Panic Attack Management: deciding you want to do it

The inside of my tent was damp from condensation and the ground was soft from the mud and rain. The clouds were so low that you could only see the bottom of the hillsides and the lake was engulfed in grey mist with the sun trying to break through. Who doesn’t love waking up in a soggy tent with ducks waddling by? This was camping in Keswick and this weekend would be the climax of my panic attack management.

Panic Attack Management can start with exposure therapy goals such as leaving the house alone and visiting busy shopping centres, but we all have hopes and dreams; the pinnacle of my exposure therapy plan was to hike to a peak. Sometimes it is important for us to understand why we leave situations when we panic or why we avoid places where escape would be difficult or it would be embarrassing to leave or where help might not be available if things go wrong (Agoraphobia). Linked to this is the fight or flight theory.

Fight or Flight

Triggers: An Anxiety Help Website, Calm Clinic state that the triggers of Panic Attacks could be health fears, light-headedness, heart palpitations, chest pains, trouble taking a deep breath, or over sensitivity to physical sensations. For me, unexpected light-headedness (from a cold, or being drunk; hence why I was T-Total for a long time) and heart palpitations could trigger my panic attacks. I then feared panic and being ill while out, which led to me not leaving the house alone.

Threat Sensed: Life Changes Counselling, a UK Counselling Service, mention that when you sense a threat, your body prepares itself for action (fight or flight).

Chemical release: A Clinical Research Unit for Anxiety and Depression, This Way Up, state “When our fight or flight response goes off, our bodies release adrenaline, which causes various changes throughout the body.”

Physical Symptoms Activated: Life Changes Counselling also state that when the body releases adrenaline, it can cause the following:

Panic Attack Symptoms

Fight or Flight: with the symptoms above, our bodies are ready to protect themselves from danger by being alert to fight or escape danger… but what danger? Is there a physical threat or is this the panic kicking in?

Leave situation: The help and advice site, Anxiety No more, state that a normal reaction during a panic attack is to run away. Although this is our normal reaction, this is counterproductive for panic attack management in the long run. As mentioned previously, exposure can help us to overcome panic.

When we flee, we can then end up living a life of fear. This is something I did for years:

Fear of what happens if I have a panic attack
Fear of my next panic attack
Continuously researching symptoms and looking for a cure.

This was not a good quality of life and it was exhausting. Like we have basic needs to survive, Panic Attacks need fear to survive; therefore, one way to take the fear out of things and subsequently starve panic is by exposure therapy: this is the step by step list of building up to my goal and exposing myself to panic symptoms in the great outdoors.

Exposure Therapy Steps

Panic Attack Confrontation

So how were each of the steps?

Steps 1-3: these were panic attack free.

Step 4: this is where the “what if’s” took over my mind: what happens if I am up there and I have a panic attack? Or if I become ill and can’t get help? I was torn; I looked at the mountains and thought “I want to go up there”. When people came down from their hikes, I kept thinking “I want to do that”. Eventually I talked myself into accepting that people do this every day and that whatever happens, it will pass.

Step 5: I plucked up the courage and I selected a hike on Grizedale pike. Picking the hike was panic free and exciting.

Steps 6-9: the next day, we packed, drove to the location and parked at the car park. I had a lot of what if’s going through my head “what if I panic, what if the dizziness kicks in, what if I fall, what if people notice me nervous, what if people think I am stupid, what if I pass out”. But I didn’t back off from it, I reassured myself saying “So what. If I have a panic attack, it will pass. If I become ill, I will sit until it passes or send my girlfriend for help. I have nothing to fear, people do this every day.”

Step 10: we began the first climb up some steps, through some trees and then into the open. It felt great being out in the open air and knowing that this was a chance to kick my panic’s ass. The views from the first part were amazing, I wondered how great it must be at the top. I started to become mildly excited that I could be possibly to beat this panic attack demon…

Panic Attack Management

We approached the last section before the summit, which is a bit of a scramble. And then BAM, the sneaky little bastard was there. It had its hands around my throat, was stirring the contents of my stomach, playing drums on my heart and brushing my mind with a feather duster making it all fuzzy. How can something do all these things simultaneously? Could this be where my aspiration for panic attack management goes out the window? My breathing was funny and I became paralysed with fear. All I kept thinking was I need to get off this scramble NOW! I explained to my girlfriend what was happening and she calmly said “we can go down”. Once again, this means running from all situations when I feel panic. But then a thought came back: ”I can’t continue to live like this, this feeling will pass!”

Kneeling facing the rocks, I ensured that I did not look down or around, then ensured that my feet were stable and my hands were securely holding the rock and I did the following:

Breathe: deep and slow
Positive Thinking: the worst that will happen is that I sit here and there are no threats. This is temporary and it will pass.
Relax my muscles: sit down

Panic Attacks are temporary

I was shaking, but could feel the panic subside a bit. I looked at the view and thought “I wonder how great it is at the top”. I then turned and began to scramble as fast as I could to the top.

Still with my hands on the ground, I reached the summit, crawled away from the edge of the scramble and stood up. I had made it, I was shaky, but had made it. OMG the sneaky little bastard left me alone, I waited for the panic to subside, then it left.

My body was in fight or flight mode without just cause. I was totally safe, the rocks were dry, I had good foot and hand holds and my girlfriend for support. It went something like this:

Panic Attack Exposure

Afterwards I felt so tired and shakey, this photo was taken just after those moments; living proof that it is possible to face your fears and wait for the panic to subside. I have since climbed many more strenuous and higher summits (5,895m highest to date), but Grizedale Pike and Keswick always hold a special place in my heart.