When Fear Overwhelms: Panic Attacks
Episode Description
In this episode of Mind Your Mind, Host Tim Unsinn talks to Therapist Falan Johnson about panic attacks. What do they feel like? What causes them? How can you prevent or manage them? Listen now to learn more and discover techniques that might work for you or your loved one.What to Expect
- Learn about panic attacks and how they feel in your body.
- Discover why your body might react this way.
- Learn several different ways to cope so you can find the ones that work for you.
- Understand that panic attacks are treatable—you don't have to continue suffering.
Resources: Learn More
- Anxiety.org: Panic Attacks at Panic Disorder
- Anxiety and Depression Association of America: Self-help Steps to Break the Panic Cycle
- Calm Clinic: What is the Best Way to Breathe During a Panic Attack
Things to Think About
- Can you identify things that trigger your panic attacks?
- What techniques have you used to get through a panic attack?
- Have you considered seeing a mental health professional?
About the Guest
Falan Johnson provides therapy for children, adolescents, and young adults ages 7-25. She earned her master's degree in Social Work from the University of North Dakota and is certified in Eye Movement Desensitization and Reprocessing. Falan specializes in anxiety, depression, ADHD, trauma, stress, self-esteem, and anger. Aside from being a therapist, she is a friend, partner, dog mom, athlete, outdoor lover, and a continuous learner. Falan provides telehealth and in-person services at Dakota Family Services. Call 1-701-922-9072 to make an appointment.
Transcript
When Fear Overwhelms: Panic Attacks
Featuring Falan Johnson, LCSW, Dakota Family Services
Host Tim Unsinn (00:00):
Welcome to Mind Your Mind, a podcast presented by Dakota Family Services, an outpatient behavioral health clinic, located in Minot, Bismarck, and Fargo, North Dakota. In this podcast, I will talk with our experts about understanding and nurturing our mental health and wellness. I'm your host, Tim Unsinn. Join me each episode as we explore the intricacies of our minds, decrease the stigma of mental illness, learn practical tips for managing our mental health and wellbeing, and recognize when it's time to ask for help. Join me now to mind your mind.
TU (00:31):
Welcome to this episode of Mind Your Mind. Our guest is Falan Johnson. Falan is an outpatient behavioral health therapist on the Fargo campus and provides outpatient therapy for children, adolescents, and young adults. It is great to have you on Mind Your Mind. Our topic is what does an anxiety/panic attack feel like and how do we manage them. However, before we get to the topic, let's talk about why you do what you do. Why is this work important to you?
Falan Johnson (01:00):
Oh, hi Tim. Yeah, it's great to be on. Why is this work important to me? I think ultimately it comes down to getting to be that helper for a person, it's getting to help make a difference for other people, and really get to the bottom of what's getting in people's way. Helping people see things that they maybe wouldn't have seen otherwise.
TU (01:25):
Knowing there's a better tomorrow.
FJ (01:26):
Right. Yep.
TU (01:27):
Well, today's topic. What does an anxiety panic attack feel like and how do we manage them? So how do I know if I'm having an anxiety panic attack?
FJ (01:38):
Okay. So this can be kind of a tricky one. Well actually it's really not all that tricky because it can be kind of scary. Usually it's gonna be like it's happening or it's not. So I want to just start with the physical sensation. So a lot of times you're gonna feel maybe your heart starting to race. You might start feeling perspiration throughout your body. You might actually start sweating. It might be more of just like a warmth to your cheeks. For some people you're gonna feel like, kind of in your stomach. It might kind of turn to knots. Some people have even described it as like, wondering if they're almost having a heart attack. And I certainly wanna say like, if that's, if you have any concern that that could be happening or if you have any kind of history, I mean, definitely talk to a medical professional. You always wanna rule that out, but I don't wanna leave that out either because it can almost feel like your body's going into to overdrive.
TU (02:36):
So, so if you're, if you are feeling the chest pain, the arm hurting, all those things, and if you have any questions at all, any doubts it's 9 1 1. Okay.
FJ (02:46):
Exactly. Thanks Tim. Yes. But otherwise it's kind of like if you really can't attribute it to anything, it seems kind of out of place, you might be having a panic attack. Sometimes it is difficult to identify the trigger. And I wanna mention why the body reacts this way. So what's actually happening is it is an adrenal response. Your whole nervous system is going into a fight or flight response, which is why your body is feeling that adrenaline rush. It's literally going into like a protection mode, if that makes sense.
