Panic Attack Or Going Mad?

Question: My fear is whether I’m having a panic attack or just going mad.  I feel as if there is no way out of this fear.  I could be driving home and I get a feeling over me and I get very scared.  I have not been told by docs that I suffer panic attacks but had blood tests and all come back fine.   What tests are there for panic attacks anxiety…will I ever get my life back to normal?"

Note: You can also print this document in Adobe PDF format by clicking here. (It requires Adobe Reader which you can obtain for free here.)

Answer:

This person should now proceed to a psychologist who can diagnose the panic attacks and anxiety.  He/she will do an assessment as part of their process and can then make the diagnosis.

For the purpose of a learning example let’s say that the above statement was made by an individual with the name John (obviously the person’s true identity will be held in confidence).  What we are going to do is use Cognitive Behavioral Therapy to analyze the thoughts behind the statement to locate the cognitive distortions and then substitute healthier thoughts that can make us feel better.

The key points of the statement are:

“I feel as if there is no way out of this fear.  I could be driving home and I get a feeling over me and I get very scared.”

First I recommend that you click here and look at the list of Cognitive Distortions (Don't worry: A seperate webpage will open up so you don't lose this page and can easily come back) and then try to locate what possible distortions might be present in John’s thinking before continuing to read directly below.  Hint: There is more than one distortion present.  Once you’ve done this, write them down or type them out and then come back to this spot.

Okay, welcome back (I hope you have really given this a try yourself)

If you guessed that the following four distortions are present then you’re right: 1. All-or-nothing thinking, 2. Overgeneralization, 3. Emotional reasoning, 4. Making should statements.

Let’s look specifically at how each distortion is actually present in this statement and then we will look at some alternative more realistic thoughts.

1. All-or-nothing thinking - By stating that there is no way out of the fear (or feeling this way) John is making an absolute statement – which is exactly what All-or-nothing thinking refers to.

2. Overgeneralization – John is taking this episode and generalizing it to the rest of his life, thus making a wide generalization.

3. Emotional reasoning –  Notice one key word that John uses “feel.” This is significant because emotional reasoning is making an argument on the basis of how one feels not on objective evidence.

4. Making should statements – The premise behind John’s argument is that he shouldn’t feel this way when driving home.  The truth is that by beating himself up by stating he shouldn’t feel this way he is actually exacerbating his anxiety.  (Should statements refer to the way one thinks a situation should unfold rather than the actual situation one is faced with.) 

Now let’s try to generate some alternative, more accurate thoughts that we can substitute in place of the ones containing distortions.  Again, before reading on, try to generate some on your own. Once you’ve done this, write them down or type them out and then come back to this spot.

Okay here are some alternatives:

Just because at the present time John cannot think of techniques to deal with his panic attacks, in reality, it does not mean there is no way out of them.  There are many techniques out there and many people that have indeed gotten over panic.

Rather than John concluding that there is no way out of the fear, he can acknowledge that while he is definitely feeling anxious, there is no real evidence to suggest that he will always feel this way.

Just because John “feels” that there is no way out of the fear does not make it so.  He is reasoning on the basis of his emotions not according to objective reality.

John has a “should” rule in is mind that he should not feel anxious doing simple tasks like driving.  However the truth is he is feeling anxious and that’s okay.  This does not mean he is inadequate in any way nor that he will always be anxious doing routine tasks.  The truth is: by “buying into” the belief that he shouldn’t feel anxious, he feeds his anxiety.  Simply by learning to accept his anxiety, it will lessen.

As you are probably starting to see the cognitive distortions in your thinking, you can see that they represent a “locked-in” belief that can be changed – and for the better!

Now it’s certainly not realistic to think that you can do this once and instantly get better, but over time this process can definitely be a great way to deal with anxiety and panic attacks.

A great thing about doing cognitive behavioral therapy is that it tends to draw your thinking into the present instead of racing into the future. 

I really liked one of the points made about CBT on the website of Dr. Virginia Chow, Psychologist:

[CBT deals with the "here and now", focusing on factors that are maintaining the problem, rather than what started it. Since you cannot change the past, CBT deals with factors in the present that you can control]¹

Being in the moment can be very relaxing and beneficial and is perfectly complemented by doing activities that induce relaxation.  Over time this combination can not only help with panic attacks but it can improve the quality of one’s life!