Various forms of panic attacks and anxiety conspire with clinical depression in various ways.  The panic attacks and anxiety issues can be primary and causing a secondary condition of clinical depression. But it can also go the other way:  The clinical depression can be the primary condition that turns the ignition key for panic attacks and anxiety.  In this article we are going to briefly consider this strange relationship in which depression cozies up to panic attacks and anxiety, as well as the way panic attacks and anxiety invite depression to move in just to share rent.  Who pays the burdensome rent?  You do, if you have both anxiety and depression taking up residence in your life.

Panic Attacks and Anxiety are Cut From the Same Cloth

Sometimes a client will be describing to me an ongoing experience of stress and I will mention the word anxiety.  “Oh, no,” she replies.  “Not anxiety.”  I have a puzzled look on my face.  She goes on, “It’s more like worry.”  Then I am reminded that many people don’t like to think of themselves as having anxiety.

Anxiety is a physical response in which a particular branch of our nervous system is activated to prepare the body for defensive action (fight or flight).  Brief anxiety is something we all experience frequently as a part of  normal life.  If your boss hands you an urgent new assignment minutes before you were to leave work early for an appointment, you feel something.  It’s probably not panic attacks and anxiety.  But it’s anxiety, however small.

Anxiety can come in the form of mild stress, caution, worry, concern, a startle response, and….an anxiety attack.  It’s a matter of degree.  Normal anxiety seems to fit well with the situation.  If you work on the 10th floor of an office building and the fire alarm begins sounding, it’s normal to feel a rush of anxiety.  But panic attacks and anxiety for weeks following the event can be a real pain, besides being unnecessary.

So panic attacks are a form of anxiety.  Panic attacks become dysfunctional when your whole body shutters with anxiety and there is no apparent danger.   You may know all too well that being ambushed by panic attacks and anxiety “out of the blue” is most undesirable.

Which Came First? The Chicken?

Or, the Egg?

How Panic Attacks and Anxiety Lead to Depression

A chicken is not an egg.  Chickens can walk around and even fly.  Eggs can do neither. So, which came first?

Likewise, anxiety and depression are not the same at all.  Anxiety ramps our bodies up for defensive action, while depression slows (depresses) the systems of the body.  In particular, the brain has a kind of fog, not to mention the sadness.   This is why it’s so hard to feel “with it” when we are depressed.  It seems that our brains have been designed to slide into depression when subjected to anxiety and stress over a long period of time.  Depression loves chronic stress in the way that eggs love chickens because they provide just the right environment in which to incubate and ultimately hatch.

So, people with frequent panic attacks and anxiety will almost always become depressed because the brain eventually says, “I’m not made to handle all this adrenalin  (anxiety) without a break, so I’m shutting things down (depression).  Frequent, ongoing panic attacks push the brain chemistry into depression.  Chronic anxiety makes depression appear in your crystal ball:  it’s coming.

The Vicious Cycle Begins:  How Depression Sows the Seeds for Panic Attacks and Anxiety

It’s almost a cruel joke of brain chemistry, that depression can also lead to panic attacks and anxiety.  This is because panic attacks and anxiety seem to thrive when we are not thriving.  The key mechanism here is our the sense of vulnerability.  Depression over many days plants in us a sense of vulnerability that just happens to be the soil that panic attacks and anxiety love.

Panic Attacks, and Anxiety Resources to Take Back Your Life

If panic attacks and anxiety are constantly hounding you, what kind of help do you need to reclaim your enjoyment of life?  You certainly don’t need to be told to “just get over it.” Instead, you need a tried and true method for systematically overcoming your panic attacks and anxiety, one step at a time.

Therapy May Not be Necessary

What about therapy?  You may need therapy and it’s a good idea to have at least one session of evaluation by a competent psychologist to make sure your situation lends itself to self help.  A professional evaluation of the “league” of panic attacks and anxiety that you are in can save you unnecessary discouragement.

On the other hand, a good self help program may be all you need.  For many people starting with something at home can help them begin to make progress and even eliminate panic attacks entirely.  The point here is that a self study program at home may help you determine if you need therapy or not.

Double Benefit

Either way, you need a program that can give you the tools and perspective to deflate panic attacks and anxiety one twinge at a time…so that you make progress without becoming overwhelmed in the process.  For many people the end of panic attacks means that the prison cell door of depression opens wide and they obtain a double benefit:  no more panic attacks and anxiety as well as relief from depression.

