edge, it affects their relationships, their ability to hold down a job and even the way they behave. They can wake up with a feeling of dread that they just can’t seem to shift. When anxiety becomes this bad it can be very scary.

The feelings of anxiety no matter how big or small are usually triggered by an event. whether it be a current situation you are in like a confrontation with someone or it could be triggered by something big that has happened in your life like moving house or a death of a loved one. The most important thing to remember is that anxiety is a part of every day life and you shouldn’t be worried about it. The more you worry about feeling anxious the more anxious you are likely to feel. If these feelings become too much and happen on an every day occurrence it could be the time to seek medical advice.

"Paxil worked wonders when I first started"

2009-10-10T14:00:00.000-07:00

I have been on Paxil for 5 years now. It worked wonders when I first started. For the last two years I have been trying to get off it. Like some of you I tried to quit cold turkey. I ended up in the emergency room with a headache so severe, they thought I had ruptured a vessel in my brain. Depressed by the event, I went back to Paxil. Then I tried to taper it down, from 20mg to 10mg a day, and now I take half of that for last two months, when Itried to quit that, I fell into a depression so severe that I became suicidal, so I went back again. Now a friend (a psychiatrist friend of mine tells me that if I substituted it with Prozac, it will be easier to wean off Prozac. I havent tried because I am afraid of the side effects. I have gained 20lbs, and lost the motivation and spunk I had before. It is sad that the general practitioners dont know about the adverse effects.

I will be trying the Prozac maybe next month. If it works, I'll let you know. Good luck to you all. Whatever you do, NEVER quit suddenly, especially if you have been on it for more than a year.

-- submitted by Dr. Swadud, 39

"I had a sour stomach, and fatigue and reached a point that I could not get off the couch."

2009-10-10T12:05:00.000-07:00

Now, to tell my story I have been on Paxil for 3 1/2 years and when I first started it felt an immediate improvement in my anxiety and depression. My attitude was a noticeable improvement to everyone around me. In the 3 years I tried to take myself off many times. I honestly don't remember all the physical side effects that alot of people have mentioned. But, I did experience extreme mood changes and extreme anxiety and depression. So, like everyone else I decided to go back on. Well, in the last 6 months I felt the PAXIL wasn't helping me. I felt I was (am) entering into a deeper depression. I have extreme fatigue, don't feel like working, much less taking care of my home and 3 children and HAVE NO SEXUAL DESIRE AT ALL. Oh, and not to mention the slow but steady weight gain.

One day I heard an ad on the radio saying "Do you want your sex life back" "Tried of feeling ...." The ad then when on to say that these are part of the long term effects of anti-depressants and gave an 800 number to call to see if you qualified to part of the study. Well, for some reason I did not qualify. But started believing that my lack of interest in sex was due to the Paxil. So in December I have slowly started to wean my self off. Again, I can't pinpoint the all the side effects like many people have mentioned. But, I can say that my depression and fatigue is so extreme all I want to do is sleep!

I have been completely off of Paxil the entire month of February and was forced to go t to my Doctor today and he told switched me to EFFEXOR. I now wonder that my feelings my all be part of the withdrawal problems.

I am remembered a period in December over the course of two weeks where I felt somewhat similar. It was December and that terrible flu was going around and I really thought it was that. But now that I am reading and remembering I don't think it was the flu and believe now it was the "withdrawals". I now remember telling my husband, God, if this is the flu why don't I have a fever like everyone else. I remembering one Monday I had such an extreme headache I took Excedrin PM and slept from 8:00am-3:00pm and the went to bed that evening at 7:00pm. And just like Friday, I had the same flu like symptoms. I had a sour stomach, and fatigue and reached a point that I could not get off the couch. I am getting worried that all these flu days were not flu days withdrawal side effects.

-- submitted Jane, 37

"Paxil was very beneficial in getting me through a rough patch"

2009-10-09T14:09:00.000-07:00

I have been on paxil for over 2 years. At one point I self-upped my dose to 60mgs/day. Paxil was very beneficial in getting me through a rough patch but I don't need it anymore and am trying to wean off. I self weaned down to 30 successfully, but when I went down to 20 I started having mood swings, headache, flu/cold symptoms. I am an attorney and can't afford to not be sharp. I will probably go up to 25 and take it more slowly from here. It sucks that it could take another year before I am free of it.

I wonder if anyone has successfully used st. john's wort to help them wean. What about prozac? I had a friend get off paxil onto prozac with no problems. Is it possible to go to prozac and then get off prozac which doesn't have such terrible withdrawal?

-- submitted by John, 27

"I feel that Paxil saved my life"

2009-10-09T13:31:00.000-07:00

Before anything I want to say that I feel that Paxil saved my life. It transformed my life- and got me out of a severe depression which I suffered for three years which one year of therapy alone was not able to cure.

However, now that five years later after taking 10 mg a day (initially I took 60 mg daily) I am having some withdrawal symptoms from trying to stop too quickly. My doctor says that I can successfully withdraw if I do it slowly enough. I realize there are some side effects, but I also experienced side effects for two weeks when I began, which eventually went away. SO I want to say while there are clearly side effects which are negative, I think this has been a very useful and positive medication, which helped me to return to my highest functioning, while I took it.

-- submitted by John, 31

"I've tried twice to get off of paxil"

2009-10-09T11:29:00.000-07:00

I've tried twice to get off of paxil. The first time with the weaning process under a doctor's care. It didn't work and only after three weeks I was back on my full dose of 40mg. I then decide to stop completely, which was a bad choice. I went a total of five days and had to have my husband go to the drugstore and have it refilled. I seemed to be ok for the first two days, and then my husband and son would notice that I was talking a lot to myself, which I'm not in the happen of doing a lot of, especially if someone is around, and when they would bring it up to me, I didn't remember this. I just thought I was "thinking" to myself. Then there was the chest pains, the arm pains and the worst ever dizzy spells I have ever had! I was sick at my stomach, lost my appetite, I had chills one minute and the next I was burning up. I did take my temperature once during the period of have this hot flash and it was 96.1 I'm back on my 40mg. per day. I don't like the drug, feel even more depressed on it, and someday I will sleep 19 or more hours! And did wake up tired and sluggish. I was totally unsuccessful my two times getting off of this drug.

-- submitted by Crrickkett, 37

"I am taking 15-30mg. of paxil per day for severe depression and OCD."

2009-10-08T21:15:00.000-07:00

I am taking 15-30mg. of paxil per day for severe depression and OCD. Mentally, I feel great. Physically, I'm in good health, but have gained 30 pounds while taking paxil. My docotr explained that I could get off paxil after taking it from 6months to a year. Well, last month was 6 months and I felt great-so I tried to get off it. My docotr explained that some people need to be weined off and others can just quit taking it. I tried to just stop taking it. This was a bad idea. I felt those same electrical pulses you described. It was too weird. I also started crying a lot-not sure if this was from PMS, the depression returning, or from withdrawal. I have read that withdrawal from paxil can cause "alcohol withdrawal" like symptoms. For two weeks, I endured these electrical pulses, night sweats, and extreme nightmares. I didn't want to take it anymore, but my husband begged me to get back on it and try weining myself off. A few weeks ago, I started taking 15mg a day again. Now, I feel fine. I still want to get off this stuff. I'm interested to know how to get off it?

-- submitted by Amanda, 27

"I tried to describe to my doctor the electrical zaps I have been feeling."

2009-10-08T21:13:00.000-07:00

Wow. About a month ago, I began decreasing my Paxil does of 20mgs. daily. I've been on Paxil for about 2 years and before that I was taking 150 mgs. of Imipramine (Tofranil). Most recently, I tried to describe to my doctor the electrical zaps I have been feeling. She attributed it to pre-menopause stuff. Mainly because I told her that my menstrual cycle, which is normally like clockwork, has been highly irregular. I got my period THREE times in January. I am now thinking that this is one of the withdrawal symptoms of Paxil. I also suddenly have terrible water retention. After reading the other posts, I am convinced that the electrical "surges" as I call them are a direct result of me weaning off Paxil. I hate this. Will I have to spend the rest of my life feeling these "surges?" A couple years ago, there was an article in the Pacific Sun, a Marin County California publication about the lifelong side effects of antidepressants. I will have to dig that out and read it again. Otherwise, I think the Paxil did me some good. However, I feel happy and content enough with myself to try life without it.

-- submitted by Ede, 45

"I was diagnosed with clinical depression three years ago"

2009-10-08T21:10:00.000-07:00

I hope that all of you that have written in are feeling better. I was diagnosed with clinical depression three years ago. My doctor at the time perscribed Paxil. I was on the drug for two and a half years at 20mg and experienced all the usual side effects, weight gain(20 lbs) and a general feeling of laziness being the most prominent. My mood greatly improved and I was finally able to function as a normal human being. When it came time to go off Paxil, my doctor instructed me to drop down to 10mg for a week and then down to 5mg for another week. After being on 5mg for a week, I would take one on Monday and then skip Tuesday and then take one on Wednesday and so forth for a couple of weeks. This method of weining seemed to work. Though I did experience some side effects(Brain Buzzing and sleep disorders) all of which were gone after a week or so after completely going off Paxil. In short, I feel that Paxil did indeed change my life for the better. There is a light at the end of all tunnels.

-- submitted by Dan, 25

"I STARTED TO EXPERIENCE ABOUT 5 - 6 PANIC ATTACKS A DAY"

2009-10-08T21:08:00.000-07:00

I WAS PUT ON PAXIL IN JULY 1999 , I WAS ON 20 MG UNTIL I TOOK MY LAST DOSE ON JAN 1 2000 IT TOOK ME AWHILE TO GO OFF OF IT. I HAVE BEEN OFF FOR ABOUT 6 WEEKS AND I FEEL BETTER, BUT I CAN ASSURE YOU THAT I WILL NEVER GO ON IT AGAIN. I GOT MARRIED ON JUNE 11 1999 A COUPLE OF WEEKS LATER, I STARTED TO EXPERIENCE ABOUT 5 - 6 PANIC ATTACKS A DAY, I THINK THAT IT WAS JUST A CHANGE OF LIFESTYLE THAT PUT STRESS ON MYSELF, I WENT TO THE DOCTOR AND HE PRESCRIBED ME PAXIL, AND THAT IS WHEN MY NIGHTMARE STARTED. I GAINED ABOUT 40 LBS AND I WAS ALWAYS TIRED AND LOST ALL INITIATIVE TO DO ANYTHING AND I LOST ALL SEXUAL DESIRE. IT DID STOP THE PANIC ATTACKS, BUT IT ALSO MADE ME FEEL THINGS THAT I NEVER FELT BRFORE EITHER. THE WITHDRAWALS WERE HORRIBLE, AND I WOULD NOT RECOMMEND THE DRUG TO ANYONE.

-- submitted by DAWN, 24

"I have gotten extremely dizzy, lightheaded and have bad headaches and pains in my neck and shoulders."

2009-10-08T20:59:00.000-07:00

My doctor prescribed Paxil at the time my husband had terminal brain cancer. I DID NOT request medication and did not feel I was depressed..sad, yes, but NOT depressed. This was about five years ago and I have tried unsuccessfully more than once to withdraw from the Paxil. Every time, I have gotten extremely dizzy, lightheaded and have bad headaches and pains in my neck and shoulders. Each time, I have reduced the dosage slowly but still have the systems and each time, I have resumed the medication of 10mg rather than continue withdrawal. Last week, I discussed this with my doctor when I went for my annual physical and he seemed totally disinterested. He said I "need" to take it and it is doing me no harm. (How the heck does anyone know what long-term effects it will have!) I am now happily remarried and as far as I can tell, have no adverse reaction to Paxil such as sleeplessness, sexual dysfunction, etc. The positive effect is that I do feel more organized and not quite so "hyper."

-- submitted jchimsef, 54

"The anxiety was situational. My situation changed, I stopped taking it and the third day I was very ill."

2009-10-08T20:56:00.000-07:00

This was the second time I took Paxil. This time 30mg. for anxiety, last time 20mg.for depression. The anxiety was situational. My situation changed, I stopped taking it and the third day I was very ill. I thought I had a stomach virus at first then I found out what it was. PAXIL WITHDRAWAL! I called the doctor and asked for some 20 mg. so I could taper off. She recommended. One a day for a week, then one every other day for a week, then one 3 times a week. Today I went back to the doctor because I have felt so bad. I didn't get much help there. I appreciate everyone that posted here because it validated my illness. I have several(most) of the symptoms posted here. I told someone today that I felt like I had a migrane without a headache. (Thank God) the nausea comes and goes but mainly on the 2nd day of no Paxil. I am going to start 10mg. everyday and see if that is any better. People need to be warned of the withdrawal. The first time I took Paxil, it was worth it because I was so depressed, but there was no withdrawal. Please help get the word out. I feel emotionally better because I know now that is not in my head.

-- submitted by forkers, 34

"This is my 3rd attempt to get off the paxil"

2009-10-08T20:51:00.000-07:00

This is my 3rd attempt to get off the paxil. I wonder if I'll be successful? I believe I will (also did the other times). It's now been a year that I was prescribed paxil for panic attacks. Let me tell you that most doctors do not inform us well at all. If I had known there were so many withdrawal syptoms, I would have chosen something else. I can say the paxil at a proper dose really helped me. But when I first started on the paxil it didn't work. The doctors said it was going to be a gradual improvment. A month and 1\2 passed and I wasn't better. (I took 10mg for 3weeks and then 20mg) I was only better 2 to 3 days after the increase but for only a couple of days. I still had to go to the emergency many times, cause the panic attacks persisted uncontrollably. So between the hospital, my GP and the psychiatrist everything got mixed up. The hospital put my dosage up to 30mg. (good for a few days) Then I was worst. Now not only panic attacks but obsessive suicidal flashes. (which I feared tremendously cause I did not want to do that) So again to the emergency room for a huge panic attack and confusion. My dosage was put up to 40mg. What a mistake. It got worse after a few days of feeling good. With the panic attacks and suicidal flashes, add lots of ups and downs (laughing then crying 10-15 times a day). Also the shakes and increased occurrences of the attacks. So my GP put the paxil up to 50mg. What an overdose. You figure between them they would know the increase is worst. So this time the emergency admitted me for a week. I automatically refused to take that high of a dose of paxil. With lots of pushing they agreed to reduce it to 30mg and they gave me some ativan. I felt great after two days and then even better after a week. I say I felt great cause it was really hell before. so when I left the hospital we reduced it to 20mg with regular intake of ativans(ativans for about 1 month). It worked wonders. Panic attacks were controlled and not as frequent. Like once or twice a day instead of 10-12 times. And improving to only a few controlled ones a week to almost nothing. Now 9 months had past. I was well so decided to quit the paxil. Big mistake. I stopped cold turkey. It feels really great for a few days but then it's hell. I experienced major dizziness, being like off balance, nausea, vomiting, diarrhea, being light headed, major tingling and vibrating and numbness in my arms, hands, legs and feet, lack of energy. I coulldn't stand cause I would be sick and I was weak almost not able to move around. I forgot to add the major heart palpitations. fast regular fast regular... After a week I couldn't take it anymore and went back on the paxil at 20mg. a few weeks later I attempted to do it the right way and reduce the dosage slowly to 10mg and the 5mg. But I felt bad everytime I reduced. There's this high everytime for about two days and then it's hell. So I went back to 10mg and stayed at that for a few weeks. I didn't feel good but I wanted off so bad. So I managed to regulate my system at 10mg. Wow. I took it for about 15days after that then reduced it to 5mg for a week and then a few days of every other day. Today I did not take the 5mg and all the withdrawal symptoms came back. I'm so upset. But I'm also determined to get off. I'm taking my last 5mg tomorrow. My doctor said that the withdrawal symptoms would last about 2 weeks and fade away. He said that the symptoms were well documented. Yah right, WHERE? I can someone have access to this info before taking the medication in the first place. I'm pretty frustrated by my experience and the lack of knowledge of the doctors regarding paxil. It almost feels like were rats. Well I'll let you know if I last and how long it took for the syptoms to go away . (if I succeed) Good luck to all of you out there. We'll find what works.

-- submitted by cveer, 27

"withdrawal symptoms are incredibly awful"

2009-10-08T20:46:00.000-07:00

if someone would like to respond, pleas do so!!

I must be on day 11 now, paxil free. i am so proud, these withdrawal symptoms are incredibly awful. But i need to change the subject here...

Has anyone been to a doctor and discussed this with them. I went to three different doctors last week and got the run around?? why?? is this a conspiracy?? do the doctors get "kick backs" from giving this drug to us?? i don't understand.!

What's funny is, i am going to my doctors office tomorrow and requesting a copy of my medical files for the period of time i was on paxil, as i sit here and think about it, i think i was having more side effects than i realized. I feel like a detective right now, and i need to get to the bottom of this.

I think people should obviously be made more aware of the options they have before going on a drug. I think consoling is the way to go..

-- submitted by Tristan, 27

"I have been taking an SSRI similar to Paxil, called Zoloft, for over a year"

2009-10-08T20:34:00.000-07:00

I have been taking an SSRI similar to Paxil, called Zoloft, for over a year. Curiously, I've experienced every negative symptom described by the participants of this web site, all of whom were using Paxil.

Believe me, Zoloft can be every bit as terrible to drop.

My doc suggested switching from Zoloft to Paxil; the idea being that a person must try a few anti-depressants to find the one most effective for him or herself.

But after researching on this site and others, the withdrawal symptoms associated with Paxil, no way will I get on Paxil.

Which leaves me with a lot of thinking to do about next steps...

-- submitted by LM, 29

"I began taking paxil for anxiety and since have encountered a new host of difficulties"

2009-10-08T20:32:00.000-07:00

I began taking paxil for anxiety and since have encountered a new host of difficulties: I am so dizzy as I am writing this that I will make it as brief as possible. I experienced extreme tiredness for months, on paxil, I feel that my whole system has gone into slow motion and I have gained almost thirty pounds, has anyone else experienced this? I am now seeing a homeopathic medical doctor and have been easing off the drug, I am now going through the withdrawals I am beginning to hear others are experiencing such as; extreme dizziness, headaches, more tiredness, feelings of anxiety, disorientation or blurriness and I relate to what one man referred to as brain shocks. I also feel that my heart is beating funny even though my pulse doesn't seem to reflect this. I also feel like I am out of breath some times. My moods have been WILD as well. I am interested to know if anyone feels that this drug has slowed their metabolism down, this was supposed to be an anti-depressant, but gaining weight has not helped my self image very much. I am angry to discover how many others are going through the same things, no doctor ever warned me about all of this!!! Did this drug help me at ALL?

-- submitted by oldjed, 25

"i have watched my wife spiral completely out of control"

2009-10-08T20:28:00.000-07:00

i am the spouse of the person taking this damn drug paxil - and i want to tell you i am at my wits end with all this - this is really a long story ill try and compress it - i live in canada and am moving to san francisco - have been spending lots of time here in san fran where my parents live - my dad is dieing - my mom got fleeced by some con men for a lot of money - my brother in law tried to grab the estate etc - am now 3 days from taking oath for us citizenship - my wife who is in canada right now had started on paxil after i came here in july and she has gradually increased the dosage to i believe some where in the neighborhood of 40-50 mg - also she is taking atavan and drinking - everything has been ok between us and we have been together for about 10 years - we were looking forward to moving to the us and she had taken stress leave from work back in july and the damn doctor had prescribed this to make her feel better - yeah right - i have watched my wife spiral completely out of control - we have been visiting as she would come here or i would go there to see each other - so i was not completely tuned in to what was happening - i am horrified from the things i have been reading about here and in other places on the net - and i am mad as hell that this doctor prescribed this stuff to her - the absolute least he should have done was to inform me of what was happening

well monday night i spoke to her on the phone and all i can say is "this is not my wife" - she told me among other things that she wanted a divorce - never wanted to see me again - never wanted to speak to me again - and that she was going to mail my personal possessions to me and she was going to see a lawyer etc etc - for about 45 minutes of screaming yelling and crying - for the next 4 days i have been a complete wreck - i can not leave here to go back there until after the oath taking ceremony for citizenship on tuesday - i will be leaving right after that - yesterday was the first time i was able to put this whole thing together - i now feel as though my wife is suffering from some kind of paxil induced psychosis but none of our friends want to hear that - they are all convinced that she wants a divorce and thats that - i have just heard today that she has stopped taking this paxil cold turkey - but i dont know if thats true or if she stopped last week and this is withdrawl

at this point my life is going down the toilet and i am not the one taking this damn drug - i am so mad at the doctor and at the medical establishment in general also pissed off with her family and friends as everyone thinks she just wants a divorce - maybe she does i dont know - 3 weeks ago when she was here which was a few days before my citizenship interview she told me she was hearing voices - i asked her directly if she was really hearing voices and she said no so i thought she had been joking - now i know and i feel very guilty for not having realized that she was out of control

what in gods name has happened - i am a wreck - she must be a lot worse but i didnt realize this til yesterday when i put it all together and started reading about paxil - im afraid that now its too late to salvage my marriage

i dont know what to do - i need to talk to someone - no one (our friends) seems to understand the dangers of this drug - im positive this is all due to the drug or her withdrawal from it

-- submitted by Chris, 44

"I have been feeling boosted like hell for 2 or 3 months, though side effects were still there."

2009-10-08T20:26:00.000-07:00

I am not yet about to stop. I am taking 10mg a day since 6 months. My experience isn't very positive so far. I was very unwell during the two first weeks of treatment. I quickly realized that the medicine I was taking was not an "innocent" one. Part of the numerous side effects disappeared after 3 weeks. I have been feeling boosted like hell for 2 or 3 months, though side effects were still there. Some remain today and do not evolve anymore. One of the most intrusive is sexual (in first instance difficulty to have an orgasm (while erection was no problem), later significant decrease of the sexual desire. Another side effect I can't ge rid off is a kind of internal vibration. And finally I can't really sleep for a whole night. Falling asleep is no problem but after an hour or two I get awake and remain awake for hours. I can't have a really nice night with the feel that I recover some energy. The boost I got is gone and I merely feel any positive effect anymore (energy is low, I am always tired). Considering the low dose (10mg) I would not be surprised that my doctor would increase it. But when I read the problems you got to withdraw ... then I really get scared.

-- submitted by Pierre Becquart Av. de Tancarville, 18 1410 Wareloo Belgium

"I have been having panic attacks since I was 14 or 15."

2009-10-08T20:16:00.001-07:00

I have been having panic attacks since I was 14 or 15. Finally, I went to a doctor a year ago and he diagnosed me with social phobia/generalized anxiety disorder. I waited a year to see another doctor. That was Thursday. It's Saturday now. I was prescribed paxil, without knowing anything about it, except the doctor said "it can be weird at first, but stick with it". I am very grateful for this website, because, after only taking it for 2 days, I am not going to take it again, I don't think. I hate it. I feel very weird. I was usually awkward around people, but know I am paranoid. I feel like I am floating. I feel either apathetic or emotional. I can't even listen to music I usually like. I woke up the first morning and looked in the mirror. My pupils were huge and I felt like I was looking at someone else. My jaw started shaking and chattering. This is unlike me. I am only awkward in social situations. I was in my own bathroom and felt very, very strange. I started crying, thinking "this is not me..." Do NOT listen to people who try and say that your withdrawal is because you are "so depressed". Get real, it is no coincidence that so many people experience weird feelings, immediately after they quit. That is weird and messed up. I think all of these new "cures" for depression and anxiety and all, are weird as hell. I have also noticed that doctors do not take people with mental ilness very seriously. For example, one of my first concerns was "Don't even mention Prozac, because I know a girl who took it and and it made her really weird. She was bipolar and she said she felt better when she forgot to take it." The doctor laughed and said "Ha, well, most bipolar people do feel better when they don't take their medicine". He kind of chuckled again. I was thinking, this is my friend, that was rude. Do not let some doctor tell you why you feel the way you do. They might have more insight than you do into the brain, but you know how you feel. They don't. Anyway, thanks a lot for the information. I was looking earlier, and all I saw was : "May cause drowsiness, constipation, decreased sex drive". I wanted to hear something real. They forget to mention that the drug makes you feel insane. Another good example of the weirdness - I am a cashier, and last night when i was working, I became totally paranoid. I thought everyone was laughing at me, and that they knew I was on Paxil. Weird, huh? Oh, finally, I find it impossible to study like this (the major reason I'm not taking it anymore).

-- submitted by page, 20

"I was prescribed paxil for panic disorder related to post traumatic disorder."

2009-10-08T20:14:00.001-07:00

I was prescribed paxil for panic disorder related to post traumatic disorder. I was on 40mg of Paxil for one year. I decided to go off the medication because I believe it was making me lethargic and lazy. I also believed that it was causing more anxiety accompanied with heart palpitations. I began reducing the dose by 1mg weekly. I have been off the medication totally for three weeks. I continue to experience withdrawal symptoms which include: dizziness, anxiety, head and facial "jolts". I have also been very emotional. I am easily angered which is not in my character. I wish I could rid myself of these irritating withdrawal symptoms.

-- submitted by monkeyboyt, 29

"I was having a very difficult time sleeping, and didn't have any energy. I was extremely lazy.."

2009-10-08T20:11:00.000-07:00

Been taking paxil for 3.5 yrs. Last week i decided that paxil wasn't doing anything for me, that i didn't need to take it. I was having a very difficult time sleeping, and didn't have any energy. I was extremely lazy.. So on Thursday, i stopped taking paxil cold turkey. I was feeling fine over the weekend, i still couldn't sleep, but on sunday night i was feeling "crabby", monday i had a horrible day at work, felt very moody. Tuesday was the worst day of my life. My hands and fingers felt numb, my legs felt odd. My mind was cloudy. like i was in a haze. hard to explain how i felt, and how i am still feeling. I became very emotional. started crying a couple of times. which is not a characteristic of mine. so i can to the internet and i was honestly surprised at the other responses i read.. It seems like a lot of people describe the same feelings toward paxil.. why is that?? because its a sham?? it made me feel better to know that others were feeling the same way i was, that i wasn't alone. I went to a psychologist yesterday, explained the way i was feeling, and his response was: Thats the depression kicking in without paxil... That made me mad, because of all the people that are talking about its ineffectiveness. I know i am fine, i just need that drug out of my body. I feel paxil was making me sleeplessness, i believe it was zapping my energy, making me lazy.. Whatever it is, i can control it myself, as soon as i rid myself of Paxil. thank you.

-- submitted by Tristan, 27

"...severe problems with concentration, became very antisocial, had hallucinations and could not sleep well"

2009-10-08T19:58:00.000-07:00

My 17 year old daughter was taking 10mgs and then 20mgs paxil for 2 months and had severe problems with concentration, became very antisocial, had hallucinations and could not sleep well. I took her off of the drug cold turkey and she got so depressed she became suicidal, I put her back on at 10mgs for 2 days then 5 then 2&one half every other day and then every three days and then off. She seems to be fine now and cannot believe the nightmare we went through she remembers the withdrawal more than the the months on the medication. It was like a DR. Jeklyl -Mr. Hyde show. Paxil is not for everyone-it can be a dangerous drug to the wrong people. I wonder if people that react so badly to it are allergic to the drug as I have a psychotic allergic reaction to the drug codiene.

-- submitted by Sue, 47

"I have been taking Paxil for two and one half months now for situational depression"

2009-10-08T19:55:00.000-07:00

I have been taking Paxil for two and one half months now for situational depression. I recently missed 4 doses due to illness. Since then,I have been experiencing dizziness to the point of not being able to drive or play with my children.

I made an appointment with my Doctor, who prescribed yet another drug to take care of the dizziness. Meclizine is a generic antivertigo drug and the pharmacist explained to me that it should help take the edge off, but if I plan to continue not taking the Paxil, I can look forward to 3 - 9 days of this.

He suggested that I go cold turkey with the Paxil and get it over with. He said that people who taper off the drug still get the side effects, they just last longer.

I am going to try to keep going. I am on day 4 and counting.

-- submitted by berzins, 31

"While treating me for migratory arthritis (the dr. THINKS), and depression, I was given 20 mgs of paxil."

2009-10-08T19:53:00.000-07:00

While treating me for migratory arthritis (the dr. THINKS), and depression, I was given 20 mgs of paxil. After taking it for a few weeks, my arthritis subsided (was absolutely TERRIBLE - joint swelling and severe pain). I have been taking paxil now since 1998 (10mgs daily) and although if I "overdo a joint", I will get swelling, I no longer have the severe pain.

PS: I am currently in the process of quitting taking paxil due to finances and no insurance. I am anticipating hopefully, that my joint swelling/pain and depression does not return. No money - No Dr. - No Meds. I'm going to give it 6 months or (if the pain returns) 3 months before I attempt to restart taking the paxil.

-- submitted by DL, 39

"Paxil was prescribed for situational depression"

2009-10-08T19:52:00.000-07:00

Since I've been taking it, I do not sleep. Others seem to indicate that it helps them relax, but I am drowsy all day at work, so I fall right to sleep at night. I sleep about 2 hours, and then I'm wide awake. I just wondered if the "happy" part of the drug wasn't an upper since I'm very, very sensitive to uppers. I can't take diet pills for the same reason, and I have to limit my caffeine intake.

-- submitted by Donna, 48

"On Paxil, I was always sleepy, and would constantly have to take naps."

2009-10-08T18:51:00.000-07:00

I spent about 13 months on Paxil and have just switched to Effexor XR. On Paxil, I was always sleepy, and would constantly have to take naps. It was an irresistible urge to lie down and sleep, and really got in the way of a normal daily life. I could no longer drive for more than an hour or two without having to pull over for a nap, and I spent most of my days off on the couch, too tired to go out and do anything. The other main effect I suffered was weight gain -- 30 pounds' worth. Unfortunately, I had mononucleosis when I began taking Paxil for depression, and since mono's symptoms include fatigue and possible weight gain due to less exercise and a slowed-down metabolism, it took my family doctor and myself a long time after my recovery from mono to determine that Paxil might be the culprit causing the weight gain and continuing fatigue. My psychiatrist (who initially prescribed the Paxil and whom I no longer see) dismissed my concerns that I was rapidly gaining weight, even though this had never happened to me before in 30 years. He said Paxil rarely causes weight gain and was more likely to cause weight loss. Skimming through the Disease Management Forum paints a different story. My family doctor has run a battery of tests and ruled out pretty much anything he can think of that would cause this weight gain and fatigue (thyroid, anemia, hepatitis, ect.). That's why he has switched me to Effexor XR, which he says may improve my condition. To be fair, Paxil did get rid of my depression, mood swings and temper, and the only other side effect I experienced, mild sexual dysfunction, was not serious. However, after months of convincing myself that Paxil was a wonder drug (in that it improved my mood so much) I decided I was not willing to continue with the drug if the tradeoff was constant fatigue and steady weight gain. I am now going to Weight Watchers to get rid of those 30 pounds, and after just five days on Effexor, I already more energy and my head is a lot clearer.

-- submitted by anouk, 30

"I am doing OK but I am addicted to Paxil"

2009-10-08T18:44:00.000-07:00

I was diagnosed as bi-polar in my second year of university. I had been suffering with it for many years previous but was good at hiding it. I saw a university therapist for 2 years during which time I tried many different medications. I was on zoloft for over two years. But when the zoloft decreased its effectiveness I was eventually put on paxil which helped me remain relatively stable for over 4 years. But when I moved cities and started a new job I was finding that I was getting panic attacks and having major trouble sleeping. I went to this doctor who told me I should try and decrease my dose. When that did not work I went back and he told me to go off the paxil for 2 weeks to clean out my system and then I should try this other drug. I trusted him. I knew I would get off centre if I went off my drug but I thought if I was careful and did not let myself get out of control I would be OK. I can't tell you how wrong I was!

Day one: I was OK. A bit "high" if anything.

Day two: I was very unstable, crying and shaking like a leaf (I thought it would be the worst of it).

Day three: I was violently ill for three hours straight, I could barely see, move, or function. My mood was beyond low, I was almost ready to jump out my window to make it all stop). A friend came over and helped me to calm down.

Day four: I slept for 12 hours straight. I thought I was just tired from the craziness of the night before. But later in the night I became almost hysterical, I could not sit still, I was sick again for hours, and the incredible feeling of dizziness (almost like you are in another dimension). I eventually ended up in the hospital because I was unable to control anything going on with me and I needed to get help before it was too late. They gave me drugs to calm me and put me asleep so I made it through the night but the next day I was no better.

By this time I had this incredible dizziness, nauseousness, exhaustion, and shakiness. I went to this doctor who originally told me to go off the medication. He did not believe me when i told him what I was experiencing and he gave me valium and told me to leave. Obviously, that was of no help. I had to call my parents from out of town to come and take care of me because there was no way I was able to function.

My break came because of my hospital visit. I got a referral to the psychiatric assessment team. I got in a couple days later and they started to try and help me. They agreed that what was going on was a withdrawal from paxil. I was prescribed Wellabutrin. As it is a drug in the same genre as paxil he thought it was stop the withdrawal symptoms. He was wrong. Five days later (I was at home all this time, missing work, hardly able to function), he put me back on 10 mg of paxil (he hoped that it would decrease the side effects while the other drug started working). On the 10 mg of paxil I was OK. I actually felt beter for the first time in weeks. I was still not feeling good but I could do simple things like dishes and walks. But as I tried, again, to wein myself off it, I got worse. Anything under 10 mgs and I had all the effects again.

