How do I be confident using the cane in public when I look like an otherwise healthy, able-bodied person?
I can’t give you a direct definite answer to your question. But I will share a couple of things with you. When my oldest daughter was 13 she had surgery for scoliosis. She walked back to the surgery suite turning back, smiling and waving.
Totally secure in what she was doing. 13 1/2 hours later they came out and told me that she was paralyzed and would never walk again. Fortunately, God’s bigger than that. Three months later she was wheeled to the hospital doors and with the aid of some braces, she walked out to the car.
It took about two years of PT but she got to the point that she was able to put the wheelchair away and use two canes. Then later she went to one cane. She’s had 2 more major surgeries to stabilize her back and she now walks with a walker to help take some of the pressure torque off her spine. So never give up! Keep fighting!
The second thing that I want to share with you is my disability. I have a lung disease that requires me to be on high flow oxygen. For several years after being put on oxygen random strangers would walk up to me in Walmart and ask me why was I on oxygen?
I didn’t look sick! I spent a lot of time trying to explain things to people but it was really almost offensive. I don’t offend easily. But it bothered me enough that I got to the point where I started looking at people and asking Really!?! And what exactly does sick look like! There are many times that I’ve caught myself watching someone park in a handicapped space and get out of the car looking perfectly able.
I often wondered why they seemed to need a handicap spot. At some point, I made the connection and reminded myself that I had NO IDEA what their health issues were, and frankly, it was none of my business and not mine to judge. I take care of my own issues and usually find that I’m left with little time to squander on placing judgment on other people. It’s not my place to judge.
So my point is this. Do what you need to do to take the best care of yourself that you can. Don’t even worry about what other people are going to think! You won’t be able to do anything to change it anyway. People that are that worried about your health, they’re going to find something to be critical of no matter what you do.
Don’t waste your energy on them. You do the best that you can do to take as good of care of yourself as you can. It will help you in the long run and will remove some of your burden in the short run. Take care!
It’s not taken seriously for many reasons. They’ve been doing more and more research on it but it’s very complex. Some of the medical community claims it’s a rheumatological issue like lupus or rheumatoid arthritis. Some claim it’s all in our brains and faulty nervous systems. Some claim it’s a virus like Epstein-Barr.
It’s usually the last thing you’re diagnosed with when they can’t seem to find out what’s wrong through many tests, X-rays, MRIs, etc. The symptoms, the other comorbid illnesses and syndromes, and the ever-changing way it affects each individual make it difficult to treat and deal with. They try all sorts of drugs and therapies but nothing fixes it forever.
The symptoms of exhaustion, fatigue, pain aren’t something someone can see on the outside. We can get dressed and go somewhere and smile and be okay for a short time and so people think we’re just fine and that we’re not as sick as we say. They don’t know how hard it was to do that thing for a bit or how much it took out of us to do it.
We can do something “normal” one day and then spend a week in bed, exhausted and in pain. Depression and anxiety are common with fibro because it works with the same part of the brain and chemicals. It is exacerbated by stress and physical activity and we’re often told we aren’t trying hard enough, to push through it.
No one can empathize and so that adds to the stress and difficulties because we’re fighting this and no one believes what it is like for us. This is a big problem because we’re so sick we depend on others and sometimes can’t work and function like everyone wants us to, so we’re labeled as lazy or crazy.
I’ve had to go on medical leave twice. The last time was the worst. I could barely function for over a year. I had to move back in with my parents after raising my own family and teaching for 20 years. I was treated like I was a burden, that I didn’t try hard enough, and that I needed to try all these things that others had heard about. It’s different for each one of us, so what works for one won’t work for another.
Depression and anxiety add this other dimension to it and some would say the whole thing was just a mental disorder and that’s wrong. We’re battling lots of things at once. It’s true that a lot of us start unraveling mentally when we are so sick and especially when we aren’t treated with respect to knowing what our own reality is, and it becomes very isolating and scary.
