She enters into survival mode and fight or flight kicks in.
Her hands are shaking and her heart is beating way faster than it should.
Her breathing quickens alongside her heart as she gasps for air.
Her reality becomes skewed.
She feels like something is going to happen to her, that someone is going to hurt her.
She just stops. Yet, everything around her keeps moving.
She is in the midst of a panic attack.
Nicole Tanaka is a senior psychology major at Point Loma Nazarene University and she suffers from anxiety. Tanaka’s anxiety includes the feeling of social discomfort and panic attacks.
Her anxiety is most of the time triggered by the feeling that she needs to be a dependent person for her employers and also her friends. The feeling of responsibility for the autistic brothers that she tutors and the other kids she’s responsible for is enough to instill these anxious feelings.
This deep need for her to perform can occasionally send her into a panic attack. She describes it as a bear charging at her and her not being able to move or change the situation. So that immense amount of fear paralyzes her leaving her to hyperventilate and have an uncontrollable and immobilizing fear.
The seemingly overwhelming trust placed in her from her friends can also cause a feeling of anxiety in Tanaka that makes her want to cling onto another friend or a family member in order to not succumb to her anxiety.
“I love being there and I love helping people,” said Tanaka. “But sometimes it can, if I feel overwhelmed, it can mask itself as anxiety and fear.”
Tanaka also gets uncomfortable in some social situations which forces her to cling to someone else, like a friend, or to leave the situation and participate in her own coping method: cleaning.
Tanaka says that when she gets really overwhelmed and anxious, she will start cleaning her room. She will organize, vacuum, wipe down surfaces, anything to try and keep her mind occupied.
Dr. Dan Jenkins, a psychology professor on the Mission Valley campus of PLNU, said in an email that most of the time, it’s the anticipation of negative events that can cause anxiety.
“Sometimes we are aware of these negative imaginations and sometimes we are not,
but the subjective experience is as if this negative event is actually happening right now,” said Jenkins. “Consequently, the body’s fight or flight response is activated even though there really is no threat present.”
This fight or flight response, in severe cases, will trigger a panic attack where individuals will start to hyperventilate, their heartbeat quickens, and they may start to feel dizzy.
Yet, even as people suffer from panic attacks and other forms of anxiety like phobias, post traumatic stress disorder (PTSD) and generalized anxiety, these individuals typically don’t seek help said Dr. Ross Oakes Mueller, Chair of the psychology department and professor of psychology.
Generalized anxiety is a condition where the body is in a permanent state of arousal with free floating anxiety.
Tanaka explains that one of reasons people don’t seek help is there tends to be a stigma placed on those with mental illnesses and especially those with anxiety that makes them appear to be powerless and weak.
Jenkins says that the stigma shouldn’t keep a student from getting the help and the therapy they need in order to improve both in their academic and social life.
“Students need to know that they are not being stigmatized for seeking help,” said Jenkins. “Suffering from anxiety is far worse when one is suffering in isolation.”
Additionally, Tim Hall, professor of psychology at PLNU, says that someone who is struggling with a mental illness must have one trait in order to seek help and do something about taking the first step toward getting better.
“It takes the courage to go attack it,” Hall said.
Mueller said that students typically don’t seek help in fear of the stigma placed upon individuals and the fact that there is little physiological evidence that goes along with mental illnesses.
According to the National College Health Assessment sent out by the American College Health Association, 61.8% of students at PLNU who took the survey said they felt overwhelming anxiety in the last 12 months. Only 17.7% of those students were diagnosed or treated by a professional for anxiety and only 9.7% were diagnosed or treated by a professional for panic attacks.
These numbers show the prevalence of anxiety on campus with the reluctance to seek help and get diagnosed by a professional.
Mueller said that helping a friend or a peer who is struggling with anxiety could start with suggesting them to a therapist and more specifically, a therapist that specializes in Cognitive Behavioral Therapy (CBT).
CBT allows for the someone suffering from anxiety to become more aware of their feelings and then be immersed in their anxious state in order to control it.
The cognitive side of CBT is what Mueller explains as “thought catching”. This approach allows people with anxiety to question their thoughts to see how much reality is actually accredited to them and then coming up with a moderated feeling out of it.
The behavioral side to CBT includes two forms of exposure therapy which can be beneficial to both patients struggling with panic disorder and phobias, the extreme fear of something. Those two forms include systematic desensitization and flooding.
For systematic desensitization, the patient is supposed to imagine themselves in a situation that makes them anxious. Then they let themselves reach a point of peak anxiety where they wait for the fear to plateau and then stay in it until it slowly decreases.
In flooding therapy, a panic disorder patient is usually told to elevate their heart rate which most of the time, will trigger a panic attack. The person then must experience these symptoms and sit in the state for a few minutes.
They are then asked to interpret the feelings in a different way than the initial response. Mueller uses the example of the initial thought that the heart beating faster is because it’s not working. The new thought would be its pumping blood through the veins and doing its job.
In addition to therapy, Mueller and Tanaka both suggest that if someone is having a panic attack, the other person can be supportive by being there and being a source of comfort.
Yet, Tanaka also says that in college moving away from home into a new place where no one knows the whole story of another person’s life can make opening up to people a hard thing to do.
She also says that factors attributing to this stress and anxiety could include the pressure of body image and the want for that perfect beach body as well as trying to be complacent with where the person is at that time in their life.
“It creates this whole web of deceit and it creates this whole web of who you need to be to be accepted, who you need to be to be wanted,” said Tanaka.
She says how people need that human connection and that talking it out with friends that she feels comfortable with is better than isolating herself away from people and social situations.
Mueller also explains that isolation can lead to unhealthy social habits for people who struggle with anxiety and especially those who have panic disorders. According to Mueller, the isolation will make the panic worse in the future.
“People with panic disorder, if it goes untreated, start to flee and then avoid the situation where panic attacks have occured,” said Mueller.
To help avoid this social isolation, Mueller suggests finding friends to confide in and also not being afraid to be that friend that someone with anxiety can come to and talk openly to.
Another way of helping with anxiety is the practice of mindfulness and controlled breathing to calm the parasympathetic nervous system. For a busy college student, just taking a little bit out of the day to do breathing exercises can be beneficial.
Jenkins also adds three things that can help someone minimize the effects of anxiety which includes learning to relax, exercising and eating healthy.
“Exercise actually gives the body an outlet to expend the energy and adrenaline caused from being in a state of fight or flight,” said Jenkins. “Exercise also helps promote sound sleep, which many college students undervalue and under-experience. Thirdly, taking the time to eat healthy foods rather than sugary processed foods can make a huge impact on anxiety levels.”
Her thoughts return to reality.
Her hands steady along with her head.
Her heart beat slows and so her breathing deepens.
Though this fight is over, she has many more battles to fight in this war against anxiety.
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