Eventually, my doctor put me back on paxil (30 mg) and gave me another drug to stop the panic attacks and help me sleep.

SO I am left here. I am doing OK but I am addicted to Paxil. I know the only way I will ever get off it is in a supervised hospital setting (if that will even work?). I hate this feeling of being stuck on it, like I have lost control over a part of my life. (and yes, I still have the other side effects like weight gain, but I have given up worrying about that).

I was interviewed over the phone for the 20/20 story though I never did see if it was aired. (Does anyone have a copy, or was it even shown?)

I would like to participate in some sort of legal action. Not because I want anything, but because I want people to know about this! I want them to know that it is a good drug while you are on it, but not if you ever need to get off it.

-- submitted by LLB35, 24

"I am so dizzy and nauseous all I can do is lie down."

2009-10-08T18:41:00.000-07:00

After reading this I am so shocked! I have been dying for over a week, getting worse, trying to figure out what I have and bingo everyone here is experiencing the same thing! I am so dizzy and nauseous all I can do is lie down. I have a 2 year old and a 6 year old and they just don't understand why mommy is sick. I have gone to bed the last few nights at 7:30 and slept till 6:30 the next morning, napping every chance I get just to get some relief. Now I need to decide if I should take another pill and wean myself slowly, instead of the cold turkey I've been trying. I was misdiagnosed with bi polar disorder about two years ago, now they say I am insulin intolerant and have hormonal problems! Paxil and Wellbutrin are the last two drugs I've been on. I've been feeling better, so I quit. If anyone out there has been successful please email me. I'm desperate.

-- submitted by Klhardin, 30

"I was put on Paxil for a panic disorder"

2009-10-08T18:31:00.000-07:00

I was put on Paxil for a panic disorder and I have to say it did work well for that. While on Paxil I put on 50 pounds and was tired all of the time. After being on it for 15 months I started to have flu like symptoms, severe joint pain, night sweats and zaps. My doctor ran numerous tests to find out the source and never came up with anything. I started looking on the internet and that was were I found out that it was probably this medication giving me all these problems. My doctor started weaning me off of Paxil last Sept. and was finally off completely in the middle of November. Even though I was down to only 5 mg. at that time the withdrawals were horrible. The first two weeks were the worse with all of the above symptoms I mentioned only magnified much worse and also severe depression which I had never experienced. It has now been about 12 weeks being off of Paxil and it is much better but I am still suffering from some joint pain but nothing like what it was. I have only taken off 10 pounds so far and I am still tired a lot.

-- submitted by Linda, 51

"Diagnosed for bipolar 7 years ago - was put on prozac, zoloft, lithium, depakote, ritalin and other drugs over a four year period"

2009-10-08T18:26:00.000-07:00

Diagnosed for bipolar 7 years ago - was put on prozac, zoloft, lithium, depakote, ritalin and other drugs over a four year period - all with side effects. Did the normal 6-8 week withdrawal and became suicidal. Last medication the pdoc gave was paxil. One evening I forgot to take dosage, woke up in the morning with hand paralysis (I am a professional violinist, BIG TERROR). Took paxil and within 20 minutes could bend fingers. Rapid and mixed cycling became worse to the point that I finally told the pdoc I wanted off - he agreed that I was having an extreme reaction to this drug. After a month the depression got worse and then had a major rapid cycling event in an hour - knew that this drug was bad news. That night began night terrors, slept 1.5-3 hours per night for a month. GI tract stopped functioning, had to eat rice, broth, steamed veggies. If I ate anything solid, it came through the intestines solid (sorry for the graphic detail but true). Would wake up in the middle of the night in hysteria. Then my legs would feel as if they were hooked up to an electrical battery - could feel energy going down legs like what you would see in the old Frankenstein movies. I knew this was dangerous because my mother, who was also bipolar, died in withdrawal from other medications in the early 80's and had the same reactions the month before she died (heart stopped from exhaustion). Worst part was, because of exhaustion, lost temper with colleague because of my terror and his insensitivity to how sick I was (he had been support person). He filed grievance, suspended from work, had breakdown while pdoc out of country. This was all 2 years ago in February. I am just now starting to be "normal" though the pdoc now has diagnosed me as having Postraumatic Stress Disorder from what I experienced. I am using bodywork/massage therapy, polarity therapy, ayurvedic medicine all under the supervision of the same pdoc. He has told me that I am doing incredibly well. I actually think that I am LESS depressed than ever!

-- submitted by Orty, 47

"It was like electricity running through my body, and major anxiety attack and hyperventilation"

2009-10-08T18:18:00.000-07:00

I have taken Paxil for 5 years and before that Imipramine for 8 years for a severe anxiety disorder. I was completely house bound, I didn't go out of my home for 6 months. I went to see a psychiatrist as this disorder ran in my family, and was put on Imipramine It was amazing how fast and well this medication worked. I was back to my normal self within a week. Over the next 5 years I would still have episodes of anxiety so I went to a clinic in California (I am from Washington State) that I saw an advertisement for. They were successfully treating anxiety patients by figuring out what chemical it was your brain was not producing enough of, in turn causing anxiety. I tested several different drugs and Paxil worked the best for me. It wasn't until about 3 years after that that I began hearing all the side effects of this drug. I never realized I had side effects until I heard what they were. I am always tired, I mean I could sleep 12 hours and still feel exhausted. I also gained alot of weight and basically had no energy at all. I decided I wanted off the Paxil and I new you couldn't just stop all at once. I started out cutting my dosing from 20 mg to 10 mg for about 2 weeks then I went to 5 mg for a week. This is when the withdraw hit me! It was like electricity running through my body, and major anxiety attack and hyperventilation. Of course this freaked me out and I went right back to 20 mg. I tried 2 more times unsuccessfully. Currently I have cut my dose down to 10 mg w/o any side effects, it has been about 2 weeks since I did it. I did have a period in which I felt extremely agitated, like I was going through major withdraw. This lasted about a week and now I feel fine. My plan is to stay at 10 mg's for 3 months and then go to 5 mg's for about 3 months and then completely go off. I think the main thing I realized is that no matter what you are going to have withdraw symptoms of some sort when you quit taking his medication, especially for the length of time I have. You have to mentally prepare yourself for it and not panic when you start feeling weird things happen. I find that when I start feeling anxious or panicky if I just stop whatever I am doing and completely relax my body and take deep breaths that I can usually deal with it. Another thing to tell yourself is that this isn't gonna kill you or injure you it is temporary and you can overcome it, lot's of self talk is very important.

-- submitted by Sara, 30

"I lost weight on Paxil and my sex drive went through the roof."

2009-09-10T12:23:00.000-07:00

I was one of the first to post here so I thought I would comment on some other posts.

I went through major twitching episodes which lasted OVER A YEAR (I was on SSRI's over a 4 year period). Eastern medicine (such as Chinese and Indian [ayurvedic]) explain that the drug may be out of your blood but not out of the organs. Yes 4-6 weeks to be able to switch drugs but the remainder stays in your liver, spleen, kidneys, and BRAIN for up to a year. Therefore, the longer you are on these drugs, the more ingrained they become with the organs in your body and the longer it takes to get out.

My experience with Paxil was atypical. I have been turned into a rapid cycling Bipolar because of the SSRI's. I lost weight on them and my sex drive went through the roof. I feel like I am getting back to normal (after TWO AND A HALF YEARS since my last dose). Yes, I am a bipolar controlling it without medications. What am I using? Polarity Therapy, Ayurvedic medicine, Therapeutic Body Massage (this is INCREDIBLE for those energy twitches and headaches), and orthomolecular medicine (see this month's "Natural Health" magazine for the article on Margot Kidder for further information.

As in other posts, remember that your doctors can't POSSIBLY know everything about everything. They are seeing patients all day and don't have the time to do updated research on EVERY medication that is out on the market. It is up to US to be vigilant and tell our doctors about things like this web page to get the word out. Don't let a doctor talk you out of what your intuition is telling you. THEY are NOT the ones experiencing what you are. You know what your body did before you were on this medication and it is up to you to insist that there is a problem.

-- submitted by Orty, 47

Antidotes to Stress - Your Relaxation Response

2008-11-17T08:07:00.000-08:00

The key to successful stress management is to keep a mild, healthy degree of stress in your life, in intermittent amounts. Each person has a unique response to stress, so experiment with techniques that help bring you back into balance, and learn what works best for you.

Stress, You Take My Breath Away — Breath, You Take My Stress Away
Nature has conveniently provided the perfect way to initiate your parasympathetic nervous system, your relaxation response, and it involves the one involuntary bodily function that you can also consciously control — your breathing. Nothing is more convenient than using your breath to bring yourself back into balance. Whether quieting a rapid fearful breath or boosting a shallow anxious one, just a few mindful breaths can shift your experience.

The first step is to simply bring your breathing under control:

Exhale completely.
Then slowly take a deep breath in through your nose.
Expand your diaphragm/belly to bring air into the lower portion of your lungs.
As you gradually fill your lungs from bottom to top, expand your chest.
Even lift your shoulders for a last bit of fresh air.
Briefly pause your breathing and your thoughts.
Then relax and let the air flow smoothly out of your body.
Pull in your stomach at the end to expel the last bit of stress.
Enjoy the emptiness for a few seconds.
Then begin another breath.

As you do this few times, pay attention to the sound and sensation of your breath. If you get light-headed at first, then breath normally. Your brain is probably not used to all that oxygen.

Rapid Relaxation Breath
New York's Stress Management and Counseling Center recommends a breathing technique for rapid relaxation. According to program director and practicing psychologist Allen Elkin, Ph.D.:

"You take a deep breath, deeper than normal, and hold it in until you notice a little discomfort. At the same time, squeeze your thumb and first finger together (as if you were making the okay sign) for six or seven seconds. Then exhale slowly through your mouth, release the pressure in your fingers, and allow all your tension to drain out. Repeat these deep breaths three times to extend the relaxation. With each breath, allow your shoulders to droop, your jaw to drop and your body to relax."

Control Power
Loss of control is itself a principal cause of stress. For example, when hospital patients are allowed to administer their own painkillers as often as they like, they use less painkillers than patients who have no control over their medication. A study of coronary angioplasty patients found that ones who "perceive control over their futures by having positive expectations . . . seem to be at less risk for a new cardiac event." (Psychosomatic Medicine 1999;61)

By using your breath to take control of the situation, you always have an immediate and natural way to calm down. Then you can proceed with other ways to initiate your relaxation response and get the situation under control.

Derailing Your Train of Thoughts
Concentrating on your breath is just one way to slow and stop the train of normal everyday thoughts that trigger stress — especially the kind of circular thinking that gets you nowhere. Perhaps you have a simple thought or quote, even a word or sound, that you can use to initiate your relaxation response.

"Grant me the serenity to accept things I cannot change, courage to change the things I can, and wisdom to know the difference."

A Sound Way to Counter Stress
Maybe Mozart is the muse whose complex compositions conduct your endocrine ensemble of stress-relieving hormones. Whatever kind of music soothes your savage beast — classical, Celtic, Celine — let it shift your brain into its parasympathetic symphony. Toning, chanting, and other self-generated sounds have transforming effects on the mind end emotions. Augment sounds with mental images of stress being washed or blown away. Let your mind use all its resources to protect itself from stress hormones.

Open Your Mind's Eye —Visualization and Guided Imagery
For a quick shift into a calmer state of mind, simply imagine yourself in a favorite, tranquil place: a serene scene from your past or a hopeful one in your future. Close your eyes, breathe deeply, and try to see and feel your surroundings. The key to successful visualization is first to practice with real objects until you can vividly see them in your mind's eye. Then you will be able to better visualize imaginary ones.

You can start with images from books or listen to audio tapes, but the best images are the ones that your subconscious provides. A skilled guided imagery therapist can facilitate the process of bringing these images into consciousness.

Regular practice of visualization is important. Be sure to take advantage of the transition states between sleeping and waking, when the door to your subconscious mind is open.

Sixty-five patients who listened to guided imagery tapes for three days before and six days after surgery reported less stress and physical pain than a control group. Moreover, they requested only about half as many painkillers as those who had not listened to the tapes. The tapes helped patients imagine themselves in a beautiful and peaceful place along with a person they cared for. They visualized that their upcoming operation caused little pain or stress. (Psychology Today, Mar/Apr 1998)

It's Time We had a Brain-to-Brain Talk
When you're stressed out, first of all, realize what is actually going on inside your body and what the consequences are for your brain cells. Here's a brain transcript from "Attack of the Adrenals!"

"Attention all parasympathetic forces. Urgent. Missile silos mounted atop kidneys have just released chemical weapons of mass destruction. Must mobilize internal defenses. Launch immediate counter-calm before hippocampus hammered by cortisol."

Visualize fire hoses spraying cooling hormones that soak your adrenal glands until they're no longer steaming with cortisol. Then visualize security hormones rounding up the cortisol delinquents still loitering in your hippocampus — and taking them to Kidneyland for a one-way ride on the Bladderhorn.

Guided Metabolism
Create your own metabolic story, one that works vividly for you. Use imagination to reinforce your inner troops as they try to keep you alive and healthy. Have fun with it. Swim with the "endolphins" of your mind. Hey, it's not brain surgery. (And let's keep it that way.) This "guided metabolism" is similar to the way cancer patients use visualization to increase their immune system's T-cell count.

Sleep On It — The Brain Power Nap
Why do cats nap? Because they can. But so can you. Taking a "Brain Power Nap" may be one of the best things you can do to correct poor mental performance, especially after a stressful night of disrupted sleep. It makes sense: naps can help restore what insomnia steals.

It's been found that for every hour of lost sleep you lose an IQ point — reversible with sleep therapy or meditation. One study found that higher cognitive functions in children — verbal creativity and abstract thinking — were impaired after a single night of restricted sleep, even though the children could maintain routine activities. (Sleep 1998;21/8:861-8) A study of Japanese men found that a mid-afternoon nap had positive effects upon the maintenance of their daytime vigilance level. The 20-minute nap improved performance level and their self-confidence. (Clin Neurophysiol 1999;110/2:272-9)

Acute stress is known to modify sleep-wakefulness cycle, which leads to poor mental performance. Reverse the sequence: improve your performance with naps that reduces stress. Learn how easily it is to enjoy a Brain Power Nap, a variation on Tom Edison's famous catnaps. If he found time to take them, so can you.

Meditation — It's Not What You Think
Unlike prayer, where you do the talking, meditation is more akin to listening. And, your breath is the most natural thing to tune in to. Just observe your breathing. Listen to the sounds it makes and feel the sensations it creates. This leads you into a meditative state. If thoughts enter your mind, just let them go. Passively disregard them. Instead, stay with your breath. Let it settle into its own circular rhythm.

Dharma Singh Khalsa, M.D., author of Brain Longevity, found that meditation not only lowers oxygen consumption, heart rate, blood pressure, and blood lactate, it also causes a decline in cortisol production. "Among people who meditate regularly, cortisol levels tend to remain low, day after day. . . . Meditation has been shown to slow the aging process significantly, and to increase not just lifespan but 'health span.'" He also found that meditation promotes theta brain wave activity, which heightens learning ability and creative problem solving.

A daily session of meditation — preferably at the same time every day — will change the way your body responds to stress, because the effects of one session can last throughout the day. There are many nuances to meditation, and a qualified teacher may be advisable.

In a study at the Medical College of Georgia, scientists discovered that the daily practice of transcendental meditation kept blood vessels open, thus significantly lowering the blood pressure of meditators compared to those who just relaxed as completely as possible. (Psychosomatic Medicine, Aug 2, 1999)

Breath is even more than a mind-body interface. It is the gateway to spirit. The ancients knew this, and their language underscores the connection. In Sanskrit, atman means world-soul and atma is breath. In Hebrew, neshuma refers to both spirit and breath. The English word inspiration also hints at the connection. After years of studying meditation, Dr. Khalsa found that "the space between our thoughts — what the Asian healers call 'the sacred space' — is where most spirit-directed healing originates."

Biofeedback and Hypnotherapy
Some people benefit from more modern techniques of initiating the relaxation response. Biofeedback training uses sensitive electronic instruments that enable you to measure and eventually regulate bodily functions such as heart rate and blood pressure. Chronic heart failure patients who used biofeedback in a UCLA study were able to improve their blood flow compared to patients who only rested. In the 20-minute sessions, patients increased their skin temperature by imagining their hands becoming warmer. (Spectrum, Mar/Apr 1998)

A qualified practitioner is essential, as it is with hypnotherapy, which accesses your unconscious mind. From this advanced state of relaxation, a posthypnotic suggestion is given that may help you deal more effectively with stress in your daily life. Patients preparing for coronary bypass surgery who used self-hypnosis relaxation techniques were calmer and required less pain medication after their operations, compared to a control group. (Alternative Therapies, Jan 1998)

LET'S GET PHYSICAL — Flight or Fight (not just Fright)
To avoid stewing in your own juices of adrenaline and cortisol, it can be a good idea to do what nature has best prepared you to do — move it to use it to lose it. Burn up those hormones with physical activity.

Do exercises that work your leg muscles, as in "Run away!"
Bounce on a rebounder or jog in place.
Climb stairs or use a stair-stepper.
Walk it off or run around the block.
Use a treadmill. (It works for rats.)

When two groups of rats were given mild shocks, the ones that had an outlet for stress, such as treadmill, had lower levels of cortisol and stress-related illnesses than the group without a way to alleviate their stress.

Use short bursts of muscular energy, as in "Put 'em up!"
Kick-box or have a punching bag handy.
Do push-ups, sit-ups, and other upper body work.

Exercise not only defuses a stressful situation, it better prepares you to cope with future stress and even stimulates your brain to grow.

Progressive Relaxation
Another option — especially if you're stuck in your car or at your desk — is c. Tense, then release different muscles in a set sequence. It's easy to learn, simple to do, and it works. Scientists at Ohio University in Athens found it to be the best therapy for reducing tension headaches. In several studies, chronic headache sufferers experienced a 50 percent reduction in pain and frequency using progressive relaxation. (Prevention, June 1998)

Yoga and Tai Chi
These moving meditations that came to us from Asia are excellent long-term practices that can help you develop a healthy response to stress. A good teacher will get you moving in the right direction.

Special mind-body exercises are the centerpiece of Dr. Khalsa's brain longevity program. These unique combinations of movement, breath, and sound are energizing and regenerating yoga techniques that have helped his patients better cope with stress as well as improve their overall brain health and fitness.

The Medium is the Massage
Because mind and muscle are connected through the peripheral nervous system, massage does more than just relax your muscles. By relieving muscular stress, massage may improve brain function. A study of preschoolers found that those who received a 15-minute massage scored better on tests of cognitive performance than children who just read stories with an adult for the 15 minutes prior to testing. (Touchpoints, Vol. 5 #1)

Massage reduced levels of the stress hormones cortisol and adrenaline in depressed mothers with infants. A study at the Touch Research Institute at the University of Miami Medical School found that massage therapy also improved sleep and reduced the mothers' depression. Massage releases endorphins that calm the peripheral nervous system. It increases circulation and speeds up the removal of toxins from the body. (Alternative & Complementary Therapies, Jan/Feb 1996)

Feet First
Foot reflexology is a form of massage that works with the thousands of nerve endings in the soles of your feet. A session with an experienced reflexologist can be a liberating experience. Simply rolling your foot over a golf ball can be a good way to reduce tension.

In a Chinese study of 86 individuals, blood tests were taken before and after 30- to 45-minute reflexology sessions, ten days in a row. The results showed that levels of free radicals decreased while antioxidant enzymes increased. (China Reflexology China Symposium Report, Oct 1996) In a three-year study, Danish postal workers given access to reflexology therapy missed fewer days of work, saving thousands of dollars per month. (Self Healing, May 1997)

LET'S GET PHILOSOPHICAL — Mind Over What's the Matter

See problems as opportunities.
See problems as personal trainers.
There is no right answer.
It's not a perfect world.
Let go, and let God.
This too shall pass.
Refute negative thoughts.
Stop overgeneralizing.
Control yourself, not others.
Be you now.
You are a human being, not a human doing.
"Don't sweat the small stuff."
"Work like you will live forever; pray like you may die tomorrow." (Ben Franklin)

Another powerful way to elicit the relaxation response is prayer — your own or the prayer, and care, of another.

News Fast
No, not another media feed. Just the opposite. Stop absorbing all the information — mostly negative — that assaults you throughout the day. Information overload is an insidious form of chronic stress. Turn off your TV. Andrew Weil, M.D., often suggests his patients try a one-week news fast.

Laugh First — Ask Questions Later
Before you react to some stressor, first try becoming an observer whose job it is to find the humor in the situation. Seek belly laughs that release those pain-killing endorphins which make you feel good as well as more stress-proof. The pioneering work of Norman Cousins demonstrated the value of laughter in stress-reduction.

Friends who make you laugh are one of life's greatest blessings. Here's where the right social network pays off. One of the most important anti-stress coping skills is to develop a social support system. For example, in a five-year study of 1350 coronary disease patients, those who had no spouse or intimate friends were three times more likely to die than those who had support. Even pets are effective.

Crying Out Loud
Crying is another one of nature's stress-relieving strategies. A psychiatric chemist named William Frey, Ph.D., showed that not all tears are alike. Emotional tears have a different composition than tears caused by eye irritants, and they are especially abundant in adrenaline and other stress-related chemicals.

Allies from Planted Earth
Plants have been at the heart of medicinal systems throughout the history, and today we are verifying that compounds extracted from herbs do indeed have properties that account for the benefits ascribed to the herb. Traditional cultures have always used relaxants such as chamomile, valerian, and kava. A 1998 survey by Consumer Health Sciences showed that 19 percent of individuals with depression used St. John's wort, 18 percent ginseng, and 17 percent ginkgo. The closest pharmaceutical was Prozac (17 percent).

Ginkgo and Depression
A Swiss study found that ginkgo biloba may help improve both sleep and cognitive behavior in depressed patients. "Results from the depressed patients' brain scans provide the first direct evidence that ginkgo biloba may improve their sleep," said Dr. Martin Hatzinger, one of the researchers from Basel Psychiatric University. Ginkgo appeared to significantly reduce the number of awakenings and increase both short wave and slow wave sleep. Both types of sleep returned to original levels however after ginkgo treatment stopped. (American Psychiatric Association's 152nd annual meeting in Washington)

Ginseng and Cortisol Regulation
Ginseng is a traditional herb that has long been valued as an adaptogen that helps the body better handle physical and psychological stressors. Apparently it does this by strengthening of the adrenaline glands, thereby reducing the overproduction of cortisol that is secreted in response to stress.

Ginseng helps to create a calm, focused state of mind, a greater ability to adapt to life's changes so you can bend not break. Numerous studies demonstrate its ability to improve the mental performance of people, especially when they're under stress. Russian telegraph operators who took ginseng for thirty days showed improved concentration and coordination, reflexes and endurance. Another study measured increased blood flow in the main arteries to the brain, while others demonstrated ginseng's positive effects on memory and learning — even for the elderly.

Vitamin C Reduces Stress Hormones
New research shows that high daily doses of vitamin C reduced the levels of stress hormones in rats' blood. P. Samuel Campbell, chairman of the University of Alabama's biological sciences department, reported that megadoses of vitamin C also increased the levels of an immune system antibody in stressed and unstressed rats, as well as reduced other indicators of stress. Rats were given 200 mg of vitamin C daily. The equivalent human dosage would be several grams per day. (Speech to the American Chemical Society, August 23, 1999)

Magnesium helps control the firing rate of neurons, and along with vitamin B1 is an essential nutrient that supports the reparative process that neurons need to offset the stress from the continual firing of the electrical impulse. Low synaptic levels of magnesium can cause hypersensitivity and increase your body's response to stress. Noises will sound too loud and lights will seem too bright. Stress affects your kidneys' ability to recycle magnesium, which in turn increases your sensitivity.

Aromatherapy — Common Scents that Your Brain Knows
The all-encompassing word "chemistry" derives from the Greek khemeia — "the extracting and mixing of medicinal plant juices." The famous 16th century Swiss physician and chemist Paracelsus referred to the oils he distilled from medicinal plants as "quinta essentia," hence our modern term, "essential oil." We obtain these unique compounds from the seeds and flowers, the roots and barks, and the fruits and resins of plants.

Smell was the first sense that animal life developed and is the most nostalgic of all your senses. A certain fragrance can immediately remind you of an experience in your distant past. This is because smell takes a direct route to your limbic brain where emotional memories are processed — and where stress hormones do their worst damage. Perhaps this why the sense of smell if often the first to go in older individuals.

Aromas have an intimate and irresistible effect. Unlike other senses, molecules of the object you are detecting actually come in contact with your brain. Your olfactory receptors are the only part of your brain that is exposed to the outside. Essential oils from plants are very powerful chemicals that influence brain chemistry, hormone production, and stress levels. Obnoxious smells certainly demonstrate this, but positive scents also have a subtle but powerful affect on emotional well being. It's not known for sure how essential oils work on the brain, but it's thought that they interact with certain membrane lipids as well as affect enzymatic processes.

A study of depressed men showed that citrus fragrance in their room reduced their intake of anti-depressants. Lavender has a calming effect on many people. A few drops of lavender oil on a handkerchief can help suppress the distress of frustrating situations, like being stuck in traffic or on the runway. Vaporized lavender oil was used in a British nursing home to help residents relax into sleep. It worked as well as sedative drugs. (Alternative Therapies, May 1997)

Andrew Weil, M.D., mentions research showing that the essential oil of a tropical flower called ylang-ylang causes the pituitary gland to secrete more euphoric endorphins, while oil of grapefruit stimulates the brain to produce natural painkillers called enkephalins. The scent of oil of marjoram boosts production of the calming neurotransmitter serotonin. (Self Healing, Oct 1996)

Essential oils added to bath water or massage oil are good ways to use aromatherapy, because heat helps the oils penetrate into the skin and bloodstream, as well as releases the oil's aromatic molecules for entry through the nose.

Trees are People, Too
Plants have their own stressors and have evolved chemicals to defend themselves. Trees have been shown to react to stress strikingly similar to the way we do. In her excellent book, The Fragrant Mind, Valerie Ann Worwood describes how trees respond to predators. When threatened by deer, a tree produces chemicals called tanins that deter the animals from chewing its leaves. Within 15 minutes, tanin levels in leaves have been observed to increase up to 282 percent, depending on the tree. And, like us, it takes much longer for the tree to return to its normal chemical state — from 24 to 100 hours after the attack.

Quick and Convenient Relaxation Techniques:

Gain control of your breathing.
Repeat a helpful quote or word.
Visualize yourself in a tranquil place.
Have a brain-to-brain talk.
Use progressive relaxation.
Get away from the noise.
Use good scents.
Lose the coffee.
Laugh.

With More Time and on a Regular Basis:

Exercise.
Meditate.
Get a massage.
Practice yoga or tai chi.
Take a Brain Power Nap.
Use guided imagery tapes.
Take an aromatherapy bath.
Listen to Mozart or other music.
Use biofeedback or hypnotherapy.
Take time-out: a short walk or a long vacation.
Take a news fast: stop being a receptacle for the world's problems.

"We are disturbed not by things, but by the views we take of things." — Epictetus

"There is nothing either good or bad, but thinking makes it so." — Shakespeare

"I've had many terrible experiences in my life, and some of them actually happened." — anon.

Stress and Your Brain

2008-11-13T11:34:00.000-08:00

As we gain greater insight into the effects of stress on the brain, the picture that emerges is not a pretty one. Once thought to be temporary, the stress-response is now proving to have permanent repercussions.

Those irritating things that go wrong in the day and those aggravating things that go bump in the night — disrupting routines and interrupting sleep — all have a cumulative effect on your brain, especially its ability to remember and learn. Why? Because when your brain perceives a threat, it produces a chemical that actually eats away at that part of itself which is largely responsible for memory.

As research reveals the role stress plays in deteriorating mental function, renewed importance is being placed on the many techniques used to activate the relaxation response and counteract the very real consequences of stress.

A Tiger on Your Tail
That "saber-toothed tiger" stalking you today is more likely to be a tailgating SUV or an approaching final exam. No matter. Whether the threat is real, remembered, or imagined, your brain quickly responds with powerful chemicals that initiate dramatic metabolic changes throughout your body.

Your heart pounds, chest heaves, muscles tighten. Senses sharpen and time slips into slow motion. You become impervious to pain, and butterflies emerge from their cocoons in your stomach. Under certain conditions, this would be an appropriate healthy reaction, because now you are exquisitely prepared to do battle. The trouble, however, is that you're probably still sitting in your car or at your desk — stewing in your juices.

When the danger finally passes or the perceived threat is over, your brain initiates a reverse course. This releases a different bevy of biochemicals throughout your body to slowly bring you back into balance, as your brain seeks the holy grail of "homeostasis," that elusive state of metabolic equilibrium between the stimulating and the tranquilizing chemical forces in your body.

If one of these forces dominates the other without relief, then you will experience an on-going state of internal imbalance. This condition is known as stress. And it can have serious consequences for your brain cells.

The Internal Tug of War
The term "stress" is short for distress, a word evolved from Latin that means "to draw or pull apart." The Romans even used the term districtia for "a being torn asunder." When stressed-out, most of us can probably relate to this description, but it also suggests the biochemistry of stress.

The primary area of your brain that deals with stress is its limbic system. Because of its enormous influence on emotions and memory, it is often called the emotional brain, or the mammalian brain, because it evolved with our warm-blooded relatives and marked the beginning of social cooperation in the animal kingdom. Whenever you perceive a threat, imminent or imagined, the limbic system immediately responds via your autonomic nervous system — the complex network of endocrine glands that automatically regulates your metabolism. It has two branches, each pulling in opposite directions.

Your sympathetic nervous system (SNS) turns on the "fight or flight" response, while your parasympathetic nervous system (PNS) promotes the "relaxation response." Like two tug of war teams skillfully supporting their rope with a minimum of tension, the SNS and PNS carefully maintain your metabolic equilibrium by making necessary adjustments whenever something disturbs this balance.

The strongmen on these teams are hormones, the chemical messengers produced by your endocrine glands. Named after a Greek word meaning "to set in motion," hormones travel through your bloodstream to accelerate or suppress metabolic functions. The trouble is that certain stress hormones don't know when to quit pulling. They remain active in your brain for too long, injuring and even killing the brain cells you need for memory and learning.

But all is not lost. There are ways that you can learn to overcome evolution and survive this eternal internal tug of war. These techniques are introduced in Brain.com's relaxation section.

Distress Signals from Your Brain
Your sympathetic nervous system does an excellent job of rapidly preparing you to deal with what you perceive as a threat to your safety. Its hormones initiate several metabolic processes that best allow you to cope with sudden danger.

Your adrenal glands release adrenaline (also known as epinephrine) and other hormones that increase breathing, heart rate, and blood pressure. This moves more oxygen-rich blood faster to the brain and to the muscles needed for fighting or fleeing. And you have plenty of energy to do either, because adrenaline causes a rapid release of glucose and fatty acids into your bloodstream. Also, your senses become keener, your memory sharper, and you are less sensitive to pain.

Other hormones shut down functions unnecessary during the emergency. Growth, reproduction, and the immune system all go on hold. Blood flow to the skin is reduced. That's why chronic stress leads to sexual dysfunction, increases your chance of getting sick, and often manifests in skin ailments.

With your body and mind in this temporary state of metabolic overdrive, you are now prepared to respond to a life-threatening situation. After you have done so and the danger has passed, your body then tries to return to normal. But this may not happen so easily and becomes even more difficult as you get older.

Although the hyperactivating sympathetic nervous system jumps into action immediately, it's very slow to turn off and allow the tranquilizing parasympathetic nervous system to take over and calm you down. Once the stress response has been activated, the system wisely keeps you in a state of readiness. (That saber-toothed tiger or SUV might be preparing for another pass at you.) Because of this hierarchical dominance of the SNS over the PNS, it often requires an intentional technique to activate the relaxation response and to reestablish homeostasis.

It's All in Your Head
The irony of the stress response is that it evolved in physical environments very different from the social and psychological ones today. We experience many problems, or stressors, that our brain perceives as life-threatening, although they are not.

The thought of a late menstrual period or mortgage payment does not need an intense physical response, but we get one anyway. A chronic overreaction to stressors overloads us with powerful hormones that were only intended for short-term duty in emergency situations. Their cumulative effect damages and kills brain cells.

For example, too many stress hormones can prevent the brain from laying down a new memory or accessing already existing memories. And, in a nasty irony, stress hormones can damage the very part of the brain that's supposed to signal when to shut-off their production — creating a vicious cycle that degenerates the brain and diminishes the quality of life.

The Cortisol Conspiracy
The renowned brain researcher, Robert M. Sapolsky, has shown that sustained stress can damage the hippocampus, the part of our limbic brain which is central to learning and memory. The culprits are "glucocorticoids," a class of steroid hormones secreted from the adrenal glands during stress. They are more commonly know as corticosteroids or cortisol.

