A HYPOCHANDRIACS TALE

Anxiety isn't necessarily a bad thing. Some amount of anxiety is normal for everyone, such as being a little nervous before a test or when you meet someone new who you really like. Did you ever shake somebody's hand and realize that your hand is kind of clammy? That's anxiety. Although it can be uncomfortable, it is usually our body's natural way to prepare for a stressful situation.

Our body is equipped with what's called an autonomic nervous system. This controls many of the automatic functions of our body; our heart rate, breathing, and digestion. When we are faced with a situation which requires our body to respond, the autonomic nervous system changes these functions to deal with that situation. When we get scared, we may feel our heart beating faster or harder; this helps get the blood to the muscles in case they are needed. We may also feel our skin get cold or our hands get clammy. This is because skin is an organ and blood flow may be reduced to the body's organs in order to increase the blood in the muscles. Your body may feel tense as the muscles prepare themselves and you may feel your breathing get deeper as more oxygen is required for your body at that time. These changes occur very quickly and take a lot longer to go back to normal.

When these physiological changes occur when they aren't really needed, or they occur when they shouldn't (such as when you are relaxed and suddenly feel nervous without anything in your environment changing), then anxiety may be a problem. Although these physiological symptoms are usually associated with anxiety and what has been called 'anxiety attacks' or 'panic attacks,' thoughts and emotions are also involved.

Thoughts, or cognitions, which can serve to bring about, increase, or result from an anxiety attack are different for everybody. Thoughts may be "I'm not good enough," "I'm gonna fail this test," "I look stupid," or "It's hopeless." They are typically thoughts relating to something being wrong or about to go wrong, not being good enough, making a fool of ourselves, or fear that one of these things is going to happen. Emotions that occur with anxiety, which may also cause, increase, or result from the physiological symptoms are even more diverse. They can be feelings of embarrassment, fear, not being safe (both emotionally and physically), being alone, or feelings of being closed in (such as in claustrophobia).

Just as physical exercise such as running, playing football, or lifting weights can prepare our bodies for the next time we engage in these activities, certain exercises can prepare our bodies for stressful situations. The key to both is consistency. If we exercise regularly, we feel better, and activities are less strenuous because our bodies are ready. The following ‘stress reduction’ exercises can help you’re body be prepared for stressful situations if you do them consistently and will help relieve stress during those times of high anxiety.


These exercises are listed in order of complexity. The earlier ones are quite simple to perform and can be done literally in a matter of a minute or less. These are more useful for immediate stress reduction. The later ones are more complex, taking up to 10 or 15 minutes to complete. They are more useful for generalized anxiety and stress, and to reduce your overall level of anxiety.

Start Exercising
Try each exercise at least a couple of times, both during times of stress and during times when you nay not feel it is needed. This will help you determine which one or which combination works best for you. Keep practicing them, make changes as needed, and pay attention to how you feel afterward. Being prepared is the best way to fight anxiety and stress. That way, when the stress hits, you’ll be ready. And you will likely find yourself feeling more in control of anxiety and stress and start noticing that your overall feelings of stress is diminishing. Anxiety and stress can be controlled, and now you have the power to do it.

Exercise #1: Stop!
Particularly useful when a stressor hits you suddenly or when a situation occurs which results in racing thoughts and high anxiety. Simply imagine a picture in your head, such as a Stop Sign. Focus on the image until you are able to picture it completely (color, shape, words, etc). Continue to focus for at least 10 or 15 seconds.

Exercise #2: Counting
As simple as it sounds. When you feel that stressor hit you...stop, close your eyes, and count to ten slowly. As you count, focus on your breathing and the numbers only. If stressful thoughts get in the way, start back at one.

Exercise #3: Deep Breathing
Sit in a comfortable position and close your eyes.

Focus on your breathing and breath in through your nose and out through your mouth.

Breath slowly and deeply and focus on the steady and comfortable pace that you are keeping.

Make sure to exhale completely each time, without forcing the air out.

If you find thoughts going through your mind, start to tell yourself something that helps you relax, such as just repeating the word "relax," or counting 1-2-1-2-1-2 as you breath in and out.