TU (03:22):
It does, because, you know, you think of somebody that's claustrophobic getting into an elevator, small spaces, their reaction, you kind of get an idea of if you don't go through it, but you can see it, and experience it through someone else.
FJ (03:36):
Right; yeah. It's going to really mimic this need to protect yourself. So I always kind of like to bring out caveman analogies. So like, if you really go back to very simplistic survival mode, right. We are built with an instinct that tells us there's danger coming and we either need to run away, hide, or fight. And so of course now, I mean, you know, in the caveman days it would've been something like a wild animal, right. Or some kind of physical threat, usually. Obviously that's not what we're dealing with in today's world, but oftentimes sensations of feeling extremely overwhelmed, maybe for us, it's tied to needing to pass that final, or wanting to make sure you are going to get that commission check. Because for us now that really does tie back to survival for us. So sometimes it's gonna be tied to, well, yeah, survival.
TU (04:46):
Survival's a big one. That's a big one. And, you know, as I'm thinking too, as parents, you know, you think a lot of times that some of that anxiety panic happens because we're stressed about our kids, what our kids are going through and how they're gonna deal with things. Maybe they've got a test coming up, maybe they're graduating from high school or college, and okay what's next for them? So that kind of is a little bit of a, you know, we're, we're survival moding for them, we're channeling survival for them.
FJ (05:12):
Oh, absolutely. I think some of the emotional signs are really important to look at, too. So oftentimes if you, if your body has worked its way into this physical reaction of having a full panic attack, usually there's gonna be an emotion tied to that. Oftentimes it might be tied to feeling overwhelmed or a sense of worry. Ultimately, it's gonna be about fear. And that's kinda hard to get to, sometimes
TU (05:42):
It is, it is. So now knowing this, how do I cope with these feelings? There's just so many feelings and, you know, we don't get in touch with our feelings well enough. So how do we do that?
FJ (05:54):
Well, right. And I always kind of say too, like sometimes that panic attack is your body saying like, "Hey, you've got some stuff to work out here." And that's not good or bad. We all have something. And so I think that first one, especially can be very scary. I would encourage you to reach out to a mental health professional. You know, maybe if you're a student, a lot of my students start with the counselor at school. That's a great place to start. And then you kind of go from there, like maybe there is something that you need to work out in therapy. But ultimately, through therapy or counseling, we're gonna typically start with, how do you manage this in the moment? And it's gonna be very focused on distress tolerance and managing the crisis in the moment.
FJ (06:45):
So these techniques are not necessarily meant for getting to the root of what's causing the emotional fear, but how to get through it in the moment, because unfortunately, it would be nice if panic attacks only came up, you know, when we're in the safety of our own home or where we have time to process this, but the nature of life is that unfortunately, it doesn't usually work that well. So I have so many kids who experience maybe their first panic attack in their classroom, or they can kind of feel it creeping up. So a lot of times it's totally appropriate to excuse yourself and maybe just go take a minute in the bathroom, take a lap, if you can. Ultimately I think the best place to start is breathing. I know it's the cheesiest thing. I feel like it's almost an eye roller for some people, but it really works. And that's why we talk about it. It's almost too easy it can seem, sometimes.
TU (07:40):
Well, just think of it's every time, I mean, in life, in entertainment, movies, things like that, what is the first thing they do when you're having a panic attack, they hand you a bag to breathe, breathe in the bag, just breathe.
FJ (07:55):
Right. And yeah, I almost feel like the like scenes like that almost kind of stigmatize it a little bit. So it's like, do you need the paper bag? No, you really don't.
TU (08:06):
You just need to breathe.
FJ (08:07):
Yeah! Full belly breath. So maybe breathing in through your nose for count of four, holding it, exhaling through your mouth. And I always, if you can get it longer than your inhale, great. The goal is just to get the oxygen back to your brain again, because when your brain does go into that fight or flight response, it literally is not using its fullest potential anymore. It's not thinking logically. So the point of the breathing is to get it all talking again, to get everything back to baseline. Now sometimes, ideally, if you can kind of feel that coming on, if you can start breathing proactively, maybe you can even avoid a full panic attack or reduce the intensity of it, but maybe it's your first one and you had no idea.
