Apr 01, 2008
Especially if you are new to panic and anxiety (or new to knowing that panic, as such, is what you have) you may wonder more about what it is and what to expect. If you read through the various messages and journals here, it won't be long before you see that panic and anxiety present with numerous symptoms, and with symptoms that change over time; old ones go, new ones come. And in all of this, with each change, we may ask ourselves, "is this from the anxiety, or is it something else?"
I have separately written a journal about tracking symptoms and the importance of checking in with your doctor about new problems which seem especially worrisome or even dangerous. In this journal, I'll widen the view a bit to look at general types of panic and anxiety within the general family. This can be important in assessing what medical approach is best for you.
Panic and anxiety can be divided into three general types, in my experience and opinion.
One type is what I will call "Situational" anxiety. As the name suggests, you experience it when some situation (or situations) in particular occur: a plane trip, an elevator, speaking in public, speaking in a particular PLACE in public. Church, the movies, driving -etc. In general, the anxiety or panic experience occurs so rarely that your life is really not changed very much by it, and so, so you mighht make no effort to overcome the problem. And for those occasions when you MUST encounter a situation that will cause problems, medication can be a very effective was to get through it. A doctor friend of mine who was terrified of court testimony would take a little something when he was called to testify, for example. And plenty of people use something to ease the fear of flying. The fact that the panic is evoked by a situation does not necessarily also mean that there are not deeper psychological forces at work, as well. In fact, it is probably safe to say that there are, otherwise you would not be fearful. Those factors, however, have not become generalized in daily life. My guess is that situational panic is very widespread -talk to anyone long enough and you'll find the "thing" they can't or will not do. But the occurrences are so infrequent or so easily avoided that neither you nor the friend who runs away from carnival rides would classify yourselves as "panic" victims. Situational panic can also be found when health issues are a factor. It would make sense, for example, that someone who had just experienced a heart attack would feel anxious about another one.
At the other end of the spectrum is what I'll call "organic" anxiety or panic. This refers to symptoms which arise essentially from your chemistry and/or the way we are "wired up." We are accustomed to thinking of some mental conditions as being "fixed" as part of our nature. The most obvious examples are cases of mental retardation or the opposite -very high intelligence. No one would expect to treat a person born with severe retardation so as to give them an average IQ. Likewise, we would not think to make a chess guru lose her special gift. These, and other conditions, are bells that cannot be "unrung." What medical science, family members and care-givers CAN do (and should do) is to set or facilitate the conditions which allow such indivdiuals to be as much a part of society and life as they can be. Its not about being "like" someone else, it IS about being happy, which is what we all want. Medication can play a significant role in some cases. As we all know, medication may be the only alternative to achieving stability in some cases. What we also know is that no amount of talking or therapy will "unring" the bells, or change the chemistry or rewire us -and we don't expect it to.
That leaves the anxiety and panic most of us here on the forum are familiar with. I will use the term "Generalized" here in a special way. By "generalized," I mean panic and anxiety which has definite psychological and emotional roots, but which has permeated our everyday living so much that it appears often and in many situations. Like a teaspoon of sugar dropped into a glass of iced tea, it gradually permeates our experience -it has become "generalized" in the sense of being "all over." If the tea is not stirred, it may take a long time for this to happen; if it is vigorously stirred, it happens more quickly. This kind of panic and anxiety can be successfully treated but the best way is usually a combination of drugs and talk therapy. The medication either masks or reduces the symptoms -you are more comfortable and function better. The therapy gets at those root causes. This is a bell that can be "unrung." It is important to understand that we can be fooled by the impact of medication which is especially effective in reducing the symptoms. Stop the meds, and sometimes the symptoms come back. The effect may be compared to rubbing an ointment on an aching tooth -what happens when the ointment disappears? The pain comes back. You need to have the tooth extracted (or whatever). It is also important to understand that success doesn't always -or even often- result in the initial stages of therapy. In fact, matters may seem to worsen for a bit -it hurts to dig out those splinters.