During a perceived threat, your adrenal glands immediately release adrenalin. After a couple of minutes, if the threat is severe or still persists, the adrenals then release cortisol. Once in the brain, cortisol remains much longer than adrenalin and continues to affect brain cells.

Chronic over secretion of cortisol adversely affects brain function, especially memory. Human studies show a correlation between high cortisol levels and decreased memory and cognitive functions like concentration and creativity.

How Cortisol Affects Brain Function
First, because stress hormones divert blood glucose to exercising muscles, the amount of glucose — hence energy — that reaches the hippocampus is diminished. This creates an energy crisis in the hippocampus which makes it unable to create new memories. That's why some people can't remember a very traumatic event, and why short-term memory is usually the first casualty of age-related memory loss resulting from a lifetime of stress.

Cortisol also interferes with the function of neurotransmitters, the chemicals that brain cells use to communicate with each other. This makes it difficult to think or access long-term memories. That's why people get befuddled and confused in a severe crisis. Their mind goes blank because "the lines are down."

Stress Hormones Short-Circuit Memory Retrieval
Thirty minutes after rats were stressed by an electrical shock, they were unable to remember their way around a maze. When the shock was given two minutes or four hours before going through the maze, the rats had no problem. This time-dependent effect on memory performance correlates with the levels of circulating glucocorticoids, which are highest at 30 minutes. The same thing happened when non-stressed rats were injected with glucocorticoids. When glucocorticoid production was chemically suppressed, there were no stress-induced effects on memory retrieval.

According to James McGaugh, director of the Center for the Neurobiology of Learning and Memory at the University of California at Irvine, "This effect only lasts for a couple of hours, so that the impairing effect in this case is a temporary impairment of retrieval. The memory is not lost. It is just inaccessible or less accessible for a period of time." (Nature, Aug 20, 1998)

Degeneration Why
Cortisol also causes excess amounts of calcium to enter brain cells, which eventually leads to the production of free radicals, the reactive molecules that injure and kill cells.

Unfortunately, there's a final insult. The hippocampus is extremely sensitive to cortisol. Sapolsky's studies showed that lots of exposure to cortisol or lots of stress itself accelerated the degeneration of the aging hippocampus. And because the hippocampus is part of the feedback mechanism that signals when to stop cortisol production, a damaged hippocampus causes cortisol levels to get out of control — further compromising memory and cognitive function. The cycle of degeneration then continues.

Sleeplessness Kills
Researchers at Harvard Medical School found that cheating on sleep for only a few nights increased brain levels of cortisol. Inadequate sleep also deprived the brain of the time it needs to reestablish its energy. A survey by the National Sleep Foundation revealed that almost two-thirds of Americans fail to get enough sleep. Not only does this lead to impairment and death of hippocampal cells, but also to injury and death from the 100,000 accidents caused by sleepy drivers each year. (Spectrum, Sep/Oct 1998)

Sleep Less in School
A study of 500 children, under five years of age, found that those who slept less than 10 hours a day, including naps, were 25% more likely to misbehave (throw temper tantrums, act aggressively, etc.,) than children who slept 12 or more hours a day. (J Dev and Behavioral Pediatrics 1999;20:28-33)

Depression Shrinks Hippocampus
The size of the hippocampus averaged 14% smaller in a group of septuagenarians who showed high and rising cortisol levels, compared to a group with moderate and decreasing levels. They also did worse at remembering a path through a human maze and pictures they'd seen 24 hours earlier and — two tasks that use the hippocampus. A third of the 60 volunteers, who were between ages 60 and 85, had chronically high cortisol levels, a problem that seems to be fairly common in older people. This study, titled "Cortisol levels during human aging predict hippocampal atrophy and memory deficits," was reported in Nature Neuroscience, May 1998.

Dr. Sapolsky discovered that general SNS arousal is a relative indication of anxiety and vigilance — the individual is trying to deal with the challenge. On the other hand, a heavy secretion of glucocorticoids is more a marker of depression — the individual has given up on trying to cope. This burned-out feeling of depression represents the exhaustion stage of chronic stress, where a person feels worthless and has no energy to do anything about it.

New research suggests that the hippocampus is needed temporarily to bind together the various sites that represent a whole memory — sites that are distributed elsewhere in the brain. (Psychol Rev, July 1999)

Spawn and Die
Salmon amaze us with their spectacular leaps up waterfalls and over dams, in their single-minded quest to return and lay eggs in the freshwater stream of their birth. After that, they die. But why? Dr. Sapolsky explains in his book, Why Zebras Don't Get Ulcers:

"If you catch salmon right after they spawn, just when they are looking a little green abound the gills, you find they have huge adrenal glands, peptic ulcers, and kidney lesions; their immune systems have collapsed, and they are teeming with parasites and infections. . . . Moreover, the salmon have stupendously high glucocorticoid concentrations in their bloodstreams. When salmon spawn, regulation of their glucocorticoid secretion breaks down. Basically, the brain loses its ability to measure accurately the quantities of circulating hormones and keeps sending a signal to the adrenals to secrete more of them. Lots of glucocorticoids can certainly bring about all those diseases with which the salmon are festering. Is this glucocorticoid excess really responsible for their death? Yep. Take a salmon right after spawning, remove its adrenals, and it will live for a year afterward."

The Biochemistry of the Cortisol Feedback Mechanism
In his book, Brain Longevity, Dharma Singh Khalsa, M.D., describes the system:

"Normally, in response to stress, the hypothalamus secretes a substance called 'corticotropin-releasing factor,' which then causes the pituitary gland to secrete a hormone called 'corticotropin' (or ACTH). ACTH then causes the adrenals to secrete cortisol. When levels of cortisol rise to a certain degree — a 'setpoint' — several areas of the brain tell the hypothalamus to turn off the cortisol-producing mechanism. This is the proper 'feedback' response.

"However, one of the areas of the brain that is most responsible for telling the hypothalamus to turn off cortisol production is the hippocampus . . . the area most damaged by cortisol. The hippocampus is often so damaged in older people — who may have lost about 20 to 25 percent of their hippocampus cells — that it is unable to give the proper feedback to the hypothalamus.

"When that happens, the hypothalamus keeps pumping out the chemicals that cause cortisol oversecretion. This, in turn, causes even more to the hippocampus. And this, of course, causes even more cortisol production. Thus, a catch-22, 'degenerative cascade' begins. And this cascade can be very difficult to stop."

What Blood-Brain Barrier?
To protect themselves from chemical and biological weapons during the Gulf War, Israeli soldiers were given a drug called pyridostigmine. Nearly one-quarter of them complained of headaches, nausea, and dizziness — symptoms which occur only if the drug reaches the brain. Pyridostigmine molecules generally can't get into the brain, so why had the side-effects increased during combat?

An Israeli biochemist and physician wondered whether the stress of war might somehow have increased the permeability of the blood-brain barrier. The two researchers took a group of mice and stressed some by dunking them in water. They then injected the rodents with a dye and measured its intensity in the autopsied brains. They found that the dye had passed much more readily into the brains of the stressed animals.

The fact that stress can dramatically increase the ability of chemicals to pass through the blood-brain barrier has enormous implications, since many drugs are developed under the assumption that they will stay in the periphery. (Discover, May 1997)

It's Not All in Your Head
Dr. Sapolsky's research with animals also showed that glucocorticoid excess brings about many problems, including "fatigue, thinning muscles, adult-onset diabetes, hypertension, osteoporosis, reproductive decline, and immune suppression — all conditions more common among the elderly." Dr. Sapolsky concludes that "Aged organisms not only have trouble turning off the stress-response after the end of stress, they also secrete more stress-related hormones even in their normal, nonstressed state. . . . Old individuals of all sorts tend to have the stress-response turned on even when nothing stressful is happening."

Table of Discontents
As youngsters, we were all told to settle down at the dinner table. Fine dining is synonymous with an atmosphere conducive to relaxation. All for good reason. We shouldn't eat while in a state of anxiety. The stress response diverts blood away from the digestive tract, which inhibits the absorption of nutrients from food.

In a study at Temple University in Philadelphia, stress was shown to inhibit the production of alpha-amylase, an enzyme in saliva that digests carbohydrates. Test subjects either meditated or did math problems in their head five minutes before eating cereal. When their alpha-amylase production was measured, those who concentrated on the math had 22% less enzyme than the meditators. (American Health, Dec. 1997)

Ideally, we should be content before as well as after a meal.

Why Stress Slows Healing
The wound healing process depends on the activity of two key healing compounds, but stress from emotional upset appears to reduce their activity. Interleukin-1 and interleukin-8 help protect against infection and prepare injured tissue for repair. In a study of women who were healing from blisters, researchers at Ohio State University found interleukin compounds at significantly lower levels in the women with the highest levels of cortisol. As stress and cortisol levels rise, interleukin levels fall — triggering a slowdown in the healing process. (Archives of General Psychiatry 1999;56:450-456)

Stress Adds Injury to Insult
Athletes are two to five times more likely to get injured if they're experiencing recent life stress, compared to less stressed counterparts — according to at least 18 different studies. (Spectrum, Sep/Oct 1997)

A Prescription for Dementia?
At Neuroscience 2000, a worldwide gathering of neurologists sponsored by the Society for Neuroscience, Robert Sapolsky of Stanford University expressed concern about the use of certain steroid hormones to treat arthritis. He noted that hydrocortisone may damage the hippocampus and has been linked to cases of "steroid dementia."

Stress is Not All Bad
Bear in mind that an appropriate stress response is a healthy and necessary part of life. One of the things it does is to release norepinephrine, one of the principal excitatory neurotransmitters. Norepinephrine is needed to create new memories. It improves mood. Problems feel more like challenges, which encourages creative thinking that stimulates your brain to grow new connections within itself.

The challenge in this day and age is to not let your sympathetic nervous system stay chronically aroused, but this takes a conscious effort and requires knowledge of techniques that work to activate your relaxation response.

Obsessive-Compulsive Disorder (OCD): Facts And Myths

2008-11-12T07:28:00.000-08:00

The Facts

1. YOU ARE NOT MAD

Obsessive-compulsive disorder is a psychological condition, characterized by high anxiety. Symptoms can include washing, checking, 'ruminating', ordering, hoarding, fears of harm and 'body dysmorphic disorder'. These can consume a lot of time. They can also affect family relationships, work and social life.

While the cause of obsessive-compulsive disorder has not been scientifically established yet, it is probably a chemical imbalance in the brain. The symptoms are nothing to do with the individual's basic personality, and it does not seem likely that they are caused by childhood experience.

People with OCD are usually aware that their compulsions and obsessions are irrational. They simply cannot find a way of stopping without help. Perceptions of reality are usually not distorted in other ways.

2. YOU ARE NOT ALONE

Many people have symptoms of OCD. It possibly affects as many as one in thirty of the adult population. People who suffer from OCD are often very surprised to learn that there are other people who do exactly the same things.

3. YOU CAN GET SUPPORT

OCD has been recognised for many years. During that time, a number of effective responses have been identified. These include:

Medication - particularly the Prozac family (SSRIs) and an older anti-depressant called Clomipramine

Cognitive-behavioural therapy - usually done with a psychologist, this involves the individual learning strategies for mastering their symptoms

Social support - one good way of finding this is to join a self-help group

Information - there are many useful books and leaflets available

Self-help - for some people, particularly those whose symptoms are quite mild, this can be effective

4. YOU CAN GET BETTER

In most cases, cognitive-behavioural therapy is the best treatment. Medication is also effective for many people. It can reduce symptoms by thirty to sixty per cent. A combination of medication and behavioural therapy is often recommended. The majority of people with OCD can master their symptoms with appropriate support and live a normal life.

The Myths

1. I CAN'T TELL ANYONE

Many people recognise that their obsessional thoughts and compulsive behaviours are odd, and feel so embarrassed about their symptoms that they keep them to themselves. If they don't talk to anyone, they can never get support.
It is often helpful to realise that this sort of embarrassment is very common with OCD. Sometimes it is easier to talk to a close friend or family member, or to talk in confidence to an adviser on the telephone before talking to a doctor.

2. I CAN'T TELL THE DOCTOR

People with OCD are often nervous about describing their symptoms to a doctor. They think that they will be wasting the doctor's time, or that the doctor will think they are mad.

In the last few years, doctors have become much more aware of OCD. GPs are much better at recognising the symptoms, and can often treat mild cases of OCD themselves.
GPs are also the first point of contact if you want to see a psychiatrist or a psychologist on the National Health.

If you are nervous about talking to a doctor, speaking to fellow-sufferers in support groups or to a confidential adviser on the telephone first is often helpful.

3. I DON'T NEED HELP

People with OCD sometimes imagine that there is something wrong with them if they can't master their symptoms on their own. This isn't true. Almost everybody with OCD copes better if they can get support at the right time.

4. I CAN'T GET HELP

OCD is a recognised condition, and the effective forms of treatment are well known. While there may be waiting lists, everybody who needs treatment should be able to get it on the NHS.

If you have a problem finding support in your area, it may be worth telephoning a group like Obsessive Action to discuss the problem.

5. I WILL NEVER GET BETTER

People with OCD quite often get depressed, and become pessimistic about their chances of recovery. It is important to remember that people who get the right kind of support usually make significant improvements. Individuals with OCD can have normal, satisfying lives.

Black or White, All or Nothing

2008-11-08T19:20:00.000-08:00

One of the great downfalls of anxious people is their tendency to think in "all or nothing" terms. This is the essence of the pessimistic mindset.

The pessimist has a marked inability (through accumulated habits of thought) to see things as they are: a mixture of good and bad, simple and difficult, positive and negative. To such people, an endeavor with a downside is not worth undertaking. A relationship with a flaw it rotten through and through. A misbehaving child or a trying spouse is all bad, all the time. Such a perspective overwhelms and creates a sense of hopelessness. Hopelessness begets anxiety and depression.

Such pessimism is not realism. Far from it. It is skewed, unwarranted thinking. Pessimists, for example, talk about how "my whole day is ruined" because of one negative event. But if forced to sit down with paper and pen, such complainers could find plenty of good - in fact, probably much more good than bad.

The most devastating aspect of "all or nothing" pessimism relates to events that may or may not occur in the future. "If that were to happen," the inner voice says, "it would be terrible. I couldn't stand it." Of course, that's not true. You could stand it. You might be miserable for a time or face a daunting challenge, but that's not the same thing as being unable to face it. But we convince ourselves and become fretful.

We're not forever stuck in our mindset. Thankfully, optimism is a learned discipline. What we must do is gain a more realistic vantage point, to cease our steady focus on what's wrong. We remind ourselves again and again that things are usually not as bad as they seem. That few things we encounter are unmitigated evils. That we really have more inner strength - even more life options - than we normally acknowledge.

When a pessimistic thought arises, challenge it. Ask yourself if it is truly rational. Would a disinterested bystander conclude the same thing? In other words, make the pessimistic thought prove itself - don't just swallow it as dogma. Make the thought answer logical objections that someone might bring against it, just as in a court of law. "All or nothing" thinking withers up under such scrutiny, because it's based on faulty reasoning.

Through repetition, we form our habits. The ice skater falls repeatedly until learning to glide over the ice. So it is with habits of thought. Cultivate the tendency to reject "all or nothing" and you'll become more optimistic, better able to face what life dishes out.

This is not a pie-in-the-sky philosophy that everything will turn out OK no matter what. That is naïve and presumptuous. True optimism - an attitude shorn of "black or white" assessments - helps us live well and find greater happiness.

It puts a lens over anxious eyes that they may no longer see such a distorted world.

A Roadblock to Recovery

2008-11-08T19:19:00.000-08:00

"What am I doing in Dallas?" I asked myself the question almost daily for the duration of my stay there. Not that there was anything wrong with Dallas. There’s plenty right with it. It’s just that I was homesick for the Michigan – for family and friends, for familiar sights. After only a couple of months in Texas, I was ready to go home.

I had finished one semester of grad school in nearby Denton when I decided to quit and enter the job market. My wife was working inhuman hours at the hospital to get me through school and support our three kids. Enough was enough. I was going to give her a break.

Trouble was, I bristled at the idea of staying in Dallas. In the back of my mind, I think I really hoped no one would hire me. A job means roots, and I didn’t want to plant roots there.

There were some symbolic attempts to find work -- a phone call here and there, an occasional interview. But soon I was spending consecutive days doing light chores at home rather than job-hunting. And I was getting depressed, because I knew I was shirking responsibility.

It was only a couple of weeks later when a jolting panic attack turned my life inside out. I was stunned. For days, I woke up every morning terrified at the prospect of another day. Those days became weeks. Then a month passed without any improvement in my wretched condition. "How long is this going to last?" I wondered. "How long CAN it last before I lose all of my marbles?"

Of course, looking for a job was a low priority at that point. I was in serious trouble. My life was ebbing away as I watched in bewilderment. My wife was scared. She agreed to pack up and move back to our home town – my safe haven.

Why am I relating all of this? To make a point. Many people with anxiety problems have a vested interest in staying anxious. They have a disincentive to get better. Their anxiety is an unhealthy investment that pays dividends in one form or another. For me, it was a ticket back home. It precluded my getting a job and staying in a town that I didn’t want to settle in.

Was I consciously staying anxious so I could gain these things? No. But the joyous prospect of moving back home proved a hindrance to my recovery from this episode. What I really needed was to get a job, not pack up my family and move across the country again. Had I entered the workplace, I believe I would have felt better before long. It’s possible I would even have adopted Dallas as my new hometown, and done so gladly. Instead, I retreated to the Michigan, whipped, defeated – and still anxious.

Other sufferers, I’m convinced, have their own disincentives to recovery. Maybe their anxiety furnishes an excuse to avoid doing something unpleasant. It routes them away from a challenge they’d rather not face. And so they slacken a little. They don’t do everything they can to get over their problem. They’re not entirely in earnest about moving forward and getting through it.

Are you one of those people? Are you holding back in your recovery efforts because you see anxiety as the lesser of two evils? If so, it is time to face that thing you would rather not face, whatever it is.

Be assured that any gains you or I derive from anxiety will all prove losses in the end.

The Conflict Within

2008-11-08T19:13:00.000-08:00

Many anxiety sufferers, especially those with persistent worries and obsessions, fight constant inner battles. Those conflicts are usually between the emotions and the intellect. The content of the mental struggle may vary, but the pattern is the same: A troublesome thought arises and the emotions are galvanized into a fight-or-flight mode. The intellect, however, tries to shut the emotions down, recognizing the worry as baseless. But the emotions do not give up so easily. They fight on. The agitated feelings oppose the intellect’s assertions and keep the sufferer in a state of alarm.

The longer and more furiously this goes on, the more the intellect is worn down and gradually succumbs to these fears. While it was once offering such reassurances as, "This is silly, there’s nothing to worry about," it now says things like, "Well, I don’t know, maybe there is something to worry about here." The paradox is that the more the intellect openly engages the emotions, the stronger they become. The stronger they become, the fainter the intellect’s reassurances become – the fearful feelings effectively drown out the voice of reason.

Clearly, the intellect must win if we are going to be emotionally healthy people. The intellect is the arbiter of what is right and wrong, reasonable and unreasonable. While the feelings enrich our lives and make us more authentically human, they easily lead us down the wrong path. We can multiply examples of this unhappy fact. There’s the woman whose feelings of neediness push her back into a physically abusive relationship. Or the teen who adopts reckless behavior to win the approval of his peers. Everywhere we see examples of havoc that results when feelings drive a person’s life.

The bottom line is this: We cannot live well unless the intellect – the rational faculty each of us possesses -- rules. This is doubly true of anxiety sufferers. The feelings of dread and panic cannot be permitted to carry the day. We know better than to heed irrational worries, but we do so because they become so emotion-charged, so arresting. So what do we do?

The secret is to allow these feelings to burn themselves out. The intellect must stop engaging the fearful impulses in open conflict. They must be allowed to simply spend themselves and dissipate over time.

Let’s say an obsessive worry arises. The emotions begin to flare. Instead of engaging them in open conflict, try sorting out in your mind what your feelings are telling you and what your intellect is telling you. Remind yourself that your intellect is less likely to mislead you than your emotions. Make a decision – a firm act of the will – to follow your intellect, no matter how intense your feelings are. This will take some self-discipline, but you must do it.

It may be helpful to ask yourself what belief your feelings are trying to impose upon you. At the bottom of every worry is a belief, such as "I am in terrible danger" or "I am on the verge of insanity." The intellect may reject it, but the feelings behave as if you really do believe it in your inmost being.

Having determined the belief that is being presented to you by your worries, take a short reality check. Ask yourself these questions about the belief that your emotions are presenting to you:

Dispassionately considered, is this a rational, sensible belief?
Does it look foolish written down on paper?
Would I recommend such a belief to another person?
Would an emotionally healthy person entertain such a belief?
In my stronger, more clear-headed moments, would I think it worthy of belief?

After this brief inventory, end the inner struggle right then and there and go about your business. Don’t spend any more time thinking the matter over. You will feel a prod to analyze and dissect the worry further, but you must refuse to do this -- uncomforatable as this may be. The feelings, of course, will rage on. Let them. Don’t fight them anymore. Don’t analyze them. Just keep doing whatever you were doing before the anxiety started. Or find something else to do.

As this drama is playing itself out, it’s important to tell yourself that it’s OK to feel anxious for a while. Your feelings will fire off all their artillery until they are exhausted. In time, the worries will fade. That’s the good news. Anxiety that is not fought against tends to drop off – cancelled due to lack of interest.

This is not easy to do, of course. You may have to remind yourself to hang in there, using statements like:

"I’m not going to let my feelings do my thinking for me."
"This is an irrational worry, and I don’t argue against irrational worries. They don’t deserve my attention."
"I’ll just feel some discomfort for a time, but then it will subside. It’s OK."
"I know I don’t really believe what my feelings are telling me is true, so I’m going to act like I don’t – no matter how I feel."
"Regardless of what my emotions are telling me, this is really no big deal. It’s only anxiety."

So don’t let your intellect and emotions battle any more. You’ll be the loser if you do. Instead, let your feelings punch themselves out. It’s the only way to win the anxiety war.

Healing Panic: Chapter Four: Beginning Your Eight Week Recovery Program

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Fou are ready to begin practice breathing in such a way that you will no longer be subject to panic attacks. These same exercises will help you control your tendency to hyperventilate in trigger situations, such as driving, that have brought on panic
attacks before.

This series of exercises is designed to help you quickly gain control of panic symptoms and attacks; to remain in control; and if needed, to help you overcome the residual fears some people have after they gain control of their hyperventilation and panic.

Phase One: GAINING CONTROL

GOAL: Learning deep, relaxed diaphragmatic breathing.

You do this by:

Learning to switch from upper-chest to diaphragmatic breathing
Practice slower, deeper breathing.
Increasing your breath volume by practicing with a volumetric exerciser.
Cut back on tranquilizing medications as soon as you see progress.
Practice neutralizing anxiety-producing thoughts.

Once you have gained control, staying in control becomes the focus. This takes some further awareness and practice.

Phase Two: STAYING IN CONTROL

GOAL: Make relaxed, diaphragmatic breathing a part of everyday life.

You do this by:

Using Reminders during the day to breathe using the diaphragm.
Continuing diaphragmatic breathing under stress conditions.
Reconnecting breathing with talking and moving.
Learning to relax using diaphragmatic breathing, relaxation tape and hand warming.
Learning to detect early warning signs

As you go through the exercises you will note that there is an overlap between Phase One and Phase Two exercises. Many Phase One exercises are used for the entire eight weeks of practice. Using the volumetric exerciser for more than six weeks, for instance, helps you achieve complete recovery from panic attacks.

Using the Daily Logsheets

As you get into the training you will see that more than one thing is being taught and learned at one time. The logsheets help you keep doing one exercise long enough, drop those exercises that have accomplished their purpose, and start a new phase. By keeping a written record, you can go back through the daily logsheets and see your progress. This is self-validating and provides you with an added measure of confidence.

You will notice that when something is added to the exercises, a + symbol is used to call your attention to the new material.

You have been given daily logsheets for eight Weeks and instructions of how to proceed from the Ninth Week onward. Each Week begins with goals and special instructions for that Week. Many weekly sections are preceded by additional information about the exercises you will be doing that Week. The reading and exercises appear in the order you will be using them. If you want to clarify something, you can go back and reread the information.

You may find that the pace of treatment is too fast. There is no harm, and definite
benefits, in repeating one or more of the Days or Weeks as you go along. How long you continue practicing the various exercises is up to you, but keep in mind that you don't have to achieve perfect mastery before moving on. Some of the exercises may not seem necessary to you. Try them first, then decide whether or not to continue using them. Don't give up if they are too hard; persistence pays off. Only stop if the exercises become too easy!

If you suffer from Panic Disorder without Agoraphobia, you may need only eight to ten
weeks of practice. Some people respond very quickly to this treatment. For people who have suffered for many years and have, through necessity, developed many compensatory strategies to try and avoid panic attacks, eight to ten weeks is a minimum course for learning skills. These skills will provide a good start on the road of recovery.

USING THE GRAPHS IN THE DAILY LOGSHEETS

The graph at the top of each logsheet is where you record the intensity of your symptoms, and this is where you can go back to see your progress. It is important that you fill in the graph at least once a day, as this helps you identify when your symptoms are most intense and any suspected causes of your symptoms. The grids for your charting are labeled by time of day (X axis) and severity of symptoms (Y axis). The severity scale is None (no symptoms), Mild, Moderate, Severe, and Panic Fear. Record the intensity of any type of panic or hyperventilation symptom as Mild, Moderate, or Severe. Symptoms can include trembling, dizziness, chest pains, or abdominal upset. Use "Panic Fear" when you experienced an attack during which you felt like you were being suffocated and could not breathe for a period of time.

This is an idea of how the graph might look after you have marked it to record your
symptoms.

**Record the Intensity of Your Symptoms Each Day**
SYMPTOMS	4am	6am	8am	10a	12N	2pm	4pm	6pm	8pm	10p	12M	2am
PanicFear
Severe								X
Moderate					X				X
Mild			X	X		X	X			X	X
None	X	X										X

By marking X's in the squares, you can keep a day-to-day record of your improvement.
Also, if the graphs indicate that your symptoms are habitually more severe at certain
times of the day, these are the times to watch your breathing, reduce stress, or make sure your blood sugar doesn't get too low. You may also want to consider changing the time you take a medication.

RECORD ANXIETY MEDICATIONS

The record of medications is another way you can see progress. As your symptoms are
alleviated you will feel less need for medication, take it less often, and probably stop it altogether.

If you are taking one of the benzodiazepine medications (Xanax, Valium, Atavan, and
Klonopin are the most commonly used) or buspirone (BuSpar), it is important that you
get your doctor's help in tapering off and withdrawing as soon as you are able. Starting to cut back during the first week of breathing practice is not too soon, but you may have to take more time to develop confidence in your ability to control the attacks by yourself. Do not stop taking these medications abruptly, as this can lead to extreme anxiety and provoke intense panic attacks or seizures. These medications get in the way of learning and remembering, to a much greater degree than is generally appreciated. Treatment failure for panic disorder is associated with continued use of these types of drugs. This is true even if you are taking benzodiazepine medications on only an "as needed" basis.

Choose whether you want to record each time you take a medication or simply record
your daily intake. In the case of benzodiazepine medications, it is not recommended that you space out your medications, as your body has grown accustomed to having the drug at certain times. Rather, you should taper off by cutting back on the amount you take each time (generally three or four times per day).

The following table shows an example of how you might want to take as long as 8 weeks
to taper off of alprazolam (Xanax) as you do the exercises. This helps prevent rebound anxiety and withdrawal symptoms. Tell your doctor that this is how you want to go about it.

Example of Gradual Reduction of Alprazolam (Xanax) and Other Benzodiazepines
	First Dose (AM)	Second Dose (AM)	Third Dose (PM)	Fourth Dose (Bedtime)
1st Week	Usual dose	1/2 usual dose	Usual dose	Usual dose
2nd Week	Usual dose	1/2 usual dose	Usual dose	1/2 usual dose
3rd Week	Usual dose	1/2 usual dose	1/2 usual dose	1/2 usual dose
4th Week	1/2 usual dose	1/2 usual dose	1/2 usual dose	1/2 usual dose
5th Week	1/2 usual dose	1/4 usual dose	1/2 usual dose	1/4 usual dose
6th Week	1/4 usual dose	1/4 usual dose	1/4 usual dose	1/4 usual dose
7th Week	1/4 usual dose	None	1/4 usual dose	None
From now on	None	None	None	None

Following the Exercise Directions

The program includes three types of exercises. First, there are those that you will do every Day throughout the 8-week training period. Next, there are "fall back" exercises that you will use if you experience symptoms of hyperventilation. Finally, there are those that you will do while you are in a particular phase of your training. The training logsheets are designed to remind you of all three types of exercises.

Meanwhile, you need to be aware of some general directions before you actually begin.

Practice when you are feeling at your best.

Especially in the beginning, your best may not be very good, but that's O.K. The point is that in the beginning this is practice for gaining control soon. Don't try to control panic attack symptoms right from the beginning; at first you are learning to catch the ball, not play baseball.

Stop practicing if you experience hyperventilation symptoms.

If you start to have symptoms during any exercise, stop doing the exercise. Use the "fall back" exercises to regain immediate control so that your symptoms don't escalate and get out of control. Get your mind off your breathing and come back to it later in the day.

This is so important! If you are phobic about other things and you allow symptoms to
build during breathing exercises, you'll soon be phobic about the exercises and not want to do them. That would be one more failure, and you and I want these exercises to be a success.

Build your strength gradually.

It's better to work with the exercises for just a few minutes when you begin and then increase your duration later as you develop more tolerance. When working with your breathing, always stay within the comfort zone. The comfort zone will expand as you practice. Just like with an exercise program, it may be a week or two before you notice improvement. Consider the first week or two an investment; don't give up the program without making an honest effort.

Give yourself some room to make mistakes.

In your trying, you may try too hard or may fail to follow the directions as given. You might provoke some symptoms or slow down your progress. Most people make some mistakes when they begin these exercises, because they are learning something that seems strange and unfamiliar.

Eat an adequate breakfast and a snack before you go to bed.

Many people who suffer from panic disorder seem to be prone to low blood sugar or tolerate it less well. This is stressful to the body and can cause hyperventilation. An adequate breakfast with protein, and a snack at bedtime that includes complex carbohydrates and protein will help level out your blood sugar between meals.

You do not have to do the exercises perfectly in order to feel that you can control hyperventilation symptoms or panic attacks. All you have to accomplish to get control is mostly breathe diaphragmatically and slowly when you are thinking about it. It's a downhill battle from there!

Plan for First Week

Make an appointment with your doctor to discuss any antipanic, antianxiety, and
antidepressant medications you are taking. Make a plan with your doctor to withdraw
from the antipanic and antianxiety medications.
Each morning before getting out of bed, practice three slow, diaphragmatic breaths. Continue to be aware of your breathing and breathe slowly as you get out of bed.
Use the daily logsheets, which will help you to switch from upper chest to
diaphragmatic breathing.

GENERAL INSTRUCTIONS

Always wear loose clothing during the exercises
Starting to learn diaphragmatic breathing the first week is easier if you are lying down. Lie on the floor (or bed if it's firm). If you use the floor, use a carpeted surface or get a pad. A bed sheet over the carpet is a good idea.
The volume of breath to be taken in for an exercise is either seventy percent
[70%] or one hundred percent [100%] of maximum. In the beginning you will have to estimate how much this is. If you experience symptoms, reduce the volume of the inhale and exhale more slowly.
Unless you have a nasal obstruction, keep your mouth closed and breathe through your nose. If you have a nasal obstruction, breathe through pursed lips.

CAUTIONS

Be aware of the most common hyperventilation symptoms (especially dizziness). If you experience the symptoms, use the pursed-lips breathing technique explained below to increase the carbon dioxide level in your bloodstream.

Re-breathe air from a paper bag (instructions appear below) only if overwhelmed. Don't become dependent on this technique.

When beginning to use the diaphragm for breathing again, some people experience a fluttering or shaky sensation in their abdomen. If you experience this symptom, use the pursed-lips breathing technique.

Pursed-Lips Breathing Technique

Many people will experience hyperventilation symptoms when checking their breathing or beginning breathing exercises. If this happens to you, discontinue the exercise you are doing. Breathe in slowly and hold it for as long as 20 seconds if you can. Then breathe out slowly by pursing your lips, as if gently blowing out a candle. After only two or three breaths, you should no longer feel dizzy. Then, exercise a little by walking around as you maintain awareness of slow breathing. Come back later and complete the breathing check or exercise.

Instructions for Re-breathing Air from a Paper Bag

If at any time your symptoms escalate and you begin to feel out of control, breathe into a medium-sized paper bag and re-breathe the same air for a few minutes. This will help you replace the carbon dioxide your system has lost from over-breathing. This is a common "fix," but does not help you gain control of your breathing over the long run. Whenever you can, use pursed-lips breathing or the slow exhalation count, which do help you learn to gain control.

Instructions for Slow Exhalation Count beginning on Day Five

Step One

Make yourself comfortable in a recliner or on a couch, where you can lay back but still have your head and upper body raised up a little. Use the sweep second hand of a watch or other timer that shows you the time in seconds to help you gain control of your breathing.

Watching the second hand, gradually slow your breathing to 3 seconds for each inhale and 3 seconds for each exhale. Breathe with your diaphragm as you have been practicing. At this point in the exercise you may be inhaling only 30% of your maximum capacity.

Be sure to exhale completely by squeezing in the muscles of your abdomen at the end of the exhale. As you relax, extend the length of time for each inhale and each exhale to 4 seconds, then to 5 seconds. As you extend the time of each inhale and exhale you will need to take in more air with each breath. Keep at it until you notice that you have more control over your breathing.

Step Two:

Once you feel more in control and relaxed, you can progress to practicing deeper breathing by taking in the deepest possible diaphragmatic breath, pausing for a few seconds at the top of the breath, and then breathing out slowly and counting the seconds in a whisper until you have squeezed out all the air you can. So it's:

BREATHE IN SLOW DEEP DIAPHRAGMATIC BREATH [70% to 100%].
P A U S E;

BREATHE OUT (Counting) ONE, TWO, THREE, FOUR, FIVE, SIX, SEVEN; etc.

Give yourself a rest of a few normal breaths before you try it again. Then, when you are ready, take another deep, relaxed, diaphragmatic breath and count out to a higher number if possible. You will find that the more relaxed you are, the deeper the inhale and the higher the exhale count.

The idea is to gradually increase the time you take to exhale without getting too much or too little air. This means always staying in your comfort zone. As you work with the timer and the slow exhalation count, you should start feeling a lot more relaxed. These are good exercises to do in the evening before you go to bed, as they help you become relaxed and able to sleep well once you are under the covers.

Medications

Working with your doctor is important, because your need for many types of medications will change as you practice diaphragmatic breathing and your overall breathing becomes more functional. If you are diabetic and take insulin, and if your doctor has approved slow breathing exercises, your need for insulin may change; you may need less than you did before. As you overcome panic attacks, your need for antidepressant medications may also change, or you may no longer require them. Only a medical doctor or psychiatrist in consultation with you is qualified to determine your needs.

As mentioned before, many antianxiety and antipanic medications are known or suspected to cause treatment failures. If you have taken some of these drugs for many months or years, the prospect of withdrawing can be uncomfortable. Taking this type of medication on an "as needed" basis is not recommended. Be willing to put up with some discomfort and to use the breathing exercises you will be learning to control anxious feelings. You should not stop any drug on your own; in some cases doing so can even be dangerous.

Verbal Reward

Give yourself an automatic verbal reward every time you do an exercise. This is important even if you do not feel totally successful. Positive thoughts relax your mind and body and lower anxiety. Even doing an exercise in such a way that you induce some symptoms is a positive learning experience. Such self-talk as "Wow, I did it!" or "That's O.K., I know I'm just learning" sets you up to continue your improvement the next time you practice.

-- Bert A., M.Div., Ph.D.

Healing Panic: Chapter Three: Breathe In - Breathe Out

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"Breathe in, breathe out!" I first heard this as a young man, from an old doctor who liked to relax his patients with corny jokes while he prepared an injection. "Do you want to know how to live forever?" he asked. "Sure," I naively took the bait. "Breathe in, breathe out," he said. "As long as you keep breathing in and out you can't die."

Some thirty years later I heard the same words again from another doctor, a Ph.D., who is in the forefront of developing a learning model for retraining people to breathe. The "diploma" which Dr. Erik Peper awards patients and professionals who attend his workshops in breathing bears the title "Breathe In, Breathe Out."

The sequence and types of exercises in the pages to come are the fruits of Erik Peper's many years of careful research. The specifics, however, are the product of my helping people who suffer from panic attacks.

"Breathe In, Breathe Out" Knowing How We Breathe
The old doctor's joke isn't so silly, because it implies that we have control over our own breathing, unlike involuntary actions such as our heartbeat. It's easy to take a breath when we want to, or to blow out the birthday candles just when we're ready; we very consciously take a deep breath and blow hard. Most of the time, though, our breathing is on automatic and we don't think about it.

We humans have some breathing problems, probably because of this part-time conscious control over our breathing. We can easily learn to adjust or modify our breathing, just as singers, actors, and instrument players do. The problems come when we learn the wrong things, which don't have bad effects immediately but eventually become bad habits that create the symptoms of anxiety.

So now it's time to take a close look, from an anatomical standpoint, at how breathing is "supposed" to be done.

The Anatomy of Normal Breathing
The lungs are a complex maze of air passages and minute air sacs (alveoli), with an even more complex mesh of arteries, capillaries, and veins intertwining through the air passages and sacs. For our purposes, though, the lungs (there are two, one on each side of the chest) can be thought of as balloons. The balloons are emptied and filled not in response to their own actions, but in response to the actions of the entire torso, which encloses the lungs.

Breathing takes place through the air passages leading from the nose and mouth into the lungs. Although the bronchial tubes and lungs are lined with smooth muscles that regulate the flow of air, these are not the muscles with which we breathe.

The chest and ribs, which are attached to the spine in the back and the breastbone in the front, form a somewhat flexible cage enclosing the heart and lungs. The chest cage is narrower at the top, which has an opening occupied by the neck.
Looking at the illustration, turn your attention to the wide bottom of the rib cage. The bottom ribs are not connected to the rigid breastbone, but are held together by pliable cartilage. Attached to the bottom edges of the wide cage, from front to back, is a muscle called the diaphragm. The diaphragm is shaped like an inverted bowl or funnel. Through the middle of the bowl (or neck of the funnel) run the arteries and veins that carry blood from the heart, to the organs and lower extremities, and back to the heart. The esophagus runs through the same area on its way to the stomach, and major nerves run through here as well.

The diaphragm should be the main muscle of breathing, because its location in the body gives it the most room to move in a piston-like fashion. Below it are the soft organs and the belly, which can expand outward when a deep breath is needed. Above the diaphragm are the lungs, which are also soft and pliable.

The easiest way to understand how the diaphragm works is to make a relaxed, inverted bowl, with the tips of your fingers just interlocking.

With your fingers still interconnected, tense your hands and wrists, and, if you're doing it right, you'll see the bowl flatten down. That's almost exactly how the diaphragm works.

When it's relaxed, the bowl is most bowl-like (deepest). In terms of the piston illustration, the piston is up when the diaphragm is relaxed. At this position, the diaphragm is pushing up on the soft and pliable lungs, and the air in the lungs is forced out -- exhaled. If you pull in your abdomen at the same time you push up on the underside of the diaphragm, you force out even more air.
The inhale, of course, is the opposite. The diaphragm contracts, just as your fingers flatten out. That brings the piston down, creating more space in the cage. Air, naturally, is the only thing that can fill the space, so it moves into the lungs, filling them.

Other parts of the body also assist in breathing. If you tighten and pull in your stomach, you push more air out of your lungs, because you put pressure on the underside of the diaphragm-piston. If you let your stomach pooch out, the diaphragm has more room to move down into the area of the soft organs and you take in more air.

But the muscles between the ribs all up and down the chest, especially those between the more flexible lower ribs, can also work to make the rib cage bigger. Air comes in, again because there is more space to fill. Even the muscles of the neck, shoulders, and upper back assist in the breathing process.

When you're running hard or doing aerobic exercises, the idea is to breathe hard -- to inhale and exhale a lot of air. The more air the body needs, the more of the various breathing muscles go into action to create additional space for breathing.

When breathing is done correctly, the volume of the lungs is quite phenomenal. The diaphragm can move up and down as much as six inches. In the process, it gently massages the lower organs and aids in the blood's return to the heart. A large person can have a lung capacity of five quarts. Even a small adult can breathe in two or more quarts of air.

Habitual Diaphragmatic Breathing
When at rest, the correct way to breathe is with relaxed shoulders, upper chest, and stomach muscles, allowing the diaphragm and lower rib muscles to carry on the automatic breathing process. When you breathe in this way, your body continually adjusts the volume and breathing rate as needed to maintain the acid/base balance of the blood and other factors. Eight to twelves breaths per minute is normal breathing rate.

Habitual Thoracic (Chest) Breathing
Many, and that may mean most, people breathe in a slightly abnormal fashion. They tend to hold in their stomach, make little use of the diaphragm, and breathe using the muscles of the upper chest, neck, and shoulders. This style of breathing becomes automatic, and the body adjusts volume and rate as it does in diaphragmatic breathing.

Thoracic breathing depends on the more rigid system of muscle action in the neck, chest, and shoulder area. This means that the lungs are given less room to expand or contract and that the body must work harder. As breath volume is lowered, breathing must be speeded up in order for the body to maintain its chemical balance.

My own observations of the breathing of panic attack patients confirm what other researchers have discovered: people who have panic attacks chest-breathe. Their resting breathing rate has speeded up to twenty to thirty shallow breaths per minute. They also try to compensate by sighing frequently, sometimes as often as two or three times a minute, adding significantly to the loss of carbon-dioxide. Sighing is likely the result of the small air sacs' failure to expand, and the sigh allows enough air deeper into the lungs so as to keep the sacs and airways open. When sighing or taking a deep breath, the chest-breather visibly lifts the entire chest up away from the diaphragm, thereby creating more space in the chest cage, rather than allowing the diaphragm to pull the air in.

How Breathing Changes When You Become Anxious
So far we have discussed functional and dysfunctional breathing. Relaxed abdominal breathing is better. Tight thoracic breathing isn't as good and may lead to problems. Now, how did it get that way?

When a person becomes anxious, sad, scared, aroused, or angry, the body immediately begins to go through changes in order to cope with the new situation. Of course, we needn't concentrate only on the negative emotions; changes also occur when we are delighted, loving, excited, joyful, playful, and full of laughter. We increase the amount of air we breathe, by breathing faster and deeper. Our heart quickens its pace, more blood flows through the arteries and veins, our senses become more acute, we become more alert.

Human beings are capable of a great range of emotions and physical responses. We can be placid like the waters of a gentle pond, or raging like the ocean in a fierce storm. The change from placid to raging can happen in the twinkling of an eye. It's all part of being human, even necessary to being human. Problems arise when the emotional and physical responses can't be played out, when the storm has to be held inside, not unleashed in some civilized or uncivilized way.

It is the connection between emotions and physical responses that concerns us when we think about panic attacks. Recently I was watching a person whose breathing was being monitored as he was pretending to be angry with someone else. As soon as he began to work up some pretend-anger his breathing changed as if he were actually angry. His breathing became faster and deeper, and the carbon dioxide level of his body, as monitored in his breath, began to drop. I noticed something else: as this was happening, he didn't breathe out in the same way as when he had been relaxing a few moments before. As a result, he retained more air in his lungs each time he exhaled. His deeper and more rapid breathing was actually on top of the air remaining in his lungs. It was as if his body were trying to hold on to the carbon dioxide by preventing him from exhaling too much!

Actual experiments have shown that just imagining a stressful event will cause a person to breathe faster and retain many times more air in the lungs than when relaxed and unstressed. You can well imagine that if you've had panic attacks, just the thought of another attack can be enough to change your breathing and start you on the road to another attack, without you even being aware of it.

As you begin to check out your own breathing pattern and train yourself in more relaxed and functional breathing, remember how your thoughts and emotions can work for you or against you. Keep a positive attitude.

For many victims of panic disorder, thoughts, fears, and physical reactions become automatic and create a great deal of anxiety. There are proven methods for countering or neutralizing these thoughts and reactions, and these methods need to be part of every course of treatment. These will be found in the exercises you will be doing. Retraining your breathing and knowing positively that you can prevent attacks is essential to success in your recovery from panic disorder.

-- Bert A., M.Div., Ph.D.

Healing Panic: Chapter Two: Panic and Hyperventilation Syndrome

2008-11-08T18:29:00.000-08:00

For more than 25 years, I have been counseling people with emotional problems.
Like most of my colleagues, for many of those years I was confounded by the problems of people who sought out my help for their panic and the numerous fears and other problems that accompany this condition.

A lecture I attended some years ago in order to learn some more about these attacks was of little value. The psychiatrist who presented it began by asking how many in the audience had ever experienced a panic attack. A scattering of hands went up. He said that he also had suffered from these attacks. But at the end of the lecture, when asked to pinpoint the actual cause of the attacks, he did not have a ready answer.

Medical treatment for panic usually consists mostly of anti-anxiety or anti- depressant medication and advice to watch stress. Even if the doctor understands that hyperventilation can lead to panic, he will likely do little more than recommend breathing into a paper bag for a few minutes to help re-establish the level of carbon dioxide in the bloodstream.

John

John came to me to get help with intense anxiety. As a manager, he often had to make presentations. When he was called on to lead a meeting or talk to groups, he would become so panicked that he was considering quitting his job just to avoid being put in this position. After John left my office, I reached for a new book that had just arrived in the mail. I began to read the chapter by Dr. Ronald Ley entitled "Panic Disorder, a Hyperventilation Explanation." I was fascinated. In it, Dr. Ley described John's situation exactly.

Ley did not "discover" hyperventilation. As his extensive bibliography showed, that had been documented about a century earlier. But it wasn't until 1975, in an article entitled "Hyperventilation, The Tip and the Iceberg," that Dr. C. M. Lum concluded that "faulty breathing" is the real root cause of hyperventilation and panic, perhaps along with being a perfectionist if you were a woman or a "Type A" if a man. By 1985, over 2,000 patients had been admitted into his program at Papworth and Addenbrook's Hospitals in Cambridge, England. Most of these patients were not only helped but cured.

Not all doctors agree with Dr. Lum's conclusions, but more and more scientists regard hyperventilation as the key to understanding panic.

Traci

Late one day a frantic mother called me about her daughter, who had been having panic attacks since morning. She had gone into convulsions, the mother told me, but they were afraid of going to the emergency room of the local hospital, where Traci had already been more than once. A few weeks before, she had been so agitated that she had to be injected with a powerful tranquilizer before she was able to calm down. She was told that unless she was able to get control of herself the sheriff would be called, and she would be taken to the psychiatric ward of the County Hospital.

When they arrived at my office, Traci was gasping for air. She could hardly walk, and the muscles in her face were twitching. Her eyes were glazed over from fear and exhaustion, and her pupils were dilated. She was unable to concentrate on anything for more than a few seconds. What she needed was to gain control of her breathing. Little by little, I helped her slow down and deepen her breathing. After an hour, she was weak but calm. She had gained moderate control. The panic had passed.

People experiencing a panic attack usually have difficulty breathing, a difficulty commonly thought to be caused by the attack, and one of the many recognized symptoms. But panic attacks are actually brought on by the way a person habitually breathes. That is, the breathlessness and gasping experienced during an attack is an extension of a problem that began before the first attack, sometimes long before.

When Traci began her training in controlling the attacks, I could not see her breathe at all. Only when I attached a sensor around her abdomen and others on her neck and shoulders, all connected to a computer, could I see her breathe, by watching the screen. Her breathing was shallow, rapid, erratic, and she was using only the muscles in her neck and upper chest. Her abdomen wasn't moving at all. She was breathing at a rate of 22 breaths per minute, about twice what is considered normal.

How Hyperventilation Leads To Panic

Like other victims of panic attacks, Traci showed all the characteristics of hyperventilation syndrome recognized by C.M. Lum:

She took air into her lungs by using her chest muscles.
She didn't use her diaphragm when breathing, or only partly used it.
She breathed rapidly and shallowly, so it was hard to see her breathe unless she sighed, or took a deep breath on request.
Habitual rapid, shallow breathing (something of which the victim is unaware) results in breathing out more carbon dioxide than the body produces, keeping the carbon dioxide level always too low.

Over-breathing, or breathing in and out more air than is needed with each breath, creates the same imbalance. This is a more recently recognized cause of hyperventilation and panic attacks in some people.

A case in point is a person who works out at the gym or exercises regularly and whose breathing is unrestricted. The problem is the opposite of what Lum found, but the result is the same. Here it is "habitual deep breathing" that results in breathing out more carbon dioxide than the body is producing.

Without enough carbon dioxide to maintain the acid/base balance of the body, the blood becomes too alkaline, a condition known as "blood alkalosis." Alkalosis causes the arteries to constrict, with the result that blood flow is restricted, especially to the brain. Although the blood contains plenty of oxygen, alkalosis also prevents the essential transfer of oxygen from the blood to the brain, muscles, and organs, as has been frequently verified in panic attack victims who have gone to the emergency room. This is known as the "Bohr Effect" and has long been recognized by those who study hyperventilation.

Under these circumstances, the oxygen available to the brain is reduced drastically. At first vision begins to blur. The typical sufferer reports feeling dizzy, tense, anxious, jittery, and nervous. The sufferer often feels like crying, and feels weak and confused. Starved for oxygen, the sufferer feels as if suffocating. As the condition worsens, the brain gets more confused and sends the wrong messages. One wrong message is the need to breathe even more deeply, which worsens the problem.

The heart is pounding by now, increasing (or lowering) blood pressure, sometimes to the point of causing the person to faint. Pupils dilate, the face, hands, and feet become cold or numb, the hands tremble, and the sufferer sweats. Chest pain may be present. This is usually related to chest breathing and muscle spasms in the chest wall, but in some cases may be actual heart pain.

In brief, when blood alkalosis gets serious, the sufferer is going to experience that a great deal is wrong, even life-threatening.

Maureen

Maureen had been having severe panic attacks for only a few months when she sought treatment. Carrying on the normal activities of her life was becoming difficult, even with anti-anxiety medication. When she filled out the questionnaire I gave her, she checked off all of the statements about breathing: shallow breathing, rapid breathing, breathlessness, trouble catching her breath. She had trouble sleeping, often waking up in the middle of the night and unable to go back to sleep. She had headaches from the tension she carried in her neck and shoulders. Altogether, Maureen was a classic case of advanced hyperventilation syndrome.

Maureen's breathing was very erratic. I had difficulty helping her relax and slow down her breathing. Then, while being monitored for chest and abdominal breathing, Maureen had a panic attack. She had been working on relaxing her neck and shoulders and was making progress. Sometimes when a person relaxes it will bring on an attack, because less carbon dioxide is being produced as metabolism slows.

When this happened, Maureen became apprehensive and began to breathe more deeply. As she felt increasingly short of breath, she began to use her chest, neck, and shoulders as much as she could, causing extreme tension.

For about three minutes she was almost unable to breathe. This is the most frightening part of panic. Then she began to breathe out, but still with some difficulty. As she caught her breathe again at the end of the episode she was able to relax the tension from her neck and shoulders. It was a frightening experience and left her shaky, but at least able to breathe again.

Staying Alive

A careful study of the chart made during Maureen's panic attack showed why she was unable to breathe. As her fear mounted she was not breathing out all the way. With each gasp for air she retained more air in her lungs, unable to breathe it out. At the height of the attack she could simply breathe in no more. Those frightening symptoms, however, are actually the body's way of staying alive. Before their appearance, Maureen had been breathing in such a way that she was exhaling too much carbon dioxide. If her nervous system had not detected what was wrong, she could have died. When she was prevented from breathing at the height of the attack,
it allowed her body to replace some of the carbon dioxide it had lost as she began to breathe harder. Although this was an agonizing experience, a semblance of balance was restored and life could go on.

Because we have for so long thought of panic attacks as an indication of a disease, we have failed to recognize that they prevent something far worse. Panic attacks are like the circuit breaker tripping to prevent a short in the wiring from burning
the house down.

The Habits of a Lifetime

Many panic attack victims are told by the emergency room doctor that they're just reacting to stress. Stress may be the most immediate cause, or trigger, for panic attacks, but many people cannot identify a unique stressor that preceded their first attack. John could identify that making a presentation in front of many people incited his attacks, but he had done this many times before without a problem. We have to assume, therefore, that John had an unrecognized problem that was building towards an attack. Hyperventilation was getting worse, but still did not induce symptoms until he had his first attack.

Bad breathing habits may begin for any number of reasons. Since flat tummy is part of our culture's idea of a good body image, people often learn to chest breathe in order to look trim and fit. Periods of grief, or anticipating harm over a period of time, can begin a pattern of shallow breathing that may later become serious enough to induce an attack.

The truth is that everyone hyperventilates to some degree on a regular basis. Being in a car going fast, being jammed into a crowded elevator, preparing for a dinner party, having a disagreement, going to the hospital, having blood drawn, being given an injection, reprimanding or protecting a child, being scolded, or going for a test where you might not know all the answers. Any or all of these can result in more rapid, shallow chest breathing. For most people, breathing returns to normal when the experience is over.

For people prone to panic attacks, the return to normal breathing and recovery from hyperventilation is delayed and usually insufficient.

The death of a spouse, divorce, loss of a job, being promoted, relocating, going off to college, retiring, buying a home, or starting a new career all can create a great amount of anxiety. None of us would be normal if we didn't hyperventilate while going through these experiences.

Whether stressful experiences will eventually result in panic attacks depends on whether the breathing pattern under stress becomes habitual. Some resilient folks seem to be able to go through many difficult circumstances and never have a panic attack. Yet, others who have difficulty identifying anything ever happening to them will suddenly be struck out of the blue.

The Triggers

Triggers depend on habitual and ongoing hyperventilation. John was habitually hyperventilating before he went to the meeting that triggered his attack. After repeated experiences, making a presentation or even thinking about standing in front of a group would trigger an attack. He started to anticipate the fear, and that made him more fearful.

When John noticed that he felt a little shaky, that his heart was beginning to pound, that his vision blurred, and that he began to sweat, he knew he was losing control. The resultant fear ensured that he would have an attack.

Because the physical symptoms are not actually dangerous, but only "feel" dangerous, there is no reason to fear them, and therefore no reason to panic. Many people have been helped simply by hearing this, but if they haven't solved the problem of habitual hyperventilation they keep on having physical symptoms, which frequently keep on getting worse. In some cases physical symptoms can trigger enough anxiety to cause panic. An example is a muscle spasm that feels like the pain of a heart attack.

Breaking the Habits

If you are reading this because you have experienced panic attacks, you probably already know what will trigger the physical symptoms that trigger an attack. Making a presentation, driving on the freeway, entering a market, going to church, being at work, exercising, excitement, relaxing, traveling. It's only logical that a person avoids trigger situations in order to avoid having panic attacks. The problem, of course, is that this limits your life to living only in the safety zone, places where you believe you are safe from attacks or can be quickly rescued by trusted family members.

The methods for overcoming panic attacks detailed in the coming chapters are based on observations, research, and clinical practice which have been carried out in hospitals, universities, and the practices of many disciplines.

Now that you know what is causing the symptoms you experience, it is time to examine how you breathe now, how you should breathe in order to prevent panic attacks, and what to do to train yourself to do exactly that.

-- Bert A., M.Div., Ph.D.

Healing Panic: Chapter One: How You Can Succeed

2008-11-08T18:15:00.000-08:00

Joni started having panic attacks eight years ago, when she was 28. Although she (and her husband) have raised a son, for most of those eight years Joni rarely ventured outside her home.

She did try to get out. She first took a job at an agency that kept track of credit reports. The first day she sat for about a half hour at her computer nearly paralyzed--then ran out and frantically drove home, where she pretty much stayed for the next several years.
To find some relief from the daily attacks, Joni tried drugs and alcohol, often more than once a day. Nothing worked, not even the numerous medications designed specifically for anxiety. She has been to emergency rooms more than once. She experienced so much dizziness that her doctors gave her a CT Scan to check for inner ear problems. When medical tests revealed nothing, she began to believe she had a tumor of the adrenal glands.
When Joni tried to go to work again, she again found herself in front of a computer taking care of the billing in an office. She wouldn't admit that anything was wrong, but at times the mere act of staying at work must have been real agony. This time, however, Joni was working for me, and at a time when I was serendipitously introduced to the idea of Hyperventilation Syndrome and treatment for panic attack victims.
Over the next few months Joni and I found some people who were looking for help, and we
started a group.
A few months before I started writing this, I asked Joni how she was doing. She wrote me back:
I DO NOT have panic attacks anymore...for almost a year now. A solution to this problem was and is a Godsend. Miracles can really happen in the most unusual ways!!

I don't think Joni used the word miracle lightly. If you have been looking for the miracle that Joni is talking about, the one which brought her the knowledge of what to do, look no further.

Panic attacks are so powerful they seem to be completely beyond your control. Joni thought so. But as easy as it is to believe that panic attacks are an inevitable part of your life, I can assure you that just the opposite is true. Panic attacks are not inevitable. They can be controlled. For a few of the people who read the first few chapters of this book and do the exercises, success (meaning no longer having panic attacks) will be almost immediate. Success will take a little longer for most people, but it will come.

People with Panic Disorder suffer from periods of intense fear or anxiety. The fear is a result of great physical distress that indicates something has gone seriously wrong. For some people attacks come "out of the blue" and for no discernible reason. Others report experiencing warning signs that an attack is coming on. An afflicted person must cope with the possibility of an attack occurring while shopping, driving, attending church, or being with other people socially. For some, the worst fear is that they will be alone when an attack occurs.

If you have panic attacks, you know that you may be out of breath, experience a racing heart, or have pronounced chest pain. Trembling hands, blurred vision, pressure or a knot in your throat, tingling or numbness in your face, fingers, and arm, and profuse sweating are among the dozens of symptoms reported by panic attack sufferers. Being left confused, weak, and exhausted can be a part of your attacks.

What Is the Explanation for Panic Attacks?

In the past, and even today, there is no universal agreement among professionals about the causes of the panic attacks experienced by Joni and millions of others. Many will say that the cause is not really known. Stress or anxiety is often blamed, because attacks often start after periods of unusual stress.

Only in the last few decades has there emerged an explanation for panic attacks that accounts for all the various symptoms. When this explanation is understood and applied to treatment, control is regained and panic attacks are stopped.

Panic attack sufferers have one thing in common: they don't breathe properly. People who suffer from panic attacks breathe shallowly and rapidly. They breathe mostly using the muscles of the chest, neck, and shoulders and make little or no use of the diaphragm. This type of breathing results in a disruption of the exchange of oxygen and carbon dioxide in the bloodstream and body, leading to a condition know as Hyperventilation Syndrome.

Hyperventilation occurs any time a person breathes in such a way that the amount of carbon dioxide breathed out exceeds the amount the body is manufacturing. This results in a condition known as "hypocapnia" in the medical field. When the blood's level of carbon dioxide falls below a critical point, the person begins experiencing apprehension and physical symptoms such as dizziness, shortness of breath, and rapid heartbeat.

If the person doesn't know what to do at this point, the symptoms become more severe and a panic attack results as the condition becomes more pronounced. A few people will experience partial paralysis or faint as a result of hyperventilation.

The symptoms experienced during panic attacks are not "imagined"; they are quite real. The sensation of dying that many people experience during a panic attack has a physiological basis. If too much carbon dioxide were lost from the body, life could not continue. Fortunately, the body has several ways to prevent that from happening.

What we call a panic attack is one of the ways the body protects us. The feeling of not being able to get enough air during an attack arises because the part of the brain that regulates breathing temporarily "shuts down" and allows the rebuild-up of carbon dioxide. This shutting down of the ability to breathe in the normal way can be extremely frightening.

One final point to be made before going on: Panic attacks happen to normal, healthy people who, for whatever reason, are breathing improperly. When panic occurs, the nervous system is doing exactly what it is designed to do: protect the body from death. Mostly, the mental states associated with panic disorder are the result of hyperventilating and the fear of having attacks in the future. Obviously, the place to begin treatment is learning how to breathe without hyperventilating.

Susan

Susan is one of those people who succeeded right away. Susan was never in formal treatment with me for her panic attacks; she only heard me talk in a group of people one time about hyperventilation syndrome and what could be done to remedy the condition. (She was unable to come to the rest of the scheduled meetings because of vacation plans with her husband.)

A few months after she returned from her vacation, Susan wrote the following letter so it could be used to help others who suffer from attacks:

I am so happy with the results of learning how to breathe
diaphragmatically. I wanted to share my experience. It has
changed my life for the better.

I have been a sufferer of panic attacks for over three years.
I have tried everything. I have been to doctors, had all
kinds of tests, even been into urgent care a few times. All
they would tell me is that it was stress. I finally got so
that I could go through life as long as I had my
tranquilizers. But I would still experience panic, feel
dizzy, sick, out of control, and worst of all a feeling like I was
losing my mind. The only thing that sort of worked for me
was to take Ativan and not do all the things in life that I
really wanted to do.

It was while I was at a meeting in Redlands that I met Dr.
Anderson. I was very interested in what he was telling us
about diaphragmatic breathing. It made so much sense, I
decided to give it a GOOD try.

I first started by diaphragmatic breathing before I got out of
bed in the morning. I noticed that I seemed to feel less
shaky and more calm right away. At the time I was on the
highest dosage of Ativan that I had ever taken.

My family was planning a vacation, so I took my [volumetric exerciser] to
practice my breathing. Every time I could I would practice.
By the end of my vacation I had cut my medication down by two-
thirds. I kept breathing diaphragmatically every time I would
think about myself and how I was feeling, which is pretty
often when you suffer from panic disorder.

When I returned to work, the stress returned too. But
breathing really helped. It really works! I did not want to
go back on medication.

I have had a few panic attacks since. But I try to catch it
early. I know this is hard. But there are signs of stress
coming. I also know that after breathing diaphragmatically at
least three times I could feel the panic lift. And the best
feeling of all is the feeling that I am in control again.

I have been totally off medication now for one month. I am
thrilled. I have even been tested pretty good--a trip to
the dentist. I just kept up the diaphragmatic breathing. I
really believe in diaphragmatic breathing. It has changed my
life for the better.

Sincerely,

Susan H________

The wonderful thing about Susan's letter is that she mentions several steps which helped in her
recovery. She began by deciding to give it a good try. She then:

Practiced diaphragmatic breathing before getting out of bed in the morning.
Practiced several times during the day, using a volumetric exerciser.
Used inner cues to remind herself to practice.
Began cutting back on her tranquilizing medication as soon as she made progress.
Stayed off medication even when the stress intensified; she relied on diaphragmatic breathing to deal with symptoms.
Became aware of the early signs and learned how to breathe to get rid of symptoms.

Keeping Panic Away

Several months later Susan wrote to me that she has the same ability to control attacks as when "treatment ended" and that she doesn't have panic attacks now. Thinking of others, she wrote as follows:

A person needs to stop and think at the first sign of panic
what might be triggering the attack and breathe to slow down
the increasing panic.

Since your tendency to have panic attacks may remain for some time after you've learned the skills of controlling them, it is important, as Susan found, to stay aware of early signs and breathe diaphragmatically to stop the symptoms.

All the former patients who responded to my questionnaire about their success noted that they
continued to practice breathing diaphragmatically as a way of controlling their tendency to have attacks.

Hyperventilation Syndrome is a complicated interaction of many things. This means you have to accomplish several things in order to gain control and live without attacks.

You don't have to learn "perfect" diaphragmatic breathing, but mostly you should be able to do it when you think about it. Give yourself some time to change your habitual breathing pattern.

Reward yourself for making a little progress at a time.

Practice at those times you feel best. If that's not very good, then accept it as your best time and do what you can. Go slowly. If you're in this situation, you probably haven't felt anything close to normal in a very long time.

Tranquilizing medications allow you to function, at least somewhat. But they can get in the way of recovery, because they impair learning and memory and tend to be addictive. When you have gained some skill in recognizing and controlling attacks, you can taper off your medications with the help of your doctor. For now, the medications provide you a window of opportunity that's helpful.

When Joni and I would talk about the struggles she went through and how panic attacks became the focus in her life, we both recognized that after one has mastered diaphragmatic breathing, one needs continuing support to keep on succeeding.

Functional breathing will stop panic attacks, just as stopping drinking will lead to sobriety for a person who has become addicted to alcohol. Relapse is possible, so more than functional breathing is needed. After suffering over years, many panic attack victims have become fearful of life, dependent on others, feel isolated, and have learned to manipulate others in order to protect themselves. Working with a therapist, self-help groups, and your religious faith can help you with these attendant problems.

It would be easy, in the short term, to play it safe. To stay at home. To do nothing. You must be willing to work in order to succeed. And you will succeed if you carefully follow the instructions outlined ahead. All you have to look forward to, after all, is freedom. Freedom from panic attacks and all the limitations they have placed on your life for so long.

-- Bert A., M.Div., Ph.D.

Healing Panic: Introduction

2008-11-07T19:03:00.000-08:00

Understanding Panic

A full-blown panic attack is the sort of thing that in earlier times would have been called possession by demons. This explanation has a certain logic to it; during a panic attack you appear and probably even feel to be under the control of an outside force, unable to control even the most simple physiological processes, such as breathing.

During a panic attack, you may experience the very real sensations of dying, suffocation, dizziness, and going crazy; a sense of unreality; and other frightening feelings. Despite outward appearances and your own perceptions, you are not "crazy" or in any physical danger.

We know that demons are not responsible for panic attacks. The word "Panic," however, is indeed derived from the ancient belief that the ill-tempered and ugly god Pan, who had the horns, ears, and legs of a goat, loved to frighten unwary travelers. Although we do not fully understand everything about panic, we now have better explanations.

Panic is rightfully thought of as a "disorder" and not as an illness or "disease." Perhaps the best explanation is that a panic attack is an overwhelming cascade of emotional and physiological reactions triggered by any number of uncomfortable and frightening sensations. That which has become sufficiently "out of order" to trigger panic attacks now needs to be put back "back in order."