FJ (08:54):
And you're already there. And I know if you've had a panic attack, sometimes when you're fully in it, the idea of deep breathing is really challenging. It's really hard to get your breath. So in those moments, I really would recommend any kind of technique that's gonna calm down your nervous system that's not breathing. So this could look like grounding techniques. So I like to use a DBT skill called tip. It's really about like changing the physiology in your body. So changing the temperature of it, changing your heart rhythms. So sometimes if it's like the heart of winter, if I've got a kid who's having a panic attack in class, right. Or feeling one coming on, I might just say like, go outside for 30 seconds and just put your hands in the snow and just feel that change. Go into the bathroom and splash cold water on your face, and get just a different sensation for your body.
FJ (09:51):
If you are able to, yoga is one of the best ways you can calm down an overactive brain from anxiety. So if you can implement that a little bit every day, that's gonna do, that's gonna do a lot for you long term. But even just in the moment, some basic yoga exercises, like the forward fold, which is essentially just kind of like a big breath in and bending over, and it doesn't have to be perfect. You don't have to have great flexibility. But if you can get your body turned, that's going to do wonders for your nervous system and just calm it down. Another really cool one that I am just kind of diving into actually, oh, pun intended, is ice diving. So this one's a little more, I don't wanna say extreme.
FJ (10:46):
It's not, it's not extreme, but it's just not one you could do everywhere, but let's say you are in the comfort of your own home and you're feeling very overwhelmed with an emotion. Literally filling up like a bucket or your sink with ice water. And then again, turning your body and dunking the first part of your head forward into that. It sounds kind of bizarre, you know, the people you live with might be like, what are you doing? But it really does calm the whole nervous system. So that's, that's another DBT skill that has been a great one.
TU (11:24):
I wanna say, if you are doing the ice diving and having an anxiety/panic attack, if nothing else, it will take your mind off the anxiety and panic because you're cold.
FJ (11:36):
Exactly.
TU (11:37):
I mean, it just changes your, your mind, you're going to a different fight or flight risk, you know what I mean?
FJ (11:43):
That's exactly it. Yep. You're literally just trying to offset the nervous system.
TU (11:48):
All right. So now we're talking about anxiety/panic attacks. And I'm just curious, if we over time, realize those things that bring on the anxiety and panic, if we learn to eliminate that, that should help us. But, some of these tips that you're giving us are able to, you know, we know it's coming on, but we can get ahead of it, maybe. Is that correct? Or not so much?
FJ (12:12):
Ideally. Yes. So I mean, if this is something that's coming up for you I really do encourage you to seek out some support from a mental health professional because chances are, I mean, that's coming from somewhere. Sometimes it's pretty easy to identify, but a lot of times, it's not. A lot of my clients come in and they're like, I don't even know where this came from. I just know I was overwhelmed. I felt it. I didn't know what to do. So if that's you, you're not alone. I would say, I think that's more common honestly than people being able to identify exactly where it came from. But yeah, if you can do some work with a therapist or a mental health professional, oftentimes there is some kind of, maybe like negative core belief tied that was triggered. There usually is some sort of a trigger in there somewhere. So over time, if you can kind of dissect the behavior. So what happened before the panic attack? What were your thoughts? Was there a certain smell, even. Sometimes it's a certain song. It's things that you wouldn't normally think of sometimes because trauma can be stored so deeply. So if it's tied directly to trauma, you know, it might not, the answer might not be obvious.
TU (13:38):
Yeah. So, so the answer, what I'm hearing is don't always think that getting in the elevators, the, you know, for you that are claustrophobic, you know, that's gonna be a problem, but for those that don't know, it could be deep-rooted, you don't know where it's at. So it always goes back to, don't be afraid to ask for help, because that is where we go to. I mean, that's really to get to the root of things that we don't know, all of a sudden we're having an anxiety, panic, and don't know where it came from. You're probably not gonna be able to solve it yourself because otherwise you may not have gotten into that situation.
FJ (14:09):
I mean, kind of, right? Yeah.
TU (14:11):
It's too simple for some things, you know?
FJ (14:13):
Well, and sometimes you just need to get outside yourself.
TU (14:15):
Right. That I guess what I was saying. Cause we don't always have the answers guys, gals, you know, who I'm talking with. Right. So, anyway, ask for help. Don't be afraid to do that.
FJ (14:25):
Yeah. And even if you're like, you know what, I feel like this is just a claustrophobia thing or I'm just afraid of heights or I'm just whatever it might be. That is a total thing that exists. But if you question that and you're like, well, I don't know, maybe there is more to it. You could still talk to a mental health professional, and maybe you only need one or two sessions and you sort it out and then that's clear. And now you know.
