Are You Suffering From Pandemic Panic? Here are some Tips to Help You Control Your Anxiety

Are You Experiencing Pandemic Panic? These Tips Can Help You Reduce Your Anxiety.

It is normal to have some anxiety about this relatively unknown virus. You may experience some anticipatory anxiety not knowing if "You are at risk" or if you could contract the virus from a co-worker or pushing an elevator button. Because so many events, colleges, schools, and businesses are shutting down, we are in a period of national uncertainty. Years ago, two psychologists came up with the notion of  "Locus of Control." Moos and Tsu suggested that we have an "External Locus of Control" and an "Internal Locus of Control." With the level of unpredictability of the Coronavirus, it may feel that we do not have any control over it, and it has the potential to control us. The latter is a perfect example of an External Locus of Control. An Internal Locus of Control is an internal felt sense that I am in control of a particular situation and that it is not controlling me. Washing my hands and not touching my face are examples of Internal Locus of Control.

Increased stress from the Coronavirus can weaken our immune system and thus make us more vulnerable to infections and getting the flu. So what's a Pandemic Panicked Person to do? See that little 🍎symbol in the left-hand corner of your Mac? Scroll up to it and put your computer or tablet "to sleep!" If you have a cell phone in your hand, turn it off, the same with the TV. Repeated checking about the latest newsbreak from NPR, CNN, and MSNBC keeps you stimulated in a place of fear and anxiety. If you are obsessed with reading everything you can about the Coronavirus, it does nothing to decrease the possibility of you contracting the virus!

There are a few other reasons to disconnect from all electronic devices at least one hour before you go to bed. The blue light emitted from our cell phones and computers stimulates our brains and our whole nervous system. The blue light mimics daylight causing us to be more alert making it difficult to shut down our minds. Blue light also decreases Melatonin, which helps us sleep, and messes with our Circadian Rhythm so that we don't fully experience REM sleep or rest-filled sleep.  You can turn off your cell phone and then go a mindfulness meditation app like Headspace or Mindfulness.

Between November and the end of January, I was in Urgent Care four times, once with walking pneumonia and three times with an Upper Respiratory Viral Infection. In the first week, the doctor told me not to go to work because I was contagious, and she ordered me on bed rest. She told me that I needed sleep and lots of it. Well, if you know me spending 12 hours in bed is not my forte. During that week, I found that the more I slept, the better I felt. She also told me that when I started to get my strength back that I should go on short brisk walks. Increasing my heart rate would help reduce my risk of a reoccurring chronic condition. Getting out in the sun can increase the Vitamin D in your system, which is an immunity booster, and taking a walk; especially with a loved one or your dog can also help with any Coronavirus anxiety.

Should you wear a mask? Not unless you have a cough, the flu, or sneezing a lot. The Coronavirus is transmitted from one person to another via respiratory droplets. If you are standing within three feet of the person, there is a chance that you could become infected. The new Federal Guidelines suggest that people keep six feet of separation from each other. Droplets can land on doorknobs, elevator buttons, stairway handles, and any shared workspace. Use a pen or a piece of Kleenex to push elevator buttons, Kleenex when touching shared public spaces.

Please be kind and think about others. Don't hoard, pick up the used paper towel you dropped in the restroom, flush the toilet. Practice agape love, the selfless going out to meet the needs of another. If you have elderly family members or neighbors (60+), go grocery shopping for them, take them to doctor's appointments, and check in on them frequently. Isolation and loneliness exacerbate anxiety.  

Remember to wash your hands with soap and water for at least 30 seconds and leave the soap on for enough time for it to penetrate your skin. Another option is to use hand sanitizers with at least 60% alcohol. Don't touch your face if you have contacted a contaminated surface.

Be Well!

Lawrence J. Schulte, Ph.D., C.Ht.

Ph.D. Clinical Health Psychology (1990-Present)

Certified Hypnotherapist (2016-Present)

www.centerforadultdevelopment.com

How can you stop a panic attack if you're asleep?

Most people who have a panic attack if they are asleep are having a spontaneous panic attack. These come out of the blue and may be related some trauma from the past. Most spontaneous panic attacks come from a cumulative effect of stress and are often not related to a trauma.

How do you stop a panic attack in your sleep? Often the panic attack will awaken you and the first thing you need to do is turn on a light because panic attacks at night can be disorienting. You need to then sit up slowly because you may have a rapid heartbeat or a drop in blood pressure all effects of a panic attack. Sit up slowly and literally get your bearings. If you can sit at the side of the bed put your feet on the floor. Having your feet on the floor will help you feel grounded, which will help with the symptoms of the panic attack.