Approaches to Treatment

Often, treatment for panic attacks consists of medication, talk therapy, and perhaps using one or more of the many commercially available workbooks geared towards changing your thought processes and lifestyle.

These approaches have their merits. Talk therapy and workbooks can give you a new outlook that may eventually help you prevent panic attacks. Medication can be useful in allowing you to be more comfortable and perhaps lead a "normal" life while learning techniques to stop and prevent panic attacks. These approaches bring limited success to many people; however, few go on to gain total, permanent freedom from panic attacks, even after years or decades of trying. The main limitation is that none of these approaches are completely effective until you gain control of hyperventilation symptoms, which are the primary triggers of panic attacks.

The first step in learning how to disrupt and eventually prevent the cascade of emotional and physiological reactions typical of panic is becoming aware of and learning how to control over-breathing, which leads to hyperventilation. After you progress in your recovery by learning to control hyperventilation symptoms, you go on to disrupt the cascade at an earlier stage by learning to recognize early symptoms and halt their progression. Eventually you will prevent the cascade from even starting, by having relearned diaphragmatic breathing, successfully countering anxious thoughts, and perhaps effecting changes in lifestyle and outlook. Along the way you will reduce and eventually eliminate any dependence on medication you may have.

This manual guides you through the entire process, providing specific exercises and instructions for every day of a nominal 8-week program. The package you receive with this manual includes all the training aids you will need to successfully complete the program and put your panic attacks behind you.

If you remain phobic or continue to avoid certain situations despite having gained control over attacks, you are recommended to use Healing Panic Agoraphobia Phase.

-- Bert A., M.Div., Ph.D.

What Exactly Is Social Anxiety?

2008-11-07T12:16:00.000-08:00

Social Anxiety Disorder (social phobia) is the largest anxiety disorder and the third largest mental health care problem in the world today, yet most people know little about it. People with this disorder are often labeled as "shy", "aloof", "unsociable" and even "rude", but inside they can feel trapped in their shell by this debilitating problem. The latest government data show that social anxiety may affect up to 7% of the population at any given time - the chances are we all know someone struggling with this disorder, and yet we're not even aware of it.

So, what exactly is social anxiety? It is a fear of social situations that involve interaction with other people: more specifically, the dread of being negatively judged and evaluated by other people leading to feelings of inadequacy, embarrassment, humiliation, and depression. If a person usually becomes anxious in social situations, but seems fine when they are alone, then "social anxiety" may be the problem. The feelings that accompany this disorder include intense fear, nervousness, automatic negative thinking cycles, racing heart, blushing, dry throat and mouth, trembling, weak knees, and muscle twitches. People with social anxiety know that their anxiety is irrational, yet the thoughts and feelings persist and cannot be willed away. Social anxiety is often confused with panic disorder, but people with social anxiety do not experience panic attacks. Most people who have panic attacks seek medical help, believing they are having a health-related problem (like a heart attack), but people with social anxiety realize that it is anxiety and fear that they are experiencing.

In public places, such as supermarket queues, doctor's waiting rooms, work meetings or travelling on buses, people with social anxiety feel that everyone is watching, staring, and judging them. They have great difficulty relaxing, "taking it easy", and enjoying themselves in public. In fact, they never fully relax when other people are around. The anxiety is often so distressing it becomes much easier just to stay away from social situations and avoid other people altogether. Even when they're around familiar people, a person with social anxiety may feel overwhelmed and have the feeling that others are noticing their every action and criticising their every word. People with social anxiety usually experience significant distress in the following situations: being introduced to a stranger, being teased, being the centre of attention, being watched or observed performing a task (sometimes as simple as writing their own name), meeting people of authority, making eye contact with someone, and performing any number of activities in public (making a phone call, talking, eating). The symptoms vary among individuals, and may be a generalized anxiety (overall fear of social situations) or specific (fear of performing a certain activity in public, such as eating).

Since few socially-anxious people realize they are suffering from an actual treatable disorder, they tend to keep their problem to themselves. It would be distressing, after all, if everyone realized how much anxiety they experienced in daily life. It becomes a sort of catch-22 situation - their fear of what others think keeps them from seeking help for the anxiety. If they do finally reach out to mental health professionals, however, treatment of the disorder has a high success rate. Research indicates that, after cognitive behavioural therapy, up to 90% of people with this problem report a changed life - one that is no longer controlled by fear and anxiety. There is hope for sufferers, a doorway into the world of people and healthy day-to-day social interaction.

Managing Anxiety: Expectations Are Killers

2008-11-07T12:12:00.000-08:00

STAY AWAY AT ALL COSTS - DON'T LET YOUR EXPECTATIONS GET THE BETTER OF YOU.

We do not want to "set ourselves up" ahead of time for feelings of failure and defeat. We do not want to try to "force" or "pressure" anything into happening on a particular rigid time schedule.

For example: "Today, I will go to work, march into the bosses' office, and get that raise I deserve so much."

Maybe this is a true statement, but there are too many things beyond your control in this statement that have nothing to do with overcoming anxiety.

You are setting yourself up for a fall, and it is likely that you will have one.

Maybe your company no longer is giving anyone raises. They do like your work, and they do not want to lose you, but perhaps company policy dictates that no raises are being given for the next six months.

If you take this personally and allow yourself to feel defeated, you are sabotaging yourself. Don't do it. This is not something to be taken personally.

It is NOT a slap in the face to you. This would occur to anyone asking for a raise during this time.

Or, consider this irrational expectation: "Tonight I will go out and meet someone..."

This is a big, bold, unrealistic expectation. Why? Yes, you can go out and "meet" someone, but what you mean is you want to meet someone interesting that may turn out to be a friend or a lover.

The trouble is, again, you do not have control over WHO is going to be "out there". If you have some scruples, and are really looking for a quality person who shares your interests, you have limited your chances tremendously.

This particular expectation is usually a real killer: you expect way too much, and all of it is out of your control. You are setting yourself up for defeat if you carry this expectation out.

Instead, a healthier, productive outlook is to generally increase your social activities in areas in which you have a legitimate interest. Your interest in the activity should come first, and your focus should be on having a good time that evening - not on any of the people who might be there.

If your FOCUS is on slowly expanding your social activities - and not on other things - you have automatically increased your chances of reaching your goal.

Yes, this is another paradox. the more and more (and desperately and desperately) you seek something and "expect" something, the more and more elusive it becomes.

It can turn into a depressive nightmare, and your progress against social anxiety can be halted. So, FOCUS on moving ahead for yourself, healing yourself, expanding your social circle very gradually for yourself, and you will be moving in the right direction.

Handling Stress: Alternative Cures

2008-11-07T11:13:00.000-08:00

Stress has become huge, and when looking for help or relief you will be faced with a barrage of Therapies, Practitioners and Drugs, all of which will claim to give relief from stress, and in most cases they will help. Some of the remedies available are discussed below.

The Doctor's Response

When we first fall foul of stress, we automatically go to the doctor with a whole list of symptoms and feelings, hoping there will be a miracle pill to make it all go away. But the truth is the doctor can only treat the symptoms and not the emotional or physiological reasons for the condition. In the limited time available with you, the GP will try his or her best to get to the bottom of why you are as you are.

Medication is not always the answer to solving stress, so many GP’s will refer you to a counselor or community psychiatric team. They may also refer you to a specialist: Psychotherapist, Psychiatrist or Clinical Psychologist.

Drugs

Depending on the symptoms you present to the GP, in some cases drugs will be prescribed to help you through a difficult time. In most cases these will be tranquillisers, though these will not be prescribed over a long period of time as they can be addictive.

Beta blockers help with anxiety, reduce palpitations, tremors and sweating. Depression caused by stress can be dealt with by another series of drugs, which can be given over longer periods of time, as they are in most cases not addictive, although some do carry some nasty side effects; some people experience withdrawal symptoms when they stop taking them. There are two main types of anti-depressant – the older style tricyclic drugs and the new selective serotonin inhibitors (SSRI’s) such as Prozac. Note: users of these drugs should be aware that it can take up to three weeks for these drugs to take effect and during this time you may experience side-effects, but you should continue taking the drugs under advice from the prescribing GP.

Under times of stress, we may take drugs in other formats that we don’t even consider as drugs, such as alcohol, cigarettes and recreational drugs. These will alleviate the stress short term but will not keep it at bay for good.

Alternative Cures

Talking
‘Talking it out’ is good for stress. Your GP may suggest you try a counsellor or psychotherapist who is free of charge, however the waiting time for these appointments can be up to six months in most cases, or your GP may refer you to someone private.

Counseling
Counselors generally don’t specialize in stress, anxiety or depression. However there are Stress Counselors who do. The counselors will be able to assist you in examining your causes of stress and suggest ways for you to deal with it better.

Psychotherapy
Psychotherapy delves deeper into your background, rooting out possible causes for your stress and the state you may be in. This therapy will tend to go on for longer than counselling.

Cognitive Behavior Therapy (CBT)
CBT has become more popular over the past few years. It focuses on changing negative thought processing into positive. The therapy aims to show you how to identify negative thought patterns and give you positive ways to change them.

Stress Counselling & Stress Management
Over the last ten years we have seen a rapid increase in the interest in Stress Management consultants and counselors. They can help you identify the underlying causes of your stress and give you positive coping strategies.

Aromatherapy
Aromatherapy is a world away from scented bath oils. Practitioners will use a variety of oils best suited to your needs, such as Lavender, Marjoram and Geranium. They may be added in a carrier oil to aid massage or dispensed from a diffuser.

Flower Remedies
Bach remedies are the best known flower remedy and marketed for a range of emotional difficulties.

Healing
Spiritual, Faith and Reiki healing all involve energy being passed through one to another. This can be done via the laying on of hands or distance healing.

Massage
Massage is a very relaxing experience which many people find beneficial when stressed, whether done by a practitioner, partner or friend.

Relaxation
There are many methods of Relaxation (See Services and courses), either taught by professionals or ones you can teach yourself. Many bookstores and health food shops sell books and videos for you to use yourself. Yoga is often recommended because of its relaxing qualities and the use of deep breathing.

Stress and Ulcers — Just a Myth?

2008-10-23T20:38:00.001-07:00

"You'd better relax — you're going to get an ulcer!"

Common wisdom holds that ulcers are caused by stress, and until recently, so did medical wisdom. The medical picture changed in the mid-1990s when the National Institutes of Health concluded at a major conference that most ulcers are caused by a bacterium called Heliobacter pylori (H. pylori) and should be treated with antibiotics.

Although the first antibiotic for treating peptic ulcer disease was approved in 1996, many patients and doctors remained unaware that most cases are caused by infection. In an attempt to educate the public and the medical community, government and professional associations launched extensive educational campaigns. The message was simple: ulcers are caused by infection, not by stress or spicy food.

But the pendulum may have swung too far, according to recent research. While it's true that many peptic ulcers are caused by H. pylori infection, many are not. And, only about 20 percent of those who are infected with H. pylori ever develop ulcers. So while recognizing that the bacterium is definitely a big part of the picture, researchers are turning again to look at the role of psychological factors, especially stress.

"Evidence linking psychosocial stress to peptic ulcer is too strong to be ignored," states Dr. Susan Levenstein of the San Camillo-Forlanini Hospital in Rome, Italy. "Psychosocial factors can be estimated to contribute to 30 percent to 65 percent of ulcers."

In a recent issue of Psychosomatic Medicine, Levenstein explains that although many of the studies linking ulcers to stress were poorly done, there are still many that weren't. Important among these are prospective studies that follow a group of people for a period of time to see what factors at the beginning of the study predict later development of ulcers.

These studies report that psychosocial factors such as stress, depression, trauma, job frustration and family difficulties all predict later development of ulcers. Other studies have shown that these factors slow the healing of ulcers. One problem, Levenstein points out, is that some other influence could be causing both stress and ulcers — socioeconomic status or medical conditions, for example.

But even when these factors are accounted for, it appears that stress plays an important role in at least some cases of ulcer. In an Australian study, for example, 44 percent of patients recently diagnosed with duodenal ulcers reported experiencing severe and often chronic stress during the previous six months. Among a comparison group of healthy subjects matched for age, gender and socioeconomic status, only nine percent reported such stress.

Levenstein points out that stress can contribute to the development of ulcers without actually causing them. For example, stress can influence health behaviors such as smoking, drinking and poor eating and sleeping habits — all of which are established risk factors for peptic ulcer. Research also suggests that people who feel stressed are more likely to take medications called non-steroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, ibuprofen, naproxen and a number of prescription medications. These drugs definitely can cause ulcers; this is actually one of their most serious side effects.

But even after accounting for these stress-related health behaviors, says Levenstein, stress itself remains a risk factor for ulcers. A nine-year study in California found that participants with high levels of stress were more than twice as likely to develop ulcers than those without stress, even after accounting for smoking, drinking, eating and sleeping habits.

There are several ways that psychosocial factors might contribute to ulcers, explains Levenstein. Emotional distress and severe stress (as some mood and personality disorders) are significantly associated with increased production of acid in the stomach and small intestine. These psychosocial factors can also affect the body's immune system and hormone balances, impairing its ability to heal.

According to Levenstein, about 20 percent of ulcers appear to be unrelated to either H. pylori infection or taking NSAIDs — the two major causes. Recent studies report that only one-half to two-thirds of ulcer cases involve bacterial infection. Levenstein suggests that in some cases, individuals may be physiologically predisposed to develop ulcers, and the effects of psychosocial stress in the body activate this tendency. In fact, she suggests, some ulcer cases in which H. pylori is found may not actually be caused by the bacterium.

The bottom line, says Levenstein, is to look at peptic ulcers the way we look at cardiovascular disease: as a complex condition that's influenced by a variety of genetic, physiological and psychosocial factors.

"Stress and heliobacter may be two independent risk factors with additive effects, just as diabetes and smoking carry additive risks for coronary artery disease," the researcher suggests. "[Some] ulcers may be destined to develop regardless of the individual's psychological characteristics, but there is some evidence that light infections may be helped to evolve into ulcers by psychosocial factors."

As both the general population and the medical community turns to more complex explanations of diseases from heart attack to the common cold, we can expect to see more and more research showing that psychosocial and physiological forces interact in human disease.

Stress and Asthma: What's the Connection?

2008-10-23T20:36:00.000-07:00

Most experts would agree that there is a connection between emotional stress and asthma but beyond that, a great deal of controversy still exists. Does emotional stress trigger asthma or make an attack worse? Or is emotional stress the result of asthma symptoms?

"I believe there's a link between people's emotions and asthma attacks," observes Stuart A. Tousman, Ph.D., associate professor of psychology at Rockford College in Rockford, IL. Nationally recognized for his work in this area, he conducted a workshop on the connection between asthma/allergies and stress at the 56th Annual Meeting of the American Academy of Allergy, Asthma and Immunology in San Diego

While studies show a clear relationship between emotional stress/anxiety, frequency of attacks, amount of medication needed to control symptoms and hospitalizations due to asthma, there are several possible explanations for this. Emotional stress could act as a trigger for asthma, and it could also make an attack worse as it is occurring. At the same time, symptoms and other factors associated with the disease could interfere with an individual's life to the point of damaging his or her self-esteem, and that can be very stressful.

Some researchers believe that individuals with asthma experience much of their stress as a result of asthma attacks or poorly controlled asthma. Many of these experts worry that seeing stress primarily as the trigger might lead health care providers to underestimate the impact that an individual's asthma symptoms are having on his or her emotional health.

On the other hand, researchers who believe that stress can trigger asthma symptoms or make them worse sometimes fear that other healthcare professionals aren't doing enough to help patients with asthma manage the stress in their lives.

While individual experts might focus on one explanation over others, the reality may be a combination of each, and recent studies suggest that adding psychological techniques such as muscle relaxation training and asthma self-management training to conventional asthma treatment can further improve a patient's response to asthma treatment.

Such programs work because they help patients identify and cope with stress related to their disease, and they provide education about asthma and its treatment so that patients can take better care of themselves. In addition, programs like this help patients and their health care providers to identify factors that might be keeping the patient from complying with treatment-- such as an inability to pay for prescriptions or the presence of unpleasant medication side effects.

Patients in one study experienced a reduction in asthma symptoms and anxiety level and an increased quality of life with the addition of psychological techniques to their treatment plan.

Another study, conducted by Dr. Tousman and his colleagues, examined 13 patients who completed a seven-week program that included interactive education, social support, relaxation training and humor therapy. Each week during the study, patients were asked to make a specific behavioral change such as exercising for 30 minutes or practicing relaxation for 30 minutes.

Study participants reported that the program relieved the tightness in their chest, made them feel less tired, improved their ability for achievement and improved their ability to control their asthma. These patients felt they had benefited most from education about medication options for their illness and learning how others cope with their asthma. The study also indicated that patients adhered to their medication plan better and felt more empowered to make lifestyle changes likely to improve their health.

Support and Stress: loving company of others can help reduce the negative health impact of stress

2008-10-23T20:28:00.000-07:00

For most people, emotional well-being and life satisfaction are closely linked to the quality of their social life and close relationships. The loving company of others can help reduce the negative health impact of stress. Sharing one's life and heart is healing. Meaningful, close connections are associated with peace and well-being. Physical changes that result are the same that deep relaxation brings: lower blood pressure, artery wall relaxation and slower heart rate. The immune system works best and the heart thrives in this physical and emotional environment.

But what does it take to develop and maintain relationships? Whether with friends, family or a life partner, good relationships are based in mutual trust, caring and effective communication. Start by asking yourself what "you" like in a friend or partner. Chances are it will be a combination of qualities similar to those below.

Qualities Sought In Supportive Relationships
Loyalty	Warmth or Affection	Empathy
Honesty	A Sense of Humor, Lightness	Makes Time for Me
Independence	Keeps Confidence	Meaningful Conversations

The qualities you like in others, others will like in you. Unlike the common saying "opposites attract", truly supportive relationships are more likely when people with similar values for companionship come together. If you want to attract people who have the qualities you value, be sure to work on these qualities yourself. You will be more attractive as a friend to the type of person (people) you seek to meet. And, you will bring out the best in those who are already committed to supporting you.

Communication skill is another aspect of support. This term refers to our ability and willingness to talk about ourselves, to make reasonable requests, and to listen to another with an accepting attitude. Without communication skill, a caring connection with another will be hard to initiate and harder to maintain.

Finally, social support depends on the community from which you draw. If you are alone much of the time, it may seem that support is not available at all. Or, if you spend a great deal of time with people who are unavailable for meaningful friendship, you may feel alone despite their physical presence. No one has to be lonely. While it is sometimes uncomfortable to begin the process, expanding your social circle may open up important new doors. Reaching out to make friends and joining new groups can make a big difference in your health and happiness.

Communications with Others

Communication is the task of helping another person see in their mind what we see in ours. What we need to communicate includes requests, instructions or information about our experiences and ourselves. We obviously use words to communicate, but also body movements, facial expressions, and various pitches and tones in our voice. By these means, others create pictures, feel feelings and understand our thought process.

There are also times when no action is communication. No words, no sounds, no gestures. In situations where the message is mute, the communication may be "I need to withdraw" or "I am not ready". At least, it could be interpreted this way.

So, here is the crux of so many communication errors: Interpretation! We interpret other people's verbal, non-verbal and even muted messages based upon our own experiences. They, on-the-other-hand, are usually relating to their own. Needless to say, ineffective communication can and does result. Miscommunication is often a barrier to understanding between people. When this happens, opportunity for support can be missed.

Reflect On Your Communication Style

One important skill in support building is communication style. There are four styles people use. While we use each of these styles at various times, most of us have one style of communication that is more comfortable and commonly used. However, of the four, the assertive style achieves the best results for building true support. This style respects both you and the one to whom you are speaking. It is an easy style to hear, and accept. It builds empathy and understanding, without compromising either party.

For passive individuals, developing assertiveness skills can be uncomfortable. It may help to remember that assertiveness is not aggressiveness. By speaking up and making reasonable requests of others, you do not imply that you are more valuable. You assert that you are "as valuable". It is also important to know that being assertive does not guarantee that you will get all that you want, or think that you need. It does insure that your cards, your needs, are at least on the table. Without that, you are unlikely to get find the support you need or help you desire.

For those who are aggressive, changing to a more assertive style can also be difficult. It is seductive to move through life with a sense of power or control. If we make demands, we usually get what we want. The problem with aggressiveness is that personal isolation often results. If others feel disrespected and unheard as a result of aggressive communication, they will eventually pull away. Others become resentful or angry, leading to open conflict. In the end, aggressiveness usually leads to loneliness, a lack of connection to others and no support.

Passive Aggressive communicators may be confused themselves by their difficulty in gaining support from friends and family. The problem is that initially, during a passive phase, true requests or expectations are not fully stated. As a result, a potential supportive ally may make false assumptions about the situation, and be unable to choose or change behavior based upon reality. A common pattern for passive-aggressive communicators is to let resentment build during a passive phase. Once they have "had enough", they switch to aggression or "blow up". This is a confusing communication pattern. It can lead to frustration and missed opportunities for support.

Poor communication can fuel stress, anger and depression. Frustration with self and others, as well as a lack of meaningful connections, is often the result of weak communication skills. To foster healthy relationships and create more positive emotional experiences for one's self, assertive communication skills are worth the effort they take to develop. One tool that can help guide the process of framing assertive statements is the DESC method. Don't expect change to come quickly, but practice with the techniques will improve your skill.

Meaning and Purpose

Consider the importance of meaningful activities and purpose in one's life. People who do not have a good reason to get up in the morning are less likely to thrive than those who do. Physical and emotional health both decline when we stop doing things we enjoy or we feel our life does not matter. Defining and pursuing what is most important can add to your life satisfaction, enhance your health and heighten your sense of well-being.

Meaningful activities make life worth living. They can be a lot of work, as are parenting, relationships, volunteering, or pursuing an education. They can also be light and fun, such as sports, dance, art, music, hobbies, humor, or travel. Both types are important. Balancing time should be an objective. Too much time spent in activities that are not satisfying, or avoiding activity altogether, will leave one with little enthusiasm, few smiles and more stress. It is important to routinely make time for things that bring satisfaction and enjoyment into your life.

Purpose refers to our belief that we matter, that our contributions are valuable. One's sense of purpose can be related to the lives of other people, the environment, discovery or invention, spiritual development or any number of other definitions. When positively defined, life purpose is a powerful reason to get up in the morning, to move forward in the face of challenge and contributes to life satisfaction. Positive goals and purpose are important to everyone, and there is no one path to realize them. A sense of purpose is personally derived, and must be personally pursued.

In Life's Odyssey, you have opportunity to evaluate the meaning and purpose in your life, as well as your current time priorities. From it, you can learn more about balancing activities to enhance quality of life.

"withdrawal was one of the worst weeks of my life, nausea, confusion, rage, sadness, incredible dizziness and horror"

2008-10-09T13:32:00.000-07:00

Just wanted to follow up with my post from last week. I took my last dose of Paxil on a Thursday, with dizziness starting to take place on Sunday, becoming worse through Thursday the following week. It is now Saturday and I feel I've come through the worst of it. The withdrawal was one of the worst weeks of my life, nausea, confusion, rage, sadness, incredible dizziness and horror that it went on for five days relentlessly. I was bed-ridden, and feared it would never end. I have been successful in getting off of this poison and would never take it again. I found that my experience with prozac was much more positive in treating my depression and did not have the horrendous withdrawal. And I encourage all those who are having trouble getting off this medication to get lots of rest and persist through it. My withdrawal took about nine days, and I still have a little lightheadedness here and there, though it's been manageable. Good Luck to you all!

"I have now lived three years with social anxiety disorder and panic attacks."

2008-10-09T12:07:00.000-07:00

First I have to say that I am not currently going through withdrawals and after reading this, I won't ever go through them because I won't start this terrible drug! About three years ago, I was given a three week sample of Paxil for what my "then" doctor prescribed as panic disorder. He told me that he would make sure that I got "my life back". I went to work that afternoon and started taking the drug. The very first day I felt worse than normal. I felt like I was floating and had tunnel vision. I also could not concentrate. I knew that this was not for me. I have now lived three years with social anxiety disorder and panic attacks. Going to the E.R. once with a panic attack. My job and family have suffered because of my "anti-social" behavior. But I am very blessed to have them constantly supporting me. Yesterday, I went to a new doctor, feeling like I just can't take this anymore. I am not depressed, but I want my life back. He gave me a three week sample of 10mg. a day of Paxil and told me to get back with him in two weeks. I thought maybe I was just being silly the last time, but before I took it, I wanted to see if there was anything on the Internet regarding Paxil. I am so thankful that I did! My heart goes out to each and every one of you. We are all fellow sufferers of anxiety or panic attacks, and it is really a crime what doctors are doing to us, or trying to do. I point blank asked my doctor if there would be any side effects and he answered "no". A good friend of mine suggested BuSpar for me, and I found nothing negative through the Internet regarding that drug. But I am so frightened now to take anything, that I guess I will continue fighting this anxiety battle on my own. I welcome anyone to write me with suggestions. I will pray for you all.

-- submitted by hrdfwsouth, 38

"I began having vivid, anxiety filled dreams, and lightheadedness"

2008-10-09T12:04:00.000-07:00

I switched from prozac to paxil in June. I tried tapering the dose until I was at 15 milligrams every other day for a month. I took the last dose a week ago. After 3 days, I began having vivid, anxiety filled dreams, and lightheadedness. The dizziness has been severe for the last three days, an is accompanied by a feeling that my heart is pounding when I move suddenly, mental confusion, nausea, pounding sensations in my head and ears, emotional surges and the overall feeling that I have the flu. I am determined to stay off of this poison, but I don't know how long this withdrawal will last. Previously, I had ended a cycle on Prozac with no side effects whatsoever.

-- submitted by KJHSF, 35

"I am hoping I can come off Paxil cold turkey with the help of this drug"

2008-10-09T12:02:00.000-07:00

I am on my fourth or fifth day of withdrawing from Paxil and I am very nauseous some of the time and my head spins now and then. Sometimes it is extremely bad and sometimes its not as bad but today I went to the drug store and got some thing for motion sickness and nausea and it helped tremendously. It makes me sleepy though but it is much better than the alternative. I am hoping I can come off Paxil cold turkey with the help of this drug. Also my hands and feet are icy cold and I am alternating rage with sadness but I felt so much better to read other accounts which described the same thing. This is the second time I have come off Paxil 20 Mg. and before I weaned myself by taking less and less but it took 3 or 4 weeks i think. I am hoping taking none at all might get me off faster. Paxil has worked pretty well for me but I don't have any sexual desire or much ability to have an orgasm.I also thought it would help me control my overeating and it certainly hasn't.

-- submitted by John, 46

"accumulative effects of the drug (30 mg/day) had me sleeping most of my life away"

2008-10-09T12:01:00.000-07:00

I began taking Paxil in 1996. It seemed like a God-send at the time. Last year, the accumulative effects of the drug (30 mg/day) had me sleeping most of my life away. With a 6 year old daughter, I felt very guilty about not spending enough time with her. I also had to quit my job because I could not get enough sleep to function. My house was a disaster area- laundry piled up, dishes piled up, dirty clothes piled up, what's worse is that I didn't even care! So I've tried several times to wein myself off the drug. I would like to be drug free in order to have a second child. However, every time I've tried I get off the medication, the exact same types of hellish withdrawal symptoms as described in your story occur within 3 days. Ironically, I'm more depressed now, losing the battle against this addiction. I feel defeated and robbed of the blessing of ever being able to have another baby! So far I'm unsuccessful. Right now I'm at 5mg/day and too afraid to cut it off for fear of the horrible withdrawal symptoms. My prescribing doctor says "just quit now" Yeah easy for her to say! The sickness is just as you described!!!! Aren't doctors aware of this or are they? I feel like I'm the victim of a guinea pig experiment.

-- submitted by traci, 32

"After two years I was weaned off the Prozac, but my Panic Attacks started again"

2008-10-09T11:59:00.000-07:00

I was diagnosed with Panic Disorder 5 years ago. I was first treated with Prozac and Xanax. After two years I was weaned off the Prozac, but my Panic Attacks started again. I was then put on Paxil 40 mg per day. I felt wonderful on the Paxil and the Panic Attacks stopped. After a year I was weaned off the Paxil. With each decrease in dosage I suffered terrible withdrawal symptoms, from trembling, nausea, spacey feelings,anxiety etc. It has taken me three years to be at 10 mg and I have stopped there. I'm not ready to deal with the withdrawal again! I must say Paxil was very helpful with my disorder and without it I may have been a prisoner of my house. I have spoken to several doctors about this medication and none of them are aware of the withdrawal symptoms. Many times the symptoms of withdrawal are the same as the symptoms of our disorder so even the patient may be fooled. I'm trying my best to educate my doctors, but it is a slow process.

-- submitted by myers

"diagnosed me with this social anxiety disorder and gave me a large stack of paxil"

2008-10-09T11:53:00.000-07:00

I started working in a retail business about 2 years ago and started eating more and smoking more after gaining about 40lbs I became concerned and went to my doctor with no physical exam and just asking a few questions he diagnosed me with this social anxiety disorder and gave me a large stack of paxil sample packs and gave me instructions on bringing my dosage up from 10 to 40 mgs. in just 12 days after being on 40mgs for about 4 days i had no energy any more just getting out of bed in the morn was a battle and my head became foggy and I had to stop and think about everything that always just were just every day life things I could not even drive. I decided this was not the drug for me and stopped taking it I guess I just assumed that if there were any problems with this that the doctor would have warned me about it or there would have been some sort of warning on the package. this is when my horror began 2 days after quitting came the loss of apatite sweating nausea and all the other things i have been reading about after missing two days of work I was fired from my job and a means to support my wife and son. after a week of sever withdrawals I went back to see my doctor and he told me that he had never heard of any adverse withdrawal effects its been three weeks since I have still bad effects nausea , vertigo cant drive if its not obvious writing and typing are a struggle I feel as though my brain has been fried the people who have had there lives ruined by this drug need to get together and sue smithkline beecham for doing this to us

-- submitted by robert arnson

"I felt on paxil that I couldn't have a great orgasm or none at all"

2008-10-09T11:51:00.000-07:00

Well I have just gone off paxil, I had been on it for 10 months for panic disorder. This is one full week without paxil and first attempt at going off of it, The only problem I experience is what people seem to be describing as brain shocks when ever I turn my head a certain way I feel very strange, like in my head, and nausea from time to time. I was on 20mg then 10 for three weeks and for the last week 10 every other day. I feel ok, for the most part except when I dropped down to 10 I was like whooooa, I had feelings again, I felt on paxil that I couldn't have a great orgasm or none at all, and I had no real emotion towards things, although it has helped me immensely, I have decided regardless of what withdrawal I feel, I am going drug free.

-- submitted by shelagh

"I started taking Paxil about 5 years ago for depression"

2008-10-09T11:34:00.000-07:00

Believe it or not but this is my third time to wean myself off of Paxil. I started taking Paxil about 5 years ago for depression. I took 20 mg a day for 2 years. I decided to get off and went cold turkey. It was not a pleasant experience to put it mildly. I had severe nausea, dizziness and was extremely distressed emotionally. I felt like I would never feel right again. After a couple of grueling weeks I felt better. I got back on it again about a year later because I had started getting depressed again and the Dr. encouraged me to. I took it for about a year and got off again. Same lousy symptoms getting off. Oh how we forget! I got on it again because I was having panic attacks. The Dr. told me that this was the best medicine for the panic attacks and that studies show that there are no long term effects from staying on the medicine indefinitely. I thought I possibly had mitral valve prolapse, but in fact it was panic attacks because the Paxil immediately took the symptoms away. Which at the time was a good thing. I just wonder how good it is for your body if it causes such a toxic reaction when you quit taking this drug. I've been on it a year and have just had it with this medication. I have put on 30 lbs. and feel horrible. The Dr. said that for some reason people who have been on it for a while sometimes experience weight gain. In my case I feel like it makes me hungry. I also feel like it gives me a feeling of complacency about my eating and weight gain, even though at times I feel disgusted with myself. Anyways, I've been off for 5 days and feeling lousy. I've been extremely nauseated, hot and cold (my hands have been like ice cubes), dizzy, and I feel like an emotional wreck. I ended up taking 10 mg today because I have a party scheduled at my house in 2 days and have too many things to do. My plan is to get through the next 2 days as best I can on the least amount of medicine possible. After that I will continue to refrain from the medicine and get off of this for good!!!!!!!!!!!!! I am going to hire someone to clean my house and I told my husband that he and the kids are on their on for the next week. I had him read all the testimonies so he would understand better. I don't think he really understood how bad I felt until he read what others were experiencing trying to get off this medication. The last 2 times I got off I tried to maintain my same pace with the kids and school and the house and tryed to put on a 'good face' when all I wanted to do was tell people, "Hey I feel like you know what so just get out of my blanketey blank face!" It was brutal. The last couple times I got off I remember after a couple weeks I felt better and after about a month I was back to normal. The first week is really rough. It's hard to get off this medicine but I have done it and I will do it again!

-- submitted by Dr. Marso

"I was experiencing anxiety due to some overwhelming situations in my life."