TU (14:49):
There's a reason why you're feeling that way when you go into the elevator or, you know, closed spaces, talking it out.
FJ (14:55):
Yeah, exactly.
TU (14:57):
All right, Falan. It's great to have you on Mind Your Mind. Before we wrap up though, I do have that last question for you. And that is what do you do personally, to mind your mind?
FJ (15:06):
Okay, I would say yoga and running I kind of go back and forth. I'm not like a long distance marathon runner by any means, but if I can get outside and just kinda take in the nature around me while I'm getting my heart rate up, that's probably one of my favorite things to do. And then if I can pair that with a little yoga, excellent.
TU (15:28):
Okay. I was trying to envision yoga running, and what that actually looked like.
FJ (15:33):
Oh no. Well, you know, back to back.
TU (15:36):
No, I know what you meant, that's just where my head went. So anyway, thank you so much for being on Mind Your Mind, and just a lot of information to unpack. Don't ever hesitate to pause, rewind, pause, rewind. And re-listen because there's so many nuggets that Falan shared with us, especially on this topic, which is near and dear to so many that are listening right now. So thank you.
FJ (15:57):
Thanks so much, Tim.
Speaker 1 (15:58):
Thank you for joining us for Mind Your Mind, a podcast presented by Dakota Family Services. You can't have health without behavioral health. Remember to mind your mind. For more information, links to additional resources, contact information, and much more go to dakotafamilyservices.org.
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Many people find themselves dealing with high levels of stress and anxiety in their daily lives. However, there are plenty of simple strategies to help regulate these emotions. In this episode of Mind Your Mind, host Tim Unsinn talks with therapist Sandy Richter about various coping exercises to help you regulate and calm yourself, including breathing and movement exercises for both children and adults.;
Genetic Testing & Its Role in Treatment
Medication can affect people in many different ways. In this episode of Mind Your Mind, host Tim Unsinn and psychiatric nurse practitioner Amanda Daggett talk about genetic testing and its use in discerning how different individuals might react to various medications. Tim and Amanda also touch on some of the facts and myths surrounding genetic testing, including what testing can and can’t indicate and where the science is currently at.;
Understanding Anxiety
Anxiety is one of the most common mental health problems people face. However, there are many ways to manage and understand it. On this episode of Mind Your Mind, host Tim Unsinn and therapist Lucas Mitzel discuss what causes anxiety and how it can affect people’s day-to-day lives, as well as the difference between anxiety and fear and how to combat chronic anxiety with grounding techniques.;
The Power of Social Connections (Community Chat Series)
In this special Community Chat episode of Mind Your Mind, Psychologist Megan Spencer and Psychiatrist Wayne Martinsen discuss how loneliness and social isolation are increasing in our country, as well as what that means for individuals’ health in the long term. They also give advice on how to get yourself or your loved ones more connected with others, including how to connect both in-person and online.;
Shining Light in the Darkness with DBT (Community Chat Series)
Does it seem like your child is “stuck” in therapy, or engaging in dangerous behaviors like self-harm and suicidality? In this special Community Chat episode of Mind Your Mind, Psychologist Hannah Baczynski and therapist April Morris discuss Dialectical Behavior Therapy and its effectiveness in treating patients who have found traditional therapy unsuccessful. Learn about the 4 core skills of DBT and what makes DBT unique from other forms of therapeutic treatment.;
Does My Child Need Medication?
