I know someone who has had panic attacks for 20 years or so.
Yep. Panic attacks are complex, for sure. And not
everyone in every situation can simply expect to overcome them with treatment. But in this case? That would absolutely be a very realistic short-medium term treatment goal.
Why can’t I just abandon these things?
There’s some complicated things going on for you for sure. Asking yourself to just abandon things sounds a lot like “just get over it”, which isn’t how ptsd works!
It sounds like you’ve got some insight into your personal thinking and coping styles. Rigid thinking can definitely make things hard - but you can also make it work in your favour.
For example, would happen if you were to change your priority from avoiding the risk of panic attacks to - absolutely not tolerating the constant risk of panic attacks anymore? What if you became rigid about that?
Panic attacks and hypervigilance are related, but not the same. Panic attacks are one of the consequences of hyperarousal, which is causing your hypervigilance as well. That’s important. Because getting your hypervigilance under control won’t necessarily stop the panic attacks.
Hypervigilance is much harder to ‘get under control’, and the constant underlying over-arousal? Even more so. So, it’s fantastic that tackling your hypervigilance is one of your current treatment goals, but that’s not necessarily going to solve the panic attack issue for you.
You can prioritise panic attacks specifically. Because they’re something else. And they are the type of thing where, if you decide to go in hard and practice the techniques used to manage them, they just don’t need to be a constant threat hanging over your head anymore.
And here’s the thing that your therapist (and GP) ought to know: every time you decide “I’m not going to do that again because of the risk of having a panic attack”…you become
more likely to have a panic attack.
That doesn’t mean it’s time to jump straight back in to all those things head first. It just means - life doesn’t need to be this hard, and you could be expecting a shitload more from your treatment team.
Demand a better outcome for yourself. You’re worth it.