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Tag: panic attacks

March 3, 2014

According to this study published in the September 2009 issue of the Journal of Neuroscience, researchers identified a major connection of nerve fibers between the prefrontal cortex and the amygdala as playing an important role in the severity and reduction of anxiety in people.

 

The strength of the connection called the uncinate fasciculus (UF) was inversely correlated to the severity of anxiety in people. Using functional magnetic resonance imaging (fmri) and diffusion tensor imaging (dti) the researchers where able to test the strength of the connection with 20 healthy subjects.

 

In order to understand how the uncinate fasciculus plays a role in anxiety and panic attacks, you have to understand the relationship between the prefrontal cortex and the amygdala in the human brain.

 

The prefrontal cortex is located in the frontal lope region of the brain and is also located directly behind the forehead. The prefrontal cortex is responsible for planning for the future, short term or working memory, organization of thoughts and problem solving.

amygdala-prefrontal-cortex

The amygdala is located in bottom of the temporal lope region of the brain, close to the brain stem. The amygdala has been called the emotional center of the brain, but is also more known for the processing of fear. The popular theory regarding the role of the amygdala and fear is that its location, so close to the more autonomous region of the brain, increased our survival rate as early humans in the wilderness. Meaning that if we became frightened for our lives, the distance between the amygdala and the brain stem was so small that it allowed our more autonomous or primitive brain to spur the body into action before we actually processed what was going on.

 

 

 

 

You can witness this phenomenon in this youtube video of top ten pranks.

A good prank, will trigger the fear response in a person, at which time that person will resort to his or her natural response to the perceived threat without thinking about it.

 

So back to the study regarding the nerve connection between the prefrontal cortex and the amygdala. The researchers, by introducing test subjects to fear arousing stimuli, were able to test the subjects reactions by tracking the signals sent through the unicinate fasciculus (UF) from the amygdala to the prefrontal cortex. According to the results of the study, it appears that the stronger and thicker the UF in a subject was, the faster the amygdala communicated with the prefrontal cortex and the less severe the subject’s experience with anxiety was. This also means that a thinner UF, meant a slower and weaker communication between the amygdala and the prefrontal cortex and increased experience of anxiety in subjects.

 

The results of this study would make sense, given that the amygdala is the emotional center of the brain and with it’s location in the primitive brain region it would stand to reason that reduced communication with the prefrontal cortex would increase the likelihood of reactivity, mainly a fight or flight reaction. Further, given that the prefrontal cortex is primarily responsible for rational thought processes, it would also stand to reason that increased connection between the prefrontal cortex and the amygdala would increase a more rational and calmer response to fear.

 

As a former soldier, I can testify from first hand experience that the military through repeated exposure and repetition in drills teaches soldiers during combat training on how to exercise calm during life threatening situations in order to make rational decisions.

 

Now it could be that such trainings,could lead to soldiers developing a stronger connection between their amygdala and prefrontal cortex for situations that would trigger panic in the average person. However, could the same measure be applied to people who suffer from panic attacks?

 

Could there be some sort of training regimen that panic attack sufferers could benefit from, which could lead to their ability to induce calm at the onset of an episode?

 

In my upcoming ebook, “How to End Your Panic Attacks” I will introduce the reader to six cognitive behavioral strategies designed to help people bring their episodes with panic attacks to an end.

 

I currently have a publication date for the end of March.

 

Ugo is a psychotherapist and life coach.

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February 23, 2014

What we believe helps or hinders our ability to get past fear.

I recently came across an article that discussed how scientists at Cold Spring Harbor Laboratory discovered a pathway that links to the memory of fear in the amygdala to the brain stem which controls behavior.

I was disappointed when I read the post because the role of the amygdala as a memory bank for strong emotional support like fear is old news, and it has also been long theorized that the amygdala’s proximity to the brain stem, makes it easier for us to resort to immediate action under life threatening situations, real or perceived.

The article also discussed the discovery of neurons that are central to learning fear, but then again this is also not surprising. I now suspect that a follow up article will discuss a drug the scientists are working on the help sufferers of chronic fear and panic eradicate their fears.

Regardless, given the the brain has been scientifically proven to the neuroplastic, it stands to reason that for any thoughts which contribute to the learning of fear, there exist opposite thoughts which contribute to the unlearning of fear.

Two popular ways to go about influencing this paradigm change in thinking would be the use of one fear as a motivator to get past the other and extinction through exposure.

