I encourage you all to donate just $10 to the American Red Cross for the Haiti disaster. You can do it via text message. You can text “HAITI” to 90999 to donate $10 to American Red Cross relief for Haiti. Thank You!
Blessings,
Kathryn A. R. James, MFT
Friday, January 15, 2010
Monday, January 4, 2010
Panic Attacks and Coping Skills
Happy New Year, everyone! I hope that you had a nice holiday and are looking forward to a great 2010! Some of you requested that I blog about Panic Attacks. Therefore, this blog will focus on that. We often hear "oh, I had a panic attack, and I didn't know what to do". My goal here is to first describe the criteria for panic attacks and to provide some skills on how to de-escalate yourself if you do have one. Being prepared with tools if you have panic attacks and panic disorder is key to a cure!
Criteria for a Panic Attack cited from the DSM IV-R (2000):
A discrete period of intense fear or discomfort, in which 4 or more of the following symptoms developed abruptly and reached a peak within 10 minutes:
1) palpitations, pounding heart, or accelerated heart rate
2) sweating
3) trembling or shaking
4) sensations of shortness of breath or smothering
5) feeling of choking
6) chest pain or discomfort
7) nausea or abdominal distress
8) feeling dizzy, unsteady, lightheaded, or faint
9) derealization (feelings of unreality) or depersonalization (being detached from oneself)
10) fear of losing control or going crazy
11) fear of dying
12) numbness or tingling sensations
13) chills or hot flashes
Another disorder that is associated with Panic Attacks is Panic Disorder. Panic Disorder' s essential feature is "the presence of recurrent, unexpected Panic Attacks followed by at least one month of persistent concern about having another Panic Attack, worry about the possible implications or consequences of the Panic Attacks or a significant behavioral change related to the attacks" (DSM, 2000). Panic Attacks and Panic Disorder can be very frightening, and the good news is that they can be managed or prevented effectively. However, if you continue to have them, please seek professional help either from a psychotherapist or psychiatrist. Medication can be prescribed to alleviate them also. If medication is necessary, remember to always accompany it with therapy.
Skills to help prevent and/or manage Panic Attacks:
1. Seek Safety immediately when you feel one coming on (ie go to a safe environment with "safe people" or familiar surroundings.
2. Breathe deeply and slowly. The majority of people breath incorrectly at all times. So by all means breath correctly when having a P.A. Here is the ratio for proper breathing at all times: 2 counts exhaled for ever 1 count inhaled. If you breathe in for 5 counts, exhale 10 counts. Do not breathe too fast, or you will hyperventilate. Know that this time will pass.
3. Call someone who can be of help like a therapist, a friend, a mentor, or family member. Talk with them before to ask them if they would mind being your safety call. That way they will be prepared and not be caught off guard. Remember we live in a tribal culture! The worst thing is to feel and be isolated.
4. Carry a grounding object with you. This can be a smooth stone that you keep in your pocket or a piece of jewelry. It can even be something s simple as a tube of chap stick that you hold on to in your pocket! Grounding objects need to be in reach and always with you that you touch and are able to rub or fidget it. Think of how Linus from Peanuts always had his blanket. His blanket was a safe grounding object.
5. Know your triggers for panic attacks. Pay attention and become more aware of people, places, and things that trigger you to having a P.A. and AVOID THEM! If this is impossible, plan ahead of grounding techniques and coping skills to begin BEFORE you encounter the triggers. And ALWAYS have an exit strategy. If big parties or crowds cause you to have panic attacks but you can't avoid one, plan your way to get in then get out and stick to the plan. Stay away from caffeine and stimulants and exercise regularly to burn off anxious energy. You might want to cut down on aerobic exercise and do something more anaerobic such as weight lifting or yoga instead.
I hope that this information is beneficial to you. If you have any comments or questions, please let me know. I have posted a book list too. My next blog will be on "teenage angst"! If you would like to make an appointment, please contact me at 415.244.5590 or www.kjamesmft.com.
Be Well and Many Blessings!,
Kathryn A R. James, MFT
Criteria for a Panic Attack cited from the DSM IV-R (2000):
A discrete period of intense fear or discomfort, in which 4 or more of the following symptoms developed abruptly and reached a peak within 10 minutes:
1) palpitations, pounding heart, or accelerated heart rate
2) sweating
3) trembling or shaking
4) sensations of shortness of breath or smothering
5) feeling of choking
6) chest pain or discomfort
7) nausea or abdominal distress
8) feeling dizzy, unsteady, lightheaded, or faint
9) derealization (feelings of unreality) or depersonalization (being detached from oneself)
10) fear of losing control or going crazy
11) fear of dying
12) numbness or tingling sensations
13) chills or hot flashes
Another disorder that is associated with Panic Attacks is Panic Disorder. Panic Disorder' s essential feature is "the presence of recurrent, unexpected Panic Attacks followed by at least one month of persistent concern about having another Panic Attack, worry about the possible implications or consequences of the Panic Attacks or a significant behavioral change related to the attacks" (DSM, 2000). Panic Attacks and Panic Disorder can be very frightening, and the good news is that they can be managed or prevented effectively. However, if you continue to have them, please seek professional help either from a psychotherapist or psychiatrist. Medication can be prescribed to alleviate them also. If medication is necessary, remember to always accompany it with therapy.
Skills to help prevent and/or manage Panic Attacks:
1. Seek Safety immediately when you feel one coming on (ie go to a safe environment with "safe people" or familiar surroundings.
2. Breathe deeply and slowly. The majority of people breath incorrectly at all times. So by all means breath correctly when having a P.A. Here is the ratio for proper breathing at all times: 2 counts exhaled for ever 1 count inhaled. If you breathe in for 5 counts, exhale 10 counts. Do not breathe too fast, or you will hyperventilate. Know that this time will pass.
3. Call someone who can be of help like a therapist, a friend, a mentor, or family member. Talk with them before to ask them if they would mind being your safety call. That way they will be prepared and not be caught off guard. Remember we live in a tribal culture! The worst thing is to feel and be isolated.
4. Carry a grounding object with you. This can be a smooth stone that you keep in your pocket or a piece of jewelry. It can even be something s simple as a tube of chap stick that you hold on to in your pocket! Grounding objects need to be in reach and always with you that you touch and are able to rub or fidget it. Think of how Linus from Peanuts always had his blanket. His blanket was a safe grounding object.
5. Know your triggers for panic attacks. Pay attention and become more aware of people, places, and things that trigger you to having a P.A. and AVOID THEM! If this is impossible, plan ahead of grounding techniques and coping skills to begin BEFORE you encounter the triggers. And ALWAYS have an exit strategy. If big parties or crowds cause you to have panic attacks but you can't avoid one, plan your way to get in then get out and stick to the plan. Stay away from caffeine and stimulants and exercise regularly to burn off anxious energy. You might want to cut down on aerobic exercise and do something more anaerobic such as weight lifting or yoga instead.
I hope that this information is beneficial to you. If you have any comments or questions, please let me know. I have posted a book list too. My next blog will be on "teenage angst"! If you would like to make an appointment, please contact me at 415.244.5590 or www.kjamesmft.com.
Be Well and Many Blessings!,
Kathryn A R. James, MFT
Friday, December 4, 2009
My blog that I am creating is intended communicate my thoughts and reflections as a psychotherapist and to provide mental health information that you request. I will also provide good wellness tips for living a balanced, positive, healthy life! If you have any questions or suggestions, please let me know. Overall, this blog is for you. We are in the holiday season now, which can be a very happy time for some but also a very sad or stressful time. With that in mind, I challenge you to reflect on giving and being compassionate.
Regarding giving, ask yourself "what am I giving, and when I give, am I expecting anything in return? What is the intention and motivation behind the giving and am I truly thankful?" I had a client say to me this week in session that even though she is frustrated she can't find a job, she is keeping everything in perspective because she has a home, plenty of food, and nice things. I thought that that was profound especially regarding her high skill level. Be a cheerful giver.
With regards to compassion, extend more patience for those who try your patience, perform a random act of kindness to someone, and most of all forgive yourself for your shortcomings. Compassion is contagious and healing.
We Americans are being consumed with commercialism and consumerism right now, and it has become apparent that we have lost perspective between needs, wants, and should haves. Since when did having 10 pairs of shoes become the norm when we walk past people on the street who are barefoot? Not to say that you should not enjoy your success but when is enough, enough?! Therefore, now that we are approaching Christmas and Hannukah, I challenge you to take a personal inventory of all of your things and your "emotional things" and deglut what you don't need or want! Keep the things that bring you meaning. I think of a handkerchief that belonged to one of my mother's childhood friends, Aunt Elsie. She passed a year ago suddenly. I carry it in my purse everywhere I go. I have many sweet memories of Aunt Elsie and love to smell the handkerchief for it smells of her. I will pass along books that I have finished and clothes that I no longer wear. I am thankful for my beautiful living space and the treasures I have collected over the years from around the world. I am thankful for my health and the knowledge I won't go hungry or unclothed. Mostly, I am thankful for the faces that are etched in my memory- my belated father, my mother, my nephew and nieces, my clients past and present, Baby Grace, my friends, and my family.
Those etchings are infinite and indespensible.
Many Blessings to you,
Kathryn James, LMFT
www.kjamesmft.com
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