Panic Away Review

Recently, I have reviewed one of the most popular self help programs for breaking free from panic attacks and anxiety including generalized anxiety.  The name of the program is Panic Away. It was developed by a man who suffered from relentless panic attacks and anxiety himself. Though he is not a mental health professional, I found the program content to be very solid and practical.  It is also affordable for most people.  I like it because it is consistent with what we know about panic attacks from anxiety research.  I collected my findings and put my analysis of the Panic Away program in a 30 minute audio review that you can access here. It’s included in the free SILVER membership to StepsforChange.com.

A program of self help for panic attacks is more than simply reading a book about panic attacks. Self help approaches vary significantly if for no other reason than there is so much relevant information. Add to that the different personalities and experience of the authors and you end up with widely divergent approaches and programs of self help for panic attacks.

Yet a good program will present information in more than one format. There is something to read, there are audios and videos, there are interactive assignments. A complete program of self help for panic attacks presents good content using more than one medium.  Going beyond packaging,  there are a few essentials that make up the very backbone of a program of self help for panic attacks.

1. Good Information:  Not Too Much and Not Too Little

Let’s take a look at each of four essential components. These are characteristics that should be part of any program of self help for panic attacks.  Information about panic attacks is not difficult to obtain. The trick is to sift out the information that is most pertinent to effective relief from the symptoms of anxiety attacks. Programs of self help for panic attacks should offer targeted information leads naturally into developing a new set of skills. Therefore, it’s best to look for courses that give good, solid information about panic attacks that allows you to tame the beast of panic. If you are trying to move an elephant out of the circus tent it’s nice to have the facts that really matter for getting elephants to move.

2.  The Right Skill Set:   Getting Up to Speed Quickly

Naturally building on good information is skills training. Good information will help you know that nails do better when they are pounded in straight. It’s the skill of hammering that allows you to actually hammer the nail into wood without bending the nail. So, its important that a program of self help for panic attacks provides accessible lessons for acquiring the right skills.

3.  Tools That Plug n’ Play with the Skills

A program of self help for panic attacks also must introduce tools that fit hand in glove with particular skills. Calming and stopping panic attacks is not too different from getting a boisterous St. Bernard to do what you want him to do. It really helps to have a collar and a leash (tools) at the moment you need it. The tools should plug right into the skills.

4.  Incremental:   Steps Can be Tailored to Your Pace

One of the biggest challenges for people in a program of self help for panic attacks is sustaining motivation through the entire program. In order to sustain motivation you have to see positive, encouraging results as you move through the steps. To achieve this, a program of self help for panic attacks must be tailored to the individual pace of the learner. Why is this such a big deal?

It’s about being nudged incrementally out of your comfort zone without doing it so fast that you become overwhelmed. A useful program of self help for panic attacks will provide a particular method for tailoring the pace of progress to individual needs and apprehensions.

In a Nutshell

Self help for panic attacks in the form of a defined program or course must address the need for four essential aspects. First, it should include useful and relevant information. Second, skills training should be a prominent aspect of the program. Third, the course should offer very practical tools for practicing the skills and for eliminating panic attacks. Finally, there should be adequate instruction for how to tailor the program to an individual student’s pace of learning. It’s one thing to “get back up on the horse” and face one’s fears. It’s another thing to make progress incrementally and confidently.

When you are reading the sales literature for various programs on the web, keep these four essentials in mind. It may save you time and grief as you choose a program of self help for panic attacks.

Self Help for Panic Attacks or Self-Improvement Fatigue?

Starting and finishing a program of self for panic attacks while figuring out how to fight depression is a lofty and even risky goal that might be compared to driving a truck like a speeding sports car on steep, curvy mountain roads. Does it work?  It might.  It might not.  I probably won’t.

I believe that there are times when we can wear ourselves out trying to be a better person.  If you are really into self help or self improvement you may know what I am talking about.   If you tend toward being introspective or if you are a perfectionist,  then you also know what I mean.  If a person is considering self help for panic attacks, then the anticipatory anxiety can be stressful.  (In reality, a good program of self help for panic attacks is empowering once a person gets started).  But whether it’s learning how to speak to your kids without yelling, quit smoking, starting a new routine of exercise, or tackling a major personal challenge, there is limit to how much effort we can give, after which we are maxed out.

