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Difference between panic and being triggered

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macbeth

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I'm no stranger to anxiety. It's been with me since childhood so I 've had my share of feeling anxiety coming, having panic attacks and knowing what I may need to prepare for etc. Being triggered to me is a whole lot different. It can come out of left field. A sound or noise or smell can trip that switch in my head and I'm full of adrenaline and right back in the thick of abuse. It's unpredictable what may trip me up so it can be harder to deal with. My question to everyone is how do you deal with both? Is your approach different for a panic attack than it is with being triggered? I'm finding it hard to convey to my psych there is a difference between the two. He thinks it's all just anxiety.
 
He thinks it's all just anxiety.
Like, wha!?

Both can trigger a response from your autonomic nervous system in similar ways.

But whereas a panic attack is the straight up flight/fight/freeze response, a flashback (which may trigger that same response) comes with re-experiencing the traumatic event (one of the core types of symptoms that define ptsd).

You may have a panic attack when having a flashback, but not necessarily.

With panic attacks, something that was helpful to me was learning to keep track of my SUDS throughout the day. Panic attacks often feel like they've come out of the blue, but most often the stress levels have been increasing prior to hitting the panic.

SUDS (Subjective units of distress) is basically "How stressed am I right now?", based on your own subjective experience. Monitoring that, you'll get to know what's normal for you. You might wake up at 2 out of 10, then get a difficult phone call and notice your distress levels shoot up to 6, and then something else stressful happens and you're at 8.

A panic attack is what it feels like for you when you hit 10 out of 10. So, keeping check of your SUDS, you can intervene earlier (like when you hit 7 or 8), and do whatever it is you do to bring your distress levels back down. That will massively decrease the likelihood of having a panic attack.

It takes practice, but for people who get regular panic attacks (like I used to), it can be a real game changer learning to check your SUDS levels throughout the day, and intervening when you notice them going up.

For a typical panic attack? The easiest way to force your physiological response out of panic is to use controlled breathing. And there's lots of different ways to practice that. Practice it daily. Like any emergency response, you don't want to be trying it out in an emergency, you want to get pro at it during calm situations so that when you panic, it's an easy and natural way to get yourself out of it.

Controlled breathing forces that neurological response to change - heart rate, hormones, blood pressure, circulation, switching organs and systems back on.

With practice? Controlled breathing has got me to the point where I very rarely actually reach panic level (because I intervene when my SUDS are getting too high), and it means that when I have had panic attacks, I no longer pass out or wet myself (extremely liberating). But I practice my breathing Every. Single. Day.

Flashbacks are a re-experiencing symptom. Your amygdala thinks that your trauma is happening again. So it may trigger that same fight/flight response, but the key to getting out of it is usually grounding techniques (different for everyone). Grounding techniques are the ones that bring your mind back to the present, where the trauma isn't happening again, and your brain can put it together that this is 2019, not "when the trauma occurred".

Controlled breathing can help you ground, but grounding techniques tend to be different. There's a whole tonne, and it's about finding the right grounding technique for you.

But like controlled breathing? Grounding techniques are something you practice daily, when you're actually feeling okay. So that when something triggers a flashback, the grounding technique that is helpful to you comes easily and naturally.
 
My biggest problem with the controlled breathing technique is that I find trying to control my breath triggering in itself (strangulation). Even in a resting state if I turn my attention to my breathing it can and does backfire spectacularly
 
That makes sense - maybe start it smaller - noticing that you're breathing. That's something you're doing all day, every day. So perhaps come at it gradually, like exposure therapy, and just noticing: I'm breathing right now (instead of controlling it).

There's yoga methods that might not be triggering for you, because you don't focus on your breath, but the outcome is your breath regulates itself. I can't think of the name right now, but if someone can jump in - I'm thinking of the one where you have fingers on either side of your nostril, and you push against one nostril during the inhale, then switch the pressure to the other nostril as you exhale, so your focus is on timing the movement and pressure of your fingers, rather than the breath itself.

As an interim measure while you work through that trigger with your T (I have similar triggers with guided relaxation triggering hypnosis trauma issues that I was able to make my way through with help and patience), using some prn, like low dose valium/diazepam for panic attacks.

Certainly there are ways to get your SUDS down if you notice them going up that don't involve breathing techniques. Gentle stretching exercises for example, or graduated muscle relaxation. They help bring down your SUDS without needing to focus on your breath.

Just shooting around ideas. It probably feels hopeless and like this is controlling your life. But there's tonnes of members here who will relate to your issues - controlled breathing is a difficult one for a lot of us. Hopefully some more ideas will come up for you to try out.
 
