7 Nov 2012
Well, I’m still in a strange place lol. I think with this being my 5th week off work (barring bank work at weekends) I just have too much time to think and hypothosise (catastrophise!) about my future. That and a lack of routine.
I’m just concerned with the panic reaching intensities that it does still, but I think that is based on memory. In actual fact, the other day at work I went in to an emergency buzzer (my big fear!!) and did fine!!! I still get the adrenaline rush from it of course but I am able to go in and function as part of the team.
However when I got home, telling my mum about it made my breathing a little faster, and i felt quite often that i was suffocating – i think its a sort of memory from the time i got in from work and was panicking about the emergency, being ‘unable to breath’ etc.
Last night, I was chilling on the laptop and i had one finger pressed on my nostril (lol just a random resting position!) but I think it made me briefly feel i wasnt getting enough air, so i got an adrenaline rush but it made me feel crappy. So half of me was being logical, half was saying “oh god” at one point i thought i
was going to be sick, and any movement or talking from my boyfriend made me feel worse. When I was dropping off to sleep, my limbs kept jerking as well as if i was on high alert.
gahhh. Like you say, it takes time and practise….
a funny story, I’ve been doing quite well with going on walks lately, and the other day I was walking up a huge hill that usually gets my heart rate going pretty fast, so I was trundling up it and realised I couldnt feel my heart beat..cue panic… then I realised I must be getting fitter!! hahah
You are still actually doing really well
but if you are frustrated with still having a problematic level of fear it would be helpful to go over everything again
PARTICULARLY the Interoceptive Exposure at the start of book 3 – this is SO powerful to clear up panic altogether
you keep getting ‘caught out’ by certain symptoms – so why let them be in charge
YOU take charge of THOSE symptoms by doing gradual exposure to them EVERY DAY – in a controlled systematic way
sounds mad because why bring on anxiety if it’s not there – but it IS there as anticipatory anxiety
yes you can wait till it happens and work on it – that works but as you see is hot or miss
BRING IT ON!!!!!!!
read book 3 again and let me know what you think
work out the EXACT symptoms that keep catching you out and let me see the list
29 Nov 2012
coming? going?! that’s me right now lol.
I’ve just finished a 3 day stint at work , and am deciding to have a little panic about it!!
even writing those words make me sweat, feel sick and send off another bout of adrenaline.
But writing that down helped… lol
My first two days have been fine, but I did get off pretty late on both of them so as a consequence I’ve been tired today.
Luckily, it was a really calm shift, nice and quiet, I only had 3 women (average is about 6-7 women usually) and it was great. But it gave me too much
time to think about any symptoms that arose in me! like a spot of dizziness, slight shortness of breath when talking to someone etc.
And as I went to leave the shift, I think a bit of excitement was at play (because I never usually get off early) I was handing my patients over and on the last one I got that sudden “ohmygod stop everything NOW” sensation, a true feeling of panic, as if I ‘knew’ I was about to die.
I’ve had this before though handing over – I think its a combo of slight anxiety re:missing something/having to speak for a while. I think I forget to breath sometimes haha and it sparks a bit of breathlessness, thus anxiety and panic.
I managed to hand her over though and left, thinking bummer!! off early, nice sunshiney day and I feel like this to go home! however I made myself run up the steps of the multi storey carpark (all 4 flights) as a bit of exposure and proving there was nothing wrong. I felt a bit better after that but still twitchy/ with the ‘impending doom’ hangover.
I wasn’t even going to write to you in fact, but as I’m here at home now I just got a run of palpitations, lasting a good couple of minutes every odd few beats. It just worried me because normally I get them once or twice and they go. I think it might be to do with the way I was sitting. hahahah typing this I just got another one! and another! It really is crazy how they seem to be mental – like how can you make your heart twitch with your thoughts?! I know its to do with adrenaline but still.
Gahhh I feel really sick, worried and impending doomy. I think its because I’m concentrating on it and I’m tired. My busy days at work I have been fine, much less anxious than I expected, but I think thats because I’m so busy I don’t have time for thoughts other than those to do with work.
