Saturday, July 7, 2018

Dealing With Panic Attacks

Anyone who has ever had a full blown panic attack knows how paralyzing they can be.   And they also know that there’s not always a simple solution. “Read your Bible, trust God, and pray” is good advice, but it doesn’t necessarily get to the root of the problem.   Though panic attacks can have many different causes, they always produce very real physical symptoms that can include, 
  • Paralyzing fear of impending doom, losing control, dying, or going crazy
  • Rapid and/or irregular heartbeats
  • Chest pains resembling a heart attack
  • Uncontrolled shaking,  teeth chattering
  • A feeling of being unable to breath
  • Surreal feelings as though you are detached from your surroundings
  • Choking sensation
  • Sweating or chills
  • Nausea
  • Feeling like you will faint
  • Dizziness or vertigo (the room is spinning out of control)
  • Tingling sensations or numbness
  • Leg weakness (can be severe to the point of not being able to stand up)
  • Fear that it will happen again (which can lead to agoraphobia – the fear of going out) 
*Disclaimer:  I am not a medical professional.  Some of the above symptoms may also be caused by a true medical emergency. 
I had my first panic attack after the birth of our second child and it was probably caused by hormone fluctuations.   Years later they returned with a vengeance landing me in the ER several times.     The underlying cause had to do with chronic medical conditions that were affecting my central nervous system.    Because I still have those health issues I have panic attacks occasionally, but overall my anxiety is pretty well managed with medication, stress  reduction,  and working on my thought life.     
 The problem with some nouthetic counseling 
One of the most frustrating things about some of the older more rigid forms of nouthetic Biblical Counseling was a failure to recognize biologically based causes for  anxiety and depression.  Thankfully, that seems to be changing as a more sympathetic and informed approach to Biblical counseling has come along in recent years. 
Without question, the Scriptures provide everything we need pertaining to our spiritual well being.  God's Word is our greatest source comfort when we feel anxious.        
But the Christian counselor who doesn’t understand the mind-body connection might give advice that does more harm than good.   Tragically, we lost two Christian friends to suicide who stopped taking their meds because they believed taking medication for mental illness was sinful.  
Biologically based anxiety 
Research shows that women are twice as prone to anxiety disorders as men because of hormonal fluctuations.   Autoimmune diseases which are a common cause of anxiety disorders affect 8% of the population, and  78%   of those affected are women.    
Additionally, anxiety triggered by other kinds of medical conditions are well documented by the National Institutes of Health and all major teaching institutions.  Some of the most common causes of biologically based anxiety and depression  include  menopause, endocrine disorders, thyroid disease, serious injuries,  heart and lung conditions,  gastrointestinal problems like Celiac Disease, sleep disorders causing hypoxia (oxygen desaturation), and illnesses such as ME/CFS (Chronic Fatigue Syndrome) and fibromyalgia.  PTSD and chronic long term stress can also upset the body’s chemistry and cause panic attacks.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association establishes specific criteria for coding and determining whether a mental disorder is due to a general medical condition or a psychiatric one: 
  “‘There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiological consequence of a general medical condition’ (1) When a mental disorder is due to a general medical condition, one does not diagnose the primary psychiatric disorder  with the same symptom, but rather codes the symptom secondary to the general medical condition. Thus, with anxiety one would not code 300.02, generalized anxiety disorder, but rather 293.89, anxiety disorder due to a general medical condition.”2 
 When a Christian woman confides in me that she is struggling with anxiety or depression that hasn’t resolved by using spiritual means, I always suggest that she see her doctor.   If she and her doctor decide that medication would be helpful,  it would be no more sinful than taking medication for diabetes or high blood pressure.    
Things that help anxiety and panic attacks 
Regardless the cause, here’s a few things that have helped me. 
BREATH:  Anxiety causes shallow breathing and air hunger.   Breathing through the diaphragm helps to calm the nerves and restore a proper breathing rhythm.  Here’s some simple exercises that can help:  3 Effective Anxiety Breathing Exercises  
If you’re in a pinch to get out of panic mode there’s a breathing app I have on my phone:  My Calm Beat  
RELAX:  Relaxing all of your muscles is important and one way to do that is to take a warm bath with Epsom salts.   A cup of hot tea and soothing music is calming too.    Abiding Radio –has an app with peaceful instrumental hymns.    It's great for night time anxiety. 
 SELF TALK:  Breaking that nasty habit of negative self-talk is key.   All those “what ifs?”  need to pack their bags and take a hike—easier said than done,  I know!   But again, we have God’s  wonderful Word.    Instead of dwelling on things that are scary, replace those thoughts with these things:
  Finally, brethren, whatsoever things are true, whatsoever things are honorable, whatsoever things are just, whatsoever things are pure, whatsoever things are lovely, whatsoever things are of good report; if there be any virtue, and if there be any praise, think on these things. Phil 4:8 
PRAYER:  Of course! 
“Casting all your anxieties on Him, because He cares for you." I Peter 5:7 
COGNITIVE BEHAVIOR APPROACHES:    The Anxiety and Phobia Workbook by Edmund J. Bourne is an excellent secular book that really helped when I was complete mess.   It  provides exercises  for dealing with severe  panic attacks.   I modified some of the suggested meditations by replacing them with Scripture. 
And finally, after reminding ourselves that God is with us and that He is sovereign over every nanosecond  of our life,  we can concur with Franklin D. Roosevelt,
  "The only thing we have to fear is fear itself". 

Suggested Resources 
Article:   "The Peace That Passes Understanding" by Ed Welch  
"Christians Get Depressed Too"  by Dr. David Murray   
“The Happy Christian"  by Dr. David Murray   

1. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition, Washington DC, American Psychiatric Press, 1994, 7
 * Portions of this article were originally from my post at Out of the Ordinary (2012)


  1. Ed Welch's book "Running Scared" is also an excellent book for anxiety.