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For those who’ve read my previous article, Panic Attacks and Anxiety: Derealization and Depersonalization - You Aren’t Going Crazy!, this is the perfect follow-up scoop. But if you’ve yet to read it, not to worry, there’s still much to be learned here.

Now, in review, derealization and depersonalization all too often accompany panic attacks and anxiety. In general terms, derealization is a frightening feeling of detachment from one’s external environment, and depersonalization is an equally as frightening sense of detachment from self. Both can be absolutely crippling and take you to the turnstiles of your perception of insanity.

I believe many researchers and theorists would concur that within the context of panic and anxiety, derealization and depersonalization may well be the mind’s self-protective reaction to the ultimate perceived state of overload. See, it goes like this – when the mind feels it’s mega-overwhelmed it flips the switch on a perceptual filter, believing even the slightest additional bit of in-coming stimuli may lead to various degrees of psychic meltdown. Within this theoretical framework, it’s all about the mind in a powerful state of defense, doing all it can to give itself a fighting chance to sort and process that with which it’s already wrestling. So it only makes sense that it tries to survive by inhibiting and prohibiting fresh sensory messages streaming in from one’s immediate internal and external experience. And the resultant mind states are dominated by derealization and depersonalization.

Now, as we approach delivering a knockout punch to derealization and depersonalization it’s important to always keep in mind that, as I said in the previous paragraph, both of these sensations are born of the mind’s effort to protect itself. And the very cool thing about this notion is it leads us to the unique understanding that the mind has – well – a personality of its own. Furthermore, this personality is all too often negatively impacted by the mind being overwhelmed and in great mental and emotional pain. To me, this brings to the fore a “personality of mind,” giving the hellish protection-generated sensations of derealization and depersonalization rather a bit of softness and gentleness, making them seem so much less treacherous. I mean, it’s like the mind is this living, feeling being that actively communicates with us, so often asking for help. And we, in turn, have the opportunity to provide compassion and relief.

Alrighty then – so let’s move on to what one can do to make these horrifying, but now familiar and much less terrifying, phenomena go bye-bye. First of all, if one is willing to accept derealization and depersonalization as mind-protecting phenomena, it only stands to reason that their appearance – more importantly, disappearance – will be greatly influenced by our ability to maintain balanced and tolerable loads in our mental/emotional wheel barrel. And this is accomplished by stress management, which is so often driven by how we monitor and adjust our processes of thought. Now, of course, in many cases high levels of stress, and resultant anxiety, can’t be avoided – that’s just life. But we still hold the ability to manage their intensity and fallout by keeping tabs on how we think and subsequently react. It’s a matter of maintaining enlightened perspective and calm as our reasoned powers of interpretation have time to take the stage after the panic alarms have sounded.

Allow me to reiterate, there’s no doubt that the best first strategy to keep derealization and depersonalization at bay is to do all we can to maintain management over our stress and anxiety levels. Whether it’s through relaxation, visualization, diet, guided imagery, exercise, job or school change, relationship change, lifestyle change, therapy – or my techniques of interpreaction, interpreversal, S.A.I.L., S.P.A., I.A.M. not F.E.A.R. – whatever – we must do what it takes to stay self-managed on a day-in and day-out basis. If we do this, not only will we be able to keep derealization and depersonalization at arm’s length, but should they strike and the alarms sound, we’ll be able to cruise our way past any exaggerated and inappropriate reactions. See – it’s our misinterpretations and overreactions that cause the problems, not derealization and depersonalization. How ‘bout that thought?

And as we’re approaching all of this, let’s not dismiss the concept of the mind having a personality and its expression of its need for “some love” through the frightening sensations of derealization and depersonalization. To me, as we accept this seemingly strange notion we apply a very soothing balm upon a potentially fevered mind. And this very much relates to the concept of mindfulness – a clear-minded, in-the-present-moment, self-observational technique that emphasizes viewing self as an outside observer – without criticism or judgment.