Here’s how the process works in me as a psychologist.  I go through a day having several sessions with different clients.  Many of them excel at certain areas of their life in ways that inspire me to be more that way myself.  But that is not why my clients come to see me.   Each one has a particular area of their life that seems to have some kind of blockage.  That’s what we work on together.  My job is to see what they don’t see:  see the obstacles, see the road ahead, see how to better enjoy the journey, see the specific strengths they have but are not seeing clearly.

But this “seeing” aspect of therapy involves facing some aspect of life that is difficult to look at.  It could be that they need to face their role in helping a relationship go sour.  It could be that they want to have more of this or more of that in day-to-day living.   Meanwhile, at the end of the day, I’m examining myself on the way home from the office.  “Do I really have enough of quality X or Y to be helping someone work on that? I look at all the ways that I need to grow personally and sometimes I get exhausted just thinking about it.   I’ve coined a term for this:  self-improvement fatigue.  It seems that we only have a certain amount of space in our heads to be improving ourselves at any one time.

Self-improvement fatigue is never more of a problem than when someone is learning how to fight depression and out-of-control anxiety all at the same time.  Learning how to fight depression and going through a program of self help for panic attacks is a tall order and a stiff challenge indeed.  It’s one of those situations where medication becomes a question because there is so much to try to cope with and change all at the same time.  There are the symptoms of anxiety attacks that make life most unpleasant.   If you add in the signs and symptoms of depression, then you have a boulder to roll uphill that seems impossible to move.  A person suffering from this type of self-improvement fatigue has a valid concern:  should I even attempt to make changes when the boulder simply won’t budge?

It so happens that many people suffering from anxiety attacks are also being pummeled by clinical depression.  In my opinion it is smarter for people in this situation to expend their efforts for self-improvement for self help for panic attacks and consider using antidepressant medication for how to fight depression.  One of the reasons for this is that the medications available for treating depression are not addictive, whereas many of the anti anxiety medications commonly prescribed create a biological dependence that can be very difficult to break.  Another reason is that combining medication as a tool for how to fight depression with self help for panic attacks lessons the risk of being overwhelmed by self-improvement fatigue.

The Vocabulary of War:  Be Clear About Your Words

Learning how to fight depression involves getting a crystal-clear picture of the battle lines.  While there are many types and varieties of depression,  they all fall into one of two large categories.  The first kind of depression is what most people mean when they say something like, “I was so depressed yesterday…I got stopped for speeding.”  Feeling sad or blue is a normal part of life.  It is also normal to bounce back relatively quickly.  The second type of depression is a medical condition because the brain actually undergoes a change in which it loses the ability to bounce back quickly.  This is sometimes referred to as clinical depression or major depressive disorder.  If you are reading this and wonder how to fight depression, you are most likely concerned about the second type.  It’s important to be clear about which kind of depression you are targeting.  In this article the word depression refers to the various types of depression that fall into the second large category.

How to Fight Depression by Dividing the Signs and Symptoms of Depression into 3 Main Groups

The first order of business in learning how to fight depression is to learn how clinical depression operates.  This begins with learning to recognize the signs and symptoms of depression.  There are two important questions to ask.  First, what are the signs and symptoms of depression?  Second, when do the signs and symptoms of depression become a clinical condition that needs medical treatment and/or therapy?

So one of the first steps in learning how to fight depression is to have a list of the signs and symptoms of depression and to understand what they mean.  The list has 9 symptoms.  The first five are the obvious physical signs and symptoms of depression:  (1) Significant change in weight not due to dieting (weight gain or loss of more than 5% of body weight in a month); (2) Sleep problems nearly every day (excessive sleeping or insomnia); (3) Agitation (irritable attitude and physical tension) or marked slowing of one’s thoughts and actions (e.g., much more difficulty getting started on something than usual); (4) Fatigue or loss of energy every day; (5) Diminished ability to think or concentrate or indecisiveness, nearly every day.

The second set of signs and symptoms of depression have more to do with a person’s subjective experience.  They are: (6) Feelings of worthlessness or excessive (or inappropriate) guilt nearly every day; (7) Sad mood most of the day, nearly every day; (8) Noticeable loss of interest or pleasure in nearly all activities most of every day.  This set of symptoms poses the frustrating challenge of how to fight depression when it is something so vague as a mood and difficult to measure.

