Veckans citat

The more you claim your own destiny, the easier it will be to love unconditionally. The more you love, the more comfortably you'll fit in with all sorts of people.

Martha Beck



lördag 16 augusti 2008

Om panikattacker

Panikattacker är en vanlig ångestform som handlar om intensiv rädsla och en känsla av att förlora kontrollen, att dö eller att bli galen. Panikattacker kan vara kopplade till en viss typ av situation som stora öppna ytor (agorafobi), i små utrymmen (klaustrofobi) och i pressade situationer. Men de kan också komma helt utan förvarning och är lätta att missta för kroppsliga besvär - ex hjärtattack eller kvävning. Panikattacker är oftast kopplade till en upplevelse av hot, medvetet eller omedvetet. Och hotet behöver inte vara reellt eller stort, bara upplevt och kan vara både av "fysisk" natur (exempelvis yttre stress som en pressad arbetssituation, en omöjlig deadline eller en separation) och psykisk natur (exempelvis upplevda hot mot identitet och självkänsla).



Rädlsan för panikattackerna kan både förstärka upplevelsen och medverka till att en ny panikattack skapas. Dessutom tolkas ofta kroppens reaktion vid ångesten som tecken på fysisk fara. På detta sätt psykiska faktorer bidrar till att panikattackerna accelererar i en ond cirkel (se bild).

Många lider i åratal utan att veta att det finns terapi som ofta hjälper. Vanligen rekommenderas kognitiv terapi och ibland också i kombination med medicinering. (Läs mer om panikattacker och behandling i länkarna nederst på sidan.)

Här följer en beskrivning av hur det kan upplevas att få panikattacker, och vi får följa Jessicas kamp med att komma tillrätta med detta. Berättelsen är hämtad från siten Self Help Magazine.

Journey Through Fear
by Jessica Williams

I couldn't control the terror I was feeling. My heart was racing and I couldn't breathe. My hands were going numb. The episode struck from out of the blue. I was sure I was having some type of asthma or heart problem. My doctor patted me on the shoulder and told me it was "just panic attacks." I felt reassured. Maybe it was the prescription he handed me that made me feel better. But when I took the tiny pills hoping to make my symptoms disappear, I was horribly disappointed. My panic attacks kept coming, and I was suffering from a sharp sense of helplessness.

After a few more weeks of daily attacks, I sought the advice of a professional counselor. During the first visit, she explained how behavioral therapy could help me. I left her office in disbelief. How I could help myself when I didn't even know why I was having panic attacks? I thought maybe I could just find a better medication.

When we are only in a relationship with ourselves, we determine our actions, and as long as we are acting for the best of each situation that we are in, the method of acting remains wholly with us.

I saw my doctor again. After discussing the different medications, I came home with another batch of pills. This time the side effects could not be ignored. I was weak and light-headed. My mind was clouded over. During a late shift at work, I had to sit and rest every ten minutes. My employer told me it was obvious I could not work, and I was fired that night. I wasn't angry -- she was right. After three days (and still no relief from the panic) I realized anti-anxiety medications weren't the answer for me. I called my counselor and set up an appointment.

The first few months were difficult. We talked about how I had gone through many stresses in the last year, and how they may have caught up to me. We discussed the birth of my baby, my new job, our move 1500 miles away from home, and the death of my husband's best friend. We also discussed how much I missed my dad. We had lived with him before we moved, and I was very attached to him. After working through my emotions on these issues, I felt better about my life -- but the panic was still there.

I began to form a wonderful bond with my counselor. She assured me that I had the power to control my panic by using behavior techniques. This was hard to believe in the beginning, but I trusted her. After discovering what events in my life caused me stress, it was time to look at what physical elements affected my emotional state. This was an aspect I hadn't considered.

We discovered a link between caffeine and my attacks. This was not too surprising, but the next few factors were. One by one, we went down the list of what directly related to my attacks. What had I eaten before an attack? How much sleep had I received? What were my activities like? After analyzing each factor and keeping a detailed journal of what I was doing each day, we started seeing a pattern.