Continue this for a few minutes until you feel yourself begin to relax, until the thoughts and emotions are more comfortable for you.

Exercise 4: Progressive Muscle Relaxation
Sit in a comfortable position, close your eyes if it helps, and remove your shoes if you can.

Clench your hands into fists and hold them tight for a few seconds, then allow them to relax slowly.

Do this with the other muscles in your body, in an order similar to the following: wrists, lower arms, upper arms, shoulders, neck, feet, legs, buttocks, stomach, lower back, upper back, forehead, eyes, jaw, lips.

Focus your thoughts on the tenseness of your muscles and then the feelings of relaxation.

Exercise 5: Deep Muscle Relaxation
Sit in a comfortable position, close your eyes, and remove your shoes if you can.

Clench your hands into fists and hold them tight for a few seconds, then allow them to relax slowly.

Do the same with your feet, clenching your toes and paying attention to the sensations as you do this. When you relax them, once again pay attention to the sensations as the muscles relax, often there are sensations of tingling, coolness, or warmth.

Without tensing your muscles anymore, focus on whatever sensation you noticed when your feet and/or hands relaxed. Allow this sensation to flow into your feet and past your heel to your ankle.

As fast or slow as you need to go, focus on the sensation of your muscles relaxing and allow that sensation to move upward, into your legs, buttocks, hips, stomach and back. Make sure not to force yourself to relax, as this process occurs naturally if you allow it.

Allow the sensations to move into your chest, through your shoulders and down your arms, and finally up to your neck and the rest of your head.

This whole process may take 5 minutes or it may take 20 minutes, depending on how anxious you were, how relaxed you want to be, and how used to relaxation your body is. Take your time as you do this, and practice it even if you don't feel you need it. Eventually your body will take less time to achieve the same results.

Exercise 6: Imagery
Sit in a comfortable position and close your eyes.

Think of a place were you would feel very comfortable and safe, such as lying on a beach, in a field of grass, or at the top of a mountain. Whatever image you come up with is fine, even if it seems strange or isn't real.

Concentrate on this image and pay attention to the details, such as what time of day it is, the temperature, the feeling of the wind as it blows, the sounds of the waves, or the leaves rustling.

Continue to focus on what you see, hear, and feel, and on being comfortable and safe.

Do this for 5 minutes or so.

As you do this more and more, you will be able to imagine this much more clearly. You may find that different images work better at different times.

When we are afraid of panic attacks we want to be in control, desparately. Many people say, "I feel like I am losing control !" And the sufferer goes into a deep inner search to somehow stop these fearful feelings while fretting over the future panic yet to come. But let's put "in control" IN perspective:

I will say that we never have conscious "control" and it is a futile exercise to try to attain it. In fact, what "control" we do have is all on the autonomic and subconscious level - nervous system, breathing, heart beating, swallowing, blinking, etc. When we attempt to exercise a CONSCIOUS control over our autonomic systems is when we get into trouble. It's highly stressful and not possible. If I am worried about not being able to swallow (because of a dry mouth or lodged food) and then try hard to control it CONSCIOUSLY, you can bet that I will feel like I CAN'T swallow and the resulting fear and focus will prevent more swallowing as it becomes exceedingly difficult and the subconscious control is all messed up and distorted. Why? Because we are trying to CONSCIOUSLY control a function that left to our autonomic nervous system will function just fine!

The fear that we feel in a panic attack is similiar. Fear is created by your nervous system which is an automated bodily response. Trying to gain control over fear creates tension and more desire for conscious control. When we stop trying to control our fear, which includes worrying and fretting over it, we don't lose anything...sanity or consciousness or identity. We don't even get amnesia. There is no control to lose. But in reality the "old" feelings, the old "YOU" before panic attacks began, was a state of mind of NOT trying to control your fear because you didn't feel the overwhelming fear that a panic attack brings. The point is that fear is a natural response to what you are informing your nervous system about. It reacts automatically. And you can't do a thing about it except let it happen. Or medicate it away.

"In control" is an unreasonable expectation that furthers panic attacks. The desire for such control becomes the basis for the apprehension many times that sets the panic in motion. "If only I could control this damn fear then I would feel better!" But the wish is unrealistic and never attained until the suffer gives up all hope for conscious control and by this method settles down the nervous system and returning a feeling of "control."

