Cognitive Behavioural Therapy: It’s good to panic…once a year!


My recent attempt to deal with my anxiety has been going to CBT [Cognitive Behavioural Therapy]. It’s an approach that helps to deal with the symptoms of anxiety rather than the cause, thus giving some control back to the sufferer, even if they haven’t worked through the symptoms yet (which is a much longer process).

The guy I go to has been practicing for 20 years, and has a sliding scale price per hour, which means that I can afford him. Although I’m in the UK and can get access to free CBT on the NHS (National Health Service), I opted to go private as the hours mean that I can go after work, rather than during work hours through the NHS. It’s ironic really, because asking for time off work to attend CBT increases my anxiety and the thought of it caused me too much panic to go through with it. This is why I waited 11 months after first requesting CBT from my GP (doctor) before going privately. Anyway, I digress.

I attended my second appointment with him yesterday and it was both enlightening and interesting. His idea is to educate me about panic attacks in order to help me to understand how they happen, in order to stop them from happening. At my first appointment, he asked me to keep a record of any time I felt panicked, noting all the physical, emotional and mental changes that happens to my body. He asked me to “let it go a bit further” than I normally would, rather than trying to control it, which was pretty scary.

I downloaded a mood tracker app called “My Mood Tracker” (highly original name!), which turns out to be a handy little free app that not only allows me to track my mood, but also my sleep, medication, exercise, stress, energy levels, pain and, for female bodied people, menstrual cycle. As requested, I took notes after a panic attack had subsided and here were my findings:

Chest tightened, breathing changes to shallow and I can’t change it back. Neck and back tightens, tightness spread up to head so forehead and across eyes tighten. A headache hits instantly. Shoulders lift up and come forward, then a shiver starts, which ripples through my body like an electric shock, starting at my lower back and up and out to my hands. My stomach/lower rib cage clenches. I start to feel trapped/immobile, my eyes lose focus and the internal noise inside my brain increases, drowning out external noises/conversation. I feel and hear my heartbeat thumping really loudly through my body.

My panic attacks are very physical, engaging nearly all of my senses, with the exception of smell. It’s this which has me attending the CBT in the first place, because I find myself constantly trying to control my panic and it in turn controls my whole day. I avoid situations, I lock myself into my house, I refuse to go to work on really bad days, and I hate myself for allowing my body to control my actions. But I can’t help it. I’m hoping that CBT will help.

When I went back for second appointment, he asked me to read out the symptoms of my panic attacks, and we mapped it out. I can’t remember all the details, but basically I have controlling behaviours which I need to let go of in order to stop my panic attacks. But as my CBT therapist said, they’ve become a safety blanket that I rely on and it will be really hard to let them go. He then got me to stand up and do two minutes of shallow breathing – hyperventilating – during which I started to have a panic attack, felt really light-headed and dizzy, felt all the symptoms that I mentioned above that I have in my non-induced panic attacks, while trying to remain calm, because he was making me do this so it couldn’t be all that bad, right?

When I sat down, I felt terrified. It’s that feeling that I always get when I’m super panicked. He described it to me as my fight-or-flight syndrome that’s gone into overdrive. When faced with a lion attack, our ancestors would have responded physically in the same way that I do when I’m having a panic attack – their muscles would tighten, ready to fight. The blood would rush into the bigger muscles, leaving less blood in the brain, hands and feet and more in the arms, legs and chest, readying for fight-mode. Their adrenaline would increase, quickening their heart-rate to get more oxygen to their muscles. All these symptoms are mirrored in my panic attacks to a lesser intensity. My fight-response is over-reacting to stressful stimuli in my environment and far too often for my body to cope with it. Without the fight, my body is full of adrenaline that’s going nowhere, and I end up with a massive headache and nausea. The nausea comes from an imbalance between the oxygen and carbon dioxide in my blood due to hyperventilating, which raises the pH balance in my body to acidic levels, which makes me feel sick.

Medical explanations aside, it’s good to know that if I can induce these symptoms in myself, I can prevent them too (hypothetically…) At my next appointment I’ll be shown how to better deal with my overactive internal caveman!

By the way, apparently it’s good to have a nice big panic once a year – get the adrenaline levels up! My therapist told me that, due to my high number of panic attacks, I’m unlikely to have a heart attack due to the high levels of adrenaline in my body – one positive from all this!

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