Thread by @CCCBuryStEd

Have been trying to manage the biggest panic attack in a long time. Up for hours. Struggling to breathe.

Not posting this for sympathy, but to illustrate the very real ongoing impact of trauma & the often time-consuming nature of regulating. Recovery often is not linear.
🧵

I rarely get severe panic attacks during the day. I know my body well enough to recognise symptoms in the earlier stages and prudent enough to know not to ignore the warning signs when they appear.

Ignoring them because I’m too busy is simply not an option.

I still get panic attacks when I am asleep and waking up scared out of my wits - hyperventilating and with my heart racing is still a regular occurrence.

And it’s not something I have been able to prevent/control.

Believe me, I have tried.

As soon as I am woken up by my racing heart I have to put into action certain strategies that will help to regulate my breathing.

I now do this automatically.

1) I fold over my weighted blanket and drag it over my shoulders. This means the weight has doubled (folded over the blanket weighs about 20kg/3st on top of me).

It helps to ground me ready for stage 2.

2) Breathing techniques.

I use a variety depending on how I’m breathing. Sometimes my heart races and my breath is relatively unaffected. Other times I hyperventilate and struggle to get enough oxygen.

If I’m not hyperventilating, I favour a technique called reverse breathing.

3) Focus.

This is the hardest thing. I have to stay focused. This means concentrating. Really really concentrating and maintaining that. Focus on breathing whilst thinking “ it’s ok, you know what this is, you’re not going to die, you can think later”

It is exhausting.

This isn’t the kind of concentration where your thoughts are too many, your brain is chattering and you need to empty your mind.

No, this is not getting into a zen-like zone with the aim of tranquility.

You can NOT be *zen* when your body reacts as though your life is in danger.

This is a military operation that requires the utmost concentration and dedication to the task which is:

Concentrate. On. Breathing. KEEP. FOCUS.
Don’t. Let. The. Mind. Wander.

At some stage, maybe 5 minutes, maybe 20 minutes later, breathing becomes more regulated.

Heartbeat may still be fast, but it has come down a notch.

Onto part 4…

4) Distraction Techniques

When the breathing is more manageable, it’s time to use distraction techniques to return the body to *zero*.

So, activities that require light concentration, but not too much. Just enough to not think about what preceded the panic attack.

This is important because it’s still easy to slip back into full-blown panic attack, so the focus needs to be on getting beyond that.

Some things that help me:

☑️ Puzzles
☑️ Mindless television
☑️ Scrabble
☑️ Woody Block, Fishdom, Flow Free or any kind of sorting game. I turn the music off and dim the brightness so it doesn’t overstimulate.

I keep an eye on my breathing and heart rate. The aim isn’t to *enjoy* the game ( and especially not to compete or win, or achieve a personal best).

The aim is to have a distraction and allow the body to return to normality.

When that stage has been reached, it’s time for some activity.

This could be going on a walk, a cycle ride, a run.

Or it might be doing the washing up or therapeutic cooking.

Cooking activities with a lot of repetitive action that are really good for managing panic:

Making bread ( kneading)
Making pasta ( rolling)
Making pastry (kneading/rolling/shaping)

I especially enjoy making gyoza skins. The repetitive action is soothing.

Things I’ve learnt are NOT good when both in or coming out of a panic attack:

❌ Music or films with scary music/rowsing score.
❌ Meditate ( my safety requires me to focus and not on “letting go”)
❌ Caffeine ( keep it for another time)
❌ Reading anything heavy or compex.

❌ Being expected to listen.( you won’t process)
❌ Being caught in an argument ( you’ll overreact)
❌ Put on mascara ( you’ll be clumsy and jab your eye)
❌ Collating ( keep organising to later)

❌ YOU. WILL. BE .CLUMSIER.

Reading anything heavy/complex is an important one.
It just doesn’t *go in*.

I used to think there was something wrong with me because I could not retain information I had just read or just been told.

It turns out that when my body is in fight or flight mode, it doesn’t give a shit for my need to complete a tax return, or to pick out the salient points in a research paper, or putting together a court bundle.

IT. JUST . WANTS . TO. FLEE

Over the years I’ve found that medication doesn’t suit me.

The cons of anti-depressants far outweigh the pluses of taking it. I also had significant side-effects.

And a major issue for me is the numbing of my senses and motivation and interest in life and sense of urgency.

Beta-blockers were fine for a while but they didn’t teach me to manage the symptoms. They just made me reliant on meds.

And when the beta-blockers wore off, the anxiety and panic came back with a bang 💣 and I found it a scary thing to navigate.

So I’ve had to learn to recognise what is happening in my body and manage the changes that occur.

And to treat this seriously in order to keep the symptoms from getting worse.

And on the whole, I’m pretty good at it.

But, make no mistake, it is EXHAUSTING.

The whole procedure from stage 1 to stage 4 can often take 2 hours.

That is 2 hours of my day, maybe each day, that just focuses on getting my body to a state that most people take for granted.

It means that when I wake up suddenly and in a panic, hyperventilating and heart racing at 3 am, it can take until 5 am to reach a state of *calm*.

This is SO MUCH MORE than doing a simple meditation or some mindful colouring in.

Ends.