There can be a problem when seeking more panic when the prevailing fear is "passing out" especially when driving a car or in some other immediate situation. Actual fainting is a medical problem.

But remember not to confuse fainting with lightheadedness. Most panic attack sufferers experience lightheadedness or giddiness every time. Are you a hyperventilator when anxious or in a panic state? When you are breathing rapidly you are taking in too much oxygen and not enough carbon dioxide. This affects your blood acidity and it makes you lightheaded and feel faint. Also your tension affects the muscles of the neck and eyes and this can create the sensation of lightheadedness. Panic attack sufferers WORRY about fainting but rarely do. This is a common worry during the onset of panic attacks. After more experience many individuals lose the fear of fainting because it just doesn't happen. If you are a hyperventilator then try breathing into a paper bag or even into your hand to increase the carbon dioxide in your lungs. If you are worried about passing out try to make yourself faint while sitting or standing in one spot. Not possible when you WANT IT to happen!.

The human body has zillions of processes going on all at once. Occasionally "something" can go amiss such as rapid drop in blood pressure from standing up too quickly. But the human body is also a repair and maintenance facility. The body knows how to survive. It will always try to correct itself. You can have faith in your own body. Your fainting episode many times is only temporary. There is nothing wrong with you!

Some people who actually faint or nearly faint have a low blood pressure condition. But once the fear kicks in, the blood pressure rises and the feeling decreases. Some others have had a temporary medical condition such as a viral infection, allergy, vertigo from an inner ear disorder, anemia, sinusitis, heat exhaustion, poor eating habits, low blood sugar, salt depletion, etc. that may result in the feeling of, or actual passing out. This usually goes away over time despite the fear of it.

What to do if you have actually fainted during a panic attack? Visiting a medical professional is the first thing. But our medical professionals don't always have the time or energy to be medical detectives. If there is no obvious physical problem then they may prescribe anti anxiety medications - which may be a solution for some but a problem for others. Keep trying! Seek out information about those medical professionals that are more innovative and detailed in their work. Don't accept a pat answer of "anxiety" always. You need to be convinced that the medical profession has done all it can for you.

Another good option is Cognitive Behavior Therapy (CBT). This therapy takes you through the steps of desensitizing your reactions and giving you back control. Many times a combination of meds and CBT can solve this fear of fainting (when there has been actual fainting) in panic disorder.

But remember, ACTUAL FAINTING is rare in panic attacks. When this feeling arises the natural tendency is to tense up and want to run out of the room or whatever. The opposite works much better. Relax and let the feeling come all over you. Go with it rather than fight it! Let yourself faint if that's what you fear. Try not to overreact and blow it out of proportion. A relaxed body won't faint!

Problem anxiety may be caused by a mental condition, a physical condition, the effects of drugs, or from a combination of these. The doctor's initial task is to see if your anxiety is caused by a medical condition. Conditions as varied as anemia, asthma attack, infection, drug intoxication or withdrawal, or a number of heart conditions are just a few examples of medical problems that can be associated with anxiety.

Common types of anxiety include these mental conditions:
Panic disorder: In addition to attacks of anxiety, called panic attacks, common symptoms of panic disorders are stomach upset, palpitations (feeling your heart beat), dizziness, and shortness of breath. These same symptoms also can be caused by caffeine consumption, amphetamines ("speed" is the street slang for amphetamines when they are not prescribed by a doctor), an overactive thyroid, abnormal heart rhythms, and other heart abnormalities (such as mitral valve prolapse). The panic attack sufferer may experience their mind going blank or that they somehow do not feel real, in that they feel as if they are looking at themselves from outside of themselves. In order to qualify for the diagnosis of panic disorder, the individual would experience repeated panic attacks rather than just one episode.
Generalized anxiety disorder: Those who endure this condition experience numerous worries that are more often on the mind of the sufferer than not. Those worries interfere with the person's ability to sleep or otherwise function.

Phobic disorders: People with phobias experience irrational fear that may rise to the level of panic attacks in response to a specific thing or situation. Examples of phobias include fears of spiders, insects in general, open spaces, closed-in spaces, air travel, heights, and social anxiety.

