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Emotional Impacts of Generalized Anxiety Disorder


 

Generalized Anxiety Disorder (GAD) affects over 4 million adult Americans every year. This is a condition where the person feels extremely worried or anxious on a regular basis.

Exaggerated feelings of worry or anxiety are normal in some situations, but for people who have generalized anxiety disorder or related conditions, the feelings are out of proportion with the situation at hand.

People with generalized anxiety disorder are unable to stop worrying about everyday events and situations and may become overly concerned with money, work, school, health or their families.

They spend their days in constant worry or anxiety over certain situations, and they often end up feeling worn out, depressed, sad, and cannot enjoy relationships or social activities.

They spend their days in constant worry or anxiety over certain situations, and they often end up feeling worn out, depressed, sad, and cannot enjoy relationships or social activities. Continue reading

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Fear of Fainting and Lightheadedness: Harmless panic symptoms

Whenever panic strikes it is the first feeling you notice. You feel you are going out of balance and that you are about to pass out.

Most people think that it due to some abnormality related to blood pressure or the balance system in our inner ears (The vestibular system) or they have a brain tumor which is making them dizzy, light headed and feel like fainting.

Lightheadedness and fear of fainting are interconnected in the case of the people suffering from anxiety or panic disorder. For them, lightheadedness often causes the fear of passing out or fainting and collapsing. This ultimately invites a full blown panic attack.
The common fears associated with the feeling of fainting are:

  • Fear of fainting in the public places.
  • Fear of fainting while driving or operating machinery.
  • Fear that you have a brain tumor.
  • Fear that you have a heart blockage and that is causing dizziness.
  • Fear that you will lose the sense of balance and you will not be able to stand erect.

 All of these fears are the negative thoughts which are the symptom of anxiety.

Yes. Negative Catastrophic thoughts are a symptom of anxiety.

Do you want to know how these fears are false?

For that first of all, we need to understand what fainting actually is:

Fainting occurs when there is low blood supply to the brain. It is a brief and sudden period of unconsciousness which is due to sudden and brief fall in the blood pressure. It means fainting occurs when there is simply less than needed supply of oxygen to the brain.

There can be a host of reasons which cause a reduction in the oxygen supply to the brain (cerebral oxygen).

In most cases, that is not all dangerous.  The circulatory system tries it’s best to provide ample of oxygen-rich blood to the brain. But because of some reasons, the deficit cannot be met.

In this case the body- brain system has a protective mechanism to restore normal oxygen supply to the brain. The head is above the heart. Therefore the heart has to work harder to supply blood to the brain because the gravity exerts a downward force on the blood.

Our nervous system then makes us unconscious and we faint. When we faint we collapse on the ground. This makes it easy for the heart to pump the blood to the brain as the body is in the lied down position.

This restores the normal oxygen supply to the major areas of the brain. As soon as the condition gets back to normal we get conscious again and we are fine without any harm to our body or health.

It can be understood from the above discussion that fainting is a reflex to certain conditions in the body which generally are related to the reduced oxygen supply to the brain.  It is a restoring mechanism of the mind-body system.  It restores normal oxygen supply to the brain to make your body function normally.

So, now it is pretty clear that fainting is not a dangerous or harmful thing.

What that has to do with the fear of fainting in the panic attacks?

Lightheadedness and Fear of Fainting

When you are anxious or having a panic attack you are probably breathing hard.

This increases the proportion of oxygen in your blood. Also, your heart is pounding and consequently your blood pressure rises as you are in the panic.

So in your case, the two conditions – low blood pressure and low oxygen supply to the brain are not met. This is the reason you don’t faint and collapse.

Look back and remember your past panic attacks. There is not a single incident of you collapsing or fainting.

You only got dizzy and lightheaded or disoriented to some extent. Hyperventilation causes these symptoms. It is very common to breathe rapidly and deeply in stress, anxiety or panic attacks. This causes hyperventilation and it makes you go dizzy, lightheaded, tired and anxious.

Again, hyperventilation is not dangerous. It just produces these uncomfortable symptoms which make you believe that you have some serious health problem.

