Stressful times call for

SELF CARE

Stress lands on all of us. The key is to find ways to beat it. The answer is often found in the right diet and sensible planning.

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PANIC ATTACK SYMPTOMS AND STRESS SYMPTOMS

These days, words like stress and anxiety contain a host of negative associations. They make us think of exams and injections and failing to achieve that seemingly impossible goal of work-life balance. But both stress and anxiety are normal, healthy, even necessary bodily functions? It’s true.

Stress and anxiety help keep us alive. They are the reason we go to work or school in the morning as well as the reason we don’t all just wander off into traffic. The key is balance. While a certain amount of stress and anxiety keep us moving forward in our lives, too much can make us unhappy, unable to function, and seriously ill.

A panic attack may come on suddenly, giving you feelings of being overwhelmed.

Let’s take a moment to learn a little bit more about what stress and anxiety really are and why having some, but not too much, of both is crucial to good health.

A Stress Definition

Simply put, stress is your body’s response to potential danger, such as a speeding bus bearing down on you, or a demand, such as the need to do well on an exam. Basically, it’s your body’s way of telling you something has to change in order for you to stay safe or achieve your goals.

Good vs. Bad Stress

Stress is good when it motivates you to meet life’s challenges and keeps you safe. The stress that induces you to step out of the way of that speeding bus or study for that crucial exam is good stress. When you are so worried about doing well on the exam that you can’t concentrate enough to study, or freeze when it’s time to start writing it, that’s bad stress. An anxiety attack could be described as bad stress.

The thought of taking an exam can produce both “good stress” (studying for it) and “bad stress” (a severe case of nerves during the test).

In general, stress is useful in short bursts, such as the amount of time it takes you to show your boss that you deserve that promotion or avoid that mean-looking dog. Stress that hangs around for much longer periods of time, such as stress associated with years of worry that you might lose your job, is called chronic stress. Chronic stress causes significant wear-and-tear on your body and, left unchecked, can result in illness and disability.

Stopping a Panic Attack

While panic attacks are a truly horrible experience, the good news is that there are techniques that can stop them in their tracks. One of the most effective is deep breathing. Panic attacks are often driven by hyperventilation—or breathing too quickly. Learning to slow down your breathing and to take deep, slow breaths actually tells your brain to silence those alarm bells. Whether you’re in the midst of a panic attack or just having an anxious day, deep breathing should help you feel better within a few minutes.

Try the 4-7-8 deep breathing technique:
1. Inhale slowly through your nose to the count of 4. Be sure to fill your lungs and feel your belly expand.
2. Hold your breath while you count slowly to 7.
3. Slowly breathe out through your mouth to a slow count of 8, making a whooshing sound.
4. Without pausing, start breathing in again through your nose to the count of 4.
5. Repeat several times until you feel better. Don’t stop if you don’t feel better immediately, as it can take few minutes before you feel the effects.

An Anxiety Definition

Anxiety is an emotional response characterized by feelings of tension and worry often combined with physical changes, like an increase in blood pressure. It is perfectly normal to experience anxiety in response to stressful circumstances. For instance, it’s pretty normal, even healthy, to feel anxious when you hear someone break into your house. Many people will also feel anxious about challenges such as making important presentations at work or learning to skydive for the first time.

Normal vs. Abnormal Anxiety

As with stress, good or bad anxiety is really a matter of degrees. Everyone feels anxiety, and it’s pretty easy to manage when it pops up only when we are facing real dangers or challenges, never becomes overwhelming, and then drifts away once we have overcome what we need to. Anxiety is abnormal and problematic when it seems to have no real cause, when worry seems to take over your life, when you can’t help but worry about very minor things (did that stranger give me a funny look?) or that something pretty unlikely is going to happen to you (will I be the victim of a terrorist attack?). Anxiety is also a problem when it’s overwhelming. The most extreme form of anxiety is called panic. Panic attack symptoms can prevent you from functioning at all.
Let’s look a little bit at how stress and anxiety affect the body.

Signs of Anxiety and Signs of Stress

Stress is often described in the context of the body’s fight or flight response. That is, in the presence of a danger, your body prepares to face the danger (fight) or run away to a safe place (flight).

Fight or flight: the way your body reacts when facing danger.

In order to prepare you for action, your body has to make some quick changes. This starts with an increased production of the stress-related chemicals cortisol, adrenaline and noradrenaline. These speed up your breathing and heart rate, providing much-needed oxygen to the brain and muscles to prepare them for action. Your overall body metabolism speeds up. Non-essential bodily activity, such as digestion and immune function, are temporarily suppressed so that body can focus all its energies on dealing with the task at hand.

Symptoms of Stress and Anxiety

The changes in your body that occur as the result of the presence of a stressor (that is, something that produces stress) produce all the symptoms that we associate with being stressed or anxious. These include:

• Fast heart rate or palpitations
• Dizziness
• Nausea or butterflies in the stomach
• Sweating
• Trembling
• Numbness or tingling
• Chest pain
• Pulsing in the ears
• Burning skin
• Shortness of breath
• Weakness or wobbliness in the legs

What Is Stress? Its Impact on Health

Our bodies are designed to take the “hit” of short-term stress and anxiety. We adapted for an environment where we might have to run from a hungry animal or work hard to obtain food to feed ourselves and our families. What our bodies are less able to handle is long-term stress and anxiety, the kind of stress that eats away at you over months and years. This is the kind of stress that, if you don’t learn to manage it, can promote poor health.

Stress pushes the cardiovascular system to work harder, getting oxygen-rich blood to the brain and muscles in times of need. When this stress response is continuous or when it keeps being triggered over and over every day, it can cause excessive wear and tear on your heart and blood vessels. Long-term ongoing stress can increase the risk of high blood pressure, heart attack, and stroke.

Stress causes the muscles to tense up, making them ready for action. But chronically tense muscles can lead to tension or migraine headaches. It can also lead to pain in your neck, shoulders, back, or wherever you happen to store your tension.

Your hormonal or endocrine system is also vulnerable to chronic stress or anxiety. Constant release of stress hormones triggers your liver to release sugar into the blood. It’s another way your body provides the energy needed to fight off or flee danger. But for some people, all that extra sugar can increase the risk of developing type 2 diabetes.

Many people feel the effects of stress and anxiety in their stomachs. Anxiety attack symptoms include stomachaches, diarrhea, heartburn, and a host of other gastrointestinal (GI) complaints that stem from too much uncontrolled stress or anxiety.

Your immune system also takes a hit from chronic stress and anxiety. Your body diverts its energy away from the immune system while it prepares to fight or flee the perceived danger at hand. It’s not unusual to find that you get sick more often or take longer to get over illnesses when you are stressed or anxious a lot of the time.

Chronic stress appears to contribute to the production of all-over inflammation in your body. This can trigger or worsen illnesses in which inflammation plays a key role, including asthma, heart disease, arthritis, depression, and autoimmune conditions like multiple sclerosis and lupus.

Finally, all that energy spent worrying and unconsciously preparing to fight can leave you feeling drained. Chronic fatigue is a common effect of being constantly stressed or anxious.

ANXIETY DEFINITION, CONTINUED…

When anxiety goes beyond the normal worries and concerns of everyday life, when it is intense or frequent enough to cause significant distress and affect your ability to function and enjoy your life, you may have an anxiety disorder.

Let’s look at the main features of some of the most common anxiety symptoms.

Generalized Anxiety Disorder (GAD)

Someone with GAD feels excessive anxiety or worry about a wide array of activities or events (or potential events). The level of anxiety is out of proportion with the actual risk. So, for instance, someone with GAD might be sick with worry about going canoeing for fear of drowning, even if she is wearing a lifejacket, knows how to swim, and is accompanied by a lifeguard.

Typically, people suffering from GAD find it difficult to control their worries, and worrisome thoughts become so intrusive that they find it difficult to get on with the everyday tasks of life. A mother, for instance, may worry so much about the risk of car accidents that she finds herself unable to pick her child up from school.

Concerns that are only mild annoyances for some, such as good job performance, getting chores done, or being late for appointment, can be overwhelming for someone with GAD. The specific things that a person with GAD may worry about can change from time to time. What remains constant is the tendency to worry excessively.

According to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM V), the anxiety and worry associated with GAD manifest as three or more of the following six anxiety symptoms:

• Restlessness or feeling keyed up or on edge
• Being easily fatigued
• Difficulty concentrating or mind going blank
• Irritability
• Muscle tension
• Sleep disturbance

Separation Anxiety

Typically affecting children, separation anxiety occurs when they experience excessive fear or worry upon leaving home or separating from those they are most attached to, often their mother or other parent or primary caregiver. Most young children show at least some hesitation or distress when separating from a parent, and it’s pretty normal for young children to cry when being dropped off at daycare or preschool. A child with separation anxiety, on the other hand, will be far more upset than other children their age when facing the same type and duration of separation.

A child with separation anxiety may cling to his mother even when she is present and refuse even to be in a different room from her or let her out of his sight. Bedtime can be a particularly difficult time, and the child may refuse to sleep alone or at least fall asleep while alone. For older children, refusal to go to school or experiencing significant anxiety while at school due to separation can affect academic performance. While some children go through phases of being deeply distressed when they separate from their primary caregiver, a child with separation anxiety will express this distress consistently over weeks or months.

Other features of separation anxiety listed in the DSM V include:

• Worrying that some type of harm may come to their primary caregiver
• Worrying that something will occur (e.g., kidnapping) that will separate them from their primary caregiver
• Refusing to go places because of fear of separation
• Refusing to sleep away from home without their primary caregiver
• Recurrent nightmares about separation
• Recurrent physical complaints, such as stomachaches, associated with separation or anticipated separation

Phobias

A phobia is an intense fear related to a specific situation or object. It is out of proportion with the actual risk present. Fear of spiders, known as arachnophobia, is a classic and common phobia. While most house spiders are perfectly harmless, few people would be willing to let one crawl onto their hand and many rush out of the room in terror when they see one, even if they know for a fact it is not dangerous.

Phobias are extremely common and generally pose no significant challenges to everyday life. A fear of snakes is not generally going to keep you from doing your job, taking care of your children, or having drinks with friends. But phobias do pose a problem when they are directed at objects or situations that are difficult or inconvenient to avoid in everyday life. Phobias of thunderstorms, heights, or elevators are some common examples.

Fear of, say, spiders may be a harmless phobia, but if the sight of elevators elicits panic in you, you may have an unhealthy phobia—one that may cause problems in personal or business life
or emergency situations.

Some people also suffer from several phobias, which together can severely limit their life.

Others have severe phobias that prevent them from doing things they really need to do. For instance, fear of injections can prevent people from accepting needed medical therapy or fear of elevators can prevent people from going places they need to go in order to do their jobs. In these cases, the fear is so overwhelming, it overshadows very real and rational concerns about not receiving needed treatment or losing one’s job.

People with phobias know their fears are irrational. Telling them that a spider is not dangerous or that it is “probably more frightened of you than you are of it” is of no help whatsoever. They may, however, associate greater risk associated with their feared object than is realistic. People who fear flying, for instance, may believe it is actually more dangerous than it really is.

Panic Attack Symptoms

If you’ve never had a panic attack, it may not be possible for you to imagine or understand how intense they can be. When you are having a panic attack, your whole body is in five-alarm mode, convinced that you are in life-threatening danger.

Panic attacks usually start abruptly, with a sudden surge of overwhelming, intense fear that peaks within seconds or minutes. They can come seemingly from nowhere. In fact, some people have panic attacks upon waking from sleep or while in a deeply relaxed state.
Symptoms of a panic attack can include any of the following:

• Pounding heart or palpitations
• Ringing in the ears
• Sweating, sometimes profuse
• Trembling or shaking
• Feeling like you are choking or not getting enough air
• Difficulty controlling your breathing
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, lightheaded, faint, or unsteady on your feet
• Feeling very hot or cold (or alternating between the two)
• Numbness or tingling in the extremities
• Feeling detached from yourself or reality, like you’re in a dream
• Feeling like you are losing control or going crazy
• Intense feeling that you are about to die

While an individual panic attack usually lasts only a few minutes, some people experience episodes of repeated panic attacks that can last for hours, with intense feelings of anxiety in between.

Panic Disorder

Panic disorder occurs when people experience recurrent or unexpected panic attacks. The frequency and severity of such attacks varies widely, from several attacks daily to the occasional mild attack every few weeks or months. An important characteristic of the condition is that people fear having another attack and may avoid objects or situations that they think may provoke one. There are many reasons why fear of panic attacks develops. The attacks themselves are decidedly unpleasant and often make people feel like they are dying, going crazy, or losing control.

People may also fear the social embarrassment associated with panic attacks, worrying that they may do or say something seemingly “crazy” during an attack or behave inappropriately out of a need to escape a situation producing an attack (e.g., walking out in the middle of a dinner party or important meeting). As a result, people with panic disorder may turn their lives upside down in an effort to avoid things that may trigger panic or situations they cannot easily escape from. Some may refuse to leave their homes, resulting in another anxiety disorder known as agoraphobia.

Agoraphobia

Agoraphobia is the fear of being exposed to any situation that produces significant anxiety or panic. Such situations include taking public transportation or airplanes, going over bridges, using highways, being in very open or enclosed spaces, being in crowds, or simply being outside of the home alone.

Generally, the more difficult it is to escape the situation, the greater the likelihood it will produce agoraphobia. In addition to feeling significant anxiety in such situations, people with agoraphobia often worry that something terrible might happen (e.g., the cruise ship might sink) or that they will be unable to escape or have no one to help them should panic set in.
Because of their anxiety, people with agoraphobia actively avoid certain situations, and their fear of these situations is out of proportion with any actual risk that might be present.

Social Anxiety Disorder (SAD) or Social Phobia

People with SAD have an intense fear of social situations, especially if they believe they will be judged or scrutinized by others. So, while a party may produce anxiety, a party in which the person is the guest of honor might produce anxiety so overwhelming it becomes difficult to even enter the room.

While many people feel nervous or awkward in social situations, especially if they do not know the people present, people with SAD can be so overwhelmed with anxiety that they avoid social situations of all kinds. For some, even going to school or work can be a major challenge. When they are able to force themselves into social situations, people with SAD are frequently so paralyzed with fear that they cannot enjoy themselves or even function normally.

Often, people with SAD worry excessively that others will see them in a negative light, perceiving them as anxious, weak, crazy, boring, stupid, awkward, or otherwise unlikable or offensive. Their anxiety feeds into the disorder, since a common concern is that their fear will be obvious to others. While some judgment of others does occur in social situations and people with SAD do typically appear nervous in social situations, their fear of negative judgments is out of proportion with the amount of judgment that is likely to be really going on.

Obsessive Compulsive Disorder (OCD)

While OCD and related disorders have their own category in the DSM V separate from other anxiety disorders, excessive anxiety remains a key feature of this condition. People with OCD have repetitive and persistent thoughts (obsessions) that are out of their control and cause significant distress and anxiety.

A common obsession in OCD is fear of contamination. In order to relieve the anxiety produced by these thoughts, people with OCD engage in compulsive behaviors, such as repetitive hand-washing. If they try to stop these compulsions, the obsessive thoughts and their accompanying anxiety rapidly become unbearable, no matter how much they may try to ignore or suppress them. Often the compulsive behaviors must be performed according to strict rules in order to relieve the distress, and these rules may change over time. So, for instance, a person obsessively worried about carrying germs on his hands may need to wash his hands for 10 minutes with antibacterial soap but over time, this may increase to 15 minutes and require the use of a specific brand of antibacterial soap.

Once a compulsive behavior is performed, a person with OCD will temporarily experience relief, but very soon the anxious obsessions will intrude once again, and he will have to start over. OCD can quickly take over people’s lives, forcing them to literally spend hours a day washing their hands or engaging in other compulsive behaviors.

Post-Traumatic Stress Disorder (PTSD)

PTSD is another disorder associated with significant, overwhelming anxiety that is not officially categorized as an anxiety disorder. Instead, it is included in another category of disorders known as trauma and stressor-related disorders.

In PTSD, a trauma causes people’s natural stress response to go out of whack. They may find themselves constantly in a state of fight or flight or they may be very easily brought to this state. The classic example is the war veteran who is immediately driven into fight or flight every time he hears a loud noise because it brings him back to the trauma of war. Understandably, people with PTSD avoid objects and situations that may trigger memories of traumatic events and thus produce the overwhelming fear, anxiety, helplessness, or horror they experienced in the past.

Anxiety Associated with Medical Conditions

There are several medical conditions that produce biological changes in the body that can result in anxiety. These include:

• Heart disease
• Diabetes
• Anemia
• Infection
• Thyroid problems, such as hypothyroidism or hyperthyroidism
• Asthma
• Irritable bowel syndrome and other types of gastrointestinal distress
• Some rare forms of cancer, which stimulate the release of stress hormones
• Premenstrual syndrome

It can be difficult to determine whether there is an underlying medical cause for your anxiety. You may not be having any symptoms other than anxiety itself. That’s why it’s important to see your doctor if you experience a surge in your anxiety that does not appear to have any identifiable cause.

Of course, the stress of being seriously ill can also produce anxiety. It is pretty normal to feel excessive anxiety if you are diagnosed with a serious disease. That doesn’t mean you have to suffer in silence, however. Your doctor should be able to prescribe treatments to help relieve your anxiety while you come to terms with your diagnosis.

In other cases, people with medical illnesses may experience anxiety as a side effect of the medication they are taking. Some of the medications most likely to produce anxiety as a side effect (either while you are taking it or for a period after you stop taking it) are:

• Asthma medicines (e.g., albuterol)
• Blood pressure medicines (e.g., methyldopa)
• Hormones, including oral contraceptives
• Steroids (e.g., prednisone)
• Thyroid medicines
• Antidepressants (especially when first taking or stopping them)
• Decongestants (e.g., pseudoephedrine)
• Drugs containing caffeine (including some headache tablets and weight loss preparations)
• Stimulants (including those taken for attention deficit/hyperactivity disorder)

Drugs that are used to treat anxiety, such as the benzodiazepine class of drugs (e.g., Valium, Xanax), can also have the opposite effect and produce anxiety. This is most likely to occur if the drugs are used improperly or for too long. That’s why it’s important to follow your doctor’s instructions carefully if you are prescribed an anxiety-relieving drug.

Anxiety Associated with Substance Abuse

Just as with medications, several illicit drugs can produce anxiety. It is also quite common to experience significant anxiety while undergoing withdrawal from a substance of abuse, including alcohol. Drugs of abuse that can cause anxiety include:

• Cocaine
• Crystal meth
• Marijuana
• Speed
• Alcohol
• Ecstasy (MDMA)

DIAGNOSING STRESS AND ANXIETY

As mentioned previously, everyone experiences some degree of anxiety and stress. If you didn’t, you wouldn’t bother to get out of bed in the morning. But some of us reach a point in our lives when stress and anxiety start to get out of control. Maybe a loved one has died. Perhaps you’ve lost your job or need to move. Even positive changes, like marriage, promotion, or the birth of a much-wanted child, can produce enormous stress. This added stress may be more than you can cope with, at least temporarily.

For others, anxiety may appear seemingly out of nowhere, with no clear source of new stress. Maybe you woke up one morning with a panic attack or found yourself beginning to worry excessively about your health or the safety of those you love.

Whatever your story, if you start to find that stress and anxiety are affecting your quality of life, if you just aren’t able to enjoy the things you once did because of intrusive worries or anxiety symptoms, it’s time to talk to your doctor. Don’t hesitate, as left untreated, anxiety disorders often get worse and harder to treat.

Dealing with Anxiety Attack Symptoms: Mindfulness Exercises

If you’d like to see if mindfulness meditation is something that you can use as a tool against your stress and anxiety, try the following simple mindfulness exercise:
1. Find somewhere quiet and comfortable to sit.
2. Close your eyes and take deep, slow breaths.
3. Gently, pay attention to your breath is as you breathe in and out.
4. If you are distracted by a noise, feeling, or thought, simply acknowledge it without judgment. Naming it in your mind helps. Then gently bring your attention back to your breathing.

The key to mindfulness is to be gentle with yourself. It’s normal for your mind to wander or for you to become distracted. In fact, gently bringing your mind back to your breathing is the practice. In other words, without your mind wandering or becoming distracted there is no practice. So, be kind to yourself. Don’t get frustrated or discouraged when your mind wanders, and bring yourself back to your breathing gently, without force.

Talking to Your Doctor

Talk to your doctor about the anxiety symptoms and stress symptoms that are negatively affecting your life. You can be sure that you’re not the first to need help and certainly won’t be the last. In today’s world, problems with anxiety and stress are reaching epidemic proportions, so there is no need to be ashamed or embarrassed. We all need a little help now and then coping with life’s curve balls.

Once you’re ready to talk with your doctor about your anxiety and stress, it’s a good idea to come to your appointment prepared to answer the following questions:

• What is an anxiety definition and a stress definition?
• What are your symptoms?
• How long have you been experiencing these symptoms?
• How do these symptoms affect your daily life?
• Have you experienced any significant life change (good or bad) recently?
• What are the sources of stress in your life?
• How do you like to relax?
• What do you do for fun?
• Is there anyone in your life you feel comfortable confiding in?
• Do you feel as though you may have a social anxiety disorder?
• Do you believe you may have had panic attack symptoms?

Diagnostic Questionnaires

Your doctor may also ask you to fill out some standard questionnaires designed to help diagnose anxiety problems and evaluate how severe it is. Some common questionnaires include:

• Generalized Anxiety Disorder 7-item (GAD-7) scale
• Hamilton Anxiety Rating Scale (HAM-A)
• Zung Self-Rating Anxiety Scale (SAS)
• Primary Care PTSD Screen (PC-PTSD)
• Life Event Checklist (LEC)
• Patient Stress Questionnaire
• State-Trait Anxiety Inventory (STAI)
• Beck Anxiety Inventory (BAI)
• Hospital Anxiety And Depression Scale-Anxiety (HADS-A)

Source: University Health News