Monday, July 31, 2023

Anxiety and Panic Attacks in Grief

Our anxiety does not empty tomorrow of its sorrows, but only empties today of its strengths.  ~ C.H. Spurgeon

A reader writes: I am trying to figure out if what I am going through is normal. I am thinking that it is probably some kind of panic or anxiety attack. It started when I had something upsetting happen totally unrelated to the death of my friend. Everything went okay with that situation but things seemed to get worse as the evening went on. Yesterday it was like I had tunnel vision all day. I felt shaky and detached. I have been restless, anxious, and feeling like I am sleep deprived when I have actually been sleeping.
Last night I had very bizarre nightmares that were very upsetting and frustrating and I am going through the day feeling odd. I have taken my blood pressure and it is low normal, cause I actually thought maybe my blood pressure had shot up or something. My heart rate is up though, close to 90 bpm. I have the sensation of panic. That's the only way I know how to describe it. Which is one of the reasons why I think this is a panic/anxiety attack. Has anyone else experienced this under the stress of a loss? 

My response: These certainly sound like symptoms of a panic attack to me, but the first thing I would recommend is that you make an appointment with your primary care physician as soon as possible, in order to rule out any other physical causes for your symptoms.

That said, in the normal course of grief, I can assure you that anxiety attacks are not at all unusual. The death of a close friend is a significant loss that can shake your sense of safety and predictability in this world, and raise awareness of your own mortality as well.

Since these attacks happen most often in the evening or when you’re trying to sleep, you might consider trying relaxation recordings or guided imagery CDs before you go to sleep at night, as a way to help you replace disturbing thoughts and images with more peaceful, relaxing ones. There are many websites devoted to this simple but very healing approach, and many online and corner bookstores carry some excellent pre-recorded programs, produced by highly skilled professionals, that you can use in the privacy of your own bedroom.

Members of our online Grief Healing Discussion Groups often recommend guided imagery to one another as an effective (and inexpensive!) tool to manage anxiety. As one widow recently wrote, 
A guided imagery CD by Belleruth Naparstek does the trick for me. She has a very soothing voice and I find myself so focused on it that I am able to calm myself down. I also use it on nights that I’m having trouble falling asleep. When [my husband] first died I couldn’t sleep at all. My doctor gave me a prescription but I hated that ‘hangover’ feeling I’d have the next day. The CD does the trick, and no side effects!
You might begin by doing some reading about guided imagery by Belleruth Naparstek, as she is a respected expert in the field: What is Guided Imagery? 

In addition, you can find some terrific music and relaxation tools online (for free!) Here are two examples on YouTube:

Rainforest Relaxation

Relaxing Music

Another highly effective tool for coping with anxiety is learning how to breathe. When we are anxious, we tend to hold our breath or breathe in a very shallow manner, which is not helpful since the best air exchange occurs at the lower lobes of our lungs. Another of our online members who faithfully practices healthy breathing describes her method this way:
Every morning and every night I recline back in my chair and place my hands on my belly and breathe in deeply so I see my belly raising my hands. Slow deep breaths – and on the inhale I tell myself I am breathing in goodness and calm, and on the exhale I tell myself I am breathing out the fear and doubts. The other thing that I find helpful is to think on the five senses when I feel panic, as it helps me to stay present and in the moment. What do I hear? What can I see? What can I touch? What can I smell? What can I taste? I find that when I take time to think on answering these five questions, more often than not it will stop the panic from developing into a full-blown panic attack. 
If you’d like to learn more about healthy, conscious breathing (including specific guided exercises), see How to Practice Conscious Breathing to Reduce Stress and Anxiety.

Over the last twenty years, researchers and clinicians have developed a number of useful tools for coping with anxiety. Such tools are highly effective, practical, efficient, fast-acting and accessible, and work well by themselves and in conjunction with other forms of therapy. In addition to Guided Imagery, these new therapies include Eye Movement Desensitization and Reprocessing (EMDR), Thought Field Therapy (TFT), Emotional Freedom Technique (EFT), Tapas Acupressure Technique (TAT), Prolonged Exposure Therapy (PET), Trauma Incident Reduction (TIR), Imagery Rehearsal Therapy (IRT), Visual Kinesthetic Dissociation (VKD, also known as the Rewind Technique), and Somatic Experiencing (SE), among others. 

All those choices may seem overwhelming, but I encourage you to read more about them, most especially about the potent tool of guided imagery. A good place to start is on the Alternative Healing page of my Grief Healing website, where you will find links to many helpful resources. See these especially:

Anxiety and Panic Attacks

Columns and Articles by Belleruth Naparstek

Using Emotional Freedom Techniques in Grief

Guided Imagery or Visualization

Healing Affirmations

Belleruth Naparstek’s Guided Imagery Center

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