This fear is because of misinterpretation of the symptoms of anxiety:

Dr.Helen Odessky, Psy. D  of yourchicagotherapist.com says on Fear of Fainting in Panic Attacks

 The causes of anxiety and panic disorder are:

1. Genetic predisposition ( But it does not mean that anxiety is incurable)

2. Environmental factors/conditions when you were brought up.

3. Physiological causes.

When you think of developing self-help strategies for dealing with panic disorder, there is actually no use of thinking on the causes of it. The success of treatment for anxiety and panic does not depend on whether you have understood the causes of them.

Genetic predisposition is something that cannot be controlled. Environmental factors, in which you were brought up have now gone in the past and we cannot do anything about them. Physiological causes are the causes which are due to some dysfunctions or diseases in the body. They can be corrected with proper treatment and that can resolve the problem.

The maintenance factors of Anxiety and Panic disorder are:

1. Negative thinking.

2. Fearing the symptoms and panic itself.

3. Overthinking.

4. Safety behaviors.

All these factors are the ones which maintain anxiety and panic disorder in your life. They are the behaviors which psychologists call self-defeating behaviors. You feel that they are saving you from dangers but actually, in reality, they are creating more and more distress for you.

Fear of fainting is one of them:

Now you know,

  • It is just a fear of fainting
  • Fainting is not dangerous

A well-known Anxiety Therapist Dr. David Carbonell says he witnessed only 4 individuals in his 20-year long career of the Anxiety Treatment who fainted during panic attacks. You can see it in here.

Also read: How To Reduce Anxiety: Find time to Relax in this Busy World by doctor Dr.Helen Odessky, Psy. D

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5 Actionable Steps To Handle The Discomfort In Anxiety and Panic Attacks

Anxiety is highly associated with discomfort.
The very characteristic of anxiety is to give you more and more discomfort.
This discomfort is taken as a danger to you and you get trapped in the cycle or recurring anxiety and panic attacks.

It is very important to identify if the discomforts are due to some physical conditions or anxiety. When a medical professional assures you that there are no medical causes to your discomfort and all of it is anxiety, you need not worry. You can manage your discomfort in anxiety with proper education and self-training.  You can also check out 3 panic attacks tricks that will actually make your life better

The discomforting(physical) symptoms of panic are:
  • Feeling uncomfortable for no reason
  • Getting restless
  • Tightness in the chest
  • Heaviness in chest
  • pressure or pain in the stomach with butterflies
  • Jitters
  • Pressure in the head
  • Trembling or Muscle vibrations
  • Fatigue

These are the somatic (bodily) symptoms which are regularly experienced by anxiety sufferers in varying intensity.

These 5 steps can be very helpful to you to reduce your discomfort in panic attacks or general anxiety

1. Do some simple exercises to calm downhow to manage anxiety discomfortWhen panic hits you, it is a state of high arousal of the nervous system.
You might be knowing that a panic attack is an emergency  alarm by your body to run away or combat with a danger. Only the difference here is that there is no real danger present in your case.

It is fight or flight response from our inbuilt survival mechanism which ensures us safety on this planet.

Adrenaline is a hormone produced in the adrenaline glands and it is the main chemical responsible for our nervous arousal. This hormone makes your body ready and capable of handling dangerous situations by giving you a good boost of energy and vitality. It makes you super aroused and agile to take action in certain situations. This is what we call adrenaline rush.

But here you don’t need to be powerful and agile as you are not in danger.

Then what do you do?

Just do Brisk Walking or simple exercise like jumping jacks. This has to be the first among the steps to handle the discomfort in Anxiety and Panic Attacks. That will utilize the extra boost of energy which you got from the adrenaline rush and it will help to calm your body from the aroused state. As you will return towards normal state the production of adrenaline will reduce as there will be no anxiety to fuel its production.

Finally, you will be able to calm down and focus on your breathing to relax further.

2.Focus on steady breathing

“Steady Breathing is the key to controlling the overall panic attack”

Breathing is the main aspect of the physiological process which controls the intensity of the physical symptoms of panic attacks.

When you are under stress or anxiety you breathe very fast and shallow. This happens unconsciously. You do not notice it. This causes hyperventilation.

Hyperventilation is the imbalance of the proportions of oxygen and carbon dioxide in the blood. During your rapid breathing more carbon dioxide is thrown out of the blood and more oxygen is taken in. More precisely it is a low proportion of carbon dioxide in the blood compared to the levels of oxygen.

