Coping with Panic Attacks

In Episode 2 of Unbuckle Your Fears, Megan Barrow talks about coping strategies for panic attacks.

She discusses some of the theory shared across socials and how some are not helpful, kind or compassionate, along with what her psychiatrist first taught her about getting through panic attacks.

She also shares real life examples of how she coped through panic attacks and sets herself for success in workplace meetings, public transport, hospital and concerts. 

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Transcript

(00:01):

Welcome to Unbuckle Your Fears. My name's Megan Barrow, and I'd like to begin by acknowledging the traditional owners of the land where I'm recording from. And here I'm outside of Melbourne in Australia and it's the Wurundjeri Woi-Wurring peopleof the Kulin Nation, and I pay my respects to elders past and present.

(00:26):

I'd also like to acknowledge the lived and living experience of my listeners, and I understand, and I am one of you, and acknowledge the experiences and the heartache and how hard it is to, and how much stigma we go through and lack of understanding of the breadth of mental ill health that this podcast encompasses.

(00:59):

So in this episode, I thought I would talk about coping with panic attacks. So it's actually been quite a topic of conversation here in Australia because one of the breakfast shows tv, the weatherman had a panic attack while he was presenting, and I actually watch the show and I saw where he had returned to the couch and he had talked about having had a panic attack.

(01:35):

And he's spoken in the past about having panic attacks on air. And it wasn't until I saw the video that went around on social media that I saw the actual live footage. And he has acknowledged, and I also noted, and I also know from the feedback that I receive, is that whilst it's such a huge event that we go through within our bodies and our physiology, that it's not very obvious to the rest of the world. So whilst we think that we're bringing attention to ourselves, most people wouldn't know that we're having a panic attack, but when knowing that he was having a panic attack, I could see, see that his eyes were darting around and he was clearly looking for one of his colleagues that was about to back him up and take over for him. So I could see that, I could see his mind racing, and I guess I just saw that with empathy. But if I hadn't have known that he was having a panic attack, I probably wouldn't have picked up on it either, even though I feel like I'm fairly cluey and empathetic to noticing anxiety and panic. But so it's been a very big conversation. And even interestingly, a competing breakfast show had a psychologist on this morning talking about her advice, and I was like the same old cliches. So I thought I would talk about some of the unhelpful advice that I see out there.

(03:41):

And I will caveat that by saying that I'm coming from my own experiences. So whilst I understand that there's a lot of theory out there, that's great. Not all of it has worked for me. And I think that is something I really want to embrace in this podcast is the diversity and breadth of lived experience that is out there. And in the work that I do, which you can, I kind of detailed a little bit of it in episode one in a bit of an introduction to me, my story and the work that I'm doing that I sit on a number of lived experiences or have lived experiences, work groups. And whilst there's common themes, we all have different experiences, we have different opinions, we have different language we and don't like. And it's really important that we understand that our lived experience can never be wrong, but it doesn't mean that someone else's lived experience is wrong either.

(05:01):

So the unhelpful advice that I see out there, so for example, the advice that this clinical psychologist was giving today was the old, when you're having a panic attack, meditate, deep breathe. I was like, yeah, yeah, I've heard it before, but I cannot go into a meditative state when I'm having a panic attack. And for me, breathing just focuses my mind on the fact that I might actually be hyperventilating, which I normally am when I'm having a panic attack. So whilst the theory is right, the application for me is not great. Now breathing can help me in different environments. If I'm home, it actually can work. I can still my mind still everything that's around me and really focus on some deep breathing and visually hear myself breathing, I might sigh. But if I am on stage presenting, it's not very practical, nor is meditating other unhelpful advice that I see often. And for some reason people like sending me tips, whereas I'm like, I might talk about having panic attacks, but I'm okay. I know all the tips, I know all the resources, I've read them all. I've read them all for decades. Well, that's not true. I've kind of stopped reading all the tips because how many more tips can you have?