It Takes Fear to get Past Fear

This is by far my favorite thought influence I use with clients. For example let’s say I want to get a parent to set firmer and healthier boundaries for her child, and that parent is reluctant to do so because she does not want to experience any conflicts with her child in the immediate future. I then paint a picture for the parent regarding what her relationship with her child will look like during that child’s adult years if the child’s behaviors continue to go unchecked.

This works about 99% of the time, as because that parent comes to hold her child’s future as more valuable than her child’s present anger with  her, she uses her fear of setting her child up for failure in the future to push past her child’s anger towards her in the immediate future.

Exposure to Discomfort = Comfort

With exposure, it becomes a matter of chronically being exposed to an undesirable situation which forces the brain to reevaluate and downgrade it’s original threat assessment of the situation. A good example would be using exposure to help a person get past her fear of spiders. Perhaps initially the person is introduced to spiders at a museum, and the person gets to view the spiders through a glass enclosure. Then the next step would be to have the person view the spiders outside of the glass enclosure, building up to when the person is able to hold the spider in her hand.

In my upcoming ebook on how to end panic attacks, I discuss in detail how to use these thought paradigms to bring panic attacks to a stop. I also discuss other specific cognitive behavioral strategies, I have successfully used with my clients to bring panic attacks to a stop. The ebook is near completion with a release date of March 31st.

Ugo is a psychotherapist and life coach.

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February 17, 2014

Jay Gottfried a senior researcher for this study on sleep and the memories of fear, is quoted for saying to the extent, that we form memories more strongly during sleep. The study by Gottfried and his associates had to do with getting subjects to unlearn fears during their sleep. First, using by conditioning, they paired two pictures of faces with painful electric shocks to volunteers, (seriously who volunteers for this?). During the experiment, certain odors also accompanied the faces seen, while receiving electric shocks.

 

Then they later introduced the subjects to the faces which they had seen while been shocked. Gottfried and associates noted that the subjects experienced fear upon seeing these faces, which were measured through sweat and other physiological responses. The next stage of the experiment involved getting the subject to unlearn their fear of at least one of the faces. This was done by introducing subjects to the specific odors during deep sleep, they had been introduced to while seeing faces paired with the odors and receiving electric shocks.

 

The result, subjects stopped eliciting physiological fear responses to certain faces, whose paired odor they had smelled in their sleep. They also had no memory of being reintroduced to the odors in their sleep. So if a face of Denzel Washington was paired with a lemon scent while receiving electric shocks, then being introduced to a lemon scent in deep sleep without electric shocks, led to the brain learning to no longer fear Denzel Washington’s face.

 

I have written before about how sleep promotes learning, and I even have some cognitive strategies which  I have  introduced to clients to practice fifteen minutes before bed time so as to increase the likelihood of their learning the strategies in their sleep to get them past specific issues. I will be introducing this strategy to readers in my coming ebook on how to end panic attacks.

 

So the idea that sleep can be used to unlearn fears is a phenomenon that I have believed in for some time. However for sufferers of panic attacks, what type of fear needs to be unlearned? In a previous post in which I debunked two common myths of panic attacks, I spoke about how panic attacks are related to ongoing small traumas,  we have become conditioned to create for ourselves.

An example would be growing up with an abusive parent and finding yourself in an abusive relationship as an adult. While the idea of being with an abusive partner may not be sufficient to provoke a panic attack, the idea of being unloved or unlovable certainly is.

The proposed point is this, perhaps panic attacks are triggered by the perception of never ending suffering?

 

So in the absence of an understanding of what triggers a person’s panic attack, a simple fear to work on are the reoccurring panic attacks themselves. Think about it, how much of a relief would it be to a panic attack sufferer to be able to experience panic attacks without fear?

Out of curiosity, for those who struggle with panic attacks, what type of fears do you relate to your panic episodes?

 

Ugo is a psychotherapist and life coach.

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February 14, 2014

Typically most clients who struggle with panic attacks I have seen have already been to the emergency ward. Why? They found themselves experiencing heaviness in their chest, sharp pains in their chest, dizziness, nausea accompanied by a rapid increase in heart rate. Which led them to conclude that they were experiencing a heart attack, which led to trip to the emergency ward.

As you might have guessed, in all of the stories I have heard. they were all informed that their hearts were  just fine and that they had indeed experienced a panic attack. Panic attacks and heart attack symptoms are so similar that even a former client of mine who had experienced a heart attack, struggled to recognize the difference between the two.

So here are the differences between panic and heart attacks.

