When first experieincing panic attacks they are terrifying as you have no idea what they are, your mind gives you a million worse case scenarios that you must be dying. A panic attack feels like it hits every limb and organ in your body so something major must be wrong right? This reaction to the panic is what makes them worse, you start to think of all the worse case scenarios, creating more fear and more panic and they linger longer and they are harder to discharge from your body.

After you've experienced a few (and by a few I mean well over 1000 by now!) you start to notice the patterns and sensations in the body and how your reaction to them effects it and what happens to your body after.

Even after having that many panic attacks, I can tell you they don't get any less frightening, that same fear is there, the same bodily sensations that make you think you are dying are still there, the difference now though, is you know you are in a panic attack and that means you can change how you react to it and that changes how quickly your body and mind can recover and I think reduces the frequency in which you have them.

When I started to have panic attacks the sensations would feel like I was having a heart attack (vice like grip in the chest, missed heart beats, palpatations) or a stroke (blurred vision, dizziness, slurring words, foggy mind, disorientation, hot and sweaty palms), that I was going to pass out and faint (jelly legs, sensitivity to light, breathlessness), that I'd stop breathing (tight lungs, shallow fast breathing), I'd fear I was going blind, losing my mind, memory loss all manner of things. I could experience all of these at once or different variations of the same thing at different times. Sometimes with excruciating pain, other times they would creep up on you slowly making you more and more nervous and on edge.

The thing is the symptoms are very real, they are happening, but it's how your brain interpets them that effects you. The key is switching the interpretation of the sensations, as uncomfortable and real as they are, you have to stop the fear of them, which is a hell a of lot easier said than done.When you think you are dying there is very little room to rationalise from. When you have come through the panic attack and sit on the otherside you wonder what the fuck that was. There was no danger, why was your body reacting that way? But in the midst of the panic attack there is no rationale, your automatic nervous system has taken over and it's trying to protect you and your job is to try and change your thinking from I'm dying to this is just nervous arousal leaving the body. You have to try and bring calm back to your body. When this is happening in a situaton that makes no sense for it to be happening that is even harder to do.

I'll give you an example, if you are walking in a park being surrounded by 6 people with knives ready to rob you, it's pretty rationale that you might have a little bit of fear and your body might be reacting to that fear in that situation (and I've been there, you don't even notice your breathing change or your heart rate speed up, your vision narrow as you look for an escape route, its an automated surivival response, and luckily in my siutation it saved me as I was able to escape, I was able to spot a gap in the fence as the adrenaline kicked in so I could run through it and get out of there!) , but what if your stood in the mirror brushing your teeth and your body starts feeling like you are having a heart attack, your vision goes blurry, you feel dizzy, your breathing becomes intense, there is no rationale for that. It's the same survival response kicking in but for no reason other than your body is stuck in survival mode, so its probably normal that you start to fear something is wrong and think of all the worst case scenarios and that's what you have to change. I think the real lesson is in the reaction to both scenarios.

When I was being surrounded by 6 foreigners in Parco Sempione in Milan, I could see them working in pairs trying to pin me in, coming from me from 3 sides. At first I didn't want to let them know I'd clocked them as I tried to work out my options, so I just walked slowly in the direction I was heading, scanning the area looking for escape routes, if I started running too early they'd catch me and I would be in trouble. If I acted normally and oblivious to them I might buy myself some time. Behind me was a castle and moat, no way out, I couldnt run through the 2 in front of me, and I couldn't shout as there was noone around to hear me anyway. To my left there was a gate in a fence but it was about 500m away, how was I going to get there before they closed in on me? I picked up my pace, trying to stay as casual as possible, the 2 guys to the right of me started to move a little quicker, closing in on me shouting to the others, when they started to shout I knew that was my time to run, one shot to make it through the gate and out the park. No looking back just leg it. I could sense them chasing me and could see them out the corner of my eye, I knew if I could get through the gate and across the road I'd be safe. I'd be in the public again with other people about. As I ran across the road in front of a scooter I allowed myself to look back to see the 6 of them together on the pavement just outside the gate, contemplating their options. Take that mo fo's you are not getting me now we are out in the open. I can run any direction and you can't pin me in. I was safe. I frog marched back to my hotel, allowing myself to smile that I'd beaten the fuckers and got away from trouble. There was a natural elation as the adrenline wore off. I felt relief and celebratory. I focused on how I'd survived. I was amped up on adrenaline. I didn't give any notice to how fast my chest was beating or how heavily I was breathing, my survival instincts had kicked in and worked. The panic was gone it didn't linger it was expelled from my body.

Mirror that with me bushing my teeth and having a panic attack, there was no rationale for it, the same survival instinct was kicking in for no reason. (not that I knew what it was at that time) I couldn't celebrate my survival instinct kicking in to save me as there was no danger, how was this brave, why was I even shaking, feeling out of breath and dizzy? I must be having a heart attack, I must be dying! What the hell is wrong? It must be killing me! More panic, more fear, more shitty sensations!

In hindsight I can see that the symptoms and bodily sensations were exactly the same in both situations but my reaction to both was totally different (even if one was justified and the other wasn't) and thats the lesson. How you choose to react to the sensations, you can't control them but you can choose how you react.

The sensations I have now when I have a panic attack haven't changed (not quite true, they do vary to keep you on your toes but thats another blog!) but how I react to them has changed. At first you imagine all the worst case scenarios and you are scanning your body trying to check everything is ok, you don't always know it's a panic attack when you are in it.

Now I can be having a panic attack and know its a panic attack, in the midst of all the bodily sensations I'm able to rationalise this is panic and when that happens, I'm able to tell myself this will pass, I've been here before, this is nervous energy leaving my body. Now whilst that doesnt stop the sensations or reduce the panic attack, what I've experienced is that it helps me come back to a base level and recover quicker after. Because now I'm not scannig my body as much for danger, Im not expecting the worst from every sensation and feeling in the body, I'm not keeping myself locked in the cycle of panic.Instead of thinking the heavy chest is a heart attack I can tell myself this is panic.

Before I would dwell on the symptoms and keep asking myself why? Why is this happening? Now (not always, as i'm still in recovery!) I find it a little easier to shrug them off and say "ah well, it happened because it happened, I don't try and analyse every detail as to why it happened to stop them happeing again". I've figured they are going to happen whether I want them to or not, I can't control that, what I can control is how I process them after. If I need to spend 2hrs recovering after I don't beat myself up about it, If I need to cry I cry, if I need to tell someone I don't feel ok I tell them. I don't keep it botttled inside ruminating on it. (not as much as I did anyway!) I try and engage back into life, instead of sitting in fear and ruminating, I'll do something to ground myself. I'll be honest I cant engage in anything too taxing I need to be gentle, I still feel fragile after having a panic attack but I will try and live life still, whether thats renegagng in a conversation, walking to the shops, writing a blog or doing a puzzle, something that rengages the mind and brings a sense of calm. If I can and I remember I will try and turn the sensations into excitment and celebration like when I out ran the bandits in Milan!