(06:55):

But yeah, one of the tips I see often is cold water, splash some cold water on your face, on your wrist, get some ice cubes out. And again, absolutely that will work. But that's not, again, practical if I'm in a meeting with a bunch of clients, not helpful at all. So I think some of the advice out there is very two dimensional and assuming that we're having panic attacks in safe places or that we're not out living our lives and that we can use these resources. So the other issue I have with some advice out there is the lack of compassion and kindness and that some devices and techniques are being called out as being security tools now or security systems. And I brought this up with a psychologist recently because it's really gets my goat, and she was shocked and she's like, they're not security tools, they're support tools.

(08:18):

So again, I completely understand where the theory comes from that, especially if you have panic disorder and phobic disorder and agoraphobia of which I had all three diagnosed. We don't want to develop habits and rituals to get us through our day yet. My experience is that over time, the more you build up resilience and return to living, these habits and rituals slowly drip away. They disappear. You don't need them so much. And I feel like there are people putting barriers, like there's a big one about not taking water bottle, don't have a water bottle with you. Now, the first meeting I had with my psychiatrist, Dr. M, I talked about him in episode one, and I'll refer to him often because he lives in my head and brain.

(09:32):

The first time I went into his office, it was 1997. So I need to, I've been doing this a long time and I've been recovered a long time, but I've also had a rollercoaster of recovery. But I have lived and breathed this for a long time. But my point is that I sat down in his office and the first thing he said to me apart from probably saying hello is, oh, you've got a water bottle with you. And I instantly picked up on it and said, oh, is that a problem or is that something? And he said, he just smiled at me and said, most people who come in here have a water bottle with them. And all he did was note it and he never mentioned it again. Never did he. When we got onto exposure therapy, did he ever say, do not take your water bottle over 22 years?

(10:31):

He never mentioned me having a water bottle ever again. And to this day, I still generally leave the house with a water bottle, but I also drink about three liters of water a day. And usually 99% of the time I drink out of my water bottle, it's because I'm dehydrated. So it's not to say that if I'm panicking or have a panic attack that I probably wouldn't, I probably will instantly, or I do, let's just say I do grab for the water bottle, but it's not the be all, I can leave the house with it, but I would also just be adding to discomfort in terms of hydration. But also why do we want to put ourselves through suffering if there are things that can ease us and help us through a panic attack. So yes, I understand that we need to be okay with the feelings of panic and that we have to believe that we'll get through them, that it will pass. And I'll get onto all that in a moment. But I also will flick the switch to why is this the only health condition, anxiety and panic disorder that we are meant to suffer through? I just want people to think about this. If someone's depressed, they don't say suffer through it. They say, take time out, take medication, whatever it might be.

(12:14):

We don't tell an asthmatic not to take their ventilator. We don't tell them to believe that they'll get through an asthma attack. We don't tell a diabetic not to take insulin or for someone with type two diabetes not to eat something regularly if they feel like their blood sugar is rising or dropping. If we have a headache, we don't tell people to suffer through it. We say take Panadol or whatever it might be. So why is panic disorder and panic attacks and anxiety different to that? Where's the compassion and why are we always having to conform to fit in with a society that tells us this shouldn't be happening? I don't know. It's just something that is frustrating me. And I must say, as someone that is pretty well fully recovered, yes, I will 100% own the one legacy I still have to this day is driving anxiety and I don't drive everywhere.

(13:25):

But apart from that, I'm pretty independent and I jump on public transport and planes and can pretty much travel most places. But why do some of these accounts make me feel like I'm a failure because I have a water bottle with me or I might have a lolly in my bag in case I'm feeling rotten. Just something to think about. So for me, coping strategies shouldn't set people up for failure. It shouldn't set people up to think this is a competition. It shouldn't make us feel like there's the right and wrong way to do it, as long as you're not being dangerous and you're doing things in a healthy way, that you're not going for illegal drugs or drinking too much and using alcohol as crutches. They're the dangerous things. And these accounts never talk about that. So we need to be actually thinking about what's healthy and what's not healthy.

(14:28):

And for me, the thing that breaks my heart is if someone contacts me on social media and they say that they feel like they failed an exposure therapy or an exposure activity because they had a water bottle with them. Now to me it's a brainer if you're putting a barrier up from someone, especially with agoraphobia, that they feel like that they have to do something without a support system and that makes them not do it. To me, it's a no brainer to actually have a support system, have all the support systems take a teddy bear with you, I don't care. And I know my Dr. M would not have cared either. So in terms of coping with panic attacks, I'll again bring in Dr. M in terms of where we started. So when I first arrived, I was about as bad as you could get in agoraphobia. So I pretty much was stuck to a couch. And how did I get into his office with great difficulty? I must say my mother took me that I was terrified, absolutely terrified, but I got to the point where I was just determined that I had to change it, that I had to get well. I'd read enough books by that point, there was no internet or very, it was just the beginning of the internet and access.