The sensations of tingling, lightheadedness, and pins & needles are caused due to hyperventilation.  It feels you can’t catch your breath and you are running out of air/ oxygen. Many people also fear that they are suffocating because of some lung problems. 

Many people also fear that they are suffocating because of some lung problems

Therefore in stressful situations focus on your breathing and practice slow and steady breathing for a few minutes. This will help to restore the normal proportions of Oxygen and Carbon dioxide in your blood and that will help the panic attack end.

Steady breathing is an often suggested technique to manage anxiety by experts. This will help you get relief in a few minutes.

This will help you get relief in a few minutes.

3.Understand that this state is not permanent

“Like everything, even panic attacks have to end”

When panic and anxiety strikes and you go into the state of high discomfort you feel that it will never end or it will end up in a catastrophe.

But the truth is that anxiety can last longer but it can never last forever.

As you know anxiety is the alarm system of your body and it fires with the help of certain chemicals like adrenaline. Sooner or later the fear system will shut down and you will return to normal from this high aroused state of your nervous system.

Panic attack definitely has to end at some point of time. The reasons for this is the chemicals which support panic attack to sustain get reduced after a certain time. The physiological conditions responsible for the panic attack get subsided. Consequently , the panic attack ends.

4.Understand that it was not a beginning of catastrophe but a false signal of a catastrophe

“There is difference between a catastrophe and  just feelings of a catastrophe”

It is almost certain for you to think that it is a catastrophe.

YOU become certain that it is a heart attack.

You fear many things in this phase like fear of death fear of heart attack and catastrophic thoughts. It is necessary for you to understand that this is just an imitation of a catastrophic situation. It is not a real catastrophe.

It is not a danger but a false alarm of danger which you take it as real.

5. Get going after it ends: Don’t dwell on it!
 

                     “Overthinking fuels Panic Attacks”

This is a very important thing when you get normal after a discomforting episode of high anxiety. On the contrary, you generally keep on thinking about the episode and wonder what happened and how did it happen and what might have been the consequences of the panic attack. YOU feel like you dodged a bullet and the somehow you saved yourself from a heart attack or death.

This is the anticipatory anxiety which fuels next panic attack.

You feel that you have to think of all those things in order to save yourself from the dangers you are facing. But thinking on all of these things is really useless. It only creates more anxiety and keeps you trapped in a vicious cycle of crippling anxiety.

Have you noticed the power of  forgetting something?

Take this Example

Suppose you lost your golden ring and you are not aware of it. After some time it clicks to you suddenly. You get mad over it. You get angry, anxious and irritated and you rush everywhere to find it.

Until the sense of loss hit you, you were not concerned about it. The ring was lost and it was a real loss for you but you were not aware of it consciously. You went upset, anxious, worried and restless only when the thoughts about the loss surfaced your mind.

It means if we forget or ignore certain things they tend to be less bothersome to us and if we forget about a certain thing completely, we are completely free of the distress for a certain period of time.

The same thing applies here.

If you forget that you have had a panic attack or anxiety you will be in less distress.

If you stop worrying about the next panic attack, the fueling process will be blocked and you will be less likely to have another panic attack. You will be able to concentrate on your present better. These steps to handle the discomfort in anxiety and panic attacks are practical steps and they will require practice to get the desided results.

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Intrusive Thoughts in Panic Disorder: The Chaos You Face in Extreme Anxiety

In almost all cases of Panic Disorder‚ the driving factor fuelling the sensations is anxious thinking. 

Without addressing these specific intrusive thoughts in panic disorder‚ there can be little success in eliminating the root of the anxiety.

People who experience anxiety and panic attacks frequently have to deal with the negative side–effects of unwanted thoughts that creep into their minds. 

These thoughts can range from worries about health‚ concern over loved ones‚ or even fears that do not make any rational sense at all but continue to linger in the mind.

Sometimes‚ the unwanted intrusive thoughts come from previous experiences; other times they are simply bizarre‚ leaving the person worried as to why such strange thoughts are occurring.

In all these cases‚ the person is upset by the anxious thoughts because they are causing distress and worry. I will guide you through a simple two–step process that is in part related to the One Move which I teach but tailored specifically to dealing with anxious thinking.

In all these cases‚ the person is upset by the anxious thoughts because they are causing distress and worry. I will guide you through a simple two–step process that is in part related to the One Move which I teach but tailored specifically to dealing with anxious thinking.