Next, while you are using self-talk to reassure yourself that “you are O.K. and are not having a heart attack”, start breathing through your nose and exhale through your mouth. These don’t need to be deep breaths; just regular breaths, which will help, decrease the feelings of panic. If you have previously had a panic attack, again use self-talk to “tell yourself that you have been through this before and you know that within a few minutes it will be over . . .just breathe!” You are using a Cognitive-Behavioral technique to decrease the effects of a panic attack.

It’s important to just keep breathing and focusing on your breath. If your mind wanders (It will it’s a thinking machine) then just bring your focus back to your breath. As the panic subsides you need to get up and get a drink of water (not a lot) and then tell yourself that you now will go back into a restful state of sleep and deep relaxation.

Go back to bed and focus on your breath and allow yourself to fall into that restful state of sleep and deep relaxation. Deep sleep!

Be Well!
Lawrence J. Schulte, Ph.D. C.Ht.

Ph.D. Clinical Health Psychology (1990-Present)
Registered Hypnotherapist (2016-Present)

How Do I Get Off of My Anxiety Medication Slowly & Safely?

You always need to titrate off of your anxiety pills under the supervision of the psychiatrist who prescribed them to you. If your internist has been giving you anxiety medication you must ask for a referral to a psychiatrist who can assist you with this slow process. Never try this on your own and especially never suddenly stop taking them. Immediate discontinuation of all benzodiazepines increases your risk to a grand-mal seizure even if you have never had a seizure.

The other reason for having your psychiatrist help you off of your medication is to monitor withdrawal symptoms and to know at what rate is realistic for you to come off the medication based on those symptoms. In addition, your psychiatrist should realistically assess the tools that you now have in place to manage your anxiety. If s/he does not know you that well (which s/he should) your psychiatrist should work with your therapist to identify new strategies for you to cope with your anxiety.

You and your psychiatrist should look at triggers to your anxiety including generalized anxiety, but especially if you have a panic disorder. If you have a fear of flying what tools do you now have to get on a flight and not have to take an Ativan? If you have social anxiety what tools do you have to interact with other people and not have a panic attack? Are you taking yoga, have you learned to meditate? What are you going to do if you have a rush of anxiety and you don’t have the medication in your pocket or in your purse? You need to also be very honest with your physician as to why you think you can handle the anxiety on your own. Are you using anything else to self-medicate, e.g., alcohol or cannabis?

I applaud your courage and have had a number of my patients under my treatment with the psychiatrist I work with to come off of anxiety medication. Please be patient with the process and with yourself. Don’t enter a place of shame or increased anxiety if it takes a long time or if there are times in the future where it’s better to take a pill versus white knuckling something for hours on end. I have found that Cognitive-behavioral therapy with relaxation therapy and even hypnotherapy for stress management has been most helpful for my patients. Be Well!

Be Well,
Lawrence J. Schulte, Ph.D. C.Ht.

Ph.D. Clinical Health Psychology (1993-Present)
Registered Hypnotherapist (1996-Present)

Posted on Quora 3/27/18

Who has participated in a cognitive-behavior therapy program? Was it helpful with anxiety issues?

I have participated in cognitive-behavioral therapy for anxiety for the treatment of a fear of flying. One of the first techniques that I learned was a simple breath meditation for relaxation. I was taught to breathe through my nose and exhale through my mouth (behavioral) and if my mind wandered to worrying about an upcoming flight (anticipatory anxiety) I would bring my focus back to my breath. This technique was used weeks before the flight.

My therapist focused on my catastrophic thinking (the plane will crash) and helped me challenge these thoughts (cognitive). He also taught me to use self-talk to challenge negative thoughts. “I am actually safer in an airplane than I am while driving my car on an L.A. freeway.” He also taught me to use distraction as a means to relax on longer flights, i.e., books on tape, DVDs, and Ted Talks.

I have used these techniques for other stressful situations, e.g., driving on L.A. freeways. During the course of my training for my Ph.D. in clinical health psychology, I also specialized in cognitive-behavioral therapy and use it every day with my patients with many different presenting problems. I tell them: “if you can change your thoughts, you can change your behavior!”

Be Well!
Lawrence J. Schulte, Ph.D. C.Ht.

Ph.D. Clinical Health Psychology 1990-Present
Registered Hypnotherapist (2016-Present)

Does being stressed and having panic attacks cause permanent health damage to the heart etc. and shorten your life?