(16:04):

But I'd read enough books to know that this was not going to be easy, but I knew I couldn't do it on my own. I needed someone to be there to mentor me and to make me do things, but also for me to even better understand. So we started with cognitive behavior therapy in terms of challenging the thoughts, which I will also go into in another episode. But in terms of the CBT and understanding panic, one of the first coping strategies was to understand that panic rises and falls. So when you're in a continual state of phobic disorder or acrophobia or panic disorder, I know for me that it felt like my panic and anxiety levels probably never dipped below five out of 10. So even at the lowest it was super high and I felt like I was fluctuating between a five and a 10 out of 10 panic attack, maybe three or four times a day.

(17:14):

So understanding and actually starting to actually physically write down and acknowledge that the feelings were sometimes rising but always falling after a while was super important. So it's quite common knowledge, and a lot of people will be doing this, but I do tell you to do it is to record how you're feeling in every activity. Write it down. I remember I had all this plastered over my bedroom, just notes. I even remember having stars of how I was doing each day, and it was just a real record that what I was going through in the work I was doing and things, even though it was still

Speaker 2 (18:01):

Hard,

Megan Barrow (18:02):

That I was acknowledging what I was doing. And that in itself helps.

Speaker 2 (18:07):

He also had

Megan Barrow (18:09):

An acronym for me that he would always drum into me, which was awake, A-W-A-K-E, and the acronym stands for Acknowledge the feelings. So this is during a panic

Speaker 2 (18:24):

Attack to acknowledge

Megan Barrow (18:26):

The feelings,

Speaker 2 (18:28):

To watch the

Megan Barrow (18:30):

Feelings rise and fall. So suggest what I was saying there in terms of we tend to focus on, oh my goodness, I'm having a panic attack. You can feel it coming on once you know it is, you assure yourself it's a panic attack and for me, it's having a heart attack or I'm about to vomit, or my panic attacks seem to change even to this day. But we acknowledge it going up, but we don't always acknowledge it going. So acknowledging, watching the feelings go up and down

Speaker 2 (18:59):

To accept

Megan Barrow (19:00):

That the feelings can't hurt you.

Speaker 2 (19:02):

So again, this is an interesting one because I hear and see this a

Megan Barrow (19:06):

Lot in the socials

Speaker 2 (19:08):

That a lot of people don't like the concept of acceptance. Now, acceptance doesn't mean it's

Megan Barrow (19:16):

Positive or good,

Speaker 2 (19:19):

It just means that you are acknowledging that, acknowledging it's happening and that you're going to be okay. It's sort of like I've had a lot of crap in my life and have a lot of trauma and I'm not happy it happened, but I accept it did. So it just is what it is. So I don't really care. People get

Megan Barrow (19:44):

Bogged down in semantics and words, don't use this word, use that

Speaker 2 (19:48):

Word, it doesn't matter. It's just put the lens on it yourself. It doesn't matter what language

Megan Barrow (19:55):

You use. If you don't like acceptance, change it to another word.

Speaker 2 (19:59):

But the point is that accepting

Megan Barrow (20:04):

That the feelings won't hurt you is really just acknowledging that, okay, I'm going to get through this. This isn't going to kill me.

Speaker 2 (20:15):

Kay is

Megan Barrow (20:15):

One of my old favorites, and if you follow me on Instagram, I always try and sign off all posts with this. Keep going.

Speaker 2 (20:25):

So just

Megan Barrow (20:27):

Keep doing what you're doing and ride out the panic attack. And

Speaker 2 (20:33):

E is for expect to get better.

Megan Barrow (20:36):

So again, it will

Speaker 2 (20:38):

Pass.

