Anxiety attacks

Periods of emotional uneasiness of varying intensity. Anxiety may be rooted in rational fear or caused by biochemical imbalances in the body. Overwhelming anxiety may develop into panic. Also see "Nervousness".

Anxiety is often a totally normal sensation. So is fear in many cases. Both sensations, like stress, helps us to stay alert and to fight or flight, in cases where we e.g. are attacked by someone, and to fight for our lives if we are in a threatening situation, if we are seriously injured or sick. A soldier wthout fear would be a bad soldier, one that would not be able to take proper care of him-/herself in a dangerous situation. Courage is controlling ones fears.

The psychologic term anxiety, as in anxiety neurosis, sometimes referred to as nervous fear or phobia, describes a feeling that does not correspond within reasonable limits to the provoking factor. Examples are phobia towards mice, or fear of suddenly being run over by a car, while walking on the side-walk. Nervous fear can be deprived of provoking factors or it can be elicited in specific situations, in closed spaces for example. This is called claustrophobic fear or claustrophobia. We are all alert to a certain degree, and most people are afraid of something.

Symptoms of nervous fear
Nervous fear is accompanied by nerval symptoms, because the sensation of fear is transmitted through the body by the nervous system, both the autonomic nervous system and the conscious somato-sensorial system. This can result in trembling, sweating or gastro-intestinal manifestations like diarrhea (before travelling or finals for example), sleeplessness or a lump in the throat. Many cases of muscle infiltrations or myosis are physical manifestations of an underlying chronic, nervous fear. Nervous fear can also cause damage to our internal organs and cause disease. The result can be backpains or ulcerative colitis. In this case, the disease is referred to as psycho-somatic, because of the projection from the psyche or mental life to the body.

Anxiety may be caused by underlying neurosis, but as mentioned earlier, anxiety is often a totally normal sensation that often follows from traumatic experiences, like a death in the family or severe accidents, where we are reminded of our own mortality. However, there is a certain, often genetic condition that is characterized by appearence of sudden violent attacks of fear, anxiety attacks or nervous fear. These attacks are caused by sudden release of stress hormones that push the whole body into a state of maximum alert, it has violent symptoms and often there is mortal dread. Between attacks there are often long periods without nervous fear. In this case, medical anti-depressive treatment is often called for.

Another type of anxiety attack hits the affected person with a sudden feeling of not being able to breathe. He or she therefore starts breathing more and more rapidly (hyperventilation). This results in changes in blood chemistry (acidity) that affects the concentration of active calcium in the blood stream, which results in increased excitability of the nervous system, with resulting pricking sensation of the lips, hands, and feet and increasing stiffness of the hands and whole body, accompanied by violent fear. These kinds of panic attacks can result in regular convulsive fits. However, the treatment is straight-forward: The hyperventilating person must breathe into a plastic back that firmly covers the nose and mouth, so that he or she can breathe the carbon dioxide in his or her own expirations. This restores the normal acidity of the blood, and the calcium balance, and relaxes the person.

Anxiety is also seen in relation to low blood sugar, typically a few hours after a meal, rich in carbohydrates. The importance of this connection may have been exaggerated in the past, but there are undoubtetly examples of people, who have been labled with a psychiatric diagnosis when the underlying etiology of the panic attacks is low blood sugar.

Certain physical conditions, like increased metabolic rate and cardiospasm are often accompanied by anxiety and fear. Therefore, it is important to arrange for a full physical examination at your doctor in case of a sudden development of a tendency for anxiety attacks. One should bear in mind that an unhealthy or insufficient diet can elicit psychological symptoms. This is the case in food allergy or -intolerance were psychological symptoms are elicited by the consumption of certain food groups or additives. Coffee, alcohol, amfetamine (speed), cocaine, and ecstasy can provoke anxiety and panic attacks. Some are more susceptible than others.

Chronic anxiety disorders
There are many different kinds of chronic anxiety disorders. They can be very stressfull, both to the person, who experiences them and to his or her close relatives. People suffering from chronic anxiety disorders often have compulsive ideas about nobody really caring about them, for example, and will therefore often try to control their sorroundings, and deliberately or subconsciously try to be the center of attention, and thereby be "rewarded" for their way of being. This is called secondary reward. This type of behaviour can also be used as a defence mechanism against unresolveable conflicts, which are often rooted in experiences from childhood. A person may blame himself for his parents divorce, for example. The feelings of guilt may be so pronounced that the person does not allow him- or herself to experience joy, but reacts with migraine or other physical illness to joyfull or rewarding experiences.
There are different kinds of anxiety and compulsive disorders, and the conditions have many different expressions. The patient may perform washing and cleaning rituals, have a mania for turning out the rooms, or have organic symptoms without physical explanation, symptoms of cardiac disease, for example. Another typical expression is phobia, as in e.g. claustrophobia and agoraphobia. Agoraphobia can find expression in fear of being in open spaces. People with phobias will try to avoid the object of their fears, and when this cannot be accomplished, they respond with psychological and physical symptoms which are often difficult for them to handle. This can lead to dependence on alcohol or tranqualizers and abuse and thereby cause more problems and stronger feelings of anxiety.

Recommendations

General advice on disease prevention and a healthy lifestyle can be found in the library article "General Advice - for healthy as well as for ill ones" in the VitaHealth section under Focus Articles. You can also test your health by taking our "Health Check".

Diet
It is important to follow a diet that stabilizes the blood sugar and to drink plenty of water every day. Also see "Low blood sugar ".