Anxious Intrusive Thoughts in Panic Disorder

Tackling anxious intrusive thinking effectively requires a two–pronged approach. To eliminate the negative thinking patterns‚ there needs to be a shift in attitude along with specific visualization tools.

The Attitude Shift is going to be the First Step

It is not the intrusive thoughts in themselves that cause you distress. It is how you are responding to those thoughts. It is the reaction you are having to the thoughts that enable them to have influence and power over you. In order to better understand how unwanted thoughts come about‚, it helps to paint a playful visual picture of how this happens. This is a fictional example and will help you better understand how to deal with the issue.

Imagine,

You are standing on a street and all around you thoughts are floating lazily by. Some of the thoughts are your own‚ other thoughts are from outside sources you access such as newspapers‚ TV‚ magazines‚ etc. You notice that when you pay attention to a thought it gravitates nearer. The thoughts you ignore float on by.

When you focus and examine a thought up closely‚ you notice how it connects to another similar thought‚ and you find yourself jumping from one thought to the next. Sometimes these are practical‚ day–to–day thoughts such as bills‚ chores‚ etc.‚ or the thoughts can theme by the past or a fantasy/daydream.

In our imagined scenario‚

You unexpectedly notice a thought hovering in front of you that scares you. This thought is called “Fear X.” X could be panic attacks‚ ill health‚ or something bizarre. You find it impossible not to look at the thought‚ and as you give it your full attention‚ this causes it to come closer and closer. When you examine the thought‚ you begin to react with fear as you do not like what you see. You further notice how that initial scary thought is connected to more worrying “what if” thoughts that you also examine in detail. The more you try to escape from the thought by pushing it away‚ the more it seems to follow you around as if it were stuck to you. You try to focus on more pleasant thoughts‚ but you find yourself continuously coming back to the fearful thought.

Intrusive Thoughts in Panic Disorder: The anticipation of Anxiety

There is an expression of “thoughts sticking like glue.”

The very act of reacting emotionally to the thought glues the thought all the more to you‚ and the more time you spend worrying and obsessing about the thought‚ the more that glue becomes hardened over time. The thought and all its associated connected thoughts are there in the morning when you wake and there at night when you are trying to get some sleep.

The thought becomes stuck because your emotional reaction to it is its sticking power! 

Thoughts are a form of energy‚ neither good nor bad. It is how we judge those thoughts that determines how much impact they have on our lives. Thoughts need firstly to be fed by attention‚ but what they really love is a good strong emotional reaction to make them stick!

Thoughts that stay with us are first attracted to us by the attention we pay them and then stuck firmly in place by the level of emotional reaction we have to them.

This is an important point

A thought–even negative intrusive thoughts–can only have an influence on you if you allow it to. The emotional reaction from us is a thought’s energy source. What’s interesting is that either a positive or a negative emotional reaction is fine for the thought. Energy and attention are what it is attracted to. Once you are having an emotional reaction to a thought‚ you will be regularly drawn to that thought until the emotional reaction has lost its energy and faded away.

For example‚

If someone you know pays you a very positive compliment‚ you may find yourself unintentionally drawn to that thought anytime you have a spare moment. You probably find it improves your overall level of confidence and mood throughout the day.

Sadly, however, we tend to focus less on the positive and more on the negative. We seem to forget those positive compliments all too easily and are drawn more frequently to what might upset us.

Taking the opposite example‚ if someone you know insults you‚ I am sure that you find the emotional reaction to that thought much more intense and probably very long–lasting.

So what has to be the best way to eliminate Intrusive Thoughts in Panic Disorder?

If you are not engaged in an activity or task‚ your mind will tend to wander to any thoughts that you are having a strong emotional reaction to. In general‚ as they are the ones that you are probably reacting most strongly to‚ angry or fearful thoughts seem to surface quickly.

Suppressing the Thoughts won’t help!

What I am suggesting is that suppressing the Intrusive thoughts in panic disorder is the most ineffective way to get rid of them.

Thought suppression studies‚ (Wegner‚ Schneider‚ Carter‚ & White‚ 1987) have proven that the very act of trying to suppress a thought‚ only results in a higher frequency of unwanted intrusive thoughts occurring.

This reoccurrence of the thought has been termed the ‘rebound effect’.

Simply put: The more you try suppressing a thought‚ the more the unwanted thought keeps popping up (rebounding).