2008-10-09T11:33:00.000-07:00

I began taking the 20 mg of Paxil approximately 15 months ago when I was experiencing anxiety due to some overwhelming situations in my life. I began trying to wean myself off the medication about nine months ago. I started taking 10 mg per day and then 10 mg every other day. Everytime I went more than three days without taking the medication, I began feeling sick at my stomach and somewhat disoriented. I would feel better if I took another 10 mg pill. I asked the doctor who told me that if it makes me feel better, it does not hurt to continue taking it. It has made me gain over 25 pounds and I do not want to take this drug for the rest of my life. I am now taking 10 mg every other day.

-- submitted by Dday, 35

"symptoms I had prior to taking this medication seem like a minor annoyance compared to what is happening to me now"

2008-10-09T11:30:00.000-07:00

I am a 42 year old female diagnosed with severe depressive disorder accompanied by manic episode. I have been on paxil about 2 years over the course of the 2 years my dosage has had to be increased several times until the most recent increase to 40 mg ...this is the point where I decided I no longer wish to live on this drug... under the guidance of my doctor - who I must tell you said "the withdrawal is bad from paxil" would have been nice if that was told to me in the beginning or if the information was provided with those handy little inserts that accompany your prescription....anyway I am on my 3rd day drug free and the symptoms are getting worse by the day....the symptoms I had prior to taking this medication seem like a minor annoyance compared to what is happening to me now...I am dizzy, I have the swimming feeling in my head, unprovoked rage, uncontrollable crying spells on and on ...unfortunately my appetite is fine and the food is tasting good and staying down(kidding) I am actually waiting for the nausea to set in because all the testimonials I have read include nausea...I will keep you posted on my progress....because I will be damned if I ever take another Paxil..or any other prescribed antidepressant ...

-- submitted by Pam, 42

"I decided to get myself off the Paxil"

2008-10-09T11:27:00.000-07:00

I had been on 20mg of paxil for almost 4 years. About 2-weeks ago I decided to get myself off the drug. Anyway, I dropped down to 10mg a day for 2-weeks and last Wednesday took my last pill. At first I thought I was losing my mind and falling back into depression, but after reading postings of others' experiences I am relieved that what I am going through is "normal". Overall, the drug was beneficial and helped me through a difficult period in my life. The withdrawal symptoms are rather brutal - nausea, brain-shocks, periods of intense sadness. However, I am determined to manage without it. I am on day 4 with no meds and am feeling a little better. At times I just want to go back on it. But, I do believe there is a light at the end of the tunnel and bravely I will face each day. Thanks to all the postings for shedding some light on getting off this drug. It has certainly alleviated some of my fears.

-- submitted by Lisa, 32

Stress Management: Breathing

2008-09-08T12:54:00.000-07:00

Have you ever concentrated on your breathing, while going through the daily mundane chores of life? For most of you, breathing is an unconscious activity that you tend to take for granted. You may have noticed that for a lot of activities and sports you need to concentrate on your breathing. Controlling your breathing is crucial for effective performance. That is why breathing exercises are amongst the most useful and popular relaxation techniques. The more you use this method the more you will begin to appreciate its effectiveness and reap rich rewards from it.

Despite the fact that breathing is one of the most vital functions of your body it is not only a concept that is not well-understood but is also done improperly. It can affect the way you feel, both mentally and physically. Breathing can also affect your emotional and physical feelings. Breathing right can help in reducing anxiety, depression, irritability, muscle tension and fatigue. It can improve your vitality, your thinking and even how your skin looks!

What happens when you breathe incorrectly? Because an insufficient amount of fresh air reaches your lungs, your blood is not properly purified or oxygenated. Products that should have been removed are still in circulation, slowly poisoning your system. Digestion gets hampered. The bodily organs and tissues become undernourished and deteriorate. Poorly oxygenated blood also contributes to the states of anxiety, depression and fatigue, and makes each a stressful situation harder to cope with. Thus proper breathing habits are essential for good mental and physical health.There are basically two kinds of breathing:

Chest breathing: This is characterized by an upward, outward movement of the chest wall. The breath is shallow, jerky and unsteady. It is usually seen when the body is aroused by certain challenging or stressful situations. There is a direct relationship between the mind and breathing. Unless this shallow and jerky breathing is replaced by deep and even abdominal breathing, the body will continue to be in a state of constant arousal and tension.

Abdominal breathing: This is also referred to as diaphragmatic breathing, since it involves the diaphragm. The diaphragm is a sheet of muscle that separates the chest activity from the abdomen. When you breathe in, the diaphragm contracts and pushes downwards. This relaxes the abdominal muscles.

When you breath out, the diaphragm relaxes and the abdominal muscles contract to expel the impure air. It is the most efficient type of breathing, because it enhances greater expansion and ventilation of the lungs. It also improves circulation. When you are calm and relaxed, you breathe abdominally. Learn to breathe correctly and you will feel a marked difference in your life.

Avoiding Exam Stress

2008-09-08T07:08:00.002-07:00

How do you know if you are suffering from examination stress or not? Broadly speaking, you can have three types of symptoms -- psychological, physical and bodily symptoms.

Psychological symptoms would include your inability to concentrate on your work, getting angry at the slightest pretext, feeling tense, brooding and being unable to relax. Physical symptoms include feeling tired, being unable to sleep, a feeling of throwing up, indigestion and sweaty palms.
Other common symptoms include eating chocolates, drinking loads of coffee, neglecting your looks, biting your nails, pulling your hair and tapping your fingers on the table. If you have most of these symptoms, then you are stressed out. Here are a few tips on how to avoid exam stress:

Acknowledge the problem: The first and foremost rule of beating stress is to acknowledge the fact that ‘yes I do have a problem’. Identify the problem, or else you are not going to know what you are dealing with.

Get help: Once the problem is identified then you need to get help. You can go to anybody who you feel comfortable with. For example, ask a teacher or a tutor on how to organize your material or on how to revise.

Take short tests: Self-testing is a very good assessment of judging where you stand. Remember you are doing this for yourself so don’t fool yourself. Assess yourself and then work on your weak points.

Plan your work: Make a detailed timetable and plan out your work. This will also give you a good perspective as to where you stand.

Stay healthy: You may neglect your health during exam time. However, it is important to eat well and get enough sleep in order to put in your hundred per cent.

Exercise: Sitting on your table all day long will make you dull and difficult for you to retain everything. You must exercise, go for a walk and get a breath of fresh air to keep your batteries charged.
Be positive: Do not waste your energies on negative thoughts such as, "What if I fail, or don’t finish my paper on time or don’t remember anything." This will only make things worse for you. Concentrate on your work and don’t hassle yourself thinking about the future.

Be alert: You must be totally alert while studying and should have nothing troubling you at the back of your mind.
Don’t be too relaxed: Some amount of stress is positive and will make you work harder.

Do your best: At the end, what’s important is that you give your exams your best shot and leave the rest to your teachers.
Remember the more stressed you are, the more difficult the period of exams will be for you. It is in your hands to control your stress. Follow these simple rules and do it now.

Your Guide to Stress Free Working

2008-09-08T07:08:00.001-07:00

"My boss is always picking on me, my colleagues think I am footloose and fancy free, I am always discriminated against because of my sex, my views are often ignored… all this because I am single and working…oh the travails of a single working woman."

Is this your story? Today, as more and more women aspire for top positions, social and gender prejudices have become all the more glaring. So what are you doing about it? Suffering in silence and being victimised for no reason, or taking some proactive steps to counter the critics. There's no law that says that you can't be single and working and happy, all at the same time. Here's how to get started:

1. Get Organised
Organise your work in such a way that nobody ever gets a chance to point fingers at you. You will feel a spurt of new confidence creeping in and people will start respecting you. Follow the dictum 'People get to you only if you let them' so it is all in your hands. Don't give anybody a chance to say anything by keeping yourself updated and organized.

2. Be Assertive
Learn to stand up for yourself and assert your views. You are a mature young woman of the 21st century who wants to make her own space in the professional world, so don't take everything lying down? Charge forward, air your thoughts and opinions, make your presence felt by sheer dint of hard work and your intelligence. Assert yourself when you know you are right and just watch the balance tilt in your favour.

3. Learn to ignore
Turn a blind eye to things that don't affect you directly and you will be better off. Remember ignorance is bliss. Of course, don't make this a universal rule.

4. Speak your mind
Remember people will take advantage of you if you let them, so sit up and speak your mind. Nothing and nobody can stop you if you are in the right. Only don't be rude or step on anybody's toes! Be soft spoken and amiable and if you are right, you will be heard.

5. Say NO when you have to
Learn to say NO. There is absolutely no need to accept social invitations from colleagues or requests to finish off somebody else's work. If you always feel cornered into agreeing to some issues, remember that it is in your hands to not get cornered.

6. Confront the culprits
If somebody in the office is trying to act funny or get too close, be it the boss or a colleague, tell them frankly that it is in bad taste. Being single does not mean that you are fair game. If you feel that there are hands brushing against you or some one forever banging into you then it is time to confront them. Just tell them to watch where they are going and to keep their hands in their pockets loud enough so that the entire staff hears you!

7. Don't get involved in office politics
Colleagues might try to involve you in office politics and groupism, but the best policy is to stay neutral. Avoid gossip and gossipmongers and concentrate on your work.

8. Be aware of your own strengths and weaknesses
Recognize your strengths and weaknesses and leverage them to your advantage. Work on your weaknesses and gradually improve them.

9. Always look confident
Always have an air of confidence about you even if you are all jittery inside. Only beware of not being overconfident!

10. Be proud of yourself
Last but not the least, be proud of what and who you are. You are a beautiful, intelligent, single woman determined to create your own niche in today's world. So just stay focused, go ahead and do it!

Think of Indira Gandhi, Margret Thatcher, Benazir Bhutto - three women of steel who fought against all odds and changed the face of history. If they could do it, so can you!

Simple Tips: Unleash the Power of Positive Thinking

2008-09-08T07:07:00.000-07:00

It’s Monday morning. Sanjay is edgy and worried. He has to make an important presentation in front of the top management team, for which he has been working through the weekend. He says to himself: "I am dreading this. What should I do? Will the top brass rip apart my presentation? Will I be able to answer their questions or not? May be they won’t like my presentation."

Sanjay is definitely making things difficult for himself by harboring negative thoughts in his mind. To make himself feel better all he has to do is some positive thinking. He should say to himself: "This presentation is going to go off well. I have worked hard on this and I know it is good. I know my work and I will be able to keep them interested."

Thinking positively will change your attitude and make you positive. It will help you cope with the pressure and the stress that is taking the toil on your body due to the constant reminder that you find a task difficult and you won’t be able to do it. You can become positive by constantly talking to yourself and motivating yourself. This is known as self-talk.

Self-Talk

This is a process of endless monologue, which you carry inside your head. It influences the way you perceive things and the message that you give to yourself. Self-talk can either be positive or negative. There are two ways at looking at every situation.

For Example:

Car problem on the way to office
" Damn this old car. I'll miss all my meetings. It's hopeless". You can change this to: " Bad time for a problem. Maybe if I call office and let someone know, they can start the meeting and I will join in as soon as possible."
Anticipation of a presentation
" What if I blow it? What if nobody laughs at the opening joke? What if they ask about…. I hate talking to groups." You can change this to: " This ought to be a challenge. I'll take a deep breath and relax. I am sure they will enjoy it. Each presentation goes a bit better. I know I am good and I can do it."

It is important to pay attention to the quality of your thoughts, because they determine how you feel during the day, how well you perform and how well you sleep at night. What positive thinking can do is to get you into the right frame of mind, to demonstrate your skills to the best of your advantage while you stay calm and focused. When you are relaxed you are likely to deal with problems more effectively and constructively. So a positive outlook is a must. When you think and tell yourself that you can, you will, and you must, notice the marked difference it will make in the job that you undertake.

Positive thoughts: Once you undertake a task tell yourself positive thoughts about:

You as a person:

I am good
I can cope
I am better than a whole lot of people
I can do this
Its not that bad after all
I have done more difficult things before
Use mental mantra's " I will…., I can…"
I am the best and I will achieve it
I can influence my destiny
I look and feel good
I enjoy my own company
I can succeed

About specific events:

I will succeed in this presentation
People will listen to me in this meeting
I am a little nervous, but I will relax
I can make a difference
I will achieve the result I want
I can win
Now get working and see the difference it will make in your life and work. Start now and get results today, for tomorrow might be too late.

Dealing With Post Pregnancy Stress

2008-09-08T07:06:00.000-07:00

The wait is over. After nine long months of waiting and watching, dreaming and hoping, your bundle of joy has finally arrived in this world and in your life. Only to turn it topsy-turvy. Welcome to the world of nappies and diapers, sleepless nights and bawling infants. In short, coping with the initial phase of motherhood will be quite demanding and exhausting and may result in irritability, mood swings and stress.

However, tackling post pregnancy stress is not such a daunting task. Here are some expert tips to help you cope with motherhood blues:

1. Catch up on sleep: The first casualty after the baby is going to be your sleep. Most babies are nocturnal creatures and keep awake at night. So what do you do? Set 2 hours in the day when somebody else can look after your baby while you catch up on your much craved for sleep. Try and make this a daily routine and you will find yourself fresh and happy.

2. Involve your husband: Actively involve your spouse in bringing up the baby. At the beginning he may feel apprehensive or even uncomfortable handling such a small and fragile being, but he will soon get used to it. Let him cradle the baby, try and put him/her to sleep and gradually learn how to change the diaper too.

3. Fix a time for guests: A new baby is the center of attraction and all your friends and relatives will want to come and see the new arrival. But do not encourage guests in the afternoon. Use this time to rest and if possible make the baby sleep during the afternoon. You will find that resting post lunch will revive your spirits and make you feel energetic.

4. Relax with music: Put on your favorite music and just relax. Listening to soft soothing music is a panacea for stress-related problems. And your baby too will love to listen to soft melodious tunes.

5. Talk to friends: Talking and sharing all your emotions is a great stressbuster. The first couple of months will be a new experience for you and one that will test your nerves. The baby may fall sick, may refuse to feed, and will cry for long without you being able to understand what the matter is. Talking to a friend who has undergone all this will help you deal with the situation better. Even otherwise, just sharing your woes will make you feel much lighter.

6. Pamper yourself: There is nothing like a luxurious massage to soothe those frayed nerves. Go in for a real refreshing aromatherapy massage or bath and feel the difference.

7. Walk your blues away: Walking will not only revive your tired spirits and body but will get you back in shape as soon as possible. Take the baby along in a pram so that he/she too can breathe in the fresh air and be close to nature.

8. Do some yoga or meditation. Yoga is a great exercise as well as helps in relaxation. Of course, limit yourself to asanas that are easy and not so strenuous. Meditation too will help you relax and stay focused.

9. Talk to your baby. Gurgle and coo with your baby and slowly start talking to your little one. This will help you forge a bond as strong as steel.

10. Let things be: Don't try to be superhuman. If the house is a bit messy then let it be or give others a chance to do something. Just concentrate on the baby, relax and enjoy this time to the full.

Above all, remember to give yourself time and deal with everything patiently. Instead of getting bogged down by all the strains and pressures of post pregnancy, enjoy this time and make the most of it.

Stress Management: Thought Stopping

2008-09-08T07:03:00.000-07:00

You've heard the old saying, 'All work and no play makes Jack a dull boy. Modify it and you'll get, 'All stress and no relaxation makes Jack a dead guy.' Yes it's true that stress can sometimes lead to life-threatening consequences. But the brutal truth is that in today's competitive world, stress has become unavoidable.

Talking about stress always reminds me of my friend Sona. She has a tendency to get worried and anxious about every little thing. Once that happens, her mind works overtime thinking of every possible disaster that could happen. Her thoughts range from "I have to complete this work today ... or else my boss will get mad at me ... and if I loose my job it will be awful ... I wonder if my marriage would survive tough times. Times are bad ... & so on."

A recent international survey on worry showed that 40 per cent of the time we worry about things which never happen; 30 per cent about things that are over; 12 per cent are needless health worries & 10 per cent are miscellaneous worries. Only a marginal eight per cent of our worries are legitimate. However, if you are caught in the vortex of worry, there is hope. Start practicing thought stopping, part of a technique of behavioral therapy that is helpful in dealing with the problem of continuous and upsetting thoughts.

It can be practiced by doing any of the following: Say STOP aloud to yourself, wear a rubber band around your wrist pull it hard and leave it, pinch yourself unobtrusively or dig your fingernails into the palms of your hand.

Thought Stopping
This technique requires time, patience and constant practice. Thoughts don't go away easily. So as soon as you encounter a difficult thought, interrupt it constantly as this will lead to a gradual decrease in their frequency & eventually they will go away. Initially, select thoughts that are not too stressful graduate on to the more stressful ones and slowly you will master the technique. Besides thought stopping, you can practice the following steps to control your negative thoughts:

1. Imagine the forthcoming event: From your past experience you can figure out how a particular event or the person concerned affected you and in what way.
2. Specify goal: Define the problem and work out all the details. Prepare in advance how to handle criticism without getting upset.
3. Rehearse before the event: If you rehearse thoroughly you can make sure to give a faultless performance.
4. Give yourself a break with pleasurable activities: While preparing for a stressful activity take a break. Go for a walk, listen to music etc.
5. Prepare for the worst: Think of the worst that can happen and ways of coping with it.
6. Relax before the event: Just before the event relax, take a slow deep breath, unclench your jaws and fists, relax your shoulders, uncross your legs and allow your entire body to relax.
7. Expect some stress: A small amount of stress enhances performance.
8. Take time to recover: When the stressful event is over; relax completely.

Once you manage to control your negative thoughts, your life will be stress-free.

Crying: A Great Stress Reliever

2008-05-08T12:53:00.000-07:00

Who can forget Kapil Dev weeping copiously during a primetime interview with the BBC as accusations of match-fixing were flung on him? India's greatest sporting icon cried inconsolably irrespective of the fact that he was watched by millions of television viewers not only in India but all over the world. You may have felt sorry for the cricket legend or you may have thought he was being over emotional. But the fact is Kapil Dev was a relieved man after emptying his tear glands. That's because crying is a great stress reliever. Crying helps you unburden your mind and gets rid of all the tension and hurt that has been bothering you.

A Historical Perspective

To be a successful politician in the 19th century, you had to be able to weep on the stump. If you could not weep at the proper places you were a lousy orator. But perceptions changed in 1968 when Edmund Muskie was drilled out of the presidential race for crying. Weeping was deemed as unacceptable. But today who can forget the tear-streaked faces of Bob Dole or Bill Clinton, who is famous for being caught on camera crying.

How much is too much?

Almost everyone has some questions and confusion about crying. How much crying is enough? If I start crying will I ever be able to stop? Do I have to cry at all? Can I cry if I feel like it or am I going to be thought of as a weakling? I wish I were a woman at least I could cry and let it all out?

In fact, boys are conditioned by birth not to display their emotions. They are told that crying is for wimps and so they tend to bottle up their emotions and put up a stoic front. However, there is no better therapy than crying. Learn to let go and cry your eyes out. Crying acts as a short-term energy relieving action, and relieves, temporarily, some of the emotional energy that is generated by the loss that you may be experiencing. Cry to release the physiological tension resulting from the trauma. Crying also removes excess stress- related chemicals from the body and restores the body's chemical balance after a stressful event has occurred.

Weeping must not be taken as a sign of weakness. A denial of your feelings will only make recovery longer and painful. All of us experience emotions of happiness, love, pain, sadness, and grief. While most of us do have the courage to experience and express them by, laughing or crying to our hearts content and letting out our feelings there are many who suppress these emotions. Despite society's tendency to repress emotion, expressing sadness and grief can be very therapeutic. And if you bottle up your emotions, then sooner or later you will reach saturation point and explode.

Yet on the other hand do not be fooled by those who cry all the time. People can actually use crocodile tears to gain unnecessary sympathy. However, all of us are unique and different in the way we deal with our emotions. Do not let anyone else dictate what is emotionally correct for you. If you feel like crying, go ahead and relieve yourself, get rid of all that is bottled up inside you. Man or woman, let your guard down, be hugged and comforted and weep like a willow.

Stress Can Impair Memory

2007-11-18T11:22:00.000-08:00

Ever blank out on an easy exam question? Blame it on stress. According to results of a study, stress can make it harder to remember facts and details stored in your brain. The finding suggests that memory might be impaired in a number of stressful situations besides exams, such as during job interviews and testimony on the witness stand, the study's authors explain. Dr. Dominique de Quervain, of the University of Zurich, Switzerland, and colleagues based the results on memory tests performed on 36 healthy adults. Participants were asked to memorize 60 German nouns that were displayed on a computer screen for 4 seconds each. Later they had to write down as many of the words as they could remember. In another test, the participants had to pick out the original words from a larger list of words. To test the effect of stress on memory, cortisone tablets or placebo ("dummy") pills were given at various times during the tests. Cortisone raises blood levels of cortisol, a hormone produced during stressful situations. One hour after treatment with cortisone, cortisol levels in saliva were comparable to levels caused by major physical or psychological stress, the authors report. After taking a cortisone tablet an hour in advance, participants were not able to remember as many words as they could after they took a placebo pill, according to the report in the April issue of the journal Nature Neuroscience. Despite its effect on memory, however, cortisone did not appear to impair any other mental abilities. The researchers conclude that stress may have a detrimental effect in stressful situations in which memory is important, such as exams, job interviews, combat and courtrooms. SOURCE: Nature Neuroscience

Panic Attack Help: Eliminating Panic Attacks

2007-11-09T07:32:00.000-08:00

We know what anxiety and panic are, we know what the sources of anxiety can be, and we know how to cope with Panic Attacks when they strike, but now we need to know how to eliminate them altogether. This chapter discusses my ideas on how to "squash the mosquito" and eliminate panic attacks.

To eliminate our panic attacks we had to find out what was causing them. Basically, the build up of adrenaline in our body that was not used to fight or flee a given situation or circumstance that was found to be the primary culprit. It is these fearful, worrisome, or stressful situations and circumstances (lifestyle) that we have to eliminate, take control of, or change to stop the adrenaline flow and thus stop our panic attacks. Sometimes though, it really is not the situation or circumstance that is causing the adrenaline flow but rather it is the way we think about or deal with (psychological) a situation or circumstance that is causing the adrenaline to flow and that is what must be changed or controlled in order to stop our panic attacks.

To help illustrate, think about the Chinese Finger Trap game. It is not really a "trap" until you get caught in it. If we decide to put our fingers in the trap and cannot get them out, then the trap becomes a trap. How could we stop the trap from becoming a trap? We could eliminate the trap altogether by not purchasing it or by getting rid of the trap. We could choose not to play the game. We could learn how to beat the trap so that we did not get caught in it. We could change our thinking about the trap and realize that it is just a game and react to it as such. Or, we could seek out the advice of someone who is an expert at beating the trap or who has beaten the trap themselves and ask for their expertise. All of these things could stop the trap from being a trap. Since Panic Attacks are themselves like a trap we can use similar Strategies to eliminate Panic Attacks from our lives. We can use one of the following Strategies:

PANIC ATTACK ELIMINATION STRATEGIES

STRATEGY 1) AVOID OR ELIMINATE THE SOURCE
*Get rid of trap sources
*Avoid known trap sources
*Take away the fuel and the fire cannot burn

STRATEGY 2) CONFRONT OR TACKLE THE SOURCE
*Learn how to beat the trap
*Only thing to fear is fear itself

STRATEGY 3) TRANSFORM OR CONTROL THE SOURCE
*Change the way we think about trap sources
*You cannot control a TV show so change the channel

STRATEGY 4) SEE A PROFESSIONAL
*Ask an expert on the trap for help and advice
(SEEK OUT PSYCHIATRIC HELP, MEDICAL HELP, OR COUNSELING etc...)

What we will do next is take our Anxiety Attack Sources Chart (5) and go through some examples from each source category and show you how to eliminate your panic sources by one of the 4 Strategies mentioned in this chapter. After a few examples you should see a pattern develop as to how to deal with your sources of panic, whether they are on the chart or not. You will have to ask of each source, is this something that I have to avoid or eliminate from my life? Is this something that I have to confront or deal with differently? Is this something that I have to change or take control of in my life? or is this something that is beyond my own capability that I need to seek professional help for? Once you have determined what your source(s) are and what course of action needs to be taken, then all you have to do is figure out the best way to carry out that action. Hopefully, by following the examples listed you will have a good idea as to
what to do in any situation that you may face.

I. DIET:

The first category on the Anxiety Sources Chart is Diet. The old saying "you are what you eat" certainly is true. What you eat can have a great effect on your body and mind. Certainly you would want to do whatever it takes to make sure you are eating a balanced diet. By eating right your brain will be able to function better and this will help you to handle life better. You will be able to handle stress better as well, and thus deal more effectively with potential Anxiety sources.

EXAMPLE A)

From your Anxiety Sources Worksheet and Chart 5 you have determined that a source of your panic attacks is from drinking to much caffeine. You believe that caffeine is causing your heart rate to increase. What should you do? The answer to this is simple, you would have to use Strategy 1 and eliminate the source. You could try drinking caffeine free soda or decaffeinated coffee. You could also read the labels on all of your food to make sure you are not consuming caffeine in your food. You will have a headache from the withdraw effects when you first stop drinking caffeine, but they will go away after awhile and so to will your panic attacks. Make sure that any medicine you take to alleviate your headaches does not have any caffeine in it. When I found that caffeine was a contributing factor to my panic attacks, I reduced the amount of caffeine in my diet and this greatly reduced the number and severity of my panic attacks. You can see how easy this Strategy was, so let us go on to another example.

EXAMPLE B)

Perhaps you have determined that you have an alcohol problem and that maybe this plays a major role in your panic attacks. Strategy 4 would definitely be recommended in this case. Alcohol is a very addictive drug that requires professional help to try and overcome if there is a serious problem. If you even suspect that you have a problem you should seek out help at once. Panic attacks are probably the least of your worries if alcohol is what you think is driving your attacks. So please use Strategy 4 and seek out professional help. This step may not be so easy, so you might want to have some friends and family help you with this difficult battle. Let us now continue to the next source category the JOB.

II. JOB:

The second category of sources listed on the Anxiety Sources Chart come from the job. One thing to remember about your job and life in general is that "success is a journey not a destination." So many people have anxieties over whether or not they are successful. Strategy 3 is in order here because the source of our anxiety is our own way of thinking, we need to transform our thinking to that of as long we do our best and never give up we are always successful. This is discussed in a little more detail in the PSYCHOLOGICAL section of this chapter.

EXAMPLE A)

What if you have determined from your Panic Sources Chart that you are overloaded with projects to do at work and you do not ever have enough time to complete these projects. This is causing you to be stressed and is contributing to your panic attacks. Well you could use a combination of Strategies to deal with this source of anxiety. If you are in a position to do so you might want to try Strategy 1 and delegate some of your projects to coworkers or you could have your boss help you out. By doing so you would eliminate some of your panic sources.

You could also use Strategy 2 and prioritize you projects. Daily prioritization of your projects is essential in tackling them in an organized and efficient way. Writing down in order of importance your projects allows you to see them and realize that they are not an insurmountable task. As you complete one project you cross it off the list and continue on to the next project. Before you know it the list will be complete. Sometimes it is a good idea to do an easy project first to get one out of the way quickly. When you see an early success, tackling the rest of your projects will seem much easier and more possible. Sometimes you cannot just eliminate a source of anxiety altogether, like school or your job so you have to use Strategy 2 and tackle or confront these sources head on one at a time. When you get control on these seemingly overwhelming projects you then change them from a source of anxiety into a source of self esteem and pride.

Sometimes though, prioritization is not enough. For example, where I worked the projects kept coming and the hours I spent trying to accomplish them got longer and longer. My boss did not seem to appreciate the work I was doing. My wife and child never saw me, so I worried about them. I couldn't pursue personal interests outside of work since all of my time and energy was spent at work. I did not eat right. Things just snowballed and were not getting any better. My panic attacks became more frequent as tension at my job and in my life grew. Fortunately, my company is a large one and this enabled me to make a drastic move in order to deal with my sources of anxiety. I used Strategy 1 to the extreme. After some serious consideration, by using Strategy 1 I single-handedly wiped out multiple sources of anxiety in my life. I did this by transferring to another job within the company. This job was less stressful, had straight hours, and was one that I knew I could be successful at. I took a small pay cut as well, but my health and family were worth the move. The end result was nothing less than spectacular. Since eliminating multiple sources of anxiety, I have not had a single panic attack. Strategy 1 truly worked for me. You may find that you have multiple sources of anxiety emanating from one place, such as your job. You may want to consider whether or not to make such a drastic change in your life in order to improve your health and life. The choice is yours but for me life without panic attacks has been like being set free from a trap. I now have a boss that appreciates the work I do, I have straight hours, I see a lot more of my family, I get to pursue personal interests outside of work, and I feel successful at work. The pay cut has not really had a great impact in my life since I have been prioritizing my expenses and sticking to a budget. All in all, my life is much happier because I made this move to eliminate multiple sources of anxiety in my life. I hope this can work this well for you too. Let us look at another example of Anxiety Sources from the job category.

EXAMPLE B)

What if you have determined that the source of your anxiety is coming from poor relationships with your coworkers. Perhaps someone you work with is very difficult to get along with and nothing that you do seems to help the matter. This is worrying you and is causing you undo stress. The coworker does a good job, but your personalities just clash. In this case you could try Strategy 1 (if it were bad enough) and transfer to another department. If this is not possible Strategy 2 might be viable. You could try and confront your coworker and talk about the specific problem you are having. Focus on the problem and on finding a positive resolution. The key is to confront the problem and not to attack the person. By focusing on the problem in a positive light you don't make the situation worse by insulting or offending the person. Still yet, another Strategy you may want to try is starting a daily exercise routine. This could help you to burn some the extra tension you have away and help you to cope with the situation better. When a source of panic cannot be eliminated the best way to burn of the excess adrenaline is to exercise. Hopefully you can burn enough of the adrenaline away in your exercise, that your panic attacks would stop.

III. SCHOOL:

EXAMPLE A)

Today more and more emphasis and pressure is placed on getting high grades in school and on going to college. There is a lot of competition on standardized tests and for scholarship dollars. You may have found that some of your stress and worry are coming from this area of your life. Maybe poor grades of you or your child have you worrying excessively or maybe you are worried about upcoming tests. In this case you would want to try Strategy 2. The reason most people do poorly in school is due to lack of preparation or study. So you would have to attack this problem up front. This requires some work. In order for you to gain control over your grades you will need to take time and study. To do this you will need to learn how to prioritize your time to allow for study. You can use my Daily Prioritization Chart Workbook included with this manual to help you. On the chart you would want to make study a high priority and things like social events and television a low priority. If you continue to have trouble studying and with your grades after trying this, you may have to use Strategy 4. This means you should see a professional counselor or tutor. Whatever the case you will have to get organized and have a plan of action so that you can get prepared enough to do your best in school. Then and only then will your anxieties be reduced about school. When you are prepared for school you know you are in control and that you can do well. You may not be a straight A student but doing your best is what counts. When you do your best all of your energies are expended on the task and the likelihood of a panic attack happening is reduced. Let us now go to the next anxiety source category-The Family.

IV. FAMILY:

EXAMPLE A)

There are a lot of problems in families these days and the divorce rate is higher than ever. Single parent families are almost the norm in today's society. Many have multiple family problems that create anxiety about the future that drives panic attacks. From your Anxiety Source Worksheet and Chart you have found that your child's rebellious attitude is a source of your anxiety. Many parents today are to busy and to ill-equipped to deal with problems of this type effectively. To challenge a rebellious child head-on is a delicate matter to say the least. My suggestion is for each parent to deduce what the best course of action is in their individual case. A little love does go a long way and that may be all that is needed, but Strategy 4 is probably the best solution. A family Counselor has seen this problem before and is an expert in dealing with this in the most successful way. By confronting the problem through a professional you may gain some control of the situation and thus reduce your anxieties about your child. This in turn should help you to eliminate you Panic Attacks.

EXAMPLE B)

From your Anxiety Source Worksheet and Chart you have ascertained that a major source of anxiety in your life came from worrying about money problems in the household. You find that you are living paycheck to paycheck and that you do not know how you are going to pay all of your bills. To try and eliminate this source of anxiety you can try several elimination Strategies. Using Strategy 1 you can try and design a budget that will prevent you from getting into a situation where money is an overwhelming concern. This however, may require Strategy 4, the help of a professional accountant or credit counseling agency. If you are already in a tight situation you can use these same Strategies to get you out of it. Using Strategy 2 you could attack the problem and set some financial goals. You would want to make your goals attainable and write them down. For instance, maybe you would want to make a goal of paying off your credit card in six months. To do this you could make a budget with goals attached to it. You would follow this budget until your card is paid off. Again if you are not certain about how to make a budget you could seek the advice of a professional credit counselor. Making a budget and setting goals should help you gain control of the problem and reduce your anxiety. I This can be compared to driving your car. When you are out for a pleasant drive you roll down your window and feel great because you are in control and are free. However, when you are driving and you are late for work and you are caught in construction, you lose control and get stressed out. You are no longer free and are at the mercy of other traffic. Then driving becomes a source of stress and anxiety. When we lose control of our money we get the same way. This then is a source of anxiety and can drive our panic attacks. By using Strategy 2 and making a budget and setting goals we get control back and money no longer is a source of anxiety. Sometimes though a budget is not enough. We may need extra income to make ends meet. Then maybe you need to look at getting another job or look at securing overtime to help get a control over your bills. You still need to use Strategy 2 and deduce what the best course of action is to attack the problem. You need to organize, prioritize, and set goals. Another good thing to do is use Strategy 3 in this situation. You have to remember that money does not solve problems. If you were to suddenly come into some money your money problems might be solved but your focus would shift to other problems in your life such as health and family. Sometimes you have to transform your way of thinking and have the ability to see things in a broader perspective in order to eliminate your anxieties. This is easier said than done though and brings us to the final Anxiety Source category- The Psychological category.