Obsessive compulsive disorder: Individuals with this condition either suffer from intrusive and distressing thoughts (obsessions) or engage in irresistible, often repetitive behaviors (compulsions). Examples of obsessions include worries about germs or having items in a particular order. Examples of compulsions include counting items or activities, avoiding walking on cracks, or avoiding touching doorknobs.

Separation anxiety disorder: Considered a disorder of children, separation anxiety disorder can be diagnosed when a child becomes extremely anxious in response to anticipating or being separated from one or more caregiving adults (usually a parent). The separation may come with the child's going to school each day or going to bed each evening, for example.

Stress disorders
These common external factors can cause anxiety:

Stress at work

Stress from school

Stress in a personal relationship such as marriage or friendships

Financial stress

Stress from an emotional trauma such as the death of a loved one, a natural disaster, victimization by crime, physical abuse or sexual abuse (for example, acute stress disorder or post traumatic stress disorder)

Stress from a serious medical illness

Side effects of medication

Intoxication (being "high" on) with an illicit drug, such as cocaine or amphetamines

Withdrawal from an illicit drug, such as opiates (for example, heroin) or from prescription drugs like Vicodin, benzodiazepines, or barbituates

Symptoms of a medical illness

Lack of oxygen: In circumstances as diverse as high altitude sickness, emphysema, or pulmonary embolism (a blood clot with the vessels of the lung)

The doctor has the often difficult task of determining which symptoms come from which causes. For example, in a study of people with chest pain that could be heart disease but turned out not to be heart related, 43% were found to have a panic disorder—a common form of anxiety.

Three small acupressure exercises that are shure to help just squeeze for about 20 seconds and move on to the next exercise repeat if needed. This was taught to me by an old korean man the studys acupressure.

Do you often think that you always have anxiety? Or that you are always depressed? That you are always having panic attacks? I used to think that. And to some extent it was true - I can remember feeling that way probably 95% of the time. But the truth is that no one is anxious or depressed every second of everyday. It may seem like a lot, but there are times when you are probably feeling other emotions.

Here's the challenge. Listen to your thoughts today. If you hear yourself saying that you are always a certain way - depressed, anxious, boring, whatever - I want you to stop yourself and say instead, "I'm only a certain way (fill in negative state here) sometimes".

For example you catch yourself saying "I'm always anxious, I can't take it", just stop, don't get mad at yourself, but just say in your head:

"I'm anxious sometimes, It's ok, I can live with it".

or

"I'm not always anxious, sometimes I'm ok".

Even if you feel these statement aren't true, just try it for a day or two. I guarantee you will feel a little different.

If you think you have an anxiety disorder, the first person you should see is your family doctor. A physician can determine whether the symptoms that alarm you are due to an anxiety disorder, another medical condition, or both.

If an anxiety disorder is diagnosed, the next step is usually seeing a mental health professional. The practitioners who are most helpful with anxiety disorders are those who have training in cognitive-behavioral therapy and/or behavioral therapy, and who are open to using medication if it is needed.

You should feel comfortable talking with the mental health professional you choose. If you do not, you should seek help elsewhere. Once you find a mental health professional with whom you are comfortable, the two of you should work as a team and make a plan to treat your anxiety disorder together.

Remember that once you start on medication, it is important not to stop taking it abruptly. Certain drugs must be tapered off under the supervision of a doctor or bad reactions can occur. Make sure you talk to the doctor who prescribed your medication before you stop taking it. If you are having trouble with side effects, it’s possible that they can be eliminated by adjusting how much medication you take and when you take it.

Most insurance plans, including health maintenance organizations (HMOs), will cover treatment for anxiety disorders. Check with your insurance company and find out. If you don’t have insurance, the Health and Human Services division of your county government may offer mental health care at a public mental health center that charges people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.

The 1-year prevalence of agoraphobia is about 5 percent.
Recent research also suggests that suicide attempts are more frequent in people with panic disorder.
Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men.
People who have full-blown, repeated panic attacks can become very disabled by their condition and should seek treatment before they start to avoid places or situations where panic attacks have occurred.