Okay – but let’s say in spite of our self-management efforts, derealization or depersonalization make a surprise visit. Ya’ ready? First and foremost – just stop whatever it is you’re doing. If you’re driving, pull over when you can. If you’re in a meeting, take a break. Heck – take a walk, if you’d like. Now, take a few full abdominal breaths, and as you take them immediately tell yourself that the one and only thing happening right now is your mind telling you it’s operating on overload and needs a little help. It’s talking with you, and that’s pretty cool. Nothing dangerous, without a reason, or permanent is happening to you. And since you know what’s going on, and why, take some time to communicate with your mind, letting it know you’re there for it and will do whatever it takes to provide aid and comfort. Visualize your mind as if you’re looking at it from outside of your physical self (a healthy “out-of-body” experience). And as you do, visualize your mind very nicely calming down. Simply open yourself to a spirit of insight and reason, as you employ relaxation techniques, guided imagery, visualization, the strategies I’ve mentioned before, or anything that’s worked for you in the past. And as you’re keeping yourself together, know that as soon as you get your sea-legs back, moving on with your day is the next order of business. It’s this thinking and believing that keeps the alarm from increasing in decibels, and keeps it from sounding in the future.

Yes – it’s this mindset, along with a few victories, that will enable you to function in the presence of derealization and depersonalization, allowing you to explore these uncomfortable states, accumulating insight along the way. And I’m betting you’ll find that this philosophy, as well as time-proven strategies and techniques, will keep these icky sensations at bay – period. It’s all about making peace with derealization and depersonalization - indeed, making the best of an initially perceived unpleasant situation. I mean, who knows what kind of inner secrets could be unveiled upon exploration of our altered states of perception and consciousness. And I’ll tell you this – establishing a level of insight and comfort with a nemesis is a great way to remove any potential threat. But, make sure you identify the true nemesis. In this case, it’s not derealization and depersonalization, rather our misinterpretation and overreaction to a foreign perceptual experience.

From tons of experience I can tell you that you must ride out episodes of derealization and depersonalization. As was said earlier, if and when they pop onto the scene, acknowledge they’re there and calmly tell yourself they’re not a permanent state of consciousness and will shortly pass – that is if you stay cool. Remind yourself that your mind is overloaded and it’s talking with you, asking for a little help. And do a friend a favor. Just use any intervention strategy and technique you’ve come across, including those presented in my book, and go on about your business and your day, as no one will have a clue as to what you’re going through. I’ll go you one better. I’m challenging you to welcome derealization and depersonalization as they arrive, and dive right in to some intrapersonal exploration in their presence. Wouldn’t that be an interesting twist? And how disarming would it be to the all out dread and fear these sensations traditionally generate.

Ah – the mysteries and miseries of derealization and depersonalization. Nothing with which we can’t peacefully coexist. Go get ‘em, tiger!

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You´re terrified that any minute your next panic attack will strike. These worries consume your day, completing tasks is difficult, going new places almost impossible. What will trigger your next panic attack and how can you avoid it?

These questions consume your thoughts and influence your actions. Walking around plagued by these thoughts can be extremely disconcerting but it is what passes through the minds of many panic attack sufferers. 

Such overwhelming feelings and fears can make completing even simple daily tasks a challenge.  Suddenly we become forgetful, distracted, unfocused. Since you are so worried about having a panic attack, your levels of anxiety are so high that you are probably suffering from generalized anxiety as well or even agoraphobia. 

Driving a car, going to a new place, performing your responsibilities at work or at home can suddenly take on epic quality. Some people become so terrified of the unfamiliar and its potential to trigger a panic attack that they refuse to leave their safe zone or places they are familiar with. 

These people have developed agoraphobia and if this situation describes you, take comfort, you´re not alone and you can do something about it.

Whatever your present state of panic, anxiety or agitation, you can manage and eliminate your panic attacks as well as your resulting fear, anxiety or agoraphobia. There are important proactive steps that can get you started now on the road to a panic free life.

Imagine living your life free from the worry over your next impending panic attack, free from the anxiety that accompanies these feelings and free from the fear that seems so overwhelming. 

You can deal with you panic attacks and eliminate your anxiety as long as you are willing to try some panic attack management techniques. The most important step in eliminating your panic attacks is to end your fear of having panic attacks. 

This is probably not the first step in your journey to panic attack elimination, it may even be your last. But by getting rid of the anticipatory fear of your next panic attack, it will greatly reduce your likelihood of having one. 

This means you confront anxiety provoking situations head on because this eliminates the need to worry about them. It is the anxious thoughts coursing through your mind that trigger your panic attacks. You have to jump into the storm to get over your fear of the storm. 