Ah the joys of panic disorder
If it helps I went round in circles like that for what seemed like forever
some times it’s just down to a good imagination
some people aren’t great in imagining things so they get over panic quicker
and then some – like ourselves – can write a thriller novel in our heads every time we feel the slightest twinge
It may help to go over it all again – and if I were you I would see if I could bring on those feared sensations everyday in some way
it’s all about repetition
and I know it’s hard to believe but you WILL eventually reach a place where you will wonder how on earth you could even worry about fight or flight
Thats how I am now – its a total relaxation (from fight or flight not from everyday anxieties that we can all have) but it did take me a long long time
each time you are forced to work with this you will learn even a tiny amount more – so dont worry
there is obviously still some misinterpretation to clear – so dont be thinking you are just different – or mabye you wont recover – maybe its something else in your case – and all that stuff
thats what I thought again and again and again – but it was just misinterpretation – trust me you ARE well on the road to recovery
just knuckle down and keep practicing
speed it up by deliberately bringing that level of fight or flight on every day in a controlled way
I know the temptation is to leave well alone but then recovery is spread over a longer time
how brave do you feel? 🙂
15 Dec 2012
Really sorry to be emailing you again – genuinely I am, I bet you’re thinking I’m not trying hard enough with your advice (to which that may be some truth!)
but I’d really appreciate a chat – I’ve just come home from work a measly 4 hours in to an 8 hour shift. I actually got out without causing too much inconvenience, because I was “extra” staff helping out – so I said I felt unwell and asked if I could have some time owing back (of which I am actually owed over 4 hours!!)
So that’s why I’m here. But I’m pretty upset and frightened by it. What happened was : I went on shift feeling a little bit sick, but not that bad. Then as time went on I felt my anxiety increasing – sudden waves from nowhere, which increased my nausea. Then, I went into a lady’s room to give her some discharge information – I THINK what happened was that I was speaking too fast and not stopping to take a breath – but suddenly I got that feeling that I’ve only ever had about 4/5 times in my whole time of having panic disorder – a feeling that I was choking and/or my heart was about to stop – it was OBVIOUS as I sort of choked over my words, and the woman and her family looked at me concerned. It was like my voicebox didn’t want to work. I took a couple of breaths and continued what I needed to say (Absolutely TERRIFIED) then left the room.
Well I was CONVINCED that it was heart related, I was about to collapse, etc. I almost went in to full blown panic breathing mode, but with my experience I actually managed to keep my breathing ok. I focused on my paper work, thinking “should I go or just ride it out?!” I really really wanted to ride it out, and began to feel a little better, but the nagging doubt saying “oh my GOD people don’t just feel like that for nothing. you seriously need to go to a&e before it’s too late”
Then I remembered about the time-owing, so I told the coordinator I felt ill and asked if I could take the time. She said yes not a problem.
So I managed to finish what I needed and left relatively calm etc, drove home quite calm, so I AM impressed and pleased with myself on that scale.
But it’s just the fact I’ve left work – I have a very responsible job and it’s just fortunate I didn’t have 7 patients of my own today – what if I did? I know these thoughts stir adrenaline but it’s something I need to seriously consider.
I just don’t know what that sensation was- rationally, I was probably speaking too fast without a breath, and with “nervous” vocal chords that like to trip you up – like when you nervous swallow when speaking without intending to?
But it’s just the way I feel with this sensation – mega anxiety and a horrible horrible surreal feeling that I’m about to collapse. I KNOW it’s happened before and I haven’t died – but I’m just worried that it’s a warning sign my body is stress-overloaded or something?? and if I push past it, I really will collapse
Have you had any experience with this sensation? It feels related to a “locked” diaphraghm and ‘tense’ vocal chords . I also had a heart palpitation a few minutes beforehand but didn’t really think anything of it. Describing it like that really doesn’t do any justice to how awful it feels – it really feels like I’m about to start choking or gasping for breath
Thanks for listening, I appreciate it so much, it must be extremely frustrating – I’m incredibly frustrated too
Am just about to head out but will try to give some help 🙂
On the plus side – you will learn that even with what you believe is absolute proof that there is something wrong with your heart – you are still here and still will be for a long time to come – so you can add that to your memory bank – “I felt CERTAIN before that I was about to die of heart failure – but I didn’t”
This will be very useful the next time you feel the symptoms are more than just anxiety
another plus is that despite feeling total terror you kept right on going – ok you were anxious but you DID catch it and deal with the situation – another thing you can remember in future
You say you ‘almost’ went into full panic – which shows you DIDN’T – well done 🙂
and you kept your breathing ok 🙂
you were also prepared to ride it out so even though you didn’t at least you thought about it which is good 🙂
What has happened is that ‘normal’ fight or flight which is bad enough got increased by worrying what others think – this is why public speaking is the worlds number one fear even over death!