It’s easy to lose hope with this illness and it’s very hard to get the meds and everything right, lots of appointments, and trial and error. It’s very hard to get on disability or to figure out how to afford all the medical bills and be too sick to work. Over 50% of people with fibromyalgia will try or will commit suicide. There needs to be more understanding out there, support. No one would wish this syndrome on anyone.
The answers to this question are true and help to explain some of the new symptoms I’m experiencing. For example, when I stand up, I’m dizzy and have to be very careful or I walk into walls or furniture or trip and fall down.
Everyone has been blaming this on the medication I take for depression and pain but when I look them up, dizziness is not a side effect. I’ve taken some of them for years before the dizziness started.
I used to be smart. This is perhaps the worst thing that has happened.
Before FM, I started a home business, raised our two children, one of whom has significant mental health issues, never gave up on my marriage, and volunteered in our community.
Now I sit at home all day and write – until the fibro fog gets so bad that I can’t read the words on the screen. They aren’t blurry, they jump around and one line will appear on top of another, or the letters are offset enough that it feels like my brain is failing.
Around 3:00 every afternoon I can feel myself get dumber. I can’t remember words or have a conversation with someone because I can’t remember what was said three seconds ago.
So, I have learned to adjust. The best time of the day for me is 10:00 – 3:00. I use that time wisely. That is when I do my writing (and editing) or read something important that I need to understand.
I always have a notebook with me to write down ideas for my next novel, when I’m supposed to meet someone, or which book I’m reading next. This really helps because once I have it written it down, I don’t need to remember it anymore. It frees up space in my brain. I know to check my notebook frequently.
I am planning to write a book about fibromyalgia in the fall (2019). It will be filled with people’s experiences and input, and all of the things I have learned in 30 years. If you would like to fill out a short survey or be interviewed about your experience with fibromyalgia,
Let’s remember that despite all of our great science, we don’t fully understand either central sensitization or fibromyalgia. So the question is cute but unanswerable.
Central sensitization means that there is altered processing of sensation in the spinal cord and brain. Imagine you have an mp3 player and you plug it into an amplifier and then to some speakers. The mp3 player is like the tiny signals coming **constantly** from the nerves that touch all of your body. Central sensitization is when the amplifier is turned up. So various aspects of sensation are turned on high.
People with fibromyalgia have central sensitization. Their pain processing is amplified.
But central sensitization is just one kind of physiologic imbalance that shows up in fibromyalgia. People with fibromyalgia can also have a variety of other physiologic imbalances, depending on the person.
That includes immune system dysregulation, activation of inflammatory cells in the brain, dysregulation of hormones like cortisol or thyroid, irritable bowel syndrome, nutritional deficiencies, impaired energy production by mitochondria. Based on physiologic principles and some research, these imbalances are related to interlocking vicious cycles. Positive feedback loops that drive the physiology forward.
These are underlying physiologic issues that probably result in the syndrome of symptoms that we call fibromyalgia. In other words: brain fog, abdominal pain, constipation/diarrhea, painful muscles with minimal activity, fatigue, insomnia, and so on.
In my judgment, the complexity of fibromyalgia is the reason why there is so much difficulty with diagnosis and treatment. In conventional medicine, we get trained to look for one cause and one treatment for a problem.
Fibromyalgia appears to be a different thing. There are many different triggers that can start to shift physiology. And many different perpetuating factors that can permit or drive the cycle of imbalances.
In the meantime, people with fibromyalgia get to decide whether they want to be conservative and go with the conventional approach or to be more open-minded and go with an integrative approach. That means
1. A strictly conventional medicine approach, which says ‘you have central sensitization, we don’t know what causes it, do therapy and exercise and try Lyrica, Cymbalta, gabapentin, and so on. or
2. An integrative approach says, ‘there are a number of physiologic imbalances that are probably driving the symptoms. We can try the meds if you want. And for sure address mind-body variables and movement.
But also let’s help you shift your diet, heal your gastrointestinal barrier and biome, use botanicals and supplements to help sleep, balance your hormones, nourish your mitochondria, reduce stress, and so on’.
In my experience, the second one gets real results for more people.
