Panic Attack Symptoms and Treatment.

Prescription benzodiazepine tranquilizers such as alprazolam (Xanax) and diazepam (Valium) aren't all bad. They can help you cope with overwhelming acute anxiety, such as may occur when there's a sudden death in the family.

When you take tranquilizers day after day to control chronic anxiety, however, as many Americans do, they can actually cause the very problem they're supposed to treat.

That's because tranquilizers are addictive, says Edward
Drummond, M.D., associate medical director of the Seacoast Mental Health Center in Portsmouth, New Hampshire. Your brain and body may develop a physical dependence on tranquilizers within 4 weeks of daily use. Then, if you try to stop using the drug, the inevitable period of physical withdrawal produces-you guessed it-anxiety.

Tranquilizers have another drawback. They convince you that you need a medication to control anxiety rather than being able to tap your own inner resources to deal with the problem through alternative home remedies such as deep breathing and relaxation techniques.
"Using tranquilizers interferes with the pursuit of treatment that is truly effective," says Dr. Drummond.

Before you start using those methods, though, you should know that there's nothing abnormal about being a high-anxiety person. "High-anxiety people tend to be more intuitive, great listeners, and very sympathetic," says Reneau Z. Peurifoy, a marriage and family therapist and anxiety specialist in the Sacramento area. "They just need to learn how to manage their anxiety better."

RELAXATION: A Response to Calm You Down
Techniques that create the relaxation response-a calmer mind and a more relaxed body-are great for high-anxiety people, says Peurifoy. A common and effective one is the focal-point technique. Sit quietly and comfortably in a place where you won't be disturbed and repeat a word, such as calm or relax, each time you exhale. When your mind wanders (as it inevitably will), don't worry; just bring it back to your breathing and the word. Do this technique for 10 to 20 minutes every day.

RELAXATION: Take Your Cue
The only problem with relaxation response techniques is that they don't help you much when you really need them, when you're out and about and feeling anxious. That's why Peurifoy recommends cue-controlled relaxation, which is a means of practicing your relaxation technique so that you can produce the same results even when you can't do the technique. Here's how it works.
As you're practicing the focal-point technique, also perform your cue. It could be simply placing your thumb and index finger together. Then, when you experience anxiety during the day, perform the cue. Over time, you'll notice that your body and mind will start to relax on cue.

KAVA KAVA: Take Your Anxiety to the South Pacific
The South Pacific herb kava kava may be as effective as a prescription tranquilizer for reducing anxiety, says Hyla Cass, M.D., assistant professor of psychiatry at the University of California, Los Angeles, School of Medicine. In fact, she says, it may actually be more effective, since low doses often enhance alertness rather than making you feel sedated the way a tranquilizer often does.
Dr. Cass recommends taking 135 to 250 milligrams of the herb in capsule or tablet form. Look for a standardized product that contains 30 percent (40 to 75 milligrams) kavalactones, the active ingredient, and take it two or three times daily as long as you find it helpful. To help you get a good night's sleep, take two doses at bedtime.

YOGA: A Revitalizing Visualization
"Yoga poses provide effective relief of anxiety," says Susan Lark, M.D., a physician in Los Altos, California. They work, she says, by relaxing tense muscles and oxygenating your entire body, which quiets and calms your mood.

The following pose is known as the sponge. Do it three times a week or even daily if you notice that your anxiety symptoms respond particularly well to it.
First, says Dr. Lark, lie on your back with a rolled towel under your knees and your arms at your sides, palms up. Close your eyes and relax your whole body. Inhale slowly, breathing from your diaphragm.
As you inhale, says Dr. Lark, visualize the energy in the air around you being drawn through your entire body. Imagine that your body is porous and open like a sponge so it can draw in this energy to revitalize every cell.
Exhale slowly and deeply, allowing every ounce of tension to drain from your body. Stay in the pose as long as you're comfortable.

BREATHING: Short-Circuit Those Panic Attacks
High-anxiety people may start worrying that they'll lose control, because they don't understand the cause of their anxiety symptoms. When those symptoms occur, these people can become so flustered, jittery, and physically upset that they precipitate a full-fledged panic attack. Soon, the mere anticipation of a panic attack can trigger one.
Many people who have panic attacks are hyperventilating-taking short, rapid breaths that produce such classic symptoms as dizziness or faintness; difficulty swallowing; shaking or muscle spasms; numbness and tingling of the mouth, hands, or feet; heart palpitations; and a feeling that they can't get enough air.

"In those situations, it is particularly helpful to do deep, diaphragmatic breathing," says Elke Zuercher-White, Ph.D., a psychologist at Kaiser-Permanente in the San Francisco area. "It is an effective technique for controlling anxiety symptoms. To overcome panic disorder, however, you must also work toward a change in your thought process so you no longer fear the symptoms of anxiety and panic attacks." Dr. Zuercher-White recommends a very systematic method of
learning this breathing, which she calls breathing retraining. Practice each of her phases for 5 minutes twice a day until you've mastered it. Then move on to the next phase.

Phase one:
Lie on your back on a bed or carpeted floor. Place one or two pillows on your stomach. Watch the tops of the pillows from the corner of your eye. As you breathe in, your diaphragm should expand, raising the pillows. When you breathe out, the pillows should move down again.

Your anxious feelings about any situation are usually based on habitual, automatic thinking patterns, says Reneau Z. Peurifoy, a marriage and family therapist and anxiety specialist in the Sacramento area. Those thoughts may sound something like "This is terrible," "I can't handle even this simple thing:' or "I'm never going to get any better:' By deliberately changing these to what Peurifoy calls coping self-statements, you can deal with any situation. The affirming statements may not immediately reduce your anxiety, but with practice, Peurifoy says, you'll

create a set of positive messages to replace the old negative ones, thereby reducing chronic anxiety.
Here are some examples of coping self-statements. Memorize them and use them as needed.

. I've survived feelings like this, and worse, before.
. I don't have to do this perfectly.
. I always have options. I'm free to come and go according to my comfort. . This will only take a short time. Soon it will be over, and I will be very pleased with myself.
. It doesn't matter what others think.

Phase two:
Lie on your back without the pillows and put one hand over your navel. Look at the ceiling or close your eyes. Take deep breaths. With your hand, feel your stomach moving up and down. . Phase three: Repeat phase two, but keep your attention on your diaphragm and feel it move up and down. "Become one with your breathing," says Dr. Zuercher-White. . Phase four: Sit on a sofa, leaning back so that you can watch your stomach area. Watch your diaphragm move up as you breathe in and down as you breathe out. . Phase five: Sitting straight, repeat phase four. Be sure that your upper chest and shoulders are perfectly still; that's a sign that you're doing the exercise correctly. . Phase six: While standing, repeat phase five.