Panic Disorder

So I have had a panic disorder for most of my life. Its just been a part of my life. Has been worse and better at times, but has always been there and been a worry. My life has been controlled by avoiding situations that may lead to panic and being anxious always that it may occur. Social situations, enclosed spaces, transport, relationships, even talking to people have all become situations to avoid. I never bothered to get it diagnosed but parts of it are very OCD. So recently I put together all my learning on this problem and solved it. Here is the solution.

There are 4 stages to combating my panic disorder. They rely on ideas primarily from Buddhism and Psychology. Starting meditation is the important preliminary as the stronger your mind the easier to implement what follows. But meditation alone is only a helpful part. In the past I have "got over" my panic disorder and been strong enough to throw it away, but I have never solved it before and it has come back. This is the solution.

1. Panic is caused by a sense of Danger. Danger is the key. If you think about every situation in which you panic you can see that actually there is very little danger. You know this because other people can breeze through your situation without any concern. What is different between you (and me) and other people in that situation, is that you think about it differently from them that is all. The Danger lies in the way you see things not in the situation. Not much help when you are panicking but this is the key. Careful consideration of this in calm private moments must be undertaken to develop a deep belief that actually there is No Danger to your situation.

As an example: one side of my panic makes me think that inside me there is a evil side that will automatically, at any moment, do something bad and I must guard against that. It stems from a few bad things I remember doing as a kid, and I rationalised this as me having an evil side which my good side must control. This belief I must be on guard developed into a continual anxiety and loss of ease and sense of Danger that I was going to do something terrible like shout out in a theatre, or push someone under a train on a packed tube platform (a million little worries). Any bad thought became evidence of my evil side plotting a horrendous crime. I have read about OCD and that the obsessive sense you are imminently going to do something is not real, that is very helpful in convincing myself that I am not in Real Danger. Meditation is also extremely helpful. If you can meditate into the "Present Moment" you can see clearly even when panicking that there is actually No Danger. Danger is things like a Tiger running for you that you need to run away from. Bad thoughts and fears of being trapped or being socially excluded etc are not real danger they leave you completely unharmed and you don't need to do anything. I went to a lecture where it was explained that the epidemic in childhood anxiety and mental health can be attributed to us never experiencing real danger anymore so our panic response gets over active. I used to go caving and climbing to tackle my fears and I found being in really dangerous situations really helped to reset and over active panic response.

The Panic response to Danger I understand is caused by a part of the brain called the Amygdala (it doesn't really matter the point is to see panic response as a distinct thing we can study). This is designed to respond to danger and override the brain to run away or fight. It is useful for protection from tigers but of no use at all with 99.9% of our modern anxieties. A panic disorder happens when our Amygdala gets a bit too trigger happy. I call mine Maisie, she is a bitch. The key to fixing Maisie lies in persuading her there is no danger. But before that we must reject her insistence to run away or fight. So stage 1 when panic happens is to just remain seated or where we are and remind our self that actually there is No Danger At All. Maisie has got it wrong. Much easier said than done when you have been listening to her robotically and panicking for more than 30 years. I have tried this stage before but without the next stages the panic just gets worse.

2. Stage 1 explained in a lot of depth how we arrive at the belief we are in danger. It is all to do with the story we tell our self that convinces us we are in danger. I call this "The Book". In my case there are a ton of stories in particular the story of a hidden evil side that causes me to do all the bad things in my life. It's a silly story now I review it in later life, but as a kid it was compelling and I habitually still read it from The Story book all the time. Unfortunately so does Maisie my Amygdala. She likes that Story book cos it gives her all the ammunition she needs to step in and shut my brain down and panic. Stage 2 then it closing the book. There is simply no need for stories when we are panicking. A quick survey of the situation will tell us if a tiger is about to consume us, there after we Shut the Book. No more ruminating on stories of how we are in Danger, or remembering why we are panicking. Just close the book. There is No Danger full stop, end of. We must be strong with Maisie she nags and nags and asks to open the book and start reading all the tell tail signs that we are in impending doom and need to get out. Its all a trick served up by an over eager part of our brain.

It is important also to avoid a further trick. How many years have we been writing and exploring that Story book. Was there ever an end or does it go on forever? OCD is like that, we get locked in a thought and can't escape. It just goes around and around with no way out. We get tricked into the Book cos we believe we just need go around one more time and we finish the book, just one more page and we are there. It is endless... Just Close The Book! For this meditation is the most helpful approach. Close the book and enter Present Moment / Mindfulness (same thing) is the key, but will take a lot of daily practice to get good at.