Multiple doctors have told me I very likely have fibromyalgia (but my mother never took me to a rheumatologist), and I would say that I only am controlling to protect myself from being harmed…
So I am not officially diagnosed, but doctors have told me I likely have it, as in a neurologist, psychiatrist, and a family practitioner. A physical therapist named Marcos who is not an MD, but knows my family, also told me he thinks I have it, and he’s worked with a lot of fibromyalgia patients.
Most people who have CPTSD, have some chronic pain disorder… Depression (which almost always occurs with anxiety) and forms of PTSD is the most common psychiatric associations to fibromyalgia… The Link Between Fibromyalgia and PTSD
Those of us abused will be controlling as to protect ourselves from further harm, and when you’re always fatigued and achy, it makes it easy to be controlled, so that you avoid feeling worse and more drained. I 80% of the time always feel lethargic and energy-depleted, and when under stress, I get aches and pains in various places of my body, icepick headaches, and muscles spasms.
My hands and feet intensely throb the fronts that are not directly my shoulder, but more the muscle in front of the shoulder blades that maybe are like in the center of them ache badly. I get shocks of pain to my head, which are known as icepick/suicide headaches, but I only get those when I am under very, very severe stress.
I have gotten vertigo when I came out of a psychiatric hospital from attempting suicide, and I don’t know if that’s fibromyalgia-related or not, but I felt nonstop dizzy for two days and a very scary type of dizzy. That makes it pretty hard to always be happy, and atop that, I am dealing with CPTSD, my childhood abuse, borderline PD, and major depressive disorder.
I have THE WORST periods, and it feels like a knife is being stabbed into my ovaries. Makes it even harder to be nice, and not as controlling. The day child protective services came to investigate my mom and dad is the first day my period cramps have been as horrible as they now are, but I was having issues five years ago, and this only was three years ago.
My period came a week early and it came that night instead. It’s only the first day they’re unbearably bad to where I am crying and sometimes, screaming, and the second day, they lessen but are somewhat bad. I wonder if it’s post-traumatic-related, and is only bad just like how they were bad the day cps came.
Depression almost always occurs with fibro, and actually treatment most times involves an antidepressant, so the moodiness can be depression-related, or it can be something to do with our gut, as 90% of neurotransmitters formulate within our gut. It is so, so important to healthful wat when you have fibromyalgia. Study shows how serotonin and a popular anti-depressant affect the gut’s microbiota
I never once said I was not diagnosed with my psychiatric conditions. I said I was not officially diagnosed with fibromyalgia. I am officially diagnosed with complex post-traumatic stress disorder, borderline personality disorder, major depressive disorder, and as I specified in my bio because my credentials ran out of space, a schizotypal personality disorder is an armchair by my psychiatrist.
She didn’t want to diagnose me with two personality disorders whilst I was a minor. Aspergers isn’t in my bio or credentials, but I’ve been diagnosed with that, too.
For me, it was addressing the root cause of the illness: heavy metal toxicity. I had 8 dental amalgams as well as a couple of root canals. I used to get vaxxed. I ate a lot of fish. I had some imaging with contrast dyes. Nowadays everyone is exposed to multiple heavy metals.
So once I had the amalgams safely removed that was a huge step forward I have been working on getting my body’s detox pathways to work right (liver, kidneys, and gut, for example, are how we do a lot of our detox) as well as boosting natural detox such as glutathione levels.
This has helped tremendously. It is taking some major time but I’ve been being poisoned for decades so not surprised to get the garbage out and to repair the damage is taking time and effort.
I am not “cured” but the fibro is nowhere near as bad as it had been. I do think it is part of why I still have major sleep issues. I fatigue way easier than I should. I DO have chronic pain—but it is not at the level it was. I am still never pain-free but I actually have hopes of getting there.
I saw pain specialists. I had strong pain meds. Only took the edge off. The McKenzie PT has been a real help. I get an “edge off” pain with arnica gel or Penetrex.
I believe it is crucial for fibro folks to stop eating processed foods, give up fake sugars. reduce real ones, eat fermented foods, and do other things that help the gut to improve. Doing that and much more has made this a presence in my life instead of the dominating force.
Going to keep getting better; there is a lot of room for improvement but my docs have been astonished I have come this far. My PT has been great. He told me many years ago I was in the sub-sub-(about ten times)-basement and needed to NOT PUSH myself as it kept leading to flares.
I still drop in on him and he is IMPRESSED. He still offers me tweaks to the routine AND works on me because I still have serious problems but I did not give up; it’s stopped progressing (and contrary to what is claimed, I found it most certainly DID progress and got worse.
Maybe technically it was the OTHER problems that DO come from it, but it got worse and worse without a doubt.) Infections, Lyme, mold, and more can also be caused or exacerbate the condition so it’s not just heavy metals and I had a lot of those factors so had to address those topics as well.
I don’t know what it takes to make a fibromyalgia diagnosis because I don’t trust science’s model to describe and assess what the phenomenon really is.
They do more harm when they label human beings with all kinds of “disorders”. Those assumed disorders become something that human beings wrongly identify with, later on in their lives, which render them unable to truly ever transcend their condition. Simply because they have grown to identify with it.
I also understand, on the other hand, that it is the best we can come up with in terms of organizing humanity efficiently. But in my opinion, it does not serve the individual anymore, really.
And yes, in my view – after observing and experiencing the phenomena quite closely – it is clear to me that fibromyalgia is indeed a throw-away diagnosis. But perhaps, for the medical field – not at all.
I have come to understand that science and the medical field alike, suffer from a disease called compartmentalization.
That is, the label and invent names for anything that has the slightest difference in symptomatology and thus create more confusion than not. Rendering them unable to see the forest for the trees anymore.
Fibromyalgia, Multiple Sclerosis, Rheumatoid Arthritis, Lupus, Lyme Disease, Crohn’s Disease, Huntington Disease, Duchenne muscular dystrophy syndrome, PTSD, Parkinson, Alzheimer, Guillain–Barré syndrome, Autism, ASD, AFM, all other muscle dystrophy diseases and disorders, and I can go on and on filling pages of pages with sophisticated names that describe even the most minute detail indifference, just to justify a new name.
They have lost their ways of being able to look at the human body as a holistic machine. Rendering them unable to see that all of those “disorders” come from a unified place in the body, but as each human body is unique and therefore different, those imbalances – by the time they come out onto the surface – they take a slightly different form in symptomatology.
You will notice that the common denominator for all of these “disorders” has to do with electrical( action-potential) imbalances within our nervous system coupled with autoimmune “activity” that arises and takes place within the body.
In other words, the byproduct of pain, spasms that we feel as a result, (but not only limited to) are a byproduct of locked action-potential electricity within our nervous system: either within the brain, extrapolated within the CNS ( Central Nervous System) – this is where we get the Alzheimer’s and Parkinson’s’ stuff, or within the somatic and peripheral nervous system that is dispersed all around and within the body – where we get the fibromyalgia, multiple sclerosis, etc. All of that ensues as a result of a change deepwithin thebody.
As a result of that change, other systems such as our immune system, “doesn’t” recognize that said change as a positive change: That is, a change that coming from within the body, and so it thinks that this “change” is a result of an alien attack if I can use that language.
And so, the immune system rises and attacks this change within the infrastructure. And what we get is the onset of the conditions associated with fibromyalgia and all other conditions stated above.
You know this is the craziest thing I am going to talk about now…
I’m not sure what the percentage is, but I can tell you that I spent years taking Adderall for ADHD and then had to stop taking it when I got pregnant. During the hiatus from that medication, I was diagnosed with fibromyalgia.
After unsuccessful attempts at treating it with many of the same methods you mentioned, I decided that I was sick of being a test monkey and asked my doctor to put me back on the Adderall. This time around, not only did it manage my ADHD symptoms, but it also seemingly “cured” my fibro.
Being a stimulant medication, its purpose is to counteract the area of an ADHD patient’s brain that makes them feel restless and unfocused by “tricking” the brain into believing it has produced too much of its own stimulant, therefore making it produce the chemicals that calm.
While it still does this for me, it also cleared up the brain fog and mental sluggishness that accompanies fibro, but the best thing it’s done is make the pain tolerable so I can normally physically function. As you certainly know, with fibro, some days are worse than others, and it’s not as though this medication blocks the pain as an opiate does, rather, it keeps me so focused on the task at hand that it also distracts me from the pain.
Upon realizing this, I started doing things to help further lessen the background pain, such as yoga and taking daily vitamin B12 and folic acid supplements, as they support nerve health.
Adderall is not recognized as a pain management drug, and only a small handful of doctors currently acknowledge it as a treatment for fibromyalgia. It is a controlled substance with a high potential for abuse, so, doctors won’t prescribe it without a perfectly valid reason, and they usually require a clear EKG prior to prescribing because the stimulant property is sometimes hard on the heart muscle.
BUT, Adderall IS recognized as a treatment for chronic fatigue, so, if you approach your doctor after having utilized so many other medications unsuccessfully and specifically address the concern that the fatigue which accompanies your fibro is debilitating in nature, and you propose the idea of trying a stimulant, he or she may agree to prescribe it at a low dose on a trial run.
Be prepared, however, as it is a common practice for doctors to perform drug tests before and during treatment with a controlled substance to ensure a patient is not abusing it or any other drugs.
I’m certain this is a treatment that will not be appropriate for every person with fibro or other chronic pain disorders, but it has worked in this way for me and a decent handful of other people in our shoes. That being said, for how significantly my quality of life has improved, I firmly believe that it is a treatment that deserves consideration by doctors and sufferers alike.
Get your genes mapped. If you have either fibromyalgia or chronic fatigue it is probably most likely due to “Soft Tissue Calcification” which is caused by the body not excreting enough sulfur and phosphorus, which is caused by having genetic mutations like CBS 699 and SUOX mutations.
The treatment for these mutations right now is to eat a diet that is very low in sulfur and phosphorus and calcium and vitamin D because these will all lead to pain or chronicfatigue.
Also, it is important to supplement daily with a well-absorbed brand of magnesium citrate like Solgar magnesium citrate tablets, or CALM magnesium citrate powder by Natural Vitality that you dissolve in water and drink, or CALM magnesium citrate gummies that you just chew up.
Pick one of the three, depending on which would work best for you. They are all very well absorbed.
It is also very important to avoid vitamin D and calcium in both supplements and foods, so this also means to avoid multivitamins as they are all very high in calcium and vitamin D and only have unabsorbable magnesium in them (aka they usually contain magnesium oxide, which is only 4% bioavailable)
So ditch the D, calcium, and multi vibes, start taking magnesium citrate daily and avoid all foods high in sulfur, phosphorus, vitamin D, and calcium. And also avoid MSG and MSG chemicals like the plague.
Doing these things will help you to get rid of or lessen any fibromyalgia pain or chronic fatigue that you may have.
If you think I’m crazy, then all you have to do is try what I am saying for a couple of weeks (as it is not dangerous) and you should see your symptoms lessening.
And then to be absolutely sure, get your genes mapped to see if you have the CBS699 or SUOX (SUlfur OXidase) mutations.
See genetic genie dot org and 23andme dot com for more info. (It will cost about $250 to get this done or maybe less if 23andme is having a sale or if you buy more than one gene testing kit)
I had this done and it turns out that I have a lot of these mutations from both parents so my body cannot properly metabolize and excrete sulfur and phosphorus, and this causes excess sulfur and phosphorus in all my cells which causes both pain and fatigue in the cells and calcium and vitamin D make the pain worse.
So as long as I stay away from all foods high in sulfur and phosphorus and avoid calcium and vitamin D and all MSG chemicals, I am pain–free.
If I eat anything that is high in sulfur and phosphorus or high in calcium or vitamin D, I will get bad pain within half an hour of ingestion. Black pepper and foods high in oxalic acid will also cause pain, so I avoid those as well.
And I also avoid zinc supplements since zinc strengthens the glutamate response in the body.
At any rate, this is something for others to try and see if it works. It is cheap and easy and safe. And as they say, the proof is in the pudding.
I no longer have bad fibromyalgia pain and before, I had such bad pain that I couldn’t even sit down. So this just might work for others as well. I can’t be the only one with these mutations. And I know I’m not because both sides of my family carry them and have all sorts of medical issues.
It’s hard to address them all at once. I’ll just mention that your issue with panic attacks is probably both psychological as well as physiological. From your wording, it sounds as though you experienced anticipatory anxiety about having a panic attack which then operates in a self-fulfilling prophecy fashion to trigger a panic attack.
So there’s an initial cognitive element, which then produces a physiological result. That’s pretty common but also points to the fact that at the very least, you’ll need to use a two-pronged approach to resolving your issues with panic: your psychological tendency to talk to yourself in catastrophic terms (i.e. “it would be awful, terrible and unbearable for me to have a panic attack this morning.
The fact that I have them must mean there’s something seriously wrong with me; I must be defective and so not measure up to the other people out there who don’t have my problem”) and also the physiological effects of tensing up in reaction to what you’re telling yourself and so beginning to hyperventilate as well as release adrenalin into your system.
As far as dealing with the cognitive or psychological side of your problem, you would be best serving yourself if you can begin to challenge your catastrophic thinking: i.e. “where’s the evidence that having a panic attack this morning is truly awful and horrible and not simply an uncomfortable, inconvenient pain in the ass? Where’s the evidence I can’t bear to have another panic attack?
I’ve had them multiple times before and I’m still here. While there’s evidence I don’t like panic attacks, there’s no evidence I can’t bear them. I can, even if I’m strongly uncomfortable having them. Where’s the evidence there’s something truly wrong with me compared to other people? Do I fully know the lives of other people to be able to make that kind of comparison?
Am I saying I’m the only person to have this problem or that others who share this problem with me are somehow inferior to other people who don’t have this problem? Where’s the proof for this assertion? And if other people, say my best friend, isn’t inferior because of her problems, why do I claim I am?”
Things like this.
Challenging your catastrophic thinking, whatever it is, will begin to help you calm down, decrease your physiological reactions and begin to move you out of the fight-or-flight response which is a trigger for many panic attacks.
In going about this cognitive house cleaning, I’d recommend you find a local therapist skilled in rational-emotive-behavioral therapy, otherwise known as REBT. You can also begin to work on this yourself, with the help of books such as “Overcoming Destructive Beliefs, Feelings and Behaviors” by Albert Ellis, the founder of REBT, or another of his many books, such as “How to Stubbornly Refuse to Make Yourself Miserable About Anything. Yes, Anything!”
On the physiological side of things, apart from your thyroid condition (Hashimoto’s or hypothyroidism?), much of what you’re describing you’re going through is made significantly worse by chronic muscle tension and breathing faster than your body actually requires. This is a common problem with most people in our hectic, stress-filled society (and depending on your students, with being a high school teacher).
Here’s a copy of what I wrote in an earlier post. For more details, I recommend the books “Breathe to Heal,” by Sasha Yakoleva as well as the “Buteyko Breathing Course Manual” by Dr. Eduard Reuvers.
Before I retired as a psychotherapist and counselor in various hospital and university settings, I treated hundreds of people with panic disorder, with I’d say roughly a 90%+ success rate among those who actually followed my suggestions.
On the physiological side: panic attacks are the “little brother” or the “little sister” of asthma attacks. They’re caused by what’s called “subclinical hyperventilation,” which is a fancy way of saying they’re caused by the person unconsciously breathing faster than what his or her body requires.
Here’s how you tell where you’re at in this: breathe normally for a while as you always do and when you’re ready, exhale normally (don’t try to “empty your lungs”) and as soon as you’re done exhaling, hold your breath exhaled while timing yourself.
You’ll feel an initial bump of discomfort and then that discomfort will plateau for a while, then all of a sudden your discomfort will start to rise very quickly. As soon as you feel your discomfort starting to take off after that plateau period, inhale normally and note how long you were comfortably able to hold your breath exhaled.