Chest Pains

During heart attacks, chest pain is begins in the middle of the chest. Survivors will describe this as a feeling of heaviness in the middle of the chest which compromises their breathing. The pain will sometimes radiate to the left arm, neck or back and will last for about fifteen minutes plus.

During panic attacks, the pain is localized just above the heart and doesn’t move. The pain is usually reported to come and go as the sufferer breathes and will last for less than ten minutes.

Nausea

During heart attacks, sufferers experience nausea which is immediately followed by vomiting and sometimes diarrhea. While during panic attacks, sufferers do experience nausea, but with no vomiting.

Hyperventilate

Heart attacks sufferers do not hyperventilate unlike sufferers of panic attacks who do hyperventilate.

Onset

Then there is the most defining of characteristics, which is the onset of the attacks. With heart attacks the onset is gradual and will last for hours during which the intensity of the pain and general discomfort becomes more severe. With panic attacks the onset is sudden and the intensity and severity of the pain and discomfort are high from the start and remain that way for about five to ten minutes, after which it slowly goes away. For some panic attack sufferers they report that the attack goes away as suddenly as it came.

This would make sense given that in most cases the panic ends only because the hormones producing adrenaline have become depleted, thus leaving the body no choice but to return to it’s former state. In most cases with panic attack sufferers this former state maybe a state of chronic anxiety.

Regardless, even if you recognize yourself as going through a panic attack, it is always advisable to have a medical doctor give you a thorough physical, for the sake of ruling out any medical issues.

In my next post, I will discuss how an contradictions between our realities and our thoughts can lead to chronic anxiety and panic attacks. 

Ugo is a psychotherapist and life coach.

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February 10, 2014

In looking through research for my ebook, “How to End Panic Attacks”, I have become accustomed to finding false information on websites about panic attacks. These false pieces of information have become so redundant that I have broken them down into two myths.

Myth #1 Anxiety Attacks and Different from Panic Attacks.

For example, I came across a question and answer post in which the doctor  discussed the difference between anxiety attacks and panic attacks. The author described anxiety attacks as being triggered by frightening stimuli, with the attack expiring once the shock over the stimuli is over or once you have gotten used to the stimuli. An example would be if you were startled by someone walking up behind you, your feelings of shock would go away once you turned around and saw that the person behind wasn’t a threat.

First of all anxiety attack is not an official term, no medical or psychological association uses that term. Often times when people do use the term anxiety attacks, they are referring to panic attacks, so there lies no difference between anxiety and panic attacks.

 There is a difference however between generalized anxiety and panic attacks. While people who do suffer from generalized anxiety do experience unpleasant physiological symptoms, these symptoms are nowhere as acute and as severe as panic attacks. It is also important to note that people who do suffer from panic attacks also suffer from chronic generalized anxiety between panic attacks, however not everyone who suffers from generalized anxiety suffers from panic attacks.
Myth#2 Panic Attacks Happen for No Reason
Another post I came across then goes on to describe panic attacks as unexpected physiological arousal as evidenced by rapid heartbeat, chest pains, increased blood pressure, etc. that occur for no reason. Just about the only thing the author got right was his description of panic attacks, now I shall address this second myth that panic attacks happen out of the blue. From my experience as a psychotherapist, most people who come in to seek help are clueless about how their past and present experiences have brought them to their current boiling point. They will usually proclaim that their experiences with panic attacks usually come out of nowhere. Just this idea that panic attacks come out of nowhere is anxiety provoking by itself and can itself become a triggering thought for future panic attacks with sufferers.
The best way to debunk this falsehood is to present the analogy of the boiling lobster. Put a lobster in a pot of boiling water and that lobster will resist the water with all it’s might, but put that same lobster in cool water, which you gradually heat to boiling point, and that lobster will not notice that it is being killed.
This is the best way to understand how panic attacks work, most people who suffer from panic attacks have been immersed in traumatic situations their entire lives and they don’t know any different. What’s even worse is that since their brains have become wired to exist in these traumatic situations, they seek similar situations in their adulthood. Unfortunately, much like a heroine user’s brain has become wired to survive on heroine, the point of diminishing return is always inevitable with prolonged exposure.

The good news is that the brain is neuro plastic and with understanding of oneself and triggers, people can learn to bring their experiences with panic attacks to an end and live more meaningful and purposeful lives.

Ugo is psychotherapist and life coach.

 

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February 7, 2014

Are panic attacks caused by genetics? Perhaps a singular mutated gene, or a host of multiple genes that trigger recurring panic attacks under certain conditions?