V. PSYCHOLOGICAL

From the Anxiety Sources Chart you have seen some similarities in the way you think to those that are mentioned on the chart. If you tend to think the same way of those areas mentioned on the chart you may be your own source of anxiety. All of these ways of thinking: All or nothing, negative, paranoid, exaggerating, and obsessive/compulsive make everyday normal events seem to you worse than they are and thus can make you more stressed, worried, and fearful than you should be about life. This in turn makes your body react more often in the form of panic and thus you may have more panic attacks. To overcome this is difficult because it is in fact who you are and how you have been brought up. The best thing you can do is try Strategy 3 and control your thinking by stepping outside of yourself and recognizing when you are potentially thinking in an extreme way and by curtailing it at that point. Again, this is easier said than done so you may decide that you need help and that you need to see a professional using Strategy 4. A professional Psychiatrist can help you to change your way of thinking and deal with life better. If you are experiencing any of these extreme ways of thinking a visit to the psychiatrist may be the best thing you can do. Panic attacks may be the least of your problems if there is an underlying mental problem that needs to be addressed.

ANXIETY/PANIC SOURCES WORKSHEET EXAMPLE ANXIETY WORKBOOK PROCESS

* NOTE THIS WAS IN THE ORIGINAL MANUAL. YOU CAN USE A DAILY LOG AND FIND YOUR PANIC TRIGGERS. THEN DETERMINE WHAT METHODS TO USE TO DEAL WITH THOSE TRIGGERS.

STEP 1) USE ANXIETY SOURCES WORKSHEETS (OR KEEP A DAILY LOG OF YOUR OWN AND DETERMINE YOUR SOURCES) UNTIL A PATTERN DEVELOPS

STEP 2) COMPARE PATTERNS TO ANXIETY SOURCES CHART AND SEE WHAT CATEGORY YOUR SOURCES FALL UNDER

STEP 3) REFER TO PANIC ATTACK COPING AND ELIMINATION GRID FOR SUGGESTED ACTION ( OR USE YOUR OWN COMMON SENSE TO DECIDE WHAT IS BEST FOR YOU)

STEP 4) LOG SUCCESSFUL Strategies ON YOUR PERSONAL PANIC ATTACK TRIED Strategies GRID (REMEMBER WHAT HAS WORKED IN THE PAST)

STEP5) USE SUCCESSFUL PANIC ATTACK COPING AND ELIMINATION Strategies OFF OF PERSONAL GRID (OR ONES THAT YOU HAVE LOGGED PERSONALLY)

MY WORKSHEET/DAILY LOG EXAMPLE:

WHAT DID YOU DRINK TODAY?
1) I HAD 4 COLAS

WHAT DID YOU EAT TODAY?
1) HAD A BANANA
2) HAD A BAG OF PRETZELS
3) PIZZA
4) LEFT OVER SPAGHETTI

WHAT STRESSES AT WORK ARE THERE TODAY?
1) MORE FLIGHTS CANCELED DUE TO WEATHER
2) PAPERWORK BACKED UP
3) WORKED 9 HOURS
4) BOSS MAD BECAUSE HIS COMPUTER IS BROKEN AND BLAMES ME

WHAT STRESSES IN SCHOOL ARE THERE TODAY?
1) NA

WHAT STRESSES ARE THERE IN THE FAMILY TODAY?
1) WIFE MAD AT ME BECAUSE OF WORKING LATE
2) CANNOT VISIT PARENTS THIS WEEKEND

HOW IS YOUR MONEY SITUATION TODAY?
1) ALL BILLS PAID

IS THERE ANYTHING ELSE WORRYING YOU TODAY?
1) DID NOT GET TO SEE FOOTBALL GAME BECAUSE OF WORKING LATE

ARE THERE ANY EXTREME THOUGHTS THAT YOU HAVE HAD TODAY?
NA

CROSS REFERENCE YOUR ANSWERS WITH PANIC ATTACK SOURCES CHART 5

ARE THERE ANY REPEATING STRESSES OR PATTERNS NOTED FROM PAST LISTS?
1) CAFFEINE
2) LONG HOURS AT WORK
3) OPERATIONAL PROBLEMS AT WORK AND BOSS UNHAPPY
4) POOR DIET
5) NOT SEEING FAMILY ENOUGH IS HURTING FAMILY

Panic Attack Help: Coping With Panic Attacks

2007-11-09T07:29:00.000-08:00

Knowing what you are dealing with is a key that allows you to attack panic at its source. You don't have to just shoot in the dark at something you don't understand. That is why you can succeed at eliminating your panic attacks. But before you can eliminate your panic attacks you will have to learn how to cope with them. This chapter discusses some ideas I have on coping with panic attacks and describes some coping Strategies that I have tried. Hopefully, they can help you to cope with your panic attacks as well as they have for me.

Knowing that your panic attack is not a heart attack or something that is going to kill you is a comforting thought in itself. In fact it is the first step in coping with panic attacks. To illustrate this point think of your panic attacks as if they were the Chinese Finger Trap. This is a game that you may have played with when you were a kid. With this game you would stick one finger in each end of a paper woven tube. When you would pull your fingers apart the tube would tighten around your fingers and your fingers would be trapped in the tube. The harder you pulled the tighter the grip of the trap became on your fingers. The trick to the game, in order for you to get your fingers out of the trap, was to relax and push your finger(s) inwards, then the weave of the tube trap would relax and loosen. When the weave loosened you could then get your fingers freed from the trap. The key to getting your fingers out was to relax and work with the trap and not against it.

When a panic attack strikes it is much like the Chinese Finger Trap. The more you fight the panic the more it tightens it's grip on you. When you fight the panic you can work yourself up into a frenzy which only worsens the symptoms of the panic attack. When the symptoms intensify you get more worried about the attack. As you get more worried about the attack the symptoms intensify more. As the symptoms intensify more you tend to get more introverted and focus more and more on the attack. This makes the attack seem even worse and it's grip tightens on you. So what is the key? You have to learn to relax and not fight the panic attack. In fact, you must do the opposite and work with the attack just like you would work with the finger trap. You need to relax and ride the attack out like a surfer rides a wave out, using the wave's energy to propel him forward and not resisting it. By relaxing and riding with the attack and using it's energy it can go by much quicker and soon releases it's grip on you just like the finger trap does. All of this sounds good but it is easier said than done. However, it is not impossible to do and this chapter is going to show you how to cope with panic attacks in this manner.

Once a panic attack strikes the Strategy you choose to cope with it is up to you. There are many techniques commonly used to cope with panic attacks but the results are different for each individual that uses them. In other words what may work for me might not work for you. What this chapter will do is list some coping Strategies that have worked for me. Then you should use the most effective coping Strategy for you anytime a panic attack strikes. Some will work better than others depending on the circumstances.

The coping Strategies described next basically try to get you through the attack as quick as possible by relaxing you and/or by helping you to ride the attack out. This is accomplished by diverting your attention away from the attack and yourself. You are not going to be able to stop the attack once it starts because the adrenaline is already running its course. The best thing you can do is ride the attack out by using the Strategies in this chapter. These Strategies follow the same line of reasoning as Lamaze. Basically the idea is that one's mind can only receive one thought or feeling at a time and no more than that, thus if you can divert your mind away from thinking about the attack it can no longer perceive the attack symptoms. It is a lot like your telephone. The telephone can only receive one signal at a time. When someone else tries to call they get a busy signal. The theory is that if your mind is concentrating on one thing hard enough and constant enough, anything else that tries to get through will get a busy signal (unless you have call waiting..ha ha). An example of this would be when you are daydreaming. When you daydream your mind wonders off and is completely emerged in thought and thus tunes out the rest of the world. Many students have been embarrassed when the teacher called on them to answer a question in class and they did not hear the question because they were daydreaming. So keep all of this in mind when you are trying these Strategies out. The idea is to do them completely and to put everything you got into them so that you can nullify the signals your brain is receiving from your panic attack. Someone once said that the middle of the road is the most dangerous place to drive, so don't try these Strategies halfheartedly because if you do the chances are that they will fail. Just as if you were to drive down the middle of the road, you would probably wreck and not reach your destination. Therefore, when you try these Strategies, to succeed, do them wholehearted.

REACT CALMLY
The most important thing you can do on the onset of an attack is realize what it is and that it is not going to kill you. By doing this you can react to it calmly. You know you are all right and that the attack will pass. You want to allow it to pass and you know that you have the Strategies available to you that will allow it to pass in the most direct route possible. The key is that you use a Strategy and that you use it wholehearted. Think and know that you will make it through the attack and then go onto your coping Strategy of choice. A calm reaction allows you to move forward in this process. The following are some Strategies you may want to try in order to help you cope with your panic attacks.

I BREATHING EXERCISE
To do this exercise lie down in bed and close your eyes. Once comfortable, count to 5 while inhaling a deep breath. Then exhale while counting to 6. Concentrate on breathing from your diaphragm. To ensure you are doing this place your right hand on your stomach and your left hand on your chest. When breathing make sure your right hand is moving and that your left hand is as still as possible. Doing this ensures that you are breathing from your diaphragm. Next sit up in your bed and repeat the inhale and exhale while counting. Then try standing up and repeating the exercise. Do this over and over, lying, sitting, standing, and counting. Take deep slow breaths with the count, making sure your right hand is moving. You might try playing soft music in the background to help with the rhythm. This may seem awkward at first but practice of this Strategy can turn it into a habit. I encourage you to practice this Strategy at least 5 minutes a day. When a panic attack strikes you shouldn't feel awkward and you can turn your full attention to your breathing. This should relax you and thus distract you from your attack. If done properly it should also reduce the amount of panic signals reaching your brain. This will allow you to ride out the attack, relax, and thus cope with it better.
Don't under-estimate the power of proper breathing. Breathing from the belly and not the chest allows the air to go deep into your lungs. This allows more oxygen into your system with less effort, thus your heart rate can decrease along with the number of times you have to inhale and exhale. So too your body is not as stressed to get the oxygen it needs. So, deep breathing alone can help eliminate some of the symptoms of a panic attack!

II MEDITATION
I know this sounds awkward at first but for this exercise I don't mean Yoga style meditation. Rather, I am simply suggesting taking an object, concentrating on it, and turning it over in your mind repeatedly. For example, if you have a candle at home, during an attack you could light the candle and concentrate on the image of the flame until it is the only thing that you can see. Hold that image in your mind as long as you can. After some time close your eyes but try to keep the image of the flame in your mind's eye. Hold the image as long as possible and turn it over in your mind. Make the flame your only thought. If you get distracted by outside noise try listening to soft music on some headphones to block out the distractions. If this exercise is done wholehearted, it should distract you from your attack and allow you to cope with it successfully. You should be thinking so hard about the flame that all other signals going to your brain should be blocked out. Still though, depending on your circumstances you may not be able to use this exercise, so you might want to try another Strategy. This exercise can be done with virtually any object. I chose the flame because it is easier for me to retain that particular image in my mind. Some people like to watch birds or clouds in the sky, some like to watch fish in a tank, or others like to watch a fire in a fireplace. The important thing is that you choose to meditate on something that is easy for you, so that this exercise can be successful for you in coping with your panic attacks. This Strategy should also help you to relax during an attack.

III MEDICATION
Not all panic attacks require distractions in order to cope with them. For instance sometimes the symptoms of panic attacks are the result of something you ate. I noticed that sometimes when I ate spaghetti I felt as though I was having a panic attack. This was probably due to some acid reflux in my esophagus. To help cope with this all I did was take some antacid. The antacid eliminated the symptoms almost immediately. If you have determined from you Anxiety Sources Workbook that your attacks come after eating a specific food you may want to try some antacid and see if this will help you to cope with your attacks better.

IV EXERCISE

You might want to try exercising as a coping Strategy during a panic attack. The idea is that if you concentrate hard enough on the exercise you will be distracted from the panic attack. Also, exercise should help burn off the excess adrenaline in your body that is causing the attack. I have used this Strategy more than once and have found it to be successful for me. All I did was go for a brief jog or brisk walk around the block during the onset of an attack. I ended up being so involved in the exercise that my attention was diverted from my attack, and thus I was able to ride the attack out and cope with it successfully. This coping Strategy may work for you as well. You don't have to do any fancy aerobics or have to have a fancy gym set in your house to do this Strategy either. When you feel an attack coming on, just try going for a fifteen minute jog or brisk walk, and by the time you get done your attack should be over.

V PERSONAL Strategies
A personal favorite coping Strategy that I found to be successful when a panic attack struck was taking a hot bath . I found the bath to be very relaxing and that the heat and sound from the water helped distract me from the attack. By being relaxed I was able to ride out my attacks easier. You might want to go back and try personal coping Strategies that you found to have worked in the past but try them a little harder to get better results. Some Strategies I have heard of include getting a massage, doing a hobby, praying, drinking cold water, or even snapping a rubber band on your wrist. I suppose all of these in one way or another could distract you from your attacks and/or help you to cope with them better. Some people take prescribed medication to help them ride their attacks out easier and/or to relax. If this works for you, you should probably continue taking your medicine. I know that the medications I was prescribed did not help me to cope with or ride out my attacks. If you have any coping Strategies you would like to share please feel free to write me at the same address you ordered this booklet from and maybe I can share those Strategies with others in future editions of this book.

VI. Strategies NOT TO TRY
Well, I have talked a lot about coping Strategies you should try to help you with your panic attacks, but before I continue I would like to suggest 3 things you should not do to help cope with your attacks. Due to their addictive nature and potentially harmful side effects, in my opinion the following items should not be used to cope with your panic attacks:
1) Alcohol
2) Cigarettes
3) Illegal Drugs

These things may seem to work for you but other more serious problems may result from taking them. So think twice about trying these out or in continuing to use these if they are a personal Strategy of yours. You now have the answer to the question of how to cope with Panic Attacks. Some coping Strategies are better than others and some work differently for each individual. Some Strategies shouldn't even be tried. But coping with Panic Attacks can be a lot like coping with mosquitoes. Coping Strategies can help us ride our panic attacks out, just as bug spray can help keep mosquitoes away for awhile, but these things don't eliminate the problem. You can use one coping Strategy after another and you can use bug spray again and again, but the problem is still there. Coping with Panic Attacks does help us though, and can make living with them easier; however, eliminating Panic Attacks from your life should be your goal. My next chapter describes Strategies that you can use in order to reach that goal and eliminate Panic Attacks from your life.

Panic Attack Help: Identifying The Sources Of Anxiety And Panic!

2007-11-09T07:27:00.000-08:00

There are many sources of anxiety that can fuel our panic attacks. By identifying these sources we can through different techniques cope with and eliminate panic attacks. We will learn more about this in later chapters but for now we must focus on identifying the sources of anxiety in our lives that are triggering our panic attacks. Make no mistake about it, this is no easy task since these sources vary from person to person and from attack to attack. However, it is not entirely impossible to find these sources. They are there and if you dig deep
enough you can find them. The following describes my ideas on what the most common sources are and how to identify them in your life.

Basically, I have found that the primary sources of anxiety which I believe fuel panic attacks can be broken down into 2 areas. These areas are titled Lifestyle and Psychological. Lifestyle, covers the tangible things in our life and the way that we live that can be sources of anxiety. Psychological, covers the aspects of our personality and the way we think about life that can be sources of anxiety. Both areas have multiple source areas that fall under it which can fuel our panic attacks (SEE CHART 5). I truly believe that the circumstances of our life and/or the way we think about and handle our life can trigger our panic attacks. This is what is at the core of The Panic Sources Chart (5). Since the sources of anxiety that drives panic attacks are different for everyone, it would be impossible to capture all of the potential sources of anxiety on any single chart. This chart does not attempt to capture each individual source. Instead, this chart is organized to capture as many sources as possible by categorizing potential source areas not individual sources. This should make identifying the sources of anxiety in your life easier because the search area for your anxiety sources is narrowed down. It is a lot like an Index in a book. By using an index you don't have to read the whole book to find a specific word or subject because the index can tell you what page(s) to go to. This chart will show you what areas to look for the sources of your anxiety in. It is also flexible enough to allow you to personalize it if your sources of anxiety are not in any of the charted areas.

*Note this section does not try to identify sources of panic for PANIC DISORDERS such as AGORAPHOBIA or other PHOBIAS, rather it solely tries to identify the sources of panic that fuel the panic attacks related to those mentioned throughout this booklet that have no connection to PHOBIAS. Those suffering from PANIC DISORDERS such as PHOBIAS should seek the help of professionals. (SEE CHART 6)

I am confident though, that you can go to any of the categories or areas on this chart and find something that you can relate to in your life or way of thinking that may be a source of anxiety. If you are having a little trouble don't give up hope just yet.

This Chapter may take a little work and self-examination on your part to get through, but don't panic. I have tried to make this manual as short and easy to use as possible so that you do not have to worry or get stressed by reading it. Some books and programs about this subject seem so expensive and complicated that they can give you a panic attack just thinking about them. Hopefully this manual won't do this to you as we attempt to eliminate Panic Attacks from you life. So just because I mention things like work and self-examination try not to panic. I will try to make these next sections as easy and painless for you as possible.

To help you find the sources of anxiety in your life that are fueling your panic attacks I have provided the Anxiety Sources Workbook for you with this kit. This workbook is related to the Anxiety Sources Chart(5) and will aid you in determining your personal anxiety sources. After using this workbook for a while like a diary, you should be able to determine which anxiety source area(s) are driving your panic attacks. You should be able to see a pattern of events, eating habits, or pattern of thinking that is repeating itself over and over that is related to an anxiety source area on Chart(5). Perhaps you will see a pattern of anxiety sources that are not listed on the chart or maybe you will see a pattern of combinations of anxiety source areas from Chart(5). After using the workbook for some time you should be able to look at Chart(5) and use the records from your workbook to identify what is fueling your panic attacks. You do not have to be a genius to see the sources. If you think something is a source it probably is.

The following example workbook sheet is based on my life. As you can see I did not use big words or over analyze when filling out the workbook. I kept it simple and used a little self examination when filling in my answers. After several days a pattern of potential anxiety sources developed. Why don't you see if you can see the patterns.

Now that you have read my examples from the workbook, go ahead and list what you think the sources of my anxiety were, using Chart 5 as a reference.

TO SEE MY PERSONAL WORKBOOK EXAMPLE:CLICK HERE You can go ahead and list what you think my sources are on a piece of scratch paper at home.

From my example I found that job stress, long hours, poor diet and caffeine were the main sources of anxiety contributing to my panic attacks. In these examples these source areas were repeated on almost every sheet. If you saw the same pattern you should be ready and able to go on and use the workbook for yourself. So, before you go any further in this book go ahead and use the Anxiety Sources Workbook along with Chart(5). When you are comfortable that you have identified the anxiety source(s) in your life you may continue on with this manual to see how to cope with and eliminate your panic attacks.

Some of you may have already had a clue as to what was fueling your panic attacks, while some of you had to have your sources identified with the help of my Anxiety Sources Workbook. In either case you now know what these sources are and now have the key to coping with and eliminating your panic attacks. Knowing what you are dealing with is critical because it will help you to make informed and intelligent decisions in coping with and eliminating you panic attacks.

* NOTE IF YOU ARE STILL HAVING TROUBLE IDENTIFYING THE SOURCES OF YOUR PANIC ATTACKS, AT THIS POINT IT MAY BE ADVISABLE FOR YOU TO SEEK THE HELP OF A PROFESSIONAL.

With the question of what the sources of anxiety are answered we can now proceed to the next chapter which talks about panic attack coping Strategies.

CHART 5

ANXIETY SOURCES: LIFESTYLE & PSYCHOLOGICAL

LIFESTYLE

DIET
A) CAFFEINE
B) CHOCOLATE
C) ALCOHOL
D) JUNK FOOD

JOB
A) FIRED
B) LAID-OFF
C) DISCIPLINED
D) BAD REVIEW
E) POOR COWORKER RELATIONSHIP
F) POOR CUSTOMER INTERACTION
G) POOR RELATIONSHIP WITH BOSS
H) LONG HOURS
I) PERFORMANCE PROBLEMS
J)OTHER-
K)OTHER-

SCHOOL
A) UPCOMING TEST/EXAM
B) POOR GRADES
C) POOR STUDENT RELATIONSHIP
D) POOR TEACHER RELATIONSHIP
E) GIRLFRIEND/BOYFRIEND PROBLEMS
F) POOR ATHLETIC PERFORMANCE
G) OTHER-
H)OTHER-

FAMILY
A)SPOUSE RELATIONSHIP PROBLEMS
B)CHILD RELATIONSHIP PROBLEMS
C)MONEY PROBLEMS
D) DEATH/ILLNESS
E) OTHER-
F)OTHER-
G)OTHER-

MISCELLANEOUS
A)
B)
C)
D)

PSYCHOLOGICAL

I ALL OR NOTHING THINKING
*If you don't succeed at one
thing you are a total failure.
*One room of the house is dirty so
the whole house is dirty.

II NEGATIVE PESSIMISTIC THOUGHTS
*You are not worthy of good things.
*You fail to see the good things in life.
*You see the glass as half empty
not half full.
*You feel worthless.
*You don't take action because
someone else will do the job.

III PARANOID THOUGHTS
*You think everyone is out to get you.
*A disagreement with one person
means everyone is against you.
*Failure in one relationship means that
all relationships will fail
*You take criticism
as a conspiracy.

IV EXAGGERATING NEGATIVE THINKING
*You see a small black spot
on a white shirt rather
than see all of the white.
*One old driver cuts you off
so all old drivers are bad.

V OBSESSIVE/COMPULSIVE
*You are obsessed with washing
your hands. You have to clean and tidy
everything.

Panic Attack Help: What are Anxiety and Panic Attacks?

2007-11-09T07:26:00.000-08:00

Well to see what Anxiety And Panic are let us first look at the BASIC dictionary definitions of these words.

ANXIETY:
PAINFUL OR APPREHENSIVE UNEASINESS OF THE MIND USUALLY OVER PENDING OR ANTICIPATED ILL, FEARFUL CONCERN OR INTEREST,ABNORMAL SENSE OF APPREHENSION AND FEAR MARKED BY TENSION, INCREASED HEART RATE, AND SWEATING. SELF DOUBT LACK OF SECURITY .

PANIC:
A SUDDEN OVERPOWERING FRIGHT, A SUDDEN UNREASONING TERROR OFTEN ACCOMPANIED BY MASS FLIGHT. SYNONYMS ARE: ALARM, DREAD, FRENZY, HYSTERIA, FRIGHT, AND TERROR.

What can we infer from these definitions? We can see that Anxiety is a feeling of fear, worry, or stress over something. While Panic is an intense response to fear, worry, or stress.

Fear is a feeling and can come in many forms. In fact worry and stress are very similar to fear. One can be afraid of getting into a fight or one can worry about getting into a fight. One can be afraid to lose his or her job or one can be stressed about losing their job. Panic is the response to these feelings in most cases. When confronted with a fearful situation the body will prepare itself to either fight or flee. Anxiety, fear, worry, and stress can trigger an adrenaline build up that puts the mind and body in a panic mode. This makes the heart beat faster in order to give the mind and body more energy to handle the situation being faced. This same reaction is found in a Panic Attack resulting in the same symptoms (SEE CHART 1). You may ask though, Why does Panic Attack happen at times of relaxation or at times when there is nothing to be fearful, worried, or stressed about? This has been what is called "Free-Floating" anxiety, because it seems to float around inside of us and can pop up at anytime, manifesting itself as a Panic Attack.

To describe this better, imagine that you're driving your car along a secluded road and your favorite song is playing on the radio. You are in no hurry to get anywhere, this is just a pleasant Sunday evening drive through the country. Suddenly, someone walks out in front of your car. Instantly you slam on the brakes and you swerve to miss them! You now find yourself alongside the road in a cold sweat and your heart is pounding out of control. Fear of hitting the person and of ruining your car triggered your body to produce adrenaline and panic. This in turn allowed you to react quickly so that you could react to miss the person. This also triggered the symptoms of a rapid heart rate, sweating, palpitations, tense muscles, and heavy breathing. Just as in this example, anytime you are in a fearful situation your body can produce adrenaline to allow you to react (fight or flee) quickly. Your body can also do this on a smaller scale during worrisome or stressful situations.

Now imagine that throughout the day that there are many little fears, worries, and stresses that you encounter but you did not necessarily react to these fears, worries and stresses. Inside your body was producing the adrenaline it needed to react to those situations. But because you didn't "Panic" or use the adrenaline during those situations, this adrenaline is floating around in you and is slowly building up in side of you. Imagine that this happened on a daily basis and no adrenaline was ever used up and no conclusion was ever reached for a lot of those fears, worries, and stresses you were faced with. Eventually, the adrenaline would have to manifest itself at some time. This manifestation is in the form of a Panic Attack and it can happen at anytime, even during times of relaxation. Its just like a balloon. You can blow a balloon up and then pinch the end of it with your fingers. You can hold the air in for a long time and keep the balloon inflated but sooner or later you will relax and let go of the balloon. When you do relax and let go, the air rushes out, rapidly deflating the balloon in a mad rush. Similarly, we can control our reactions to our anxieties, but when we try to relax and let go, the adrenaline inside of us rushes out of us in the form of a panic attack. Also sometimes we can over-inflate a balloon and it pops. We too can over-inflate and build up too much adrenaline and we then too can figuratively pop in the form of a panic attack. So you can see from these illustrations that panic attacks are simply a physical response to a build up of adrenaline in our body that was not used to react when we were faced with anxieties throughout our daily life.

Now that we know the answers to our first questions: what are anxiety and panic? and what are panic attacks? we need to know what source(s) of anxiety in our lives are triggering our panic attacks. Identifying these sources is the subject of my next chapter and is crucial in eliminating Panic Attacks

Panic Attack Help: Introduction & Doctors Visits

2007-11-09T07:16:00.000-08:00

About 9 years ago in Dayton, Ohio I experienced my first Panic Attack (I did not realize what it was at the time.). I was relaxing on the couch, watching some television, and drinking some pop, when without warning my heart began to palpitate and beat out of control. I couldn't seem to catch my breath. It was really scary when the attack didn't go away. I thought to myself, "Could this be a heart attack? I am only 22 years old, how could this be happening?" I then went and woke up my wife and asked her to take me to the emergency room. I kept the car window down for fresh air as the attack persisted. The ride to the hospital seemed endless. The attack continued as we arrived at the hospital's main entrance.

In the emergency room the doctors seemed to be at a loss. They thought that maybe I was doing drugs and that this was causing my heart to race out of control. The tests that they ran for drug use all came up negative. They tested my blood to look for muscle damage from my heart which would indicate that I had had a heart attack. An x-ray of my chest was taken to see if there were any abnormalities with my heart or lungs. I was also hooked up to an EKG monitor to see if my heart was beating normally. After being monitored all night I was released and prescribed some pills to help me relax. The Doctors never told me what was wrong. The only thing that they confirmed was that I had Tachycardia, or a fast heart rate.

These attacks became a normal part of my life after that night. Most of the time the attacks struck after work when I was trying to relax. Soon though they started to happen at different times of the day. They even struck when I was on family outings. Sometimes I had trouble while driving since it was so hard to concentrate when my heart was racing. At other times my chest would hurt and pain would shoot down my left arm. Sometimes this pain was so bad that I had trouble lifting objects. I thought for sure that these attacks were the symptoms of a heart attack, yet the attacks always subsided and things would go back to normal.

After living several years with these attacks I decided to go and see my personal Doctor. I now lived in Cleveland and had a new baby son, and I really did not want my son growing up without a dad. Also, my coworkers over the years had suggested that I was experiencing Panic Attacks. I had never heard of Panic Attacks before, so I wanted to find out for sure what exactly was wrong with me and see if I could eliminate these attacks from my life. There were many questions that I wanted the answers to about these attacks. I am sure you would want to know the answers to these questions as well. The questions were as follows:

WHAT ARE THESE ATTACKS?
WHY ARE THEY HAPPENING?
WHAT IS THE SOURCE?
HOW CAN I COPE WITH THEM?
HOW CAN I ELIMINATE THEM?

By reviewing my personal struggle with Panic Attacks this web site will help answer these questions. The first place I went to look for answers was the Medical Profession. Let us see what the professionals had to say about my attacks and see if they could help answer any of the questions I had about these attacks in the next chapter.

AT THE DOCTORS OFFICE:

The symptoms of Panic Attacks (SEE CHART 1) are very similar to the symptoms of many serious physical ailments; therefore, if you have not done so already I strongly urge you to go see a doctor. Did you notice on Chart 1 all of the serious ailments that share the same symptoms of Panic Attacks? The doctor has the difficult job of diagnosing which ailment is causing your symptoms before you can be treated effectively. In order to narrow down the probable causes of your symptoms the doctor will have to do a "diagnosis of exclusion" which requires a lot of questions to be asked and a lot of tests to be performed. You will need a lot of time, patience, and money or insurance to go through this process. Your life is worth the effort though so you should make sure you do follow through and see your doctor. The following summarizes my experiences during my quest to find the answers to the questions I had about these attacks. This should give you a glimpse as to what to expect on your doctor visits during the "diagnosis of exclusion" process. Remember, even though this chapter will DISCUSS many of the tests you would probably have to go through at the doctors office,it is not intended to dissuade you from seeing your doctor and going through these tests yourself.

My first visit was to my personal doctor. The first thing that the doctor did was weigh me in. This was to see if I had lost or gained weight since my last visit. Then the doctor listened to my heart through a stethoscope. The doctor then asked me a series of questions. These questions were intended to help with the diagnosis process. The questions were similar to those that follow: * Note that my answers to the questions are at the end of the questions.

1) WHAT IS THE PROBLEM YOUR EXPERIENCING?...............,Chest Pain
rapid heart rate, difficulty swallowing.
2) WHERE WAS THE PAIN?.... Left lower arm and upper chest.
3) WHEN DID IT HAPPEN?...... Continuous for some time now.
4) WHAT WERE YOU DOING WHEN IT HAPPENED?....Relaxing.
5) WAS IT A SHARP OR DULL PAIN?........Sharp continuous pain.
6) HOW LONG DID IT LAST?..........Varies
7) HAVE YOU EVER HAD THIS HAPPEN BEFORE? IF SO DESCRIBE......Yes
8) HAS ANYONE IN YOUR FAMILY EVER HAVE HEART PROBLEMS BEFORE?..No.
9) DO YOU DO DRUGS?......No.
10) DO YOU DRINK ALCOHOL?.....Once in awhile.
11) DO YOU SMOKE?............No.
12) DO YOU HAVE ALLERGIES TO ANY MEDICATIONS?..No
..ETC............ETC...........ETC.........

After these questions were answered the doctor listened to my heart again. The doctor did not hear anything abnormal with my heart when listening to it. Next, the doctor took my blood pressure. My blood pressure was normal so the doctor decided to hook me up to an EKG Monitor or Electrocardiogram. This process involved taping tiny electrodes to my chest and upper abdomen. The electrodes measured electrical impulses from my heart beats and translated this information onto a graph. By looking at the pattern produced by the electrical impulses on the graph the doctor was able to determine whether or not my heart was beating or contracting normally. This was the last test that my doctor performed during this visit. All of the tests that were done indicated that I was in good health and none of the questions I had about my attacks were answered.

My doctor did not have enough information to make a diagnosis at this visit. Based on the answers to the questions that were asked about my symptoms my doctor decided that I should go see some specialists. The specialists the doctor wanted me to see were a Cardiologist and a Gastroenterologist. At the Cardiologist my doctor wanted me to get a Chest x-ray,complete blood work-up, stress test, and an echocardiograph with Doppler mapping. At the Gastroenterologist I was to have an Upper G.I. performed. Hoping that I would not have to go through all of those tests, I suggested to my doctor that I was probably just having Panic Attacks. The doctor really did not respond to my suggestion but did go on to prescribe some anxiety related medicines for me. These medicines were Pepcid and Lorazepam. These might be some of the medicines you are prescribed during your doctor visits, so before I go any further let me tell you a little bit about these medicines, as well as another medicine you may be prescribed during your visit.

PEPCID: ,
Is a FAMOTIDINE that is used to treat ulcers and ESOPHIGITIS ( inflammation of the Esophagus). Pepcid basically stops acid production in the stomach and allows ulcers to heal. I guess the Doctor prescribed this medicine because he thought I might have an Acid Reflux problem. In any case the Pepcid did not prevent my panic attacks from happening. Note: PEPCID was also prescribed to me in Dayton after I had my first Panic Attack.

LORAZAPAM: or ATIVAN
Is a BENZODIAZEPINE( The same family as XANAX ) and it is given to treat INSOMNIA or MILD ANXIETY. It works by suppressing brain activity and is like a tranquilizer. This drug did not help prevent my attacks either, in fact it made them worse since at the same time my heart was racing out of control the drug made me sleepy, yet I couldn't sleep because my heart was PALPITATING so much. That is one feeling I do not wish upon anybody!

VISTARIL:
Which is a HYDROXYZINE. This is a ANTIHISTAMINE drug used to treat hives or motion sickness, and in some cases mild anxiety. This drug made my mouth dry and made me drowsy but did not help prevent my panic attacks.

CHART 1

SYMPTOMS

a racing or pounding heartbeat

dizziness and lightheadedness

a feeling that you can’t catch your breath

chest pains or a smothering "heaviness" in the chest

flushes or chills

tingling in the hands, feet, legs, or arms

jumpiness, trembling, or twitching muscles

sweaty palms

or

a feeling of detachment from oneself

Some of these symptoms are also associated with more serious medical conditions such as:

HEART ATTACKS

ULCERS

MITRAL VALVE PROLAPSE

MUSCLE PULLS

TACHYCARDIA ARRHYTHMIAS

HERNIAS

ACID REFLUX

ASTHMA

PERICARDITIS

SHINGLES

ANGINA

NERVE ROOT PRESSURE

After the doctors visit I went and got my anxiety medicines from the pharmacy. I tried these medicines and found that they were not effective. So I decided that I had better set up appointments with the specialists that my doctor wanted me to see. Since I thought that the heart was more vital than the digestive system, the first specialist I thought that I should see was the Cardiologist. The Cardiologist could diagnose any heart related ailments that could have been causing my attacks. See Chart 1

My Initial visit to the cardiologist was much like the visit I had with my personal doctor. I was weighed, asked a series of questions, my heart was listened to, and my blood pressure was taken again. All of this indicated that I was in good health. At the end of the visit the cardiologist set up appointments to have all of the different tests prescribed by my doctor performed.

The first procedure I had done was the chest x-ray. This was done at the hospitals outpatient center. By looking at the x-ray the doctor could see any abnormalities in the size,shape or appearance of my heart. Also, the doctor could check for Pulmonary Edema (CALCIFICATION(CALCIUM DEPOSITS) IN THE ARTERIES). The doctor could also check for engorgement of vessels which could indicate previous heart failure.This procedure took about five to ten minutes to complete.The results came back in a couple of days and did not indicate anything abnormal with my heart.(Still no answers to my questions.)

The next procedure I had performed was a complete blood work-up.This procedure was also done at the hospital's outpatient center.The hospital labs were able to check just about everything in my blood from white blood cell count to thyroid production, and from sugar levels to phosphorus counts. They compared my results with those of normal blood counts to see if there were any abnormalities in my blood. When the results came back, the only irregularity found was a high phosphorus count. The cardiologist did not know how to interpret this and thought it to be of little significance.

The third procedure I had done was the echocardiograph. This basically was an ultrasound picture of my heart. It was very similar to the ultrasound my wife had when she was pregnant. A gel was put on my upper abdominal area and a transducer was moved over my chest area. The transducer emitted inaudible sound waves into my body. These sound waves were echoed back and translated by a computer to form a picture of my heart.This picture would reveal any structural defects my heart or surrounding blood vessels might have. The cardiologist could also measure blood flow and valve efficiency through Doppler mapping. Overall this test was the most interesting, since I was able to actually see and hear my own heart beat. The results from this procedure showed no abnormalities in my heart or surrounding vessels, except for a mild tricuspid insufficiency, which according to the doctor was of no clinical significance.

The last test I had to do for the cardiologist was the stress test. In this test I had to get on a treadmill and walk against increasingly harder resistance with an EKG monitor hooked up to me. During this process my heart rate and blood pressure were measured while under stress. The doctor did not find any irregularities with my heart during the course of this test. I did work up a sweat during this test and strongly recommend that you wear comfortable clothing if your doctor prescribes a stress test. I would also like to note that if you decide to do this test that it is done at your own risk.

Through all of these tests the cardiologist concluded that from the standpoint of my heart and cardiovascular system that I was in good health. After I suggested I was probably just having Panic Attacks the cardiologist recommended that I avoid caffeine, chocolate, and alcohol to help prevent future attacks. Since I didn't drink much and was already watching my caffeine intake this advice was not much help. After all of those tests I still did not have any answers. The good news was that my heart was okay and that I was not going to have a heart attack anytime soon, so I decided to make an appointment to see the other specialist my doctor wanted me to see, the gastroenterologist.

On my visit to the gastroenterologist I was weighed, asked the questions, and my heart was listened to again.(This process sounds familiar?) This time though, the doctor heard my heart skipping beats when he listened to it. Since my cardiologist did not mention anything about my heart skipping beats the gastroenterologist did not pay much heed to it. I was supposed to get an upper G.I. on this visit but that didn't happen. Remember from CHART 1 that Ulcers and Esophigitis have the same symptoms as panic attacks. Also, if you recall, along with my panic attacks I was having difficulty in swallowing. An upper G.I. would help the doctor see whether or not a digestive problem such as an ulcer was causing these symptoms and attacks. The upper G.I. would have given the doctor an x-ray of my digestive tract. Since the Barium used in this process reflects x-rays, a good picture of any abnormalities in the digestive tract can be seen. The gastroenterologist did not think this test was necessary because he thought another "test" would be better. This "test" , a rectal exam, was rather quick and was performed right in the office. Basically, it checked for blood in my feces which could indicate if I had an ulcer or another digestive tract problem. The test results showed no indications of any problems with my digestive tract. Since, the doctor felt confident that I did not have any digestive tract problems hedid not see a need to proceed with the upper G.I..

The doctor wasn't finished though, and wanted to try another procedure with an endoscope or gastroscope. This device is a flexible fiberoptic tool that allows the doctor to look at the esophagus close up. The doctor would place the device down the esophagus to do this.Once done, he could check for signs of inflammation caused by acid reflux from the stomach. Acid reflux could have accounted for my chest pains and difficulty in swallowing. After talking with the doctor, I opted not to do this test because even if I had esophigitis it wouldn't explain away my rapid heart rate and heart palpitations. Also, from what I understood there was not much in the way of a cure for esophigitis. To cure esophigitis I would have to change my eating habits and I did not see myself realistically doing that, thus I saw no need to proceed with the test. After I made that decision a brief check was made by the doctor for signs of a hernia. No signs of a hernia were found so I was given a clean bill of health by the gastroenterologist and my visit with him came to an end.

From anxiety drugs, to stress tests, to digestive tract examinations, I still had no answers to my questions about my attacks. Therefore, I concluded that my attacks were not a result of some serious physical ailment but must be from PANIC, as my coworkers had previously suggested. The good news was that I was not going to have a heart attack or die from stomach cancer and you probably aren't going to either. The bad news was that I had no idea what a Panic Attack actually was or what caused it. Through my personal experience with these attacks though, I have been able to come to an understanding of what I think these attacks really are and why they happen. The next chapter discusses these ideas and helps to answer some of the questions we had about these attacks.

Anxiety: The Script For Self Hypnosis

2007-11-08T19:31:00.000-08:00

Give yourself some useful new instructions. You can hypnotize yourself if you put your mind to it. It' s not dangerous - you can't get 'stuck' under hypnosis or give yourself some harmful command. You'll just use the space given by deep relaxation to put some constructive thoughts where they'll do most good.

Start by lying on the floor or sitting in a straight backed chair, hands in your lap. If you have time, go through the foot-to-head relaxation. If time is short, do some breathing exercises to set the scene and put you in a calm and peaceful frame of mind.

The Script

Say to yourself, 'Everything I am doing makes me healthier, more relaxed, and more in control of my life. I will wake up immediately if I need to. When you feel comfortably relaxed, imagine sitting on a wooden bench in a beautiful garden, full of flowers. Bees are buzzing gently, and the sun warms your skin. At the end of the garden there's a gate. You walk through, noting the rough texture of the weathered wood as you push it open. Beyond it are steps leading down to a secluded beach, with waves gently lapping on the sand. You walk slowly down, feeling the coolness of stone. under your feet as you count the steps - one, two, three... at every step you feel more relaxed... four, five, six... deeply calm and relaxed... seven, eight, nine... your body is relaxed, your mind open to all the good that can come to you here... ten. You are on this beautiful beach, knowing you are perfectly safe and can leave whenever you want. Enjoy the peace and serenity. Nearby you see a wrought-iron seat facing the sea. You sit down and say to yourself, 'I am peaceful, happy and perfectly in control of my life. I easily cope with everything that happens.' Now pinch the fold of skin between thumb and first finger on your right hand (pinch your thumb if you're pregnant). From now on you can relax at will, simply by doing that and remembering this peaceful place. Repeat, 'I am peaceful, happy and perfectly in control of my life. I easily cope with everything that happens. I can relax at will, simply by pinching my right hand and thinking of this place.' When you're ready, return to the steps, knowing you can come back here any time you like. You will return to everyday consciousness as you count down, but will be able to relax at will. Count slowly down from ten, as you walk up the steps, starting to notice the everyday sounds around you. By zero you are back to everyday consciousness, relaxed and alert.

Getting started

You can do this without making a tape, but it's easier to follow spoken instructions - simply read out the script on this page. Speak in a slow, calm, rather monotonous voice and remember to leave pauses. You can give your self any suggestions you like on your secluded beach, but they must be positive, clear and harm-less. In an emergency, just say to yourself, 'One, two three, ready.' You can snap out of hypnosis instantly, but a brief wake-up formula reduces the jolt. If you find it hard to visualize, just do the counting many people find this equally effective. For deeper relaxation use 30 steps down to the beach instead of 10.

Sleeplessness

When you are wound up about stressful events that have occurred during the day, being unable to go to sleep is the final straw. When nothing seems to work, try this technique of self-hypnosis. It is worth learning it beforehand (read it over to yourself till you know it), then when you come to need it, it will be effortless. Lying down, close your eyes. Imagine a familiar image, say, for example, your bedroom (but keep your eyes shut). Say to your self: 'Nothing but this room exists.' Visualize all the different details that go to make up this room: the ceiling, the walls (are there pictures on them?), the floor (does it have a carpet or rug?), the windows (what are the curtains like?), the furniture dressing table, chest of drawers, wardrobe, the bed on which you are lying. In your mind work systematically from one end of the room to the other, from top to bottom. Then, one by one, wipe the image of each of these details from your mind, until everything has gone. You are left with absolute total emptiness. Concentrate on this void, with you in the middle of it, for a few moments. You will experience a feeling of relaxation coming from it. If you still cannot sleep, repeat the exercise several times. It's usually successful after only a few minutes of 'disconnection'.

Managing Anxiety: Determined Slow Talk

2007-11-07T12:25:00.000-08:00

Here we are working on the feelings that accompany our peaceful, quiet determination. Inside this relaxation and peace are the other positive emotions: confidence, security, strength, power, assertiveness.

We want to grow those positive emotions until they are blooming boldly and brightly. What we are doing is solidifying those feelings into your emotional brain.

This is how "Determined Slow Talk" works:

1. First, we take slow talk and move it down even slower so that we can literally FEEL the determination, the strength, and the seriousness.

2. Then we use the DETERMINATION FACTOR to synergize these positive, quiet, peaceful, confident feelings of strength and power. It is easier to feel the determination and strength when you are using determined slow talk. (Again, notice that it's the feeling we're going after here.)

3. Third, we use the handout and/or statements you are working on and use "Determined Slow Talk" to sink them down to that emotional area of your brain where things become foundational, set in stone, automatic, and natural.

Determined slow talk has the power to allow you to FEEL the confidence, the strength, and the power to allow you to FEEL the confidence, the strength, and the power of your new thoughts and behaviour.

Remember, it is important that the statements, strategies, and beliefs become FEELINGS and these FEELINGS are rooted in your determination, your peace, your inner resources.

When you start to feel these things (even if it is only briefly) instead of just saying them, move on over into "determined slow talk" - because you are ready for your new thoughts to become permanently rooted in your brain... and for you to FEEL the difference!

Managing Anxiety Strategy: Slowing Down Deliberately

2007-11-07T12:19:00.000-08:00

SLOW TALK ("CALM" TALK)

Strategy: Slow talk is nothing more than slowing your speech down very slightly. You are slowing down enough that you notice the change in your speaking rhythm. The change is so slight, however, that other people will not notice you have slowed down. Slow talk is nothing more than slowing your speech down very slightly. You are slowing down enough that you notice the change in your speaking rhythm. The change is so slight, however, that other people will not notice you have slowed down.

It is important to be as calm as possible while you are in the process of learning new ways of thinking and new strategies of acting. Remember that it takes 45-55 days of repetition before your brain starts to automatically use these strategies.

And notice that the only way your brain is going to be able to use these anti-anxiety strategies is if you are consistent and persistent and drop down these techniques into your brain over and over again... for the entire course of therapy.

The first benefit you may discover from using this technique is that it will be easier to remain calm and at peace while you do your therapy. The more you can slow talk the therapy into your brain, the easier and deeper it will get in.

As you become more familiar with the strategy and feel like you can use it in public, you will find it has great practical value in slowing you down so that you can begin to control your anxiety level. If you stay in slow talk mode, there is not much chance you can speed up, get the adrenalin pumping, and then become socially anxious. So, slow talk can prevent us from getting as socially anxious as we used to get.

Another benefit that people usually notice is that there is a slight relaxation while you're using slow talk.

Generally, as a deliberate result of slow talk, the muscles loosen up and are less tight, and many people feel a calmness or relaxation in the shoulders and upper back area where we tend to carry around much of our stress.

The more you have the ability to use slow talk, the more you will feel in control of situations. Slow talk is not something we want to do all the time, but while we are getting better, we want to be able to use this tool as an option to help us lower our social anxiety whenever we need to.

In public situations - the use of slow talk makes it easier to sound and be less anxious, and helps the words to come out more logically and clearly. High anxiety over real-world situations like this can be controlled by slow talk.

Now, please don't jump the gun. In your first week of practicing this technique, do not move this out into real-world settings yet. It is much more important to practice slow talk when you are by yourself. It is important to get it down deeply into your brain. It is important that you feel comfortable in doing it. You need to feel OK with slow talk before you ever try it out in a public situation.

So, generally, this first week, we ask you to practice slow talk for about ten minutes a day. You can read anything you want, but it generally helps to read something positive or inspirational. It isn't important what you read, the therapy is doing the slow talk. You are practicing the slow talk, not the material you choose to read.

One of our women worked in a large advertising agency where concepts and ideas were important, and she felt that no one paid her ideas very much attention. Every time she had a good idea, she would excitedly and quickly blurt it out, expecting other people to be excited, too. Instead, they just looked at her like she was weird, and they ignored her.

When this woman started using slow talk, she brought it to work with her. By this time, she was feeling comfortable with the process, and although some anxiety was involved, when it came her turn to share her new ideas, she switched over into slow talk and calmly and rationally gave her ideas to the assembled group. What happened next surprised her a great deal...

Once you learn to slow talk, you no longer will feel rushed and anxious, you can move on into your message sure you're staying calm and focused, and present a talk that everyone understands. In public, social situations like this, slow talk can be a very effective and powerful tool in decreasing anxiety and increasing clarity.

Almost everyone I've worked with has been able to pull a lot out of this technique. But keep in mind it takes practice first - when you're alone. When you do start to use this in public, we want to start out small - talking to one person, such as a friend or relative for example. We do not want to use slow talk in a gut-wrenching anxiety situation until we are ready for it.

It is important that we do things slowly, on a small scale, feel the success behind it at this point, and then move it up gradually to other situations.

And remember this is just one technique. We will be continually adding to these methods with each and every handout. Then, each and every technique will have the "synergistic" effect of strengthening the others.

The more you practice, the more results you will see.

The Cycle of Stress

2007-11-07T10:36:00.000-08:00

Human beings have an innate response to real danger. It's often referred to as the fight-or-flight response, and it triggers the secretion of certain hormones along with an increase in blood pressure, breathing rate, metabolism, and muscle tension to help us fight or flee a perceived threat.

The problem today is that our bodies can't always distinguish between real danger and the pressures of modern life, such as juggling conflicting responsibilities, meeting deadlines, or dealing with traffic. As a result, some estimate that the stress response may occur 50 times a day in the average person.

People exhibit prolonged episodic stress in a number of ways: they become anxious, irritable, angry, withdrawn, or depressed. Over time stress can contribute to a variety of chronic health problems, such as high blood pressure and irregular heart rhythms that can put people at risk for heart disease. In fact, heart disease is the leading cause of death for women. Untreated, stress can also make it more difficult for people to stop certain behaviors, such as smoking or excessive drinking, or to implement lifestyle changes such as improved eating habits or regular exercise.

There is ample evidence now that the use of stress reduction techniques can dramatically improve the body's innate ability to take care of itself. In a recent study at the UCLA School of Medicine, 22 people with high blood pressure were taught various stress reduction techniques such as biofeedback, deep breathing, and the use of relaxation tapes. Seventy-three percent were able to keep their blood pressure under control with lower levels of medication, and over half were able to safely stop taking medication altogether. In a control group of 17 people who did not learn the relaxation methods, only one-third were able to reduce their medication levels.

A major part of the program at the Mind/Body Medical Institute at the Beth Israel Deaconess Medical Center in Boston is learning how to manage stress. In addition to practicing the relaxation techniques of meditation, deep breathing, and visualization, participants learn how to identify their automatic emotional and physical reactions to stress. Then they are taught how to break the cycle with these four steps:

Stop: Don't let negative thoughts make the situation worse than it really is
Breathe: Take several deep breaths to release physical tension
Reflect: Focus your energy on the problem at hand
Choose: Now you can choose the best way to deal with the situation

"After my last child i started to suffer from severe postpartum depression"

2007-10-10T12:16:00.000-07:00

I am a 23 year old mother of three. After my last child i started to suffer from severe postpartum depression. I went to the doctor to discuss this with him( he was a doctor that I hadn't seen before, but my doctor was in a real bad accident and wasn't able to work), he didn't know a thing about me but prescribed me paxil. I started taking it because I thought it would help. Boy was I wrong. After two weeks of taking Paxil I started to experience real bad side affects, I couldn't move of the cough because if I stood up i got so dizzy I would fall, I felt like i was on a whole lot of drugs. Anyways I was at home alone one night with my three little boys and I got this horrible feeling come over my whole body, I felt almost paralyzed, i couldn't think, i was scared that I was going to die , I couldn't even talk, I phoned my husband to tell him to come home because I couldn't watch the kids but all I could say is come home, come home. he asked what was wrong but that is all that would come out of my mouth. It was the starriest thing that has ever happened to me in all my life. But to make a long story short i weaned my self of of it starting the next day. Please make sure your doctor knows your history, and you really try other help like counciling first, if that doesn't work then talk to your doctor, maybe paxil could work for you. I am not a doctor so i won't tell you not to take it because everyone is different and it could work very well for you. every thing said here is only my opinion and my experiences, and I just wanted to share them with you.

-- submitted by Reign, 23

"I started taking Paxil for postpartum depression"

2007-10-10T12:14:00.000-07:00

I started taking Paxil in November 1999 for postpartum depression. I started feeling great right away and had no side effects. In January 2000 I tried to come off of it and had dizziness and nausea. My pharmacist told me to go back on it and to wean off of it. I went back on it (feeling better immediately) and decreased the doses as advised. It is February 28 and my last pill was last Wednesday. The dizziness and sick feeling is getting worse by the day. The dizziness has become so severe that I cant stop thinking about taking a pill to make it stop but I am determined to get away from it (I hope I win). My doctor and pharmacist assured me that this drug was not addictive and I would not have any trouble coming off of it. I trusted them both. This website is just what I needed. It feels good to know that this is real and not because of an underlying illness which is what I was told. I did not understand that if was not from withdrawal then why did taking a Paxil make the symptoms stop? I am wondering just how long the withdrawal symptoms last because I need to know what I am up against. I am desperate to get back to normal and enjoy my beautiful family without Paxil.

-- submitted by Jane, 32

"I have two months on Paxil, I can said that it works on me, it helped with my depression, mood swings and temper"

2007-10-10T12:03:00.000-07:00

I have two months on Paxil, I can said that it works on me, it helped with my depression, mood swings and temper but on the side effects I feel very, very tired, I want to sleep all the time.I have also wet hands and some problems to sleep.

I am taking a 1/2 20 gms pill a day , I started with one pill daily, but it was too strong for me I was like a zombie! looking at all in gray color, with eyes of fish and with a dry mouth, looked to everything and said !bah!

I don't want to feel like that all the time! I feel better with out depression but this feeling is disturbing me now!

I read that some people here switched on Effexor Xr to avoid that lack of energy, is there anyone who have done this?

what is the dose that you are taking?

did you waited two weeks to clean your body from paxil?

Thanks in advance for your help and good luck!

--submitted by Carlos, 27

"I initially went on Paxil for severe social anxiety and panic disorder."

2007-10-10T11:58:00.000-07:00

I initially went on Paxil for severe social anxiety and panic disorder. I responded to an ad in a magazine. My doctor put me on Paxil 2 weeks ago. I took 10mg for 1 week and increased to 20mg this last week. Eventually I will go on to 40mg. After reading this website I am very scared. I don't want to feel the anxiety anymore however, I don't want to feel sick like everyone else does. So far, I've felt as if I were in a daze. I feel like I am looking past everything as if you were trying to stare at one of those 3D pictures. I have muscle twitches in my arms and legs. I have difficulties focusing and my eyes are extremely sensitive to the light. I experience a floating dizziness all the time. Sleep comes easily and fast, however, when I wake up, it's really early (5-6am) and I am still exhausted but can't get back to sleep. My head feels foggy and my body aches. Will all this go away? I keep being told it will. Also, does anyone know the best time to take this drug? I am currently taking this at night and wonder if that is part of the problem. Anyone with similar symptoms or general info please e-mail me. I see my Dr. in 2 weeks and wonder if I should try something else? Good Luck everyone. I know I'll need it

-- submitted by Foxy1er, 21

"I have overcome the physical sickness of the withdrawals, I am dealing with the mental side of it now"

2007-10-10T11:48:00.000-07:00

Well, I have been off Paxil going on 2 weeks now. That first week I felt like I was going to die. But GLORY TO GOD I feel normal again and I can't tell you how great that is! I'm not sleeping my days away. I actually look better.( not like a zombie ) I feel like I am dropping weight and that is awesome!!! I really feel for people on Paxil and are trying to come off. I was on for 2 years and once I made the decision to come off, I was fine until the withdrawals kicked in. It was a very sickening experience but I think I have made it through the worst. I have heard that it takes only a short period of time to leave your system but a very long time for it to rid itself from your body totally. Even though I have overcome the physical sickness of the withdrawals, I am dealing with the mental side of it now. I had a crying spell yesterday that lasted 30 minutes. I don't even know why I was crying but it felt good afterwards. I would like to tell all the people who are trying to come off to not give up. Middle way of your withdrawals, don't give in to Paxil. I thought about it, believe me but I felt as though I had come too far to go back. Just be strong and head strong that you are going to win this battle. I owe all my success to the LORD. Without him, I don't think I would have been physically or mentally strong enough to come off this medication. I still have a ways to go but I know I have got it whipped now. I will continue to keep you updated.

-- submitted by Ola, 31

"i started taking Paxil at 17 years old along with lithium for bi polar"

2007-10-09T14:10:00.000-07:00

i feel better to know that i am not the only "prisoner of paxil". i started taking it at 17 years old along with lithium for bi polar. honestly, i don't remember any extreme changes in my mood, i know the lithium helped. paxil seemed to allow me to see the gray in situations, it sort of numbed me a little. it had less of a strong effect than any other meds i had been on so i continued to take it until about two weeks ago. i got off cold turkey, ignoring what the doctor said. i regret ever being on it. the way i feel now is horrible. pains inside my ears occur off an on, dizziness, sensitivity to sunlight, over emotional etc. but the side effect that is most bothering me is a continuous head buzz, like a headache, but it doesn't hurt. what is feels like is a sharp fast rush in my head, it sounds almost like a helicopter in the distance. it feels like a constant hangover, without the pain. they are these real strong waves in the top of my head that occur every five to ten minutes,strong at first and then they fizzle out. they are worse when i haven't eaten, or slept enough. they continue all day, i cant stand them it feels like im on acid almost. i keep thinking that maybe im pregnant but after reading some of the symptoms other people have had maybe it is paxil, i don't know, someone please tell me if there is anything NON ADDICTIVE i can take to feel normal again. emotionally im really not doing that bad in fact i feel a little better off of it, but i cant stand walking around everyday with a throbbing head. honestly it feels like your head feels when you are extremely over tired. someone, anyone, relate? i need to feel better.

-- submitted by yippyskippy, 21

"I took Paxil because I was having some problems coping with depression"

2007-10-09T14:07:00.000-07:00

I began taking Paxil in October of 1999. I took it because I was having some problems coping with depression. At the time, I felt I was wise enough to ask the psychiatrist about any side effects Paxil might have. She pretty much assured me that the side effects were minor and, at worst, I may get some sexual side effects.

Anyhow, I took 10mg for the first 4 days (as she told me to go gradually onto it) and then I increased it to 20 mgs for my daily dose. I will say that it did calm me down but I think it did too good of a job as I was very detached feeling and showing little emotion at all.

While I was on Paxil, I did experience sexual side effects as well as muscle weakness/shakiness, was emotionally "blah" (almost zombie like I guess) and got some of the famous electrical "zaps" early on. As I got used to it, these effects were reduced to some extent but were almost always there. In fact, I started developing these muscle twitches/spasms in areas of my body as time went on (especially in one of my feet).

I decided about a month ago (after being on Paxil for over 2 months) that I did not want to continue as I didn't like the groggy, detached feeling I had and I was tired of the effects on my muscles. I went cold turkey (my doctor had advised me to wean myself off of Paxil and I didn't) for the 1st two weeks. I didn't have terrible problems but I had a dull headache and I felt less than normal.

The one thing that I did develope after a week of being off Paxil and continues to happen after about 3 weeks is that I get these involuntary muscle twitches. This is what bugs me the most (not painful or anything but a big nuisance). I have been searching for others who may have experienced this as well.... which is a big reason why I came to this website. I get these twitches all over but its really consistent near one of my eyebrows and it is so IRRITATING! They are like any normal muscle twitch that anybody experiences at one time or another in life but they are much more persistent and happen more than usual.

I am wondering if others have had these same involuntary twitches in their body after going off Paxil and how long it took for them to disappear (please tell me they eventually disappear!!). I would really welcome any Emails in response to this as it would be a big help. I have looked around and have seen that shaking/tremor is a withdrawal effect but I am not sure if muscle twitches are included in that "definition" so I want to hear from others who may have experienced this as I want to make sure this is a "normal" withdrawal effect.

With the exception of the muscle twitches, I feel like I have gotten over Paxil. I am not completely over it (it has been about 3 weeks off of it at this point) but I am hoping these twitches will eventually diappear.

I hope by giving my experience with Paxil will help others. I have felt alone at times and the muscle twitching has made me a little bit nervous that its not the medication and its something else wrong with me (although my parents and girlfriend tell me its clearly a withdrawal effect).

My advice is to anybody considering Paxil is to really weigh the pros and cons HARD. Personally, I will never go on any kind of Psych medication ever again in my life. I would rather fight through it with other means (like therapy) than to use a medication. This medication may work perfectly fine for some but it doesn't work for me.

Please Email me if you have dealt with muscle twitches from Paxil withdrawal. I need your support and advice if you can give it. Thanks in advance!

"Zoloft seemed to suck the life out of me so she then switched me to paxil"

2007-10-09T14:04:00.000-07:00

In the spring of 1999 I ran a marathon. I had a few weeks of anxiety and went to my doctor to see if this was an effect of the race. She decided to put me on zoloft which was an absolute nightmare. Zoloft seemed to suck the life out of me so she then switched me to paxil. The change over to paxil was pretty quick and the side effects kicked in fast. I was constantly irritated and very moody.I tried to ram my best friends head into a golf cart after he made a comment about changing the dosage of my meds (paxil) because of my attitude. I can relate to almost all of the comments listed. I have gained 20lbs. in the last 8 months and its really playing with my head. I want to get off of paxil and decided to check on the side effects before doing so.I am glad I did. My dosage has been 10 mgs. all along and wonder if I will have the same side effects you all have listed. If anyone has any advise please e-mail me with your comments.

-- submitted by ssatkoske, 32

"I was so addicted to xanax which i was put on by my gp for anxiety disorder"

2007-10-09T14:02:00.000-07:00

I've been on paxil for approximate 4months, I started on 20mgs.and was increased by therapist to 30mgs, this all came about in oct.99 I was so addicted to xanax which i was put on by my gp for anxiety disorder. I was on 2mgs of xanax a day. which is not that much but then i got used to it so I kept increasing my dose, I had got refills so often from my gp and other doctors that i would see. I crashed in oct. with an accidental overdose and placed in the psychiatric dept. I went through complete hell withdrawing from that crap, I had the shakes ,feeling of dizziness and sweating my head felt like i wasn't there it was so much hell i couldn't sleep and didn't have any support from my husband. It was so bad and i wasn't getting any better after about 3weeks in hospital and i had lots of therapist observing me,so i was proof that being taken of medication cold turkey was not successful. On the third week they put me on paxil to get me straightened out again. And within 2 days I was feeling totally normal, that should of been my q that this was another addictive med. but my therapist said it wasn't. After reading the other addictive paxil stories this scares me to tears and my heart goes out to you. I'm only 32 years old i don't want to be dependent on med. But I'm scared to go off this medication for fear of that terrible withdrawal. If there is anyone out there that this little note reaches I hope you will really educate yourself on the medication before you too will get addicted without knowing it. I'm a married 32 year old mother of 2 boys, and definitely not a drug addict. I thought. What I wouldn't do to be "normal" without medication.

-- submitted by Jim, 32

"NEVER take a cough suppressant called dextromethorphan with Paxil"

2007-10-09T13:59:00.000-07:00

this isn't a story about my withdrawal i just want to alert all paxil user to the drug interaction from a common over the counter cold medication. i was warned by my pharmacist NEVER under any circumstance should you take a cough suppressant called dextromethorphan or DM. i was told paxil keeps the cough med from metabolizing in your liver where it builds to a lethal amount. if your cold med says DM DITCH IT QUICK. REMEMBER TO LOOK FOR ANYTHING WITH COUGH SUPPRESSANT. THE ONLY COUGH SYRUP OK FOR US TO USE IS A PRESCRIPTION ONE LIKE CODIEN. PLEASE TALK TO YOUR DOCTOR BEFORE TAKING ANYTHING.

-- submitted by KAREN, 27

"my only symptom being having trouble getting a deep breath"

2007-10-09T13:51:00.000-07:00

Three days ago I was prescribed Paxil for anxiety...my only symptom being having trouble getting a deep breath. I was told to take 20mg in the evening with dinner. When I woke up the first morning I could not talk and breathe at the same time. I had been told it would take 2 weeks for the medication to take effect so I never even considered that Paxil was the cause. After about an hour I was fine. The second day I woke up feeling in a fog without the normal feeling in my right arm. As I sat on my bed my husband asked me if I was all right. I said not really. I quickly realized I could not talk and breathe at the same time again. Also, my hands were sweating. Next I had an attack of diarrhea. As I went downstairs afterward, I was literally shaking all over. This lasted for about an hour. I decided to go on-line to see what I could find out about this drug. Thank goodness for your stories. You saved me from what could have been a terrible mistake. I also do not like to take medication, preferring herbal remedies when possible. I am grateful to be able to learn the easy way - from all of you - that this is not the drug for me. THANK YOU

-- submitted by kmjmchugh, 39

"Paxil caused me to gain weight, and it causes me to not want to have sex with my husband"

2007-10-09T13:36:00.000-07:00

I have been taking Paxil since I had my 2nd child in December of 1995. The recovery period from a C-section the 2nd time was tremendously different than the natural childbirth the 1st time. I also had a Colicky, cranky, never sleeping baby to deal with as well as a 18-month old. Since my 2nd baby had her days and nights reversed, she would not sleep at all during the night but would sleep from about 6:00a.m. until 11:00 a.m. This was her long sleep daily. I was spending all night awake and most of the day, so I quickly became very depressed. I was put on the Paxil for this and I saw results right away. However, this wonderful drug caused me to gain weight, and it causes me to not want to have sex with my husband. The weight gain isn't as much of a problem as the other. My husband could not deal with this at all. I tried going onto other meds but nothing works as well as the Paxil. When I am not on any medication I am extremely mean and evil. I want to throw things at my husband for almost nothing at all. He has to immediately get up when I ask him to do something or it puts me over the deep end. I would rather keep peace and harmony within my marriage and family so I keep taking the Paxil. If anyone has suggestions on the mood swings that I have when not on the Paxil I would love to hear them. The other meds that I have tried that do not work as well are Zoloft, Celexa, Wellbutrin, and Prozac.