Think of your feelings of panic on a scale of 0 to 10, where 0 is totally relaxed and 10 is the very worst feeling of panic you’ve ever experienced. Doing this, you will begin to differentiate between your own levels of anxiety. We’ve included a form at the end of this chapter to help you. Now, for any anxiety you feel, you can assign a number on this scale.
Rating your own anxiety level is very helpful so that you won’t always anticipate the worst possible attack. When you are aware that you feel lower levels of anxiety, as well as the high one, it becomes a kind of cue to remind you before your anxiety spirals upwards. You will have time to respond to mild anxiety in ways that can calm you instead of alarm you. For example, as you enter a shopping mall you experience mild (level 3, for example) heart palpitations or a slight feeling of shakiness. You may begin to take short, shallow breaths, which will exaggerate your symptoms. However, remembering that a less anxious response is possible, you will have time to slow down and begin using some of the relaxation methods that you’ve learned. Any relaxation method, like those outlined above, can dramatically reduce these symptoms and help avert a panic attack.
When you feel extreme panic and may be feeling very disoriented, you can try one of the coping techniques, such as slow, gentle, deep breathing to lower your anxiety level. You may or may not succeed. But if your anxiety level remains high, do not fight to control it—let it happen. Let the feelings run their course. Remind yourself that there is nothing to fear. Observe your symptoms. You may even decide to make one symptom feel worse, like making your heart, which is already beating fast, beat even faster. Notice that catastrophes do not occur, though, even when you try to bring them on.
If you are having difficulty focusing on using these techniques due to extreme and frequent panic, evaluation for medication by a doctor who specializes in anxiety medication may be indicated. On the other hand, you might want to give yourself more time to adapt to these new ways of dealing with your physical sensations. Discuss these options with your therapist and with your doctor.
If you are already on an anti-panic medication or decide to start one at this time, still proceed with the suggestions outlined in this website in order to overcome your anticipatory fears and deal with those situations you avoid.
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