The problem with proponents for gene based illnesses and disorders is that they are usually right by accident. No doubt there are certain illnesses and psychological conditions that are caused by mutated genes, but my experience in industry has taught me that this most likely isn’t the case with panic disorder /panic attacks.

First, I say that proponents of the gene theory with panic attacks are right by accidents because our genetic factors play a constant role in our lives, specifically regarding to how we psychologically and physiologically respond to stimuli in our environment.

Even this article which calls for more research into the relationship between genes and panic disorder admits that evidence presented so far has been weak. The article goes on to list the types of studies and their outcomes which have been carried out to discover a link between  genes and panic disorder.

To the extent I believe panic disorder to be genetic is based on the bio psychological disposition of an individual. More specifically, our genetic makeup determines the outcome of what illnesses and issues we are going to experience upon exposure to extreme and prolonged stress. For example, not all soldiers who experience combat develop PTSD, and not all soldiers with combat experience who don’t develop PTSD, go illness free. While PTSD is the most prevalent, other psychological illnesses that arise are obsessive compulsive disorder, panic disorder, etc…

The same phenomenon can be observed with a person whose childhood experience was traumatic. While that person may have developed panic disorder as a result of his or her ordeal, that person’s siblings may also struggle with panic disorder or other psychological illnesses, most commonly drug and alcohol addiction.

I don’t believe that there is a specific gene that causes panic attacks, I believe that panic attacks are a result of the brain improperly wiring itself in response to a prolonged and painful traumatic stressful experience, which results in panic attacks once triggered by certain types of stimuli.

 

Ugo is a psychotherapist and life coach.

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February 6, 2014

This post discusses whether or not panic attacks are linked to heart attacks. I believe the relationship between panic attacks and heart attacks is a by product of the relationship between stress and heart attacks. If you notice in the article the researchers expressed being baffled by the low rates of people with panic attacks, actually experiencing heart attacks when the numbers where compared to the general population.

 

 

I agree that panic attacks are related to heart disease but I do not believe there to be a direct correlation. Especially given that there exists numerous research studies linking stress to heart attacks and the number one cause of panic attacks is stress.

 

 

Given that higher experiences of stress leads to prolonged production of the steroid hormone cortisol, it is also important to note that some of the symptoms of prolonged cortisol in the body is high blood pressure, low immunity and blood sugar imbalances to name a few. The identified symptoms of prolonged stress lends significant explanation to how stress, if left untreated can lead to heart attacks.

 

 

So if you are experiencing panic attacks it does not mean that you are experiencing a heart attacks, even if it feels like it. It stands to reason that it is not the panic attack that will kill, but prolonged stress likely will. Another aspect of this article on panic attacks and heart attacks I would like to point out is the hyper focus on the biological aspects of panic attacks.

 

 

Panic attacks are psychological phenomenons, caused by pent up distress, and triggered by old traumatic experiences. This is why as a psychotherapist, I have experienced a high rate of success getting people to bring their experiences with panic to stop, without any need for medication. Just about the only group of people with whom this feat is particularly challenging are people in recovery from traumatic brain injury, and this is because the brain is still in the process of slowly requiring itself.

 

 

The good news is that people can learn to bring their experiences with panic attacks to a stop and also practice cognitive strategies to prevent future attacks.

 

 

Ugo is a psychotherapist and life coach

 

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February 3, 2014

I saw a YouTube video clip of a reporter being threatened by a congressman. The congressman became angered by the reporter asking him questions about an ongoing investigation into his campaign finances, and threatened to throw the reporter of a balcony.

The next news clip showed the reporter on a cable news show describing the incident in the most passive manner he could. For example, when asked for his version of the story, he began by stating that the congressman “seemed angry.”

I am strong advocate for tact, but there is a thin line between being tactful and being fearful. My intention is not to blame the reporter here for being  threatened, but how many people can relate to being part of a bullyish workplace culture? Where you are expected to conform to a culture of tolerating disrespect and bullying from others for the sake of not getting your pay check disrupted?

That kind of stress builds up and over time it creates health issues for others. I wouldn’t be surprised if the reporter was encouraged to take a passive stance on the issue by his employers, for fear of being denied access to the congressman and other politicians. Sadly, but that kind of conformity is irrational and humiliating.

So why do people do it? Why do people conform to certain standards that go against their best interest? The reality is that most of us have been conditioned from an early age to follow the leadership of certain members of authority regardless of how  immoral or unethical that leadership is, with the promise that after all is said and done, we will be rewarded with______.