There are many techniques that you can use to help build your confidence to the point where you are able to confront and eliminate your fear.

• An exercise program and proper diet are a first step. 

• Learning abdominal breathing exercises and meditation or yoga are important relaxation techniques to help you cope.

• Training your mind to see the good in things rather than the bad and creating positive affirmations for yourself that help you have the self confidence to confront uncertain situations are other important strategies. 

By building up your self confidence, strengthening your self esteem and providing you with techniques to manage your anxiety you will have the courage to confront and eliminate your panic attacks.

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Melissa remembers her first panic attack like it was yesterday. She was coming home from work as usual on the 5:32 train. She was reviewing her to do list for the weekend and thinking about a presentation she had to give at work on Monday. 

While her obligations were many, going to her daughter´s play, arranging catering for her husband´s birthday the following weekend, making baked goods for the school bazaar and getting this work presentation done that cropped up at the last minute, they were no more than usual. She decided to pick up some food for dinner on the way home and went to the supermarket.     

She put her purse in the cart and started wheeling around the grocery store. She went to the meat counter first to see what was available and what looked good.  Suddenly her heart started racing and she felt weak in the knees. She steadied herself and tried to shake the feeling but terror struck her.

Was she going to die on top of the meat? What would happen to her children?  Where was her husband?  Would he marry someone else? She grabbed at her scarf and removed it; she tried breathing but heard only wheezing. She saw people looking at her and tried to act normal but the inability to breathe was too much. She took her purse and ran out of the store, pulling at her shirt, trying to ease the pressure in her chest. 

As soon as the cool night air hit her she felt better. She started to breath, walked a little to get the circulation going. Then she sat down on the bench outside. Someone came up to her and asked her if she was okay. She simply nodded, still unable to speak. She looked down at herself after a few minutes. She was soaked with sweat and her blouse was ripped open at the chest, her bra was showing.

What had happened and why? This thought would continue to plague Melissa in the coming months as her hesitation, fear and uncertainty mounted.   

Melissa missed the school bazaar, missed her daughter´s play, called in sick on Monday for her presentation and made up an excuse to cancel her husband´s birthday party.

This was the beginning of Melissa´s agoraphobia and the fear that dominated her life from the time she had her panic attack in the supermarket standing over the Idaho potatoes. This fear led to the alienation of her husband and children and the loss of her job and self-esteem. 

Six months after this first panic attack, Melissa´s life was unrecognizable. Melissa was unemployed, living separate from her children and in divorce proceedings from the love of her life of 15 years. Just six months ago, her life had been a picture of success and happiness. She had a great job she loved, two great children who were clever and angelic and a husband who was the light of her life and her high school sweetheart. She had a beautiful home and tons of friends and was active in a number of organizations, including the PTA.

Today, Melissa is afraid to venture too far from her home, she won´t ride the train into the city, she can´t go to crowded places and feels stressed, anxious and worried all the time. Her husband tried to help her but she pushed him away. Her children tried to be understanding but they didn´t understand. Her friends tried to be supportive but she didn´t want their support. 

While this case may be extreme, it shows how agoraphobia can start small, you miss just a couple of events, you make just a couple of excuses but the inertia of avoidance can snowball very quickly into severely damaging your life. While there are varying degrees of agoraphobia, they all have the potential to be severely life limiting and should be addressed as quickly as possible. 

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One day, you wake up, look around and realize that your life has spun out of control.  Your life, once so normal has become like a nightmare. Your job, your personal life, your family, your peace of mind has all been disturbed and you feel powerless to make any change or improvement. The source of this disturbance is the anxiety that has invaded your life and come home to roost in a seemingly permanent manner.  Everyone experiences panic; we would simply be robots if we didn’t. While these feelings of distress may be normal in small, isolated doses, they should not be a pervasive, all consuming fire that threatens your sanity with every step and action.