Megan Barrow (20:39):

You will feel better and you'll be able to move on with your day

Speaker 2 (20:44):

Or your night, whatever

Megan Barrow (20:47):

The main thing is to not turn around and revert and go home or to your safety place. But I will acknowledge that it's also okay to do that at times too and to accept that we will have great exposure days and we'll have poor ones. So when you're in sort of the throes of acrophobia recovery, be okay with that. Be really kind and compassionate to yourself, and that's what I want this to be about. So tough and you are going to be terrified. It's going to be so scary. And to this day, with everything I've achieved at 53, when someone says, what's your biggest achievement? I still say it's agoraphobia recovery. And unless you've been through it, I don't think anyone can understand how difficult it is. And bless my psychologist who's known me since 1995 who I sort of tag teamed with my psychiatrist until he passed away.

(22:00):

I love that she'll occasionally, well, not occasionally, I don't see her all that often anymore, but when I see her, she'll acknowledge that, Hey, you get up every day and go out and run a business and live an independent life and live alone, and you push yourself out the door despite the fact that you have in reality, anxiety disorder, panic disorder, you do that every day. And I think we need compassion and kindness for all of us who do that. So some examples in terms of actual coping strategies in some actual real life scenarios for me, and it's changed so much since when I first started with exposure therapies and initially my doctor talked a lot about distraction. So he would always sort of embed me with and be really thoughtful and get my mind focused on how are you going to distract your mind?

(23:06):

You are going to be terrified while I send you off on this exposure trip and when I set you homework to do every day. So what are you going to distract your mind with from the panic and his favorite tools? Have a counting game. Count backwards, buy three from a thousand onwards. I tell you what, that really would get me stumped. So I didn't particularly like that one, but gee, it does distract your mind. You really have to concentrate other things where he would keep it really simple things like count or notice a specific color car and sort of count them as you see them, or notice the letter boxes and count the street numbers as you're walking by or notice the color of flowers that you would see so you get the idea. So just sort of distract your mind that way. And again, I've recently seen someone say, that's not a good strategy, and I'm like, whatever.

(24:12):

Just my lived experience. And I do wonder, sometimes I wonder how bad these people's lived experience is. So often it's coming from lived experience, but I think people get so bogged down in theory that and theory is just a concept. A lot of the theory doesn't have evidence-based research behind it, and most of it is so old and it doesn't have lived experience embedded in it. So just because a researcher or a doctor came up with a theory doesn't mean it's practical. Okay, let's be kind to ourselves. So that was very much what I would focus on every time I would go out in terms of have a plan. So when he would send me off, he would say, right, what's the plan? What are you going to do? How are you going to get through the feelings? So things I would also take. So for me, it was a lot of music.

(25:08):

So back in those days it was a dance CD Walkman. I think I had so well before iPods and pass the cassette Walkman or I'd have a little radio with me. To this day, I still love having an iPod of music or streaming coming through other things. I would have a few rituals. I would have little crystals with me. I would often have lavender, so I'd have a lot of aromatherapy that I would use and have it in my bag. I would have little things that I would feel like was there. Yes, I guess they were security tools, but let's call 'em support tools. And often I didn't need them. It was just nice knowing they were there and eventually they all disappeared. I just realized I wasn't using them. The aroma therapy is a good one. I would just drop some lavender or whatever oil into a tissue, and that sort of gets the sensors going, which makes me think about the grounding tools that I often see.

(26:14):

What is it the see three things touch, two things, taste, sort of getting into the senses. I'm sure that also works. I think I do that just by one of my distraction sort of strategies. But what I also find fascinating with that and some other theory and tools is that people aren't acknowledging that when you have a panic attack, and it's the same with trauma, is that you go back into the part of the brain that has no critical sinking ability. So you're actually back in the part of the brain that's really just functioning your basics, your breathing, your heartbeat, it goes into those fundamentals to just keep you alive. So you're sort of in that panic mode, and it takes a while for the brain to slowly reabsorb and get back into a critical thinking state. So when you get stuck in a panic attack, that's why.