What if you came to believe that there is no reward from being a blind follower? What if you came to believe that you can create your own reality where you can advocate for yourself without detriment to your ability to provide for yourself? As a soldier I once had a senior officer come into my supply shop to bully me into giving supplies without signing them out. I always told him no. Then one day he took the direct route and pointed to the rank on his collar and asked me if I knew what that meant. I then invited him into my office where I was candid with him. I politely asked him not to harass and intimidated again, or I would file a formal complaint. He apologized and it never happened again.

Conformity is overrated, people then to put their trust in others while conveniently forgetting that there are no guarantees in life, which only calls for us to do the best we can without over thinking consequences.

Regardless of the obstacles we face, we have the ability to create our own realities, so if you want a workplace culture where you are treated with respect and dignity, you can make that your reality. In this previous post, I discuss how two types of thinking patterns shape our reality.

 

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January 24, 2014

To bring about real change in your relationships, you have to have a clear understanding of who you are and how you relate to the world around you, this process is counter intuitive because you have to learn to accept yourself unconditionally, before beginning the process of change. This is because in any relationship you find yourself in, you are the only variable which you can control.

Life is about relationships, from friendships, work, to our more intimate relationships, it is easy to recognize flaws in others and how these flaws have played a role in the failures we have experienced in our relationships. In most cases where people readily point out the flaws in others they are usually accurate, unfortunately pointing out the flaws in others when it comes to evaluating our flawed relationships is really a small part of the equation.

Let’s say you have experienced a string of poor work experiences, and you have one horror story after another to tell about supervisors and coworkers from hell, it would then become a fair question for someone to ask you how it was you came to routinely find yourself in those bad situations? If you were cognizant enough to realize that these were bad work places then it stands to reason that you should have been cognizant enough to recognize that you were not fit to work at these places before applying for the job.

Perhaps it is you, pertaining to how you relate to the world around you and those to whom you are drawn to? Regardless, if you have found yourself in a string of bad relationships it is long overdue for you to recognize and accept your personal flaws.

A man out of the group in the queue

When it comes to how we see ourselves, some people have a blindspot. This blindspot results from our innateness as social animals to fit in and belong with the larger group. So if you happen to have been raised in an environment where getting in line with everyone else was the expectation, the idea of who you are, is probably significantly different from who you really are. In today’s world, mass media plays a very influential role in getting others to embrace identities that don’t fit with who they really are. This is done by exemplifying certain types of people in a positive and flattering light, while barely mentioning others.

If you are a chronic consumer of media, and you want to see yourself in  a positive light, if stands to reason that you will come to mold your identity after those being modeled. The problem with this is that you would be focused on trying to address problems that don’t pertain to you, which only creates more problems for you.

So how do you learn about yourself? Well, on a personality level you can take a personality test like this one, or this one. Secondly, regardless of the outcome of any personality test, learn to present yourself as you are to others around. Specifically, practice being brutally honest with yourself and others at all times. Being brutally honest doesn’t mean that you tell everyone about your private affairs, but it means that you should become more cognizant of the narratives you tell yourself and others in an effort to blend in.

Our subconscious always knows the truth, and this truth about who we really are is always nagging at us at a times. This is why when people are trying to run from who they really are, they make up these false narratives, regarding their past and present in an effort to impress others.

Ultimately, by getting to know yourself and accept yourself, you will find yourself successfully addressing the right problems in your life.

Ugo is a psychotherapist and life coach.

 

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January 22, 2014

What do you do when you are stressed and in a crisis? The best stories I have heard  when people are in a crisis, are people who choose to collect themselves emotionally before taking decisive steps, rather than being reactive. So why does less equals more in overcoming stress?

One of the worst things we can do in response to stress is to be reactive, because in a state of constant motion, we are most likely to experience cognitive fatigue which leads to a poor thinking and performance in  whatever we are doing.

For example, be it anger management, anxiety or full blown panic attacks, my confidence in a client’s ability to heal increases when that client buys in to the counter intuitive approach of practicing getting plenty or rest and calm, so as to cease being reactive to his or her experiences with stress. Once the reactive habits have stopped, my prognosis for the client increases ten fold.

This is why rest is important, and also why most people find themselves most productive in the morning after a good night’s sleep. In the video below, I further explain the counterintuitive approach about why less equals more in overcoming stress.

 

Ugo is a psychotherapist and life coach.

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