One of the Signs and Symptoms of Depression Requires Special Handling

The third group is really just one symptom in a class of it’s own.  If a person is having thoughts about death that keep returning, this is almost certainly an indicator of clinical depression, whether or not the person can recognize any other signs and symptoms of depression.  But what does mean to have thoughts about death?  Recurrent thoughts and images of death (not just fear of dying), recurring thoughts about suicide, or a suicidal gesture (deliberate carelessness in dangerous situations) or an attempt, or specific plans.  While this is the most dangerous of the signs and symptoms of depression, it’s often one of the first to disappear as soon as a person catches a vision of genuine hope for the future.

How to Fight Depression When Self Help is Not the Answer

If you have recurring thoughts about death it’s important that you consult with a mental health professional and not try to go the self help route by yourself. Why?  Think of it this way.  Your wouldn’t be having suicidal thoughts if your weren’t truly stuck in some way.  Now, think about it.  If you are stuck enough to have recurring thoughts about death, what are the odds that you are going to “unstuck” enough to pull yourself out simply by your own effort?  It has nothing to do with how strong you are as a person.  If fact, I often find that the strongest people have real trouble with this concept because they can’t stand the feeling of being helpless. Also, we all have a tendency to become overly attached to our expectations about how life must be.  I can drive around town waiting for the magic day when I will have a lot of time to fix the brakes myself, or I can do the smart thing and contact someone who knows what they are doing.

It’s About Perspective and Not Strength

If self help is not how to fight depression when your are suicidal, and it’s not because of being weak, what is the reason?  It’s really about perspective and not whether or not you are strong or weak.  Depression skews one’s perspective so that you channel what little energy you have in the wrong direction.  It’s as if you’ve fallen in a pit that has a clear path to safety, but you are wearing dark glasses with distorted lenses that simply will not let you see the hope and opportunity that is right in front of you.

How to Fight Depression by Understanding the Degree of Difficulty

While learning how to fight depression is not so much about OUR strength, it is very much about the strength and intensity of the depression.  How many of the signs and symptoms of depression have to be present for it to be considered “clinical.” For the signs and symptoms of depression to be a clinical condition two important criteria must both be true and 5 out of 9 signs and symptoms of depression must be present.  Specifically, Major Depressive Disorder,  is usually defined as a combination of any five of the following signs and symptoms of depression that persist for more than 2 weeks.  For the signs and symptoms of depression to have clinical significance these two important criteria must both be true:  (1) The signs and symptoms of depression last for several days (at least 2 weeks); (2) Depression symptoms become disruptive to major areas of a person’s life;  and depression symptons negatively and noticeably impact relationships, work, or school.

These steps for how to fight depression are simply the starting place.  Once you know your enemy it’s crucial to learn the tools and techniques of attacking depression wisely and armed with the right information about the enemy you are fighting.

Many people suppose that depression is simply a feeling of overwhelming sadness. If someone has a terrible week, they might say, “I was so depressed.” But what they really mean is “I was very sad.” What doctors mean by the word depression is not the same as the common usage of the term. But if sadness (only one of several signs and symptoms of depression) is confused with depression, it is also true that the misery of clinical depression is often overlooked entirely.

I have spoken to many people who have suffered from signs and symptoms of depression for many months or even years, but they don’t think of it as depression. Why? Depression is a beast unlike the sadness that naturally comes from disappointment. Depression can morph into anger or numbness.

It is an animal that lands on our shoulders and takes up residence. Sadness, on the other hand, is more like a bird that lands on our shoulder, but soon flies away. If sadness doesn’t fly away, it can becomes one of the signs and symptoms of depression — clinical depression. So when do the signs and symptoms of depression become a medical condition that needs treatment?  These two important criteria must both be true:

1. The signs and symptoms of depression last for several days (at least 2 weeks)
2. Depression symptons become disruptive to major areas of a person’s life;  the depression symptoms negatively and noticeably impact relationships, work, or school

To make things more complicated, a person can be clinically depressed without feeling particularly sad.  Consider for a moment what that means:  a person can be clinically depressed without showing sadness–one of the signs and symptoms of depression most emblematic of depression.   How can this be?

