Good and Bad Days
For people who give support to a panic sufferer one of the most curious features is the way good and bad days come and go. This apparent lack of consistency can feel very frustrating and there is sometimes a sense that the person is far more capable than they appear. Worse still is the sense the person may be faking or manipulating the situation to their advantage.
A person who is prone to panic will go to great lengths to avoid situations that cause them discomfort. But this can be far from easy. The daily task of shaping their world to accommodate their needs can be exhausting. Often the person will be highly anxious and predict panic situations only to find it doesn’t happen. This can make supporting someone with panic a highly erratic experience.
Levels of Support
Support however can be offered at different times and at different levels. At a practical level it may be to persuade the person that their attempts at avoidance and self-help aren’t working and they need to seek professional help. Helping a loved one or friend to find a therapist and then agreeing to accompany them can be very supportive.
Many people fearful of panic are relatively secure if they have a reliable person, or someone they can trust with them. Even though you may be the person giving support it is perhaps unwise to keep asking how your partner or friend is feeling. This serves to remind them of their situation rather than focusing on the fact they are behaving in a way that is normal and needs supporting. Giving praise for accomplishments is always welcome, but if things don’t go as well as hoped, give some reassurance and steer the person back on track.
Left to their own devices a panic sufferer, who quite possibly experiences agoraphobia too, may be reluctant to leave the security of their home. Those with less severe symptoms may be able to get around very familiar routes, but have great concerns about venturing further unless accompanied by someone they trust.
Help and Responsibilities
As someone who gives support you may feel an uneasy burden of responsibility. You too may find some days easier than others and some situations more taxing to cope with. Keep in mind that anyone who experiences high levels of anxiety tends to have good and bad days. The fact that you were able to go around the shops yesterday does not necessarily mean you’ll be able to today. It may be frustrating but try not to challenge the person by pointing out obvious discrepancies in their behavior. It’s almost inevitable they already know and there’s a danger they will feel even further embarrassed and self-conscious and use this as a reason to withdraw more.
Panic can hit quickly. You may find yourself strolling along only to find the person with you suddenly comes to a halt and is beginning to struggle with their breathing. They probably look extremely alarmed and may start to shake, stagger and reach out for something to grab hold of. In situations like this the person is feeling very unsafe and extremely insecure. Assuming both you and they realize this is a panic event and not a genuine medical emergency, you can help by physically supporting the person - just holding the arm will probably do. Remind them this has happened before, that they will come out of it and then remind them to focus on their breathing and to breath normally. Rapid shallow breathing or big deep breaths can make the person feel light-headed and may simply add to symptoms.
Take what the person says to you at face value. If they say they need to leave ‘now’, they mean it. If they ask not be left alone, don’t leave them. Specific requests like this occur when the person feels especially vulnerable. Remember, they are probably already extending their usual boundaries by being with you and it may not take much to tip the balance.
Despite all your care and precautions the person may still have panic attacks. This isn’t your responsibility. You are doing what you can to give support and that’s all anyone can reasonably ask of you.
This post is an excerpt from Panic Attacks: a short introductory guide (2nd Ed) by Dr. Jerry Kennard
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Jerry Kennard, Ph.D., is a chartered psychologist and associate fellow of the British Psychological Society. Jerry’s clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.