Although the symptoms caused by a panic attack closely mimic having a heart attack, having panic attacks do not cause permanent damage to your heart. We do know that individuals who are stressed and prone to panic attacks and higher levels of anxiety may over time have complications from those higher levels of stress. Their immune system may become more compromised from stress and they tend to get sick more frequently. We also know that folks who do not manage their stress levels are more prone to high blood pressure (hypertension).

A study published in the Huffington Post, that those who are “under chronic stress exhibited shortened telomeres. Telomeres are the protective edges that bind the ends of DNA strands together. The damage of these telomeres leads to errors in how the DNA instructs cells to behave, so their length is directly tied to our longevity.” (www. Huffington Post)

Some people have a genetic predisposition to more stress-related health problems e.g., hypertension, & hyperlipidemia. Daily exercise and a healthy diet are a great place to start. You can also start to take control over your stress and panic attacks. Learn to de-stress by doing a simple mindfulness breath meditation. Start by sitting upright with your feet grounded on the floor and breathe through your nose and exhale through your mouth focusing on your breath. If your mind wanders bring it back to your breath. As you take in the next breath on the exhale let go of any stress you may feel in your body or in your mind. Imagine placing that stress on a cloud and letting it float away. Count to nine on the exhale of your second breath. With each breath continue to focus on letting go of your stress as you count down to zero. I ask my patients: “How low is your fun quotient?” “When was the last time you had a mental health day and played?”

One of my favorite books that I use with many of my patients who have panic attacks is Mastery of your Anxiety and Panic. David Barlow, Ph.D. & Michelle Craske, Ph.D. (Amazon). This workbook can be used alone or with the help of a cognitive-behavioral therapist.

Be Well!
Lawrence J. Schulte, Ph.D. C.Ht.

Ph.D. Clinical Health Psychology 1990-Present
Registered Hypnotherapist (2016-Present)

Why am I having panic attacks with no clear triggers to set them off?

We have a genetic protective mechanism that if we are experiencing an emergency situation or perceive that we are in a life-threatening situation we will fight or flee. The flight or fight response gave primitive homo sapiens a mechanism to exist in a world where danger was a daily experience. Today panic attacks occur when we experience a stressful life experience. The experience may be negative in nature (e.g., loss of a job, severe illness, death of a parent, or financial problems). The experience may also be positive (e.g., getting married, buying a home, having a child, getting a promotion). For some people, we become more susceptible to panic attacks with little or no reason. For other people they develop ulcers, headaches, or stomach problems as a reaction to stress.

If you have experienced a panic attack and you have a family member who has experienced a panic attack (genetic precursor) you have an increased probability that you will experience a panic attack as a reaction to stress.

If you are in your car and you proceed through a green light but the person who is supposed to stop at the red light runs it and slams into you this is a real type of emergency. You may experience a panic attack which is your body’s normal reaction to overwhelming stress. Next week when you drive through the same intersection you may experience another panic attack even though there is no emergency. This is an example of a spontaneous panic attack.

Those individuals who respond to stressful events with panic often become hyper vigilant to the physiological symptoms associated with a panic attack. These include difficulty breathing, pounding or racing heart, chest pain/tightness, sweating, shaking/trembling, nausea, hot or cold flashes, numbness or tingling, feelings of unreality, feeling dizzy of faint, a fear of dying or a fear of losing control. All of these sensations cause people to become frightened.

The physiological sensitivity causes the person to search for some type of danger, and if the danger does not exist s/he will make up a reason for the physical feeling, e.g., I must be having a heart attack or I’m going crazy. This cognitive catastrophic conclusion causes the person to experience even more stress and they have a panic attack “out of the blue.” Unlike the automobile accident there is no clear trigger.

It is important to keep in mind that even if there are no obvious triggers, there is always something going on that will elicit the panic attack. We know that cumulative stress can cause individuals to have panic attacks. We also know that many people develop “beliefs” about the causes of their panic attacks for which they do not have any concrete evidence. The individual may believe s/he is going crazy, is not in touch with reality or is dying.

Mastery of Your Anxiety and Panic by David H. Barlow, Ph.D. & Michelle G. Craske, Ph.D. is an excellent handbook that you can use alone or with a cognitive-behavioral therapist to manage your anxiety and panic attacks. I often use this book with many of my patients. Available at Amazon.

Be Well!
Lawrence J. Schulte, Ph.D. C.Ht.

Ph.D. Clinical Health Psychology 1990-Present
Registered Hypnotherapist (2016-Present)