Next readHow To Eliminate Intrusive Thoughts If You Suffer Panic Disorder

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Panic Attack Symptoms and their Actual Interpretation

A panic attack is a discrete period of intense fear that is accompanied by uncomfortable physical symptoms

Panic Attack Symptoms may include:

  • Palpitations.
  • Sweating.
  • Trembling or shaking.
  • Shortness of breath or smothering.
  • Feelings of choking.
  • Chest pain or discomfort.
  • Nausea or abdominal distress.
  • Dizziness or light–headedness.
  • Pins and needles.
  • Diarrhea.
  • Dry mouth.
  • Headache.
  • Derealization or depersonalization.
  • Chills or hot flushes

There are two types of panic attacks:

1) Spontaneous (Uncued) Panic Attacks: These are not associated with a situational trigger and appears to come ‘out of the blue’. These panic attacks can occur during periods of relaxation or when sleeping.
2) Situational (Cued) Panic Attacks: They occur either in anticipation of a situation or in a situation where an attack has previously been experienced. Usually, the symptoms become apparent as one enters the situation.

Panic Attack Symptoms: The Irrational Fears 

1.” Am I going crazy?”

It is understandable for anyone to fear they may be going crazy when they suffer from the panic attack symptoms. There is so little real public awareness of mental disease‚ so people often jump to extreme conclusions. These conclusions are usually based on misinformation and an overactive imagination.

The most commonly known mental health issue is schizophrenia — even the word itself strikes terror within the average person. Schizophrenia is a major disorder characterized by such severe symptoms as disjointed thoughts and speech‚ babbling‚ having delusions or strange beliefs (for example‚ sufferers often claim they are receiving messages from an inner voice)‚ and hallucinations. Furthermore, schizophrenia appears to be largely a genetic disorder and run strongly in families.

Schizophrenia generally begins very gradually‚ and not suddenly (such as during a panic attack). Additionally‚ because it runs in families‚ only a certain proportion of people can become schizophrenic‚ and in other people‚ no amount of stress will cause the disorder.

A third important point is that people who become schizophrenic will usually show some mild symptoms for most of their lives (such as unusual thoughts‚ flowery speech‚ etc.). Thus‚ if this has not been noticed in you yet‚ then chances are you will not become schizophrenic. This is especially true if you are over 25‚ since schizophrenia generally first appears in the late teens to early 20’s.

2.Fear of Losing Control: Will I Pass Out in Public?

During a panic attack,‚ people are prone to believe they are going to “lose control”. This happens because of the symptoms they are experiencing. They think this loss of control can be bodily‚ i.e.‚ that all your vital organs will completely lose the run of themselves and descend into chaos‚ or that the individual will mentally lose a grip on reality. Often‚ it is those who hate being socially embarrassed suffer from this fear the most.

Losing control could range from steering your car into an innocent passerby‚ or picking up a knife and killing the nearest and dearest person to you (not that we all don’t think of this from time to time!).

Put your mind at rest! As scary as those thoughts may be‚ you are not going to commit any of these acts. Relax. The reason you are experiencing them is that your body feels out of control with the panic attack symptoms. Your mind feels that if your body is out of control‚ it is next on the list.

You are not going to lose it. In fact‚ I am sure that with all the panic attacks you may have experienced in public places‚ nobody even noticed you looked uncomfortable. We are‚ by nature‚ social animals and dread to be seen in some kind of an embarrassing situation. Jumping up from your chair in a business meeting and screaming for an ambulance may go through your mind‚ but it is unlikely to happen.

In the end‚ even if we do embarrass ourselves socially‚ does it really matter? We have to learn to be kind to ourselves. So what if we were to cause a scene and great embarrassment? Life is too short to keep up with appearances all the time. In fact‚ the more honest you are with your fears‚ the less pressure you are subjecting yourself under‚ and the more your panic attack symptoms will dissipate.

BUT the TRUTH is: It cannot cause Fainting!

Panic attack symptoms often include light–headiness‚ which induces fears of passing out or fainting in public. The core fear of passing out in public is that we suddenly become so vulnerable‚ especially if we are alone.

Who will look after us as we lie strewn across the sidewalk?

We also dread the thought of passing out for fear that we may never wake but fall into a coma.