When our children are struggling with their mental health, it can be hard knowing how to help them. However, in addition to therapy, medication can be a viable and effective option for improving your child’s mental health. In this episode of Mind Your Mind, our host Tim Unsinn talks with psychiatric mental health nurse Amanda Daggett about how to know if your child needs medication, what the process is for a prescription, and how to tell if their medication is right for them.;
Depression in Children and Adolescents
Did you know that depression occurs in about 15% of children? In this episode of Mind Your Mind, our host Tim Unsinn talks with Psychiatrist Dr. Wayne Martinsen about depression in kids and adolescents, including signs of depression to look out for and how to know when to reach out to a care provider. They also touch on how to know whether your child’s sadness is caused by depression or other external factors and what you can do to try and prevent depression in your child.;
Recognizing Depression in Children & Adolescents (Community Chat Series)
It can be difficult knowing how to recognize and treat depression in children and adolescents. In this special community chat episode of Mind Your Mind, Psychologist Megan Spencer and Therapist April Morris discuss signs of depression to look out for, including both behavioral and physical signs that your child may be depressed. They also touch on the influence of environment, physical illnesses or diagnoses, and genetics on children’s mental health.;
How to Fit In While Staying True to Yourself
Humans are hardwired for social connection, but it can be difficult knowing where to fit in as unique individuals. In this episode of Mind Your Mind, host Tim Unsinn and therapist Christy Wilkie talk about the importance of using your strengths, interests, and relationships to figure out where you belong. They also touch on signs that you might not be staying true to yourself, as well as how to handle feelings of being left out.;
PTSD: Signs, Symptoms, & Treatment (Community Chat Series)
While often perceived as only relating to those who’ve experienced warfare, Post-Traumatic Stress Disorder (PTSD) can affect anyone. In this special Community Chat episode of Mind Your Mind, Psychologist Dr. Hannah Baczynski and therapist Lucas Mitzel explain what trauma is, how it affects each person differently, and when to seek treatment for trauma-related symptoms. They also discuss different treatment options for PTSD, touching on the pros and cons of each.;
Autism in Children & Adolescents (Community Chat Series)
Though autism is one of the most commonly discussed mental health diagnoses in the community, it is often one of the most misunderstood. In this special Community Chat episode of Mind Your Mind, therapists Lucas Mitzel and Falan Johnson discuss what autism is, how it appears in children and adolescents, and how it may look different between individuals. They also touch on how autism can show up differently in boys than in girls and offer intervention tips for parents and caregivers.;
Autism in Adults (Community Chat Series)
Autism is sometimes perceived as a disorder that only affects children and adolescents, but it is actually a lifelong diagnosis. In this special Community Chat episode of Mind Your Mind, psychologists Dr. Hannah Baczynski and Dr. Megan Spencer explore the symptoms and nuances of autism in adults, touching on the history of autism spectrum disorder, the research surrounding it, how autism commonly presents in adults, and more.;
Spirituality & Mental Health
Though spirituality is often associated with religion, it can mean much more than simply attending religious services or praying. In this episode of Mind Your Mind, host Tim Unsinn and psychiatrist Dr. Wayne Martinsen define spirituality and discuss its relevance in daily life, touching on ways people experience, express, and cultivate spirituality. They also talk about the link between spirituality, religion and meaning in life.;
Setting Healthy & Realistic Goals
Setting goals is easy. Working towards them is hard. In this episode of Mind Your Mind, host Tim Unsinn talks with Dakota Family Services therapist Christy Wilkie about how to set healthy, realistic goals, as well as the importance of managing your expectations and staying persistent. Whether you’re starting an exercise routine, writing a book, trying a new diet, or building your career, keep these tips in mind when setting your next big goal.;
Facing Your Fears
Fear is powerful. It can cause us to avoid problems, people, and even opportunities in our life. But it can also be overcome. In this episode of Mind Your Mind, host Tim Unsinn speaks with Falan Johnson, a therapist at Dakota Family Services, about the function of fear and how to face it. Learn where fear comes from, how to identify it, and how to calm down and build confidence when you’re feeling afraid.;
The Three R's: Regulate, Relate & Reason
In this episode of Mind Your Mind, our host Tim Unsinn talks with Dakota Family Services therapist Jessie Mertz about the “3 R’s”—Regulate, Relate, and Reason. They discuss what each term means, how they build upon each other, and how this approach can help you calm others who are experiencing distress.;
What is Schizophrenia?
Schizophrenia is a chronic, complex mental health disorder that affects around 1% of people in the United States. In this episode of Mind Your Mind, host Tim Unsinn and psychiatrist Dr. Wayne Martinsen discuss the symptoms and implications of schizophrenia, touching on its many effects on individual and family life. Learn about how schizophrenia is treated, how it affects physical health, when it tends to develop, and how it is perceived between cultures.;
Seasonal Affective Disorder (Community Chat Series)
Feeling like you’ve got the winter blues? If you’re noticing symptoms of depression with the change of seasons, it may be a sign that you’re suffering from Seasonal Affective Disorder, or SAD. In this special Community Chat episode of Mind Your Mind, therapists Christy Wilkie and Lucas Mitzel discuss the common symptoms of Seasonal Affective Disorder, how it can affect other mental health disorders, and some useful tips, tricks, and resources for managing symptoms of SAD.;