The new psych doesn't want me to use prn s and wants me to cbt/ breathe through my way to calming myself along with taking me off seroquel as I shouldn't be on it for PTSD. I'm struggling to find appropriate help and I'I'ma mess.
 
As I read through this, I am wondering if the new psych is "hearing" that the controlled breathing is a trigger. Just like with medications, people are wired differently and can react differently. Sometimes alternative treatments need to be investigated. I'm all for natural remedies, but sometimes meds are necessary to get balance, then back off slowly. It's not an exact science, but more of trial and error. Perhaps try to control your pulse rather than your breathing. You can check your pulse on your wrist or neck. Shoot for a consistent rhythm of about 1 beat per second. Maybe you'll be able to fool your brain into not triggering and kind of back into controlling your breathing. Prayers for guidance, wisdom and peace.
 
So... Panic is one of the possible results of/from being triggered, but it’s not the only thing, right? Panic attacks, anxiety attacks, Flashbacks and other kinds of dissociating, emotional dysregulation, etc.

So if I’m reading/understanding correctly I’ve got a question

You’re used to panic attacks resulting from anxiety & stress being built up. However, being triggered is causing you
- a different type of panic?
- same panic, but the source being different is throwing you for a loop? (Instead of rising stress, which you can account for, or have early warning ...this is just knocking you down from fine to flat with no warning)
- same panic + new stuff (flashbacks, etc.)
 
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Just thinking out loud, if something (a trigger in this case) trips the amygdala, and adrenaline is released (from the adrenal glands on the kidneys), you've got the start of 'being triggered' (including more oxygen to the lungs (fight/ flight/ freeze). But panic or increased anxiety often has potentially a genetic component, is influenced by cognitive perceptions and framing, may be involved with the level of specific neurotransmitters in the brain, and can even be caused or exacerbated for example by oxygen deprivation (though breathing in to a paper bag to inhale carbon dioxide back is also a common recommendation for hyperventilating), or increased pulse or blood pressure.

Could it be possible you experience the trigger, and what follows fuels anxiety or panic, as your body reads the cues from being triggered (increased blood pressure and heart rate, etc), and then subconsciously or semi-consciously you identify it as justifiable anxiety? So in essence it's both (triggered first, panic follows)?

Truly both are quite miserable. :( :hug:
 
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As I read through this, I am wondering if the new psych is "hearing" that the controlled breathing is a trigger. Just like with medications, people are wired differently and can react differently. Sometimes alternative treatments need to be investigated. I'm all for natural remedies, but sometimes meds are necessary to get balance, then back off slowly. It's not an exact science, but more of trial and error. Perhaps try to control your pulse rather than your breathing. You can check your pulse on your wrist or neck. Shoot for a consistent rhythm of about 1 beat per second. Maybe you'll be able to fool your brain into not triggering and kind of back into controlling your breathing. Prayers for guidance, wisdom and peace.
I like the sound of controlling my pulse. It takes the focus off my breathing which trips me up. This new psych has met me once and decided how to treat me without understanding me. More than frustrated.

So... Panic is one of the possible results of/from being triggered, but it’s not the only thing, right? Panic attacks, anxiety attacks, Flashbacks and other kinds of dissociating, emotional dysregulation, etc.

So if I’m reading/understanding correctly I’ve got a question

You’re used to panic attacks resulting from anxiety & stress being built up. However, being triggered is causing you
- a different type of panic?
- same panic, but the source being different is throwing you for a loop? (Instead of rising stress, which you can account for, or have early warning ...this is just knocking you down from fine to flat with no warning)
- same panic + new stuff (flashbacks, etc.)
I feel at least with panic/ anxiety i have a bit of warning. It really can throw me completely when I'm triggered randomly. A smell, sound word etc flips that switch and I'm suddenly full of adrenaline trying to run or freezing looking for a way out. This psych doesn't understand there's a difference
 
Sorry for the late reply, November and I are at odds
This psych doesn't understand there's a difference
They might be hipped on the panic = panic = same thing.

Which means they might understand better that you’re less talking about different types of panic, and more about needing different coping mechanisms for something that comes on slowly vs something that strikes full force out of the blue. Because your coping mechanisms for anxiety rising into panic aren’t working for panic that comes on full force with no warning.
 
Sorry for the late reply, November and I are at odds

They might be hipped on the panic = panic = same thing.

Which means they might understand better that you’re less talking about different types of panic, and more about needing different coping mechanisms for something that comes on slowly vs something that strikes full force out of the blue. Because your coping mechanisms for anxiety rising into panic aren’t working for panic that comes on full force with no warning.
Yup. You've hit the nail on the head. Do you have any suggestions? I have no way to calm my body down once its triggered. Only time seems to work and depending on what the trigger was it can take hours to months to calm the system down to a functional level again
 
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