Everyone experiences mood changes as a part of living life. Good things happen. Bad things happen. But depression involves a cluster of symptoms of which sadness is only one. Pouring rain is not a flash flood, but it is part of the combination of factors that produce a flash flood. Clinical depression, or Major Depressive Disorder,  is usually defined as a combination of any five of the following signs and symptoms of depression that persist for more than 2 weeks:

1. Sad mood most of the day, nearly every day
2. Noticeable loss of interest or pleasure in nearly all activities most of every day
3. Significant change in weight not due to dieting (weight gain or loss of more than 5% of body weight in a month)
4. Sleep problems nearly every day (excessive sleeping or insomnia)
5. Agitation (irritable attitude and physical tension) or marked slowing of one’s thoughts and actions (e.g., much more difficulty getting started on something than usual)
6. Fatigue or loss of energy every day
7. Feelings of worthlessness or excessive (or inappropriate) guilt nearly every day
8. Diminished ability to think or concentrate or indecisiveness, nearly every day
9. Recurrent thoughts of death (not just fear of dying), recurring thoughts about suicide, or a suicidal gesture (deliberate carelessness in dangerous situations) or an attempt, or specific plans.

Most people have experienced one or more of the above symptoms at some time in their lives. But when five or more of them combine and take hold, they can cause agonizing distress and can disrupt one’s ability to function well at work, at school, or socially. When this happens the depression is considered “clinical” because it is tenacious enough to need some type of treatment. If a person is having thoughts about death that keep returning, this is almost certainly an indicator of clinical depression, whether or not the person can recognize any other signs and symptoms of depression.

As you can see, a person may or may not feel sadness as their main symptom. It’s the number of depression symptons and the combination of depression symptoms that makes a person begin to see the impact on his or her life. When we have normal, everyday sadness or the blues, our brain bounces back. With clinical depression, our brain starts working in a different way and gets stuck in a mode that displays the signs and symptoms of depression.

How Psychological Trauma Leads to the Signs and Symptoms of Depression

At what point do painful memories cause the signs and symptoms of depression or anxiety? The following checklists are from the standard diagnostic manual used by mental health professionals. It’s a summary of the criteria for Posttraumatic Stress Disorder of PTSD.

Posttraumatic Stress is the persistent or delayed reaction to a life-threatening event that involves:

1. Reexperiencing the event in distressing ways (nightmares, flashbacks, anxiety attacks, depression)
2. Various tricks of the mind to avoid any reminders of the event
3. Symptoms that show that the person is much more keyed up than they used to be (sleep problems, irritability, outbursts of anger, exaggerated startle response).  Sleep problems push the brain in the direction depression.  Anger or irritability often cause problems with relationships and friendships.  Often a breakup of marriage can be traced back to the anger that results from trauma.   The loss of friendships and other important relationships helps to bring out the signs and symptoms of depression.

This type of stress becomes a disorder when it negatively impacts one’s life in significant ways. When this happens it is often referred to as Posttraumatic Stress Disorder or PTSD.  While it is classified as an anxiety disorder, the signs and symptoms of depression are often the most devastating to a person’s happiness.  Many professionals, including me, believe that PTSD is just as much a mood disorder as it is an anxiety disorder.

A trauma is an overwhelming event or situation that forces a person to develop a cluster of symptoms. Traumatic stress is the cluster of distressing symptoms. It is called posttraumatic stress because it often has a delayed onset. Many New Yorkers who seemed to be doing well after the September 11 attacks began to develop major problems months later.

It is important to understand that people usually cannot make these signs and symptoms of depression disappear just by trying hard to “put the past behind them.” The American Psychiatric Association diagnostic manual (DSM-IV) defines Posttraumatic Stress Disorder with specific clinical criteria in order to make a diagnosis:

1. Exposure to a Life Threatening Event

Exposure to a life threatening event or one in which there is a threat of serious injury. Whatever causes it, there must be intense fear at the time of the event. This can also include witnessing a violent act or being in a situation of extreme danger.

2.  The Sadness of the Traumatic Event Floods the Mind Repeatedly

This means that the event is re-experienced, over and over.  Some examples of the ways are:

• Distressing memories of the event that intrude suddenly or will not go away
• Persistent nightmares
• Acting or feeling as if the frightening event is happening all over again, such as with flashbacks or distorted perceptions
• Intense mental anguish that is triggered by cues or symbols that mimic some aspect of the original traumatic event
• Intense physiological reactivity such as tension or pain also triggered by reminders of the event

3.  Numbing and Avoidance

Emotional numbing and a strong tendency to avoid triggers or reminders in at least three of the following ways:

• The person makes efforts to avoid thoughts and feelings related to the trauma (he or she won’t talk about it)
• The person avoids activities, people or places that might remind them of the trauma
• The person can’t remember the event or can’t recall aspects of what happened
• The person shows a noticeable loss of interest or participation in significant activities
• He or she has the feeling of being estranged, disconnected or detached from other people
• The person has awkward barriers to the full range of emotions such as an inability to feel affection from another or to have loving feelings
• He or she has a distorted and short view of the future such as not expecting to have a career or normal life span.

4.  Feeling Tense and Tightly Wound in Various Ways

Persistent symptoms of increased arousal as shown by at least two of the following:

• Difficulty falling or staying asleep
• Outbursts of anger or irritability
• Difficulty concentrating
• Hypervigilance (scanning the surroundings for possible danger)
• Exaggerated startle response

To be diagnosed with PTSD the symptoms have to continue beyond one month.  Also, it has to clear that the anxiety and/or the signs and symptoms of depression are creating dysfunction in a person’s life.  But the syndrome can have a life of it’s own even if the diagnostic criteria are met precisely.

This definition of PTSD is very useful as a checklist of symptoms that can arise after an overwhelmingly dangerous event. However, I do not find it very useful in deciding who actually suffering from PTSD. Apparently, I am not alone. Dr. John Briere, a trauma specialist at USC Medical School once said that the most traumatized individual he had ever treated did not meet the exact criteria for PTSD. The definition is so tightly crafted (by a committee) that many people who suffer intensely from posttraumatic stress end up with another diagnosis that does not highlight the trauma-based roots of the problem.  The signs and symptoms of depression might be treated with medication, but the underlying posttraumatic syndrome is missed entirely.

The real value of the diagnostic criteria is in providing a partial list of trauma-related symptoms. When it comes to evaluating the signs and symptoms of depression this list can be helpful in identifying whether or not treatment for trauma (such as EMDR therapy) should be incorporated into the treatment of the signs and symptoms of depression.

If you are a married woman who suffers from panic attacks you know how difficult it can be to navigate the marital issues resulting from frequent panic attacks.  Lack of participation in family outings, too anxious or too exhausted for intimacy, feeling out of sync with the rest of your family, and isolation from family friends, just to name a few.  If you’ve gotten as far as seeing your need for self help for panic attacks, then the next challenge is to get ready to pull it off.

Getting ready to launch your program of self help for panic attacks includes bringing your family members on board.  In particular, it’s good to have your husband’s support.  But before he can offer support he may need to understand more of what it’s like.  Here are three simple steps to begin doing just that:

1.  Listen Carefully to the Bad News

First, muster the courage to ask about the impact of your panic attacks on him and on the family as a whole.  The most important thing here is listen without making it about you.  This is difficult because it may feel overcome by sadness and regret while he is talking.  Make sure you keep you focus on how this effecting him and not how sorry you are, how ashamed you are, or how much more suffering you have with your panic attacks.  It’s not a competition.  Furthermore, if you really listen to him you may find that it strengthens your resolve to start your program of self help for panic attacks.

2.  Put Yourself in His Place for a Moment

Second, empathize with him.  Try to put yourself in his place.  Here he is, married to a woman that seems to have a chronic condition that makes his life more difficult.  Just as you never know when panic will strike, so also he never knows when it will strike.  He never knows when he will suddenly have to do something that you both assumed that you would be able to do (picking up the kids from soccer practice, making dinner, etc.).  If you can find it in your heart to have two seconds of eye contact where you tell him you sincerely wish you could block the effects on him, then you have done this step.  If you have a family, then both your panic episodes and your efforts at self help for panic attacks have huge implications for the people you love most.

3.  Learn About Fearful Times in His Life Without Comparing

Third, ask about a few of the most frightening experiences of his life.  Make sure you ask clarification questions to bring out the details of his story.  Try to dig deep inside your heart to find some compassion for him in the experience or incidents he describes.  IMPORTANT:  Do not refer to your own experience of panic and don’t mention your program of self help for panic attacks during this conversation–that must be in a separate conversation and on a different day.  It’s also good to think about what he said for a day or two and send an email (or write a note) telling him you have been thinking about your conversations with him and the fear that he must have experienced earlier in his life.

Getting ready to start a program of self help for panic attacks goes more smoothly if you have the right kind of support.  You don’t need your husband to be telling you what to do.  You don’t need him to participate every step.  But you do need his spoken and unspoken encouragement to keep going.  Most importantly, you need him to understand that this is a major challenge for you.  If you do these three steps you may be glad you did when you embark on a journey of self help for panic attacks.

If you suffer from the symptoms of anxiety attacks and don’t yet have a specific program for self help for panic attacks then take a look at my 4 week  online course:  The Cure Panic Attacks Workshop.

Self Help for Panic Attacks:  Encouragement Can Make a Difference

One of the intangible success factors for any program of self help for panic attacks encouragement.  It’s often wise to take the time to enlist one, two, or thee friends to cheer you on.  The problem is that most people just don’t get it.  Unless they have experienced a panic attack themselves, it just doesn’t see like a big deal.

One of the drawbacks to self help for panic attacks is that it can be a bit lonely compared with having a coach or a therapist giving pointers and encouragement.  You can address this need by recruiting friends or family to root for you.

Problem:  People Often Just Don’t Get it

But it can very frustrating to try to explain to someone why a panic attack is such an overwhelming experience.  If they think panic attacks are no big deal, then how are they going to see your need for their encouragement while you engage in your program of self help for panic attacks.

How do you explain panic attacks to your husband or to your wife, to your boyfriend, your girlfriend? How do you explain to someone what it’s like to have a panic attack, especially if they’ve never had one themselves?

If you’ve suffered from panic attacks, I am sure that you’ve had the situation where you were describing what happened to someone and they were looking at you rather strangely like they didn’t know what to do with what you were saying, or worse, they were judging you and thinking that you should have just snapped out of it.

You May Have to Take a Crack at Explaining Panic Attacks To Them

Well, I’ve actually thought about some ways that you can explain to people what it’s like. First, what you have to do is help them picture a time in their life when they were terrified.  Second, you ask them to tell you about the experience in detail.  But it has to be a time when they were really afraid for their life or the life of someone they care about.  “My brother almost drowned.”  Third, ask them to describe the feeling and what they felt in their body.

They will probably remember, but they may be hesitant to talk in detail about it.  They might remember their heart pounding, they might remember not being able to catch their breath, they might remember their skin feeling like it’s crawling, they might describe a numbness–some of the symptoms of panic attacks.  Let them know that your program of self help for panic attacks is a little like learning to relax in such an electrified situation.

Then, say, “Well, what a panic attack is, is if you felt all of those same things but you looked around and there didn’t seem to be any cause or any reason to be afraid; you just felt those feelings come over you with no danger in sight.”  Point out that such an experience would be even more difficult than the most frightening experience they could imagine.

Why is it more difficult?  Explain that, “In addition to all the terror there would be the  fear that you are going crazy because there is nothing in your immediate surroundings that is dangerous.”  Explain to them that one of the challenges of a program of self help for panic attacks is that it’s like fighting an invisible enemy.  So you ask them to imagine this overwhelmingly fearful experience that appears to have no reason for fear.

Most programs of self help for panic attacks involve a person choosing to put herself or himself into a situation that has caused panic for brief, controlled period of time.  If you are going to tame the tiger (panic) you have to move closer and closer to the beast in a step by step fashion.

Help Them Imagine One Step at a Time

Now if they can’t recall a time when they’ve been really afraid, what you can do is just have them picture something that most people would understand as life-threatening.  For example, you could say, “It’s like if you were to walk out of a store late at night and you were held up at gunpoint, and you felt the barrel of the gun on the back of your head, and you had the feeling that very possibly this person would shoot you.”

It may be good to add, “You can imagine just the way your body would react to that, how the adrenaline would just kick in and activate your whole system for fight or flight. You might freeze, you might feel like throwing up, you might feel like you can’t get your breath. It’s just like a truck hit you.” It’s such a huge physical experience to have that much fear at one time.

So you have to explain it that way and then say, “Well, supposing you walked out of a store and you had that exact same experience except there was no one holding a gun to your head. There was no one there. You just felt all of those same panicky, terrified feelings and you had no clue where they were coming from.”  Conquering this kind of mysterious experience is the focus of self help for panic attacks.

Well, sometimes I’ve seen a glimmer of recognition in people’s eyes when I’ve explained it that way. And sometimes they say, “OK, I kind of see that. That would be pretty scary if you felt that without  anything going on around you.”

Be Wise in Choosing the Individuals to Whom You Explain Panic

It’s likely that there are people you know who don’t care what your panic attacks feel like.  Don’t waste your breath on them.  (Save your breath for efforts towards self help for panic attacks).  But for the people who do care, it can help them stop judging you.

It can also help them see that getting through a panic attack is not just about pushing through it the way we do with most challenges. If you are successful at enlisting the encouragement of even one friend or family member, then self help for panic attacks upgrades to team help for eliminating panic attacks.

Author’s note:  I wrote this article a few years ago.  I am posting it again because I think that many approaches to self help for clinical depression trivialize the overwhelmingly dark nature of the beast of clinical depression… especially if it is of the more severe variety.  If a person is going to muster the courage to learn how to fight depression, they need to know something of what they are up against.  Or, more precisely, the support people in their lives need to know something of the extent of the challenge.   The kind of depression described below requires support people in one’s life, but they must be people, (1) who care; and (2) who don’t say things like, “Why don’t you just snap out of it?”

A Moonless Night

Imagine trying to sail a small boat during a violent storm. There is no moon out. It is pitch black. The waves that swamp your boat every five minutes give no warning because you cannot see through the blackness.

Now imagine the moon rising. It’s not daylight, but you can see what you are dealing with. You are able to make slight adjustments when you see a big wave coming. You are still getting wet, but you have a fighting chance to keep your boat from being swamped. Which situation would you prefer, if you had to choose? Many people actually prefer to have the waves hidden from view.

Why would anyone prefer the blackness of a moonless night? The answer is simple: many people would rather not see how bad the storm really is. They prefer the illusion of safety.

Sometimes there is a way to prevent depression from getting worse. Sometimes there is one small thing that we need to understand about ourselves in order to position our boat before the waves crash again. A woman who loves to draw and paint finds that she feels much better when she is doing what she loves to do—even if her depression robs her of half the pleasure that she would normally feel. A businessman who loves sports feels irritable and cynical when he neglects to take time to play, but he doesn’t see the connection. He sails in the blackness of a moonless night.

Most people can find something creative or playful that fits their uniqueness as a person like hand and glove. When Gina writes poetry it is not hard for her to say, “I have been designed for this.” When Jessica works on her scrapbooks, it feels like clothing that fits just right. She feels satisfaction fulfilling part of her nature as an artistic historian. When Larry hits a homerun on Saturday with his middle-aged friends, he feels more alive. When Bob takes the job offer that pays less, he feels a surge of energy because he knows that the new job will allow him to implement his own creative ideas. All these people battle daily and weekly storms. But the moon shines and gives them just enough self-awareness so that they can maneuver the waves of unpredictable events.

Tom is depressed and is dreading having to work 70 hour weeks to complete a major project. But his depression is manageable because he defies the group and takes a lunch break. During lunch he does something he loves. While he eats he sketches plans for his dream house. There is something of an architect in Tom. Most importantly, Tom understands that and works with it. It is not a magic pill that removes his depression, but it plants the seeds of recovery every time he feels a glimmer of pleasure. He has learned how to use the moonlight of his own self-awareness to sail through his own personal storm. None of Tom’s friends get it. But if they did, something deep in Tom would answer back with a resounding, “Yes!”. When we dare to become more aware of who we are and how we have been wired we stand a better chance of sailing successfully through the storm of depression.

What if you don’t know, but would like to find out? How can you make use of the light of the moon? There are two important steps:

(1) Begin a process of becoming more aware of the deeper parts of who you are. This can be as simple as keeping a journal of your random thoughts;

(2) Experiment with small changes to your daily routine.

Try different things until you find something simple, good, and pleasurable. Then, muster the courage to do it, even if other people think it is odd. Don’t worry. When they find themselves in their own moonless night they may ask you how you pulled it off in such a violent storm.

The most challenging part of all this is to find the courage to face yourself–to know more about who you really are. It requires courage because the same moonlight of self-knowledge that illuminates your boat also lets you see the staggering height of the waves. This can be frightening, since denial often shields us from what is real. But it is a world of rest compared to the blackness of a moonless night.

I am excited about StepsforChange.com and how it will grow in the coming weeks.  This blog carries the same themes of the site, but will include shorter pieces, informal musings, and news about online events.  I am especially looking forward to providing teleseminars and webinars that address some of key aspects of this site:

What Makes for Lasting Relationships

Self Help for Panic Attacks

Signs and Symptoms of Depression

How to Fight Depression

Finding a Life Coach

The Fear of Public Speaking

Marriage Counseling Questions and Tips

Effective Parenting