Passing out is caused by a lack of blood to the brain. When we faint‚ the body falls to the ground and allows blood to be easily supplied to the brain — which is‚ again‚ another of the clever safety mechanisms of the body.

Quite simply‚ fainting during a panic attack is highly uncommon due to the amount of blood that is being circulated. Your heart is usually beating fast and there is little worry that the brain would be short of fresh supply.

The symptoms of dizziness often felt during a panic attack is caused by increased respiration‚ and while it may be confusing for the individual‚ it is harmless and does not lead to fainting.

3.Fear of Heart Attack: Am I Having A Heart Attack?

This fear really is a minefield and almost anyone who has suffered from panic attack symptoms at some point will fear for the health of their heart. Let us look at the facts of heart disease and see how this differs from panic attacks.

The major symptoms of heart disease are breathlessness and chest pain‚ as well as occasional palpitations and fainting. Such symptoms are generally related to the amount of physical effort exerted. That is‚ the harder you exercise‚ the worse the symptoms‚ and the less you exercise‚ the better.

The symptoms will usually go away quickly if the individual rests. This is very different to panic attack symptoms. Certainly, panic symptoms can occur during exercise. But, they are different to the symptoms of a heart attack as they occur frequently at rest.

Of most importance, heart disease will almost always produce major electrical changes in the heart‚ which are picked up very obviously by an EKG. In panic attacks‚ the only change that shows up on the EKG is a slight increase in heartbeat rate.

Sometimes‚ individuals go through a similar worry about their heart as they do with their breathing. People convince themselves that if they worry enough about their heart‚ or concentrate too much upon its actions‚ that it may somehow get confused and forget how to beat correctly.

It is quite common for people who suffer from panic attacks to regularly check in on their heart at intervals. They always want to make sure it is still beating away.

It is true that‚ mentally‚ we can all affect the pattern of our heartbeats. When you concentrate hard you may notice an irregular beat or two. This is nothing to get upset about. Remember that our bodies have an incredible internal intelligence and simply telling your heart out of panic that it might stop does not mean that it takes any heed of our fears.

Learn to become more comfortable with your heart‚ let it do its job. Listen to it when relaxed and also when exercising. The more comfortable you are with the diversity and range of your heartbeats‚ the more confidence you will have in it when it is exerting itself.

If you are worried about heart problems‚ treat yourself to an EKG‚ and put your mind to rest. If you have had an EKG and the doctor has cleared you‚ you can safely assume you do not have heart problems. Also‚ if your symptoms occur at any time and not solely upon exertion‚ this is additional evidence against a heart disorder.

4.Feeling Unreality/Disconnectedness:

Of all the panic attack symptoms‚ this is perhaps the least mentioned one in the literature (induced by excessive anxiety). It is the sensation of unreality. Many people become distressed by this sensation and feel they may be losing their mind.

People who experience panic attack symptoms report feeling disconnected from their world‚ or having a sensation of unreality. The sensation is described as if the world has become nothing more than a projection of a film. This sensation is quite distressing as it often leads to the individual believing that some permanent damage has been done to their brain‚ causing these sensations.

A typical manifestation of this is when the individual may be having a conversation with someone and suddenly feels alarmingly isolated and removed from the situation. Once the sensation arises it can make such an impact that it takes days to leave the eerie feeling behind and stop thinking about it.

I mention this because this condition is discussed rarely.

It is important to learn that it is only a side–effect of excessive anxiety and will pass as soon as the body learns to relax. Once the body returns to normal and has the opportunity to dispel some excess chemicals produced by the adrenal glands‚ then this unusual sensation will dissipate.

Give it time‚ and these feelings will subside as you move from a life of anxiety to a more tranquil one.

Over to You

Now you know that the following symptom-associated feelings are irrational and are not real:

  • “I am Going Crazy”
  • “I’ll lose Control and Pass Out in Public”
  • “I’m having a Heart Attack”
  • “The feeling of Unreality is Dangerous”

 Instead, you can say the scientifically true things:

  • “I am not Going Crazy. Panic does not make one go crazy”
  • “I’ll not lose Control and Pass Out in Public. It is highly impossible”
  • “I’m not having a Heart Attack. It is just Anxiety discomfort”
  • “The feeling of Unreality is not Dangerous. It is a temporary discomforting feeling”

     This will be your first step towards recovery.

 

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