For anxiety sufferers, the feelings of distress are constant companions that cannot be shaken, that cannot be reasoned with and cannot be easily tamed. The resulting stress from having to contend with such an overwhelming dread leaves many sufferers exhausted and miserable. Sustained angst can have physical manifestations that can severely affect your health.  Some of these affects include:

• A rapid heartbeat• Difficulty breathing• Dizziness• Loss of sensation or tingling in your hands and feet.  • Disorientation• Sweating

These are only some of the effects that could sweep over you as you struggle with a panic attack or excessive apprehension. After experiencing such scary symptoms many people seek to avoid duplicating this occurrence, whatever the cost. They examine the triggers that could have brought these overwhelming feelings about.  They associate the experience with whatever they were doing or wherever they were located when the panic attack struck. After identifying what they believe to be the cause of their distress they avoid any situation where the causes of their anxious episode might be duplicated.

Avoiding the fear becomes a priority and pretty soon your life gets out of whack and relationships, job performance and your physical and mental health suffer. If you are afraid to be around a crowd of people you may neglect going to the gym, seeing movies, eating out with friends or engaging in any kind of social activity. Interacting with coworkers may become problematic and job opportunities may pass you by. 

As your life contracts, your mental state spirals downwards. Cut off from friends, activities and mental stimulation, your mind becomes overwhelmed with anxiety and fear and sleep can be disrupted. 

The lack of sleep, the stress involved with avoiding panic inducing interactions and the fear make you a shadow of your former self. Understanding the power of the mind and its ability to consume your thoughts with unrealistic or exaggerated worries is the first step in changing your situation. 

Your mental and physical health are important and should be protected and cared for.  Relieving your mind of worry will help relieve your body of the manifestations of that worry. By eliminating the physical symptoms that can produce such dread, you will in turn help your mental outlook.

No one wants to contend with a rapidly beating heart or shortness of breath or disorientation. These feelings are scary and while it’s a natural instinct to avoid them, we need to find ways to resolve them without damaging our lives.

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Here are some interesting panic attack disorder facts. A panic attack normally comes out of the blue. It’s one of the most terrifying experiences any person can go through, leaving you feeling shocked and distressed.

This is not your normal ‘stress’ or ‘anxiety’ or ‘feeling worried’ situation. It’s much more powerful than that, which most people can never

understand. They may think they’ve had it too, but it’s highly unlikely.

Generally, attacks last for several minutes. When it starts happening regularly, and if you start fearing the next one, you then have a panic or

anxiety disorder.Some Symptoms & Signs

Feeling dizzy & lightheaded

Breathing difficulty

Chest pains

Racing, pounding heart

Fear of dying

Fear of losing control

Fear of going crazy

Sweating

In the United States alone, it is thought that over 4 million people suffer from panic attacks. The numbers are probably higher. Many won’t even

know about it, as they go from doctor to doctor, only to be told they’re alright.

It’s estimated that 13% of the world has an anxiety disorder. That is a staggering statistic. That means 13 out of every 100 people have some

kind of anxiety disorder.

Most of the time, a panic attack hits a person in their late teens and early adulthood. When it starts to get worse, a sufferer starts avoiding

situations. This is known as agoraphobia, which is even more serious. You will end up with no quality of life.

One important panic attack disorder fact is that it does not ‘go away on its own’. Despite doctors telling you it’s not serious, or it’s in your head, it is here to stay. You will need proper treatment, or it can go on for years.Causes

Although highly researched, no one can confirm the causes. There is strong evidence that it’s biological. There is also strong evidence of

heredity. The only thing that can be confirmed is that it’s a genuine illness that requires help.Treatment

There are many effective methods available. These include:

Cognitive Behavioral Therapy

Alternate treatments like homeopathy

Self help such as The Linden Method

Support groups

Meditation

YogaHypnosis

Medication

Gradual exposure for agoraphobia

Flooding for agoraphobia

If you begin changing your thinking, this can lead to changing the way you react. Changing your reaction gradually forces the brain to react

differently. This makes the fear of panic attacks gradually disappear.

It takes a lot of big and little changes to get over anxiety disorders. Work on the subtle changes, things that won’t cause much anxiety and work your way up slowly.

For example, if you have panic attacks that are made worse by caffeine, slowly reduce it from your diet. Then move on to relaxation techniques such as deep breathing which requires time, effort and motivation.

After that, you could incorporate exercise into your routine. Time management is going to be a major factor. You’ll have to organize your life to fit in your therapy sessions.

It’s a slow process for most people, but you have to start somewhere. With a lot of changes and with proper guidance, you can make tremendous strides.

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