(27:24):

So I've never been much good at remembering all these long theory and say this to yourself and do 4, 5, 10 things. That's never good for me. I'm just, what's one thing I can do? And then slowly I start to be able to think a bit more. So some of the strategies I have used in real life situations beyond my agoraphobia recovery. So work meetings, I've had panic attacks. Sometimes it's been because I have been anxious, but other times I've had panic attacks. Absolutely. Out of the blue, I felt really good. I've been chatting away with one client and then we'll be meeting with others and all of a sudden I'll get a panic attack. And when I say, I mean, it's very rare, but it has happened. And how I got through those moments is usually there will be a glass of water. Most people actually do offer us water in a place.

(28:25):

Most people will take a glass of water if they feel like they've got a dry mouth, they're feeling uncomfortable. Most people take a sip of water in a work meeting or on stage. If I feel like that's not getting me through, I will tend to, I do have a lolly with me, a hard boiled lolly. Very rarely will I do that. But if I feel like it's sort of getting a little bit out of control, I will do that. And just the senses of, I guess that is part of a grounding exercise because I try not to excuse myself. I feel like if I excuse myself, I will sort of spiral even further. And to be honest, in the workplace, there is still so much stigma around that. The reality is I can't say, excuse me, but I'm having a panic attack. Most people just wouldn't understand or it would be seen as a negative for me running my own business.

(29:22):

So unfortunately, the stigma is that I could lose a job, so I really have to try and hold it together. I remember a few meetings where I've had a panic attack. I've really just focused on what people are saying. So it's really just almost like note taking, but in my mind and just really paying attention of what they're saying. Ironically, often have a coffee with me because made in a lot of cafes. So even having a sip of coffee, even though that shouldn't work, again, it's just about doing something in the moment. But overall, I also just say to myself, I'm going to be okay. I'm fine. I'm fine. And I have Dr. M in my head saying, keep going. So I really just believe in the fact that it will dissipate. I watch it rise and fall, and I'm really good at acknowledging that, oh, I'm feeling better now.

(30:23):

Okay, good. What's a panic attack? Because interestingly, even though we're pretty sure it's a panic attack, they can still feel really different each time. And you can kind of think, oh my goodness, is this the time that hospital was an interesting one because I had to have a minor surgery two years ago, and boy did I panic. I was terrified. I've never had anesthetic and I was terrified. And of course I couldn't drink water or eat anything. It was pre-surgery. And that didn't in itself panic me. I felt super uncomfortable and dehydrated, but I drink so much water. But yes, that might've helped me, but I didn't feel like I was panicking more because of it. So I thought that was interesting in itself. In that environment, I actually did just ask for help. I went up to the nursing station and said, look, I have panic disorder.

(31:26):

I'm having a panic attack. I really need help to get me through to when surgery will be, because I was well low. I wasn't a priority. And interestingly, they said if I had have told them that I had panic disorder and panic attacks, that they would've made sure that I was number one on the surgery list. So again, compassion, kindness. And what they did is I was in a big area. It was actually during past lockdowns of covid, but hospitals were still in that covid infection control status. And they ended up finding a room for me and a bed so I could lie down. And that's where I did have my iPod with me. So I definitely was trying to listen to music, but it really wasn't helping, but I was closing my eyes and that is when I was doing deep breathing, I felt like I could just relax.

(32:25):

They actually drew curtains. So I had some privacy took, asked if I wanted lights on, lights off, and they really did give me the stillness to be able to get through it. The panic, I probably had two panic attacks. It sort of dissipated a bit, but then it spiked again. But that was sort of an unusual situation where I generally was petrified of the surgery and then having panic disorder just made it even worse on the tram. I've had a few panic attacks. I was a bit panicky even during this week. I had a panic attack Thursday night because of an event that was going on, not that I thought I was going to have a panic attack. So it was a sudden one in the middle of the night, and then I ended up with a visual migraine at a client and then had to sort of jump on two trams home, which is a good 90 minute trip.

(33:22):

And I second guest if the migraine was going to turn into a vomiting migraine. And I all of a sudden on the tram, got a bit panicky thinking, oh, I might vomit in front of everyone. So on that occasion, again, I just reassured myself that I'd be okay. I did have a lolly, but I was feeling nauseous at the same time. Yes, it was anxiety, but hey, it settled me. Other times where I've panicked on a tram, I have even just got out notes in my phone and just actually written out or typed away how I'm actually feeling and almost written like a mini article of how I was feeling. And I even found that just distracting myself and doing something in the moment helped get me through. And then as I was typing, I could say, oh, now I'm starting to feel a bit better.