To put your Diagnostic Pause in context, let’s say you ended up with a Diagnostic Pause of 15 seconds. That’s 1/4 the optimal time. That tells you that you’re unconsciously breathing four times faster than what your body requires; more than that when you’re stressed. Can you now understand why your body is sensitized towards panic attacks?
This is normal in our stressed society. As we live our stressful lives day after day, the inner part of our brain adjusts its resting breath setting, if you will, to accommodate that more stressful lifestyle. It’s similar to setting the idle speed on a car’s engine to a much higher RPM than what the default factory setting is.
Your job, once you find this out, is to now recalibrate your body’s breathing rate back down to its original default setting. Over time, as you slow down your breathing, your brain will reset itself back to its original breath rate.
Now that you know what I like to call your Diagnostic Pause (and others call the Control Pause), to begin to resolve the physiological side of your panic attacks, begin to now practice holding your breath exhaled for about two seconds longer than your Diagnostic Pause.
So if your diagnostic pause was ten seconds, for instance, now practice holding your breath for twelve seconds, slightly uncomfortable but not too much. This is now your Training Pause.
Do this three to five times a session, three to five sessions a day.
When you’re completely comfortable holding your breath for twelve seconds, increase your Training Pause to fourteen seconds, then sixteen, and so on. Make sure you don’t push yourself here.
Pushing yourself beyond a mild discomfort can result in reactively hyperventilating when you stop and might even precipitate a panic attack.
Not good.
Typically, it takes a person two to three weeks to go from their initial Diagnostic Pause up to being able to comfortably hold their breath exhaled for 30 seconds. At the 30 second point you’ll be functionally “immune” to panic attacks except for times when you’re overly stressed, over-tired or on the verge of getting sick.
It takes the average person about a year to progress from being able to comfortably hold his or her breath exhaled for thirty seconds to being able to comfortably hold his or her breath exhaled for sixty seconds, the optimal time. Some people work to hold their breath exhaled for as long as a minute twenty seconds but this is not really necessary.
While holding your breath exhaled, you’ll probably notice strands of muscle tension in the sides of your chest and in your cheeks. If you can consciously relax those muscles, you’ll speed up your progress while also learning how you’ve unconsciously held muscle tension in your body all these years.
Going back to the psychological side of the equation, a person suffering from panic attacks also has to learn how not to make everyday problems into catastrophes. Catastrophic thinking forms a direct link to subclinical hyperventilation and panic attacks.
One thing most people suffering from panic attacks do is engage in what I call Negative Possibility Thinking. The reason to themselves in 1,001 different ways “It’s possible I could die of a heart attack at 5PM today”; “It’s entirely possible I could be horribly injured and then die in a car crash this afternoon”;
“If I do badly on this upcoming test, it’s possible that might mean I’ll do badly on all my future tests, fail my class, get kicked out of school, not be able to get a job, and end up cold and hungry, shaking a tin cup in an alley for change”; “It’s possible that right now, Putin could be drunk, staggering around in the Kremlin and push the button today, killing us all in a nuclear blast by dinnertime.”
The problem with Negative Possibility Thinking is that you can’t disprove any of these thoughts outright: all of these things are indeed possible. You can’t say to yourself that they’re impossible.
What you can do to deal with your version of negative possibility thinking is to confront it with what I call Probability Thinking: “While it’s possible I could die of a heart attack at 5 PM today, probably I won’t”; “While it’s entirely possible I could be horribly injured and then die in a car crash today, probably I’ll be just fine”; “while it’s possible I could do poorly on this upcoming test, get kicked out of college, fail to ever get a job and end up on the poor side of town begging for money to keep myself alive.
Probably I’ll do all right on this test (although maybe not perfectly), stay in school, end up with a reasonably good job and not end up unemployable and poor—especially if I continue to study diligently and work to correct whatever errors I make”; “while it’s possible Putin is drunk right now and about to hit the button, probably he’s not.”
Keep in mind that only trying to resolve your issues with panic attacks by working on the psychological side of it alone won’t be as effective as also working on resolving your tendency to over-breathe—and working on your breath alone generally won’t resolve your tendency to think catastrophically about events or engage in negative probability thinking. The two approaches work the best hand in hand.”