Carbohydrates have a calming and relaxing effect. An old Chinese saying states that in periods of stress, you should sweeten your tea. It is therefore a good idea to put honey in camomile tea and to eat something sweet at fixed intervals during the day; not too much, however, and preferentially something that is low in fat to prevent putting on weight. To achieve a long-lasting effect one should eat complex carbohydrates which can be found in pasta, whole meal bread, and potatoes.

One should try to avoid eating proteins in combination with carbohydrates, however, since the combination reduces the anxiety-reducing and calming effect. One should rather eat vegetables together with meat. Onion has a mildly calming effect, the knowledge of which dates back to ancient Egypt.

Treating anxiety disorders
It is important to try to find the cause of the fear that leads to anxiety. This can be difficult since people who suffer from anxiety disorders often hide the cause of their symptoms from themselves. In this case, psychotherapi - including hypnosis - can help to open up, making it easier to deal with what is concealed.

It is important to try to increase the psychological coping capabilities of the patient, so that his or her everyday life can be handled without experiencing anxiety. Other key-words are confidence and self-esteem; that the person becomes aware of his or her own value, and knows that others depend on him/her. The foundation of this is made in early childhood by commending the child for what it does for others. Love, security, and tasks that can be handled by the child work together in developing its psychological coping capabilities and prevent anxiety. Dialogue is important, with a psychotherapist, psychologist, or medical practitioner - or in groups. Family and other people who are close to the patient should take part in trying to convince him/her of his/her value and their depence on him/her for help and guidance.

Anxiety can lead the patient into a viscious circle, where symptoms keep getting more and more pronounced. This pattern has to be broken and the best way to do this is through cognitive behavioural therapy, through which the patient can learn to change and control his or her ideas about the anxiety provoking stimuli and slowly learn to fight his/her tendency to avoid anxiety provoking situations. Relaxation of tension and visualization can lighten this task considerably.

What can be done on your own
Excercise is good. Strengthening of the body through hard and regular exercise increases both the physical and mental well-being, increases self-esteem and prepares the way for driving away the anxiety. Mind-body techniques like meditation, visualization, yoga, autogenous training, Tai Chi, Qi Gong, the Alexander technique, or prayer can also be beneficial. It is important to have full support and understanding of not only the family, but also of friends and acquaintances, and others in the close community.

Excercise is one of the best natural cures against anxiety. A walk - if one can handle being out in public - preferentially in daylight, with a caine and if possible a companion so that one has someone to talk to and share the experience with. Coffee (caffeine) and alcohol can potentiate or provoke anxiety, so it is a good idea to substitute your coffee with e.g. camomile tea which has a tranquilizing effect.

Calming herbs
Along with camomile (Chamomilla recutita), valerian (Valeriana officinalis), lemon balm (Melissa officinalis), St. John´s wort (Hypericum perforatum), and skullcap (Scutellaria) can be good help, and continuing use of these herbal medications does not result in the tolerance, dependence, and lethargy that results from the use of most nerve- and anti-depressive medication.

Other calming supplements
The amino acid theanine is often used for anxiety. It works very quickly. Extra supplements of easily absorbable magnesium are often also beneficial.

Music
Music also has a calming and relaxing effect, especially classical and instrumental music. Creative visualization can help by imagining something joyful and positive.

Aromatherapy
Aromatherapy can also be used; the scent of lavender, for example, is very relaxing. Oil evaporators are available that can hold a brazier or small candle under the oil container. Aromatherapy Aroma massage, where ethereal oils from plants are added to the massage oils, has proven to be effective in cancer patients suffering from depression and anxiety for periods up to a few weeks.

Breathing
Breathing exercises can also be used to calm yourself. The only thing to focus on is breathing deeply in and out very slowly, and if needed count each breath. Hyperventilating can result in increased feelings of anxiety. If one is suddenly overwhelmed by fear and uneasiness, a good idea is therefore to take three deep breaths while smiling. This very quickly and effectively relaxes both the body and mind.

The thing not to do if you feel the anxiety creeping up on you is to focus your attention on it.
Instead you should try focusing on something else by giving full attention to something joyful and calming like drawing or painting, or something more practical, like a diary, time manager, shopping list, or a crossword puzzle. Or pick up the telephone and call one of your children or friends, and go out and experience something instead of isolating yourself at home with your anxiety.

Many people use Bach's first aid drops "Resque remedy" against panic attacks with good effect.

Warnings

In severe cases of anxiety, use of conventional medicine can be neccessary. In many cases, however, medicine is only a substitute for the needed psychotherapeutical treatment and can actually take part in maintaining the patient in a psychologically unhealthy situation.
Quite a lot of the medication used in the medical treatment of anxiety makes the patient careless and blunted. Most of the medication is extremely habit-forming and cause habituation, meaning that the patient needs larger and larger doses to achieve the needed effect, and suddenly, the patient may be stuck in abuse.
Medicine often cause people to continue living under their unsatisfactory conditions.
Tranquillizers can have severe side effects, especially when mixed with alcohol, and can be dangerous in combination with driving or working.

Remarks

Some people have anxiety attacks in which a fear of dying is either the thought that elicits the attack or develops as the attack develops. These types of anxiety attacks can be treated unconventionally with Bach's flower remedy, "Resque remedy".
Conventionally, anxiety attacks are treated with anti-depressives.

Also see "Cardiovascular disease", "Food allergy", "Food intolerance", "Low blood sugar", and "Stress".