(34:17):

Other things like music events and concerts that I want to go to, I have moments where I'm really good with those and moments where fall off the horse a little bit, but I'd still try and go. And for those things, it is things like, and again, there will be people saying, I've failed at this, and I would say I was going to swear and I won't. But I will do things like try and get an aisle seat. I mean, who cares if that's the difference between me semi enjoying something more quickly as opposed to being in the middle of an aisle where I feel like I'm stuck in claustrophobic, Hey, get an aisle seat. But again, I sort of know that I might be a bit nervous, but it will ease. I know I'll get through it. I know I'll enjoy it. I know that I'll regret not going.

(35:17):

I know I'll be glad for going. I'm usually with someone and I will have told them, which is different in work. And on the tram, I don't tell anyone. But in social events, why not have a support system? So most people are really good. My core people are really good about it. So I think I'll leave it there. I've kind of rabbited on a little bit, but I think I've covered most of what I wanted to. And this will be a topic that I'm very happy and I'm sure I'll cover again, and it's probably something that will come through on episodes just embedded in other topics. But the biggest thing I could say is Dr. M's motto of keep going. So just really try and stick it out. I personally, I don't have any issues and I don't think you should have any issues using all the tools.

(36:20):

As I say, as long as they're healthy and not dangerous to get you through. I don't care if you have a whole bag of gadgets and fidget tools and teddy bears and crystals, who cares if it's a difference between you not doing something and doing it, take it and then in a few years time or whatever it might be, it might be a few days time, you don't need it. Then slowly sort of remove them from your bag or your pockets or whatever it might be. But there are so many wonderful fidget tools now out there that are designed for that purpose to help us to help support us so we don't have to suffer as much as we might have to otherwise. So what I want to leave you with, and again, I'm really wanting each episode to get you thinking and to leave you with something to contemplate and maybe help you take a step into unbuckling your fears, whether that's getting on stage, whether it's booking an overseas trip, whether it's just leaving the house.

(37:33):

I want you to have a think and I'm going to ask you what Dr. M would always ask me Before every exposure therapy or every time I would say, I've got this coming up and I waited for him to say, oh, poor you. You're going to panic. Instead, he would say, and what's your plan? So what's your plan to get through a really scary goal? We'll call it. Have a think of what you would really like to achieve in the next week or even further along, depending where you're at. What's the plan to get you through? Is it as simple as being okay and taking your water bottle with you? Is it that you'll syn out some notes, write them down and have them ready to read if you need to? Is it, there's lots of great little cards on how to get through a panic attack.

(38:28):

Is it buying one of those? And just knowing that's with you and you can recite, is it a podcast? Is it listening to me? Oh, that would be nice. That's where I want to get to that I'm part of your support tool. So what's your plan to get through a scary goal? And I'll tell you that I've got a few scary things coming up, and even though I've done them before, I've got now booked in three presentations for, are you okay? I've also got a Beyond Blue Speech coming up in October. So are you okay? I'll talk more about it in another episode. But that comes up on the second Thursday of September. So this year it's the 12th of September. So in less than a month, I'll have done three speeches and presentations in front of workplaces, big audiences too, I think. And I've also just accepted to co-present at a huge conference with a researcher at every mind.

(39:29):

So that is really outside my wheelhouse, and we're going to be talking about something that I might be able to talk about later, but something I've been involved with in a working group. She's a researcher and I'm going to be talking from the lived experience space. So I've got scary things coming up and I am going to do them knowing I will get through them and that I will be proud of myself for getting through them. So that's how I do it often. I now say, yes, commit and work out how I'm going to do it. So depending where you're at, have a think about that. Thank you for listening. Second episode, I'm still ironing out a few things, including how long I do these for in my waffle. So bear with me also working on my audio. So please do feedback if there's issues. But if you want to follow me, I'm probably best on Instagram and you can find me at Unbuckle Your Fears. I'm also on LinkedIn and Facebook. You can also email me at admin@unbuckleyourfears.com or check out a website, which I will overhaul at some point unbuckle your fears.com. But please do Google me, find me reach out. I'd love to hear from you. Until next time, take care and keep going.