My biggest offender was sugar. It played an undeniable role in the frequency of my attacks. Another cause of my panic was lack of sleep. With a seven month old baby in the house, and a job working late hours, I was not receiving enough sleep. There were many little things I had to change in order to feel better. I could no longer eat sweets, drink alcohol, soda pop, or coffee, and I had to go to bed early every night. I felt like I was being robbed of the good things in life.

Changing my eating and sleeping habits was certainly not the cure-all answer. I had many more months of work to do before I would be free of panic attacks. My counselor and I started working on how to effectively handle my panic. This began with relaxation techniques. Learning how to relax when you are dreading the next attack is very difficult, but through light hypnosis-like help from my counselor, I was able to find a place within myself that was free from fear. Accessing this place whenever I wanted would be my on-going goal.

Besides learning how to relax, our main focus was understanding how the subconscious allows a small fear to escalate into a full blown panic attack. I needed to learn how to re-program my fearful inner thoughts with positive reassurance. When a panic attack would begin, I needed to consciously tell myself that I was strong and I would get through it. I had to remind myself that I would not be hurt or die of fear. If I could just tell myself over and over that I was having a physical response to stimulus, maybe I could reason my way out of the attack.

In the beginning, this only worked on occasion. I was so afraid of the panic that when I would repeat sentences like, "you are in control"or, "you have acknowledged your fear, now it is time to move on." I could not believe myself. It took me many months of "re-programming" my subconscious to believe that I wasn't just going crazy. My counselor recommended I start using repetitive statements like "every day in every way I am getting better." This seemed useless to me because I could not believe it. But my counselor reassured me that it would register in my subconscious and eventually my mind would believe it.

Over time, I realized that what she was teaching me really did make sense. If I could see my panic attacks for what they were, and not the horrible enemy I considered them to be, maybe I could conquer them. Then I learned that "conquering" panic attacks isn't really a matter of fighting them. I had spent so much time running away from the attacks, that when I finally got angry enough, I wanted to fight them off. But I learned that the best way to deal with panic is to play the passive role. Instead of trying to escape the panic, or trying to combat it, I needed to passively watch the attack go by. Telling myself to picture the panic as a wave that would crash down on me, but then quickly flow away helped me to understand that panic truly is a physical response.

After learning to re-program the way I viewed my attacks, I could concentrate more on how to manage them when they occurred. My counselor and I found something that worked wonders for me. I carried a small case of buttons, pennies, colored paper clips, receipts, or any other items that could be put into categories. When I felt an attack coming on, I opened the case and start organizing the items into different groups. The simple distraction of this activity was enough to deter my panic, or at worst, shorten the attack.

I used this technique many times, including during a flight from Montana to California. Getting on that plane was one of the most frightening things I have ever had to do. I was so afraid of having an attack on the plane (where I would not be able to walk around -- which was one of the only activities that would calm me), that I was, ironically, throwing myself into attacks before we even took off. Finally, I grabbed my container of buttons and grouped them by color, size, and texture. Within minutes I was calm. Once we took off, I felt relaxed enough to sleep.

I conquered fears one by one, slowly building my self confidence again. I had incredible support from my husband and my aunt. Each time I felt as if I could not go somewhere or participate in an activity, they would gently remind me of my accomplishments. Eight months after my first attack, I was truly believing that I was "getting better every day in every way." I set goals for myself and worked toward a life without panic.

I knew it would take me many more months before I could look back on the attacks without fear, but I could see that wonderful day in the future and I knew I would be a better person for enduring my panic attacks without the help of medication. Knowing I was feeling better because of changes I had made in my behavior helped me understand the power I had over my life.

Today, nearly three years since my first attack, I know how to handle my panic. I usually go months without an attack. When I do have one, I rationalize it by examining what I have eaten, how much sleep I have received, or other physical happenings. It will come and go, and then I forget about it. I have not been in counseling for over a year. I am thankful I did not have to rely on medication for treatment, but more than that -- I am thankful I was able to realize that I am capable of overcoming fear. I have learned more about myself during this time, and my self confidence is greater. I can actually say that I am thankful for my panic disorder.

Du kan läsa mer om panikattacker på Wikipedia och siten Panikattack. BMJ berättar också utförligt vad en panikattack är och hur den utvecklas. Även denna site ger bra och överskådlig läsning.

Andra bloggares åsikter om , , , , , , , , , , , , , , , , ,

Inga kommentarer: