Many people write to us indicating that their anxiety leads them to something they refer to as Panic Attack Shaking. Learn what you can do about this.

Question: “I feel like I’m going crazy and don’t know what will happen if I do. Secondly, I can be out shopping, and I start to shake then my knees give out.”

My response:
I have known a lot of people who suffer from anxiety but who refer to this particular tendency as panic attack shaking. That is an indication of just how common this tendency can be. I came across an article by Arlin Cuncin who has a background in Clinical Psychology which helps to put this issue into perspective. Cuncin states that shaking “is a symptom of anxiety which is caused by the fight-or-flight response. During this response the body releases hormones such as epinephrine and norepinephrine that ready the body for physical exertion.” Many times anxiety sufferers may be unaware that shaking is a symptom, which can also be worsened the more anxious one becomes.

I hope this initial quote might be somewhat of a help, but I think that it’s also important to look for a solution to shaking within the context of Cognitive Behavioral Therapy (CBT): first by reviewing the anxiety producing thoughts and then carrying out some cognitive restructuring together*.

*Please work through the process with me, rather than just reading, and that way you’ll glean the most benefit. Some people may initially perceive the CBT process as too basic or unhelpful, but working through the example can be very beneficial to you.

Note: In the event that you are unfamiliar with the process of CBT I would recommend that you click here to see an introduction to the CBT process (which will open in a new window) and then come back to this spot.

For the purposes of this example, let’s say that the individual posing the above question is Kelly.

Right now I recommend that you try to identify the cognitive distortions present in Kelly’s thinking about panic attacks and shaking by reviewing the list of cognitive distortions. Click here to open the list in a new window.

Once you have done so, come back to this spot and see if we have agreement.

Okay so here are the distortions:

1. Emotional Reasoning is present because Kelly is stating that she FEELS like she is going crazy. Emotional reasoning is the tendency to make conclusions on the basis of how one FEELS. Although she does not specifically state that she fears going crazy, the thought that lurks in the background is that she is going crazy – so on a certain level she concludes this to be true.

2. Fortune Telling refers to the notion of predicting what will happen in the future even when there is no basis in reality. This is exactly what is happening here. Kelly states “…I can be out shopping, and I start to shake and my knees give out.” The thought that is likely lurking in the background is that she will not be able to continue shopping or doing anything else because her knees have gone out. But this is not necessarily the case.

Let’s now look at some alternative, more accurate thoughts:

1. Just because Kelly feels like she is going crazy does not make it so. She really has no evidence that this is the case. The truth is that most people who are genuinely going crazy do not realize they are going crazy so the very fact that Kelly has this fear is likely a healthy sign. It is more correct for Kelly to conclude that she is anxious; additionally she has likely felt just as anxious before and she did not go crazy. Over time she can learn to accept being anxious and her anxiety will lose its grip on her.

2. Just because Kelly gets nervous and her knees start to shake does not mean that she is unable to continue shopping. Rather, Kelly can simply have a seat somewhere and relax. It will likely pass. Over time she will realize that she can simply take a break and return to her shopping.

3. Yet another strategy she could try is to have a friend accompany her while she is shopping, initially. I have used cognitive behavioral therapy on myself and know of countless people who have benefited from it. I have done an abundance of personal research into actual cases, the thought processes and outcomes. I have also consulted with many people who have used this same process and it has proven very effective for even severe problems. It should be a staple of your anxiety recovery plan.

I would love to share more examples with you..

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References (Panic Attack Shaking)

Cuncic, A. Shaking. Retrieved January 3, 2013, from:
http://socialanxietydisorder.about.com/od/glossarys/g/Shaking.htm