When I asked Joe what was going through his mind as he sat between the two people he stated, "When I noticed I was sweating I started to think, "Here we go again, I'm going to panic." In other words, he had a negative interpretation of his sweating. Joe is well on his way into the Vicious Cycle of Panic. He had the stimulus (sitting in close proximity to two people in a warm room), the bodily sensation (sweating), and the negative interpretation of the bodily sensation (Here we go again, I'm going to panic).
Negative interpretations often lead into a string of "what if..." thoughts, which for Joe were, "What if I faint?," and "What if I have to get up and leave and everyone stares at me?" What if thoughts tend to turn into catastrophic thoughts, such as, "I will faint in front of everyone." As the intensity of thoughts progress, then the intensity of the physical sensations increases, feeding off of each other which can result in a panic attack.
It is true that this can all happen very, very quickly. However, if you start to become more aware of your reaction to the stimuli around you, you can become more sensitive to your escalating anxiety. As you become more sensitive to when your anxiety is escalating, then you will be more equipped to do something about it before it spirals into a panic attack.
In other words, while panic attacks appear to come out of the blue, once you start to closely examine them, you will often find clues as to what triggered the panic attack. Once you understand triggers, you can learn to prevent panic attacks.
As a first step, start to rate your anxiety on a scale of 0-10. 0 is completely calm and relaxed, and a 10 is a panic attack. Where would you rate yourself right now? Anything from 0-4 is ok, but when you are at a 5-7 it's time to intervene before your anxiety escalates into a panic attack. Start taking your anxiety "temperature" multiple times per day and make a note what you are doing when your anxiety is low, and what you are doing when it is high. For now, look for trends. I'd encourage you to keep a log of your anxiety temperature for a few weeks, and take it into your therapy session if you are in therapy.
In my next few SharePosts I'll go into depth about the broad categories of triggers so that you can start to hunt for what your triggers are.
Warm Regards,
Dr. Jennifer Fee
*Names and details are always changed in my client examples in order to protect confidentiality