The psychological and emotional landscape in which panic dwells can be deeply hidden and complex and is best left in the hands of medical experts who "know the territory," the psychiatrists. And, while every person is unique, the kinds of experiences we had in life and the means of dealing with them do tend to fall into a number of classifications for which effective therapy has been determined. The trick is identification. What IS that noise in the attic? A squirrel? A loose board expanding due to heat? Termites? The only way to know is to go observe. And that means a lot of talk and a lot of time. The benefits, however, can run far beyond the mere target goal of dealing with the panic. Like any attic, once you get up there you may find other things that capture your interest. A toy you loved when you were a kid. An old photo album. And maybe some other things that could stand improvement.
Neither medical science, nor herbal medicine, nor nutrition, nor any other thing has every cured anything, ever. A "cure," meaning remission of the problem and no expectation of a recurrence, is brought about always by the body itself. Those antibiotics for an infection. Yes, they kill the little beasties that trouble you; however, it is the body itself that makes repairs and restores function. The flu vaccine? Not a cure, a preventative measure. The aspirin blocks the pain of a headache, but only the body itself sets the conditions to get rid of the cause. When it comes to panic and anxiety, therefore, the "cure" is performed by the brain itself. By the same token that our experience and understanding are what set the conditions for panic to take root, it is our experience and understanding that changes us so that the panic and anxiety no longer are the result of our mental process. The chief means of doing this? Talk. The brain, after all, is the only organ that can think and talk about ITSELF. It is also true that, sometimes, very profound personal experiences can help: things like religious conversions, or the accomplishment of some heroic act which we would normally never believe possible. Those experiences, however, may or may not occur; they happen more or less randomly. Talk, on the other hand, is intentional and purposeful. It is also possible that talking and thinking may be stimulated by someone OTHER than a specialist. (And in truth, it is the talking we do to ourselves that does the actual work). But here again, if the conversation is with a non-specialist, we have less assurance then we would if we were talking to a trained and experienced specialist who "knows the territory." Finally, we should be aware of the conditions we set for ourselves, the kinds of situations in which we place ourselves. There are few examples better than this anxiety forum, for it is here that we reach out to help others, even if by the mere expression of sympathy and understanding. Our focus changes from our internal turmoil, to someone else. This is a dramatic and healthful change of perspective, and it feeds very positive results back to us.
While only a medical diagnosis can characterize which panic "family member" has made an unwelcome appearance in your life, simple observation here on the forum will tell you that many here have the "generalized" kind. But that is not to say that other members of the family are not also lurking about. In fact, a racing pulse or difficulty breathing may spawn situational anxiety symptoms on top of the more generalized ones, leading many to seek assurance either that their heart is just fine, or else the opposite; after all, if there IS some problem with the heart, then we know what to fix, right? And so, anxiety over a proper diagnosis becomes an issue, especially for "new members."
The purpose of this journal is to help you do a little bit of self-classification, subject always to medical advice. If you fall into the big "generalized" group, then looking for a permanent result from medication alone is unlikely to produce a permanent solution -you'll need to be talking to your brain, as well, hopefully with a guide who "knows the territory." You may, however, realistically consider that you CAN get over the condition -be "cured." Long story short: there is HOPE.
If you are medically assigned to the "situational" category only, then you have the option of doing nothing at all except taking a medication when you're at risk. Talk to your doctor about it. You could, of course, also decide to "get to the botom of this" once and for all. Your choice.
And if you are "wired up" for panic, then you will benefit from such combinations of life-style adjustments, medivation and any recommended therapy to deal with the issue -just as a diabetic does for insulin dependence.
I have left until last any discussion of genetic predisposition. For all of us, the genetic influence is a broad set of boundaries which influence, to one degree or another, how little or how much we can expect to do or be -in everything. To say that genetic atributes are NOT involved is simply wrong -they are ALWAYS involved, to one extent or another. But here again, we can invoke behaviors, life-styles, therapies and choices to enhance or to blunt the influence of the cards we were dealt.
And in all cases, an active presence and participation in the forum can be a great help; for everything you care to disclose, you contribute to the collective wisdom. And for everything you read and think about, you can benefit from that wisdom.