Multiple Sclerosis Strategies for Coping with Fear and Anxiety
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anxiety
Panic disorder – what is it and why do we need to know?
Panic disorder
Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear.
Everyone experiences feelings of anxiety and panic at certain times. It’s a natural response to stressful or dangerous situations.
But for someone with panic disorder, feelings of anxiety, stress and panic occur regularly and at any time, often for no apparent reason.
Symptoms
Anxiety
Anxiety is a feeling of unease. It can range from mild to severe, and can include feelings of worry and fear. The most severe form of anxiety is panic.
You may start to avoid certain situations because you fear they’ll trigger another attack.
This can create a cycle of living “in fear of fear”. It can add to your sense of panic and may cause you to have more attacks.
Panic attacks
A panic attack is when your body experiences a rush of intense mental and physical symptoms. It can come on very quickly and for no apparent reason.
A panic attack can be very frightening and distressing.
Symptoms include:
a racing heartbeat
feeling faint
sweating
nausea
chest pain
trembling
hot flushes
chills
shaky limbs
a choking sensation
dizziness
numbness or pins and needles
a need to go to the toilet
ringing in your ears
a feeling of dread or a fear of dying
a churning stomach
a tingling sensation in your fingers
feeling like you’re not connected to your body
Most panic attacks last for between 5 and 20 minutes. Some panic attacks have been reported to last up to an hour.
The number of attacks you have will depend on how severe your condition is. Some people have attacks once or twice a month, while others have them several times a week.
Although panic attacks are frightening, they’re not dangerous. An attack won’t cause you any physical harm, and it’s unlikely that you’ll be admitted to hospital if you have one.
Be aware that most of these symptoms can also be symptoms of other conditions or problems, so you may not always be experiencing a panic attack.
For example, you may have a racing heartbeat if you have very low blood pressure.
When to get help
See your GP if you have been experiencing symptoms of panic disorder.
They’ll ask you to describe your symptoms, how often they occur, and how long you have had them.
They may also carry out a physical examination to rule out other conditions that could be causing your symptoms.
Although it can sometimes be difficult to talk to someone else about your feelings, emotions and personal life, try not to feel anxious or embarrassed.
You may be diagnosed with panic disorder if you experience recurrent and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks.
Treatments for panic disorder
Treatment aims to reduce the number of panic attacks you have and ease your symptoms.
Psychological (talking) therapies and medication are the 2 main treatments for panic disorder.
Depending on your symptoms, you may need one of these treatments or a combination of the two.
Psychological therapies
You can refer yourself directly to a psychological therapies service for treatment based on cognitive behavioural therapy (CBT).
If you prefer, you can see your GP and they can refer you.
You might discuss with your therapist how you react and what you think about when you’re experiencing a panic attack.
Your therapist can teach you ways of changing your behaviour, such as breathing techniques to help you keep calm during an attack.
See your GP regularly while you’re having CBT so they can assess your progress and see how you’re doing.
Medication
If you and your doctor think it might be helpful, you may be prescribed:
a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) or, if SSRIs aren’t suitable, a tricyclic antidepressant (usually imipramine or clomipramine)
an anti-epilepsy drug such as pregabalin or, if your anxiety is severe, clonazepam (these medicines are also beneficial for treating anxiety)
Antidepressants can take 2 to 4 weeks before their effect builds up, and up to 8 weeks to work fully.
Keep taking your medications, even if you feel they’re not working, and only stop taking them if your GP advises you to do so.
Referral to a specialist
If your symptoms don’t improve after CBT, medication and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist.
The specialist will carry out an assessment of your condition and devise a treatment plan to help you manage your symptoms.
Things you can try yourself
What to do during a panic attack
The next time you feel a panic attack coming on, try the following:
don’t fight the attack and stay where you are, if possible
breathe slowly and deeply
remind yourself that the attack will pass
focus on positive, peaceful and relaxing images
remember it isn’t life threatening
It may help to read our article on how to deal with panic attacks.
You’ll also find mental health apps and tools in the NHS apps library.
Preventing a further attack
It may also help to:
read a self-help book for anxiety based on the principles of CBT (ask your GP to recommend one)
try complementary therapies such as massage and aromatherapy, or activities like yoga and pilates, to help you relax
learn breathing techniques to help ease symptoms
do regular physical exercise to reduce stress and tension
avoid sugary food and drinks, caffeine and alcohol, and stop smoking, as all these things can make attacks worse
Ask your GP about support groups for panic disorder near you.
Complications of panic disorder
Panic disorder is treatable and you can make a full recovery. It’s best to seek medical help as soon as you can if possible.
If you don’t get medical help, panic disorder can escalate and become very difficult to cope with.
You’re more at risk of developing other mental health conditions, such as agoraphobia or other phobias, or an alcohol or drug problem.