and you also worry about being seen to do your job perfectly – and you worry about letting down a patient or making a ‘mistake’
so this kind of worry just shoots adrenaline big time and before you know it you are choked up and can’t speak
all perfectly common reactions with panic and anxiety
and yes – I have been ‘frozen’ with fear many many times – choked up – could barley speak
The fight or flight response can also be called the fight flight of FREEZE response – because it is sometimes helpful for us to be immobile and not able to move if in danger (ie a snake is near us and we daren’t move)
so ALL these response have a biological – evolutionary element that is natural – but is just all out of whack with people who get it for no obvious reason
It sounds like you don’t really have a decent ‘plan’ in place
You need to be able to recite the coping statements backwards – when we skyped I got the feeling that me taking you over the practice so many times was not what you normally do for yourself
there is no other way
if you aren’t doing that you need to learn to do that
You have clicked with the truth about panic – so that is why you have improved – but the fear is still overwhelming when it strikes
and it sounds like you haven’t done enough CONTROLLED exposure where you have to ‘say your lines’ for real
You need to go back over the books – and actually take the practice bit more seriously – interoceptive exposure would be very helpful – and even imaginal exposure
ie – in your mind imagine this exact same experience happening – but imagine you doing the PRACTICE with it (dont just imagine disaster)
take yourself through it – panic – practice – panic – practice – imagine waiting till the anxiety drops – imagine it takes time but ultimately it passes
but work out some REAL interoceptive exposure where you can practice WITH these sensations in your home EVERY DAY – then you CAN’T be caught out like this
practice makes perfect
if you fear a heart problem run on the spot or up and down stairs – do the hyperventilating exercises – do ANY exercise that brings on symptoms that FEEL like what you felt today
then you can work on them
and if you do this EVERY DAY after a few days you will just be bored with them and wont feel so frightened
You DO just have panic – they ARE normal anxiety symptoms
you HAVE had this kind of thing SO many times now and yet here you are
I would say the heart palpitations that you THINK u didnt think about was the trigger – so get going – work out some heart pumping exposure exercises
if you want to be recovered SOON u will do this
if you want to avoid this so as not to rock the boat, you may avoid the anxiety of the exercises but the now and then triggers may go on a long time – if you only practice when you get triggered its not very good practice is it – to begin with you will not be well versed in what to do – you will be caught hopping – you will most likely avoid or be safe – it will pass and then you will try to practice when its all over – not very helpful
you need to do it DURING feeling anxious – and better to do this in a controlled way – with YOU running the show
You are ok even if you DON’T do this – panic is not harmful – you aren’t even stressed much nowadays – you just get these ‘moments’ – but why not speed up recovery with some exercises
Hope this helps
13 Jan 2013
Thanks, but I don’t feel like I’m doing well!! Really really just want to quit. Fed up of anything medical full stop.
Had a day off yesterday and have to go back in today, off at 9.30pm then back at 7.30am tomorrow for more theatre!! nightmare.
I suppose exposure is what I need, but I just feel exhausted and have no enjoyment whatsoever for the job at the minute.
I do know what panic is, but I do still fear it. No matter how hard I try, when I feel that feeling and like I’m about to choke all rationale goes out of the window.
SURELY this amount of stress must be damaging my body. I try mindfulness but it seems ridiculous when faced with dramatic scenarios. I just feel like everything is horrible and a potential for death etc. I was feeling quite happy last night and sat down to eat tea, then they started talking about bloody cardiac arrests on the news and defibrillators being installed into places and I nearly choked on my tea and felt like my heart was going to stop itself.
It’s like I’ve become immune to feeling relief!! I know I’m in a place of major stress right now but I CANNOT believe that my heart isn’t just going to pack up any minute due to repeated stress
when is the last time you read the workbooks or any books for HA
you cant afford to not keep studying
I felt as you do for MANY years – and I’m still here 🙂
but honestly – are you reading up on this or have you just decided that you know it and just need exposure
that’s not enough
even now with everyday life stress I read book after book on self help and mindfulness, meditation, self compassion etc
I also have my car set up to listen to audio books
so i would go over MY practice and study for several hours each day
THAT is what keeps me in balance
if I don’t do that I fall into old patterns which opens me to the usual anxiety
anyway – am just wondering if you are still reading and REMINDING yourself of the facts
do you keep panic diaries – do you fill in worksheets – etc
sounds like you only practice when in the middle of big situations – thats the hard way