3. Once we have closed the book Maisie the Amygdala is all alone. She doesn't have ammunition, there is just the feeling of panic. It is horrible, it is dreaded, it is what we have been trying to avoid perhaps for many decades. We are very unused to looking at panic because with The Story behind her Maisie has always dressed up Panic to mean the end of the world. But, we have a quick look around at other people being calm in our most feared situation and see there is no real tiger pouncing and we know Maisie is playing her attention seeking trick again. Once we feel that feeling of fear isolated from The Story we then ask Maisie to give us more. Crazy but this is the last thing she expects. We want as much fear as we can get. Feel it flowing through us, let it come, bring it on. We can be a bit crazy as we know there is no real danger! Ask: how much can there be, how bad can this get? Without The Story we know there is no Danger here, there is just a feeling caused by an overactive part of our brain. That feeling, that fear itself, can do us no harm. Our body may feel it is about the explode, our heart racing, sweating, blood draining but no harm is present and we perfectly safe. It was only ever The Story that made us believe there was a threat.

We can add a twist to this which links to stage 4. Often panic makes us very shut down and enclosed. We feel we are alone and this actually helps Maisie the Amygdala take control of us. Without other people we can really get stuck in The Story and dig ourselves as deep as we like with no way out. Other people are really important to break outside the boundaries of our self. It is after all watching other people being cool in our worst situation (maybe a plane or a meeting) which gives us one of our biggest clues that it is only our problem we are facing and not a real danger! Metta meditation is a truly healing practice which everyone should do regularly. It is the key to happiness, but will take daily practice to really get to work. In this meditation we wish ourselves and other people well being and happiness. It takes practice, especially if we have a negative approach to our self or other people which we probably do with all Maisie Amygdala's anxiety and fears around. When we feel panic it is very useful to become a bit of the hero and imagine we are feeling the fears of everyone who is struggling with our problem. Imagine there is only so much fear in the world and someone has to feel it. Since we are panicking we may as well be the one who is emptying the pot of panic so that other people can be freed from the problem. This works. Perhaps it works because secretly by helping other people we are actually stepping beyond our self which helps us get one up on Maisie the Amydala who only has control over our own brain and body. We can go beyond that and connect to other people - we are really infinite but get trapped inside our very narrow view which helps Maisie enormously.

4. The final stage is not really necessary but is a very nice end to a panic episode. We are panicking. We are stubbornly just taking it, sitting there with the storm flying off all around us. We want to open The Story and read about how bad this situation is and how much danger we and other people or in, but we are keeping the Story firmly closed. We can quickly check for tigers if we must and see that actually everything is safe, but really we should be just knowing stubbornly that we are safe full stop and not checking. We are feeling that panic feeling that has been so terrible before as just what it is a feeling, with no danger associated. We are just over reacting. We are exploring just how much fear is there, asking our Amygdala to give us it all.. what is really behind this door of fear we have run away from for so long. We are also beginning to link to everyone else who feels fear and helping them by letting their fears run through us as well. Together we are beating this. I am beating this not just for me but for everyone.

And then quite remarkably in the midst of panic that seems like it will crush us, with thoughts of "I can do this" "I can make it" "I'm about to give us" "this is the most awful thing anyone has ever experienced"... and through it all we just sit there and want more stopping intrusive thought that try to confirm our worst fears holding The Story book firmly and stubbornly closed... trying to connect to other people through the wind and driving rain that is obscuring our view... suddenly we realise that we are ok. The situation that seemed like the end of the world, that we needed to escape with such desperate urgency and dread is now just ok. We are like other people again sitting peacefully in our worst situation. It won't last Maisie the Amygdala will have another go, this is her reason for existence after all. But we go through it again. Don't run away, close the book, ask for more of that feeling until there is none left, drain the world of panic so that other people can be free from this soul destroying dread. And within a week of sitting through panics we learn very fast that really there is nothing to be afraid of with Maisie the Amydala. She is just an organ like any other and she has this effect, it is no longer the end of the world. We can panic and be left unharmed by it. Next then when we are calm if we want to start reading The Story again and exploring it, but never again will we let Maisie take that story from us and start driving the show. we are in control of The Story and we decide when things are dangerous Not our Amygdala!

Good luck.