If you have panic disorder, it may also affect your ability to drive. Legally, you need to inform the Driver and Vehicle Licensing Agency (DVLA) about a medical condition that could impact your driving ability.
Visit GOV.UK for further information about driving with a disability or health condition.
Causes
As with many mental health conditions, the exact cause of panic disorder isn’t fully understood.
But it’s thought the condition is probably linked to a combination of things, including:
a traumatic or very stressful life experience, such as bereavement
having a close family member with the disorder
an imbalance of neurotransmitters (chemical messengers) in the brain
Panic disorder in children
Panic disorder is more common in teenagers than in younger children.
Panic attacks can be particularly hard for children and young people to deal with. Severe panic disorder may affect their development and learning.
If your child displays the signs and symptoms of panic disorder, they should see a GP.
A GP will take a detailed medical history and carry out a thorough physical examination to rule out any physical causes for the symptoms.
They may refer your child to a specialist for further assessment and treatment. The specialist may recommend a course of CBT for your child.
Screening for other anxiety disorders may also be needed to help determine what’s causing your child’s panic attacks.
Read more about anxiety disorders in children or find out about mental health services for children and young people.
Understanding Anxiety And AUTISM – the view from view from the Aspie World
Anxiety is a huge factor for autistic people., find out more in this video
Find out more about dealing with anxiety here
Looking For A New Pet? Science-Proven Health Benefits Of Owning An Aquarium
Looking For A New Pet? Science-Proven Health Benefits Of Owning An Aquarium
Aquariums have the ability to reduce anxiety and stress by inducing the calming effort of a natural setting. A study in 2004 revealed that patients experienced a 12% reduction in anxiety during the presence of an aquarium. It is the sound effects of ocean waves, running streams, and rainstorms that are peaceful and relaxing to the mind. So, do you experience stress, high blood pressure, or frequent events of insomnia?
Keeping a fish tank in your home may be good therapy. In fact, studies since the late ‘80s have shown just how aquariums may improve your sleep, reduce stress, and lower blood pressure.
Calm-inducing properties in water
People with a “blue mind” experience a meditative state of calmness, unity, and a general sense of happiness within the moment, according to marine biologist, Wallace J. Nichols. Watching the livelihood of fish in their habitat helps to relax and calm children with hyperactivity disorder. Other studies revealed that dental patients experienced less pain after viewing a fish tank during their visit. Not to mention, research also showed a significant reduction in blood pressure in senior citizens.
Improve heart rate and blood pressure
Fish tanks have the ability to play a positive effect on one’s physical condition, according to a study by the UK’s Plymouth University. Scientists also found that staring at swimming fish could greatly improve an individual’s well-being. In fact, researchers also found the following:
3% reduction in heart rate when aquarium contained only rock and seaweed
7% reduction in low blood pressure when fish occupied the tank
An overall boost in mood when the tank contained high numbers of fish
Experts also believe that while public aquariums may emphasize habitat awareness, they can also offer a place for stress relief, especially for those unable to experience outdoor natural environments.
Reduce the symptoms of Alzheimer’s disease
Researchers learned that aquariums could improve eating habits and behavioral patterns in patients with Alzheimer’s disease. A study by Purdue University revealed that an aquarium increases the patients’ food intake by 21.1% – benefiting the need for less nutritional supplements, health care expenses, and boosting healthy eating practices. In fact, research also revealed an increase in attentiveness as patients viewing a fish tank for up to 30 minutes.
Induce better quality sleep
Eighty percent of individuals with sleep apnea are undiagnosed and left untreated. This is often due to an airway obstruction resulting in pauses of breathing. Meanwhile, sixty-six percent of surveyors said that their fish tanks not only helped them relieve stress and anxiety but also improve their quality of sleep. Therefore, those experiencing difficulties in sleep would benefit from gazing at a fish-filled aquarium to aid in insomnia.
Owning an aquarium comes with tons of benefits as some say the purpose of fish is to absorb the negative energy, based on Feng Shui. Others believe that fishes may even protect the home and spare you bad luck. So, whether these sayings are true or not, one thing’s for sure: a stunning fish tank can improve your health and overall well-being.
High-fibre diet ‘may help relieve stress and anxiety’
High Fiber diet
“Fibre is [a] stress beater,” states The Sun, while the Mail Online says: “high fibre diets may make you less stressed because your gut affects your brain”. Both are reporting on a study that explored whether eating more fibre might help the body to combat stress.
The researchers were particularly interested in the potential role of short-chain fatty acids. These are small molecules produced when the digestive system breaks down high-fibre foods, such as fruits and vegetables. They are known to have a beneficial effect on biological processes such as the metabolism and immune system. So, the researches researchers wanted to see if these effects could also relieve stress.
An important limitation to flag up is that the research was in mice, not people. They did find evidence that mice given supplements to mimic a high-fibre diet did in fact express fewer signs of stress and had a healthier functioning gut. But this is a long way from proving a similar effect in people.
Eating the recommended amount of fibre can bring a range of benefits, such as reducing your risk of diseases, including bowel cancer. But based on the strength of evidence presented in this study, we cannot add stress busting to the list.
Stress is a common health problem experienced by most people at some time in their lives. There are other more obvious ways to deal with stress rather than making changes in diet. Read more advice about tackling stress.
Where did the story come from?
The study was carried out by researchers from University College Cork, and Teagasc Food Research Centre, both in Cork, Ireland. The study was published in the peer-reviewed medical journal The Journal of Physiology.
The study was funded by Science Foundation Ireland and some of the authors received additional funding from food and pharmaceutical companies including Mead Johnson, Cremo, 4D Pharma, Suntory Wellness and Nutricia. There may be a conflict of interest here, given it is within the companies’ interests to find reasons to promote food supplements.
The Mail Online focused its report of the study on high-fibre diets possibly reducing “leaky guts” and therefore reducing stress. Leaky gut syndrome refers to a hypothesis that many symptoms and conditions, such as migraine and chronic fatigue syndrome, are caused by the immune system reacting to germs, toxins or other substances that have been absorbed into the bloodstream via a porous (“leaky”) bowel. While it’s true that some conditions and medications can cause a “leaky” gut, there is currently little evidence to support the theory that a porous bowel is the direct cause of any serious health conditions.
If the lining of the gut becomes more porous, this could lead to bacteria and toxins leaking through and being absorbed into the bloodstream. An additional controversial hypothesis is this “leakage” could lead to inflammation and a range of illnesses, potentially including stress. However, this remains an unproven hypothesis.
The Sun’s reporting was more cautious and made no direct reference to leaky gut syndrome.
What kind of research was this?
This was a laboratory study performed on mice. While mouse studies have some advantages, such as being fairly inexpensive, results in mice don’t automatically lead to effective treatments in people. This is because the body of a mouse and the body of a person work very differently. Even when researchers find promising leads from a mouse study, much more evaluation is required before whatever is being tested is safe for use in people.
There is a growing recognition that short-chain fatty acids (SCFA), which are mostly made during the breakdown of fibre in the gut by healthy bacteria, play a central role in keeping the metabolism and immune system healthy. It has also previously been demonstrated that stress can cause problems with regulation of the metabolism and the immune system. The researchers therefore wanted to find out if providing SCFA supplements could help relieve stress, by keeping the gut healthy and boosting metabolism and immunity.
What did the research involve?
The researchers took 40 male mice, and gave some of them supplements containing SCFA in their drinking water. After 1 week of receiving the SCFA supplement, the mice were exposed to a series of tests designed to induce stress for 3 weeks.
The researchers then assessed blood levels of the hormone corticosterone (which is known to rise in response to stress in mice and people), the amount of SCFAs in their faeces, and the quantities of healthy microbes in the gut.
The researchers then looked to see if the mice experienced changes in the amount of healthy microbes in the gut, and alternatively whether the mice that had taken the SCFA supplement in their water, were less likely to gain stress-induced weight – a sign they were more able to cope with stress, and also therefore less likely to gain stress-induced weight.
What were the basic results?
Animals, including humans, have a tendency to seek short-term pleasure (such as comfort eating) when feeling stressed.
This study found that:
the mice that received SCFA in their drinking water expressed “less reward-seeking behaviour”, and also seemed to have a more healthy functioning gut
the mice that received SCFA also seemed less depressed, even before they had been exposed to stress in the experiments
SCFA did not seem to affect stress-induced weight gain, and there were no effects on the microbiotic balance of microbes in the large intestine
How did the researchers interpret the results?
The researchers state that “these results present novel insights into mechanisms underpinning the influence of the gut microbiota on brain homeostasis, behaviour and host metabolism, informing the development of microbiota-targeted therapies for stress-related disorders”.
Conclusion
This is an interesting study that seems to demonstrate a link between SCFAs and a healthier functioning gut. However, there are several limitations that are noted below to consider.
First and foremost, this study was performed in mice, meaning it is not possible to apply these results directly to people without further testing.
People experience many different types of stress that affect the body in many different ways – it doesn’t solely affect the metabolism and immune system. This study can’t show that increasing fibre in the diet is a solution to all sources of stress, nor can it expose mice to the same types of stress that people experience.
It is very difficult to measure anxiety and depression in mice, given they can’t speak or express their feelings.
Most people do not eat enough fibre, so eating the recommended amount is a good idea. But there is no guarantee that doing so will lower your stress levels.
There are also many other, more obvious things you can do to manage stress, such as:
try these 10 simple stress busters
use these easy time-management techniques
try mindfulness – studies have